胃と腸45巻12号

2010年11月発行

今月の主題 特殊型胃癌の病理像と臨床的特徴 主題研究

glypican3，SALL4発現からみたAFP産生胃癌の再検討

著者： 牛久哲男¹ 深山正久¹

所属機関： ¹東京大学医学部附属病院病理部

ページ範囲：P.1950 - P.1958

要旨　新規胎児癌蛋白であるGPC3（glypican3），SALL4を指標としてAFP産生胃癌と関連概念について再検討した．AFP，GPC3，SALL4を同時に発現する組織は腸管などの胎生初期組織と胚細胞腫瘍の一部のみが知られている．これらの発現パターンからAFP，GPC3，SALL4は消化管における胎児分化マーカーとみることができる．AFP産生胃癌はこれらの胎児性マーカーを発現しており，胎児分化を示す胃癌と位置づけられる．胎児消化管類似癌や肝様腺癌ではAFP産生がなくてもGPC3，SALL4の発現が認められる．AFPに加えてGPC3，SALL4をマーカーとして用いることで，AFP産生胃癌，胎児消化管類似癌，肝様腺癌といった腫瘍は胎児分化を示す胃癌として位置づけられ，胎児型腺癌として包括的に理解することが可能である．

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