胃と腸57巻7号

2022年06月発行

今月の主題 特殊型胃癌—組織発生と内視鏡診断 主題

リンパ球浸潤胃癌の病理学的特徴

著者： 岩﨑晶子¹ 牛久哲男¹

所属機関： ¹東京大学大学院医学系研究科人体病理学・病理診断学

ページ範囲：P.913 - P.921

要旨●リンパ球浸潤胃癌（GCLS）は著明なリンパ球性間質を特徴とする特殊型胃癌である．GCLSの大部分はEBV（Epstein-Barr virus）陽性胃癌であり，特徴的な臨床病理像を示す．一方，GCLSの約20%程度はEBV陰性胃癌で，MSI（microsatellite instability）胃癌やその他の胃癌が含まれることから，GCLSは複数の分子サブタイプから構成されている．本稿では，GCLS全般の特徴を示した後に，① EBV陽性GCLS，② MSI型のGCLS，③ EBV陰性かつ非MSI型のGCLS，④ EBV陽性の非GCLS，の4グループに分けて比較する．加えて，EBV関連胃癌およびMSI胃癌の発癌機序と，治療に関連して内視鏡治療と腫瘍免疫療法に関わるGCLSの特徴を取り上げる．

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