具有肠胚型分化的胃腺癌（GAED）是一种侵袭性癌症，其组织学特征为富含糖原的晶莹透明细胞质和胎儿肠样结构。GAED表达至少以下肠胚型标记物之一：糖脂蛋白-3（GPC3）、类盐分转录因子4（SALL4）和α-胎蛋白（AFP）。尽管缺乏晶莹透明的细胞质，我们经常遇到表达肠胚型标记物的GA（带标记物表达的GA）；然而，GA带标记物表达的临床病理特征仍不明确。对组织芯片进行了三种标记物（AFP、GPC3和SALL4）的免疫组化表达检测。根据肿瘤细胞细胞质的透明度状态，显示标记物免疫组化表达的GA被分为GAED或带标记物表达的GA，此分析将688个GA分为94个GAED（13.7%）、58个带标记物表达的GA（8.4%）和536个常规GA（CGA）。与CGA相比，GAED和带标记物表达的GA均表现出频繁的淋巴血管侵犯、淋巴结转移和肝转移。然而，与CGA相比，GAED的静脉侵犯频率更高，但淋巴侵犯频率无明显差异。GAED和带标记物表达的GA的整体生存率相似。与CGA相比，GAED的预后显著较差，但对于带标记物表达的GA并非如此。此外，表达标记物的GA的预后较差于CGA。有趣的是，尽管肿瘤大小较小，带标记物表达的GA组具有较频繁的静脉侵犯和肝转移，比CGA组更具侵袭性。GAED和带标记物表达的GA在临床上可被分类为侵袭性肿瘤，但在病理上略有不同。© 2023. 作者（们）授予Springer-Verlag GmbH Germany独家许可，该出版社是Springer Nature的一部分。

Gastric adenocarcinoma (GA) with enteroblastic differentiation (GAED) is an aggressive carcinoma histologically characterized by a glycogen-rich clear cytoplasm and fetal gut-like structures. GAED shows the expression of at least one of the following enteroblastic markers (EMs): glypican-3 (GPC3), spalt-like transcription factor 4 (SALL4), and α-fetoprotein (AFP). Despite the absence of clear cytoplasm, we often encounter GA with EMs expression (GA with EM); however, the clinicopathological characteristics of GA with EM remain unclear. Immunohistochemical (IHC) expression of three EMs (AFP, GPC3, and SALL4) was examined on tissue microarray. According to the status of the clear cytoplasm of tumor cells, GAs showing IHC expression of EMs were classified as either GAED or GA with EM, and this analysis categorized 688 GAs into 94 GAEDs (13.7%), 58 GAs with EM (8.4%), and 536 conventional GAs (CGAs). Both GAED and GA with EM showed frequent lymphovascular invasion, lymph node metastasis, and liver metastasis compared to CGA. However, a higher frequency of venous invasion, but not of lymphatic invasion, was noted for GAED in comparison to CGA. GAED and GA with EM showed similar overall survival. GAED had significantly poorer prognosis than CGA; however, not for GA with EM. Furthermore, GA showing EM expression had a worse prognosis than CGA. Interestingly, GA showing EM-positive group was more aggressive than CGA group as they had frequent venous invasion and liver metastasis despite its smaller tumor size. GAED and GA with EM can be clinically classified as aggressive tumors but pathologically they seem to be slightly different.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.