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[目的]探讨胃肝样腺癌患者的临床表现、治疗以及预后。[方法]回顾性分析6例手术病理证实为胃肝样腺癌患者的临床、病理资料。[结果]6例胃肝样腺癌占医院同期入院胃癌患者的0.4%(6/1 494);1例表现为癌肉瘤,血清甲胎蛋白(AFP)阳性5例,均明显高于正常值上线;3例行根治性手术及化疗,1例行全胃+脾+胰切除及化疗,1例行单纯化疗,1例保守治疗。临床及术后病理提示,6例均有淋巴结转移,其中有2例伴远处转移,术后AFP无明显下降。随访全组患者存活时间2~10个月。[结论]胃肝样腺癌临床表现无明显特异性,病理诊断是其金标准,AFP可用于胃肝样腺癌早期诊断及疗效的判断,部分胃肝样腺癌可以合并肉瘤成分。胃肝样腺癌预后极差,治疗效果欠佳。
[Objective] To investigate the clinical manifestation, treatment and prognosis of patients with hepatobiliary-like adenocarcinoma. [Methods] Retrospective analysis of 6 cases of pathologically confirmed gastric adenocarcinoma of the patients with clinical and pathological data. [Results] Six cases of gastric adenoid adenocarcinoma accounted for 0.4% (6/1 494) of hospitalized patients with gastric cancer in the same period. One case showed carcinosarcoma, and 5 cases were positive for serum alpha-fetoprotein (AFP), which were significantly higher than normal On the line; 3 cases of radical surgery and chemotherapy, 1 case of full stomach + spleen + pancreatic resection and chemotherapy, 1 case of simple chemotherapy, 1 case of conservative treatment. Clinical and postoperative pathology suggest that all 6 cases had lymph node metastasis, of which 2 cases with distant metastasis, postoperative AFP no significant decline. All patients were followed up for 2 to 10 months. [Conclusion] The clinical manifestations of gastric and hepatic adenocarcinoma have no obvious specificity. The pathological diagnosis is the gold standard. AFP can be used in the early diagnosis and curative effect of gastric adenoid adenocarcinoma. Some gastric adenoid carcinomas can be combined with the sarcoma components. Poor prognosis of gastric adenoid carcinoma, poor treatment.