Krukenberg瘤的临床研究进展  

Advances in Clinical Studies of Krukenberg Tumor

作　　者：山雪华[1] 杨婷[1] 陈亮[1] 邱力[1] 李雁[1] 

机构地区：[1]武汉大学中南医院肿瘤科/湖北省肿瘤医学临床研究中心,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2009年第1期133-140,I0001,共9页Medical Journal of Wuhan University

基　　金：教育部新世纪优秀人才支持计划(编号:NCET-04-0669);教育部"国家大学生创新性实验计划"国家重点项目(编号:200710241214434393-75)

摘　　要：Krukenberg瘤是一种较少见的转移性卵巢恶性肿瘤。本文根据文献分析,深入探讨了Krukenberg瘤的认识历史、发病机制、临床病理特征、诊断、治疗及预后。Krukenberg瘤最可能的发病机制是胃肠道癌的逆行淋巴道转移,常见的原发瘤部位依次为胃、结直肠、阑尾、胆囊/胆管、小肠、胰腺,30-49岁绝经前妇女发病最多。其诊断要点有:①近3年内有胃肠癌病史;②双侧卵巢同时发生实质性肿瘤;③CA-125升高;④CK7-1/CK20+或CK7+/CK20+。治疗以根治性切除原发灶和转移灶为主,以铂类和氟脲嘧啶类为主的辅助化疗有一定的临床受益。Krukenberg瘤多预后不良,根治性切除是改善预后的关键因素,而年龄、绝经状态、肿瘤大小、分期、组织类型、放化疗及治疗后无复发生存时间与预后的关系尚有待进一步研究。Krukenberg tumor is a relatively uncommon metastatic ovarian cancer. Based on eomprehensive literature reviews, this paper summarizes the historical understanding, pathogenesis, clinicopathological features, diagnosis, treatment and prognosis of Krukenberg tumor. The most likely mechanism of Krukenberg tumor development is via retrograde lymphatic spreading from gastrointestinal （GI） cancers involving the stomach, colorectum, appendix, gall bladder/bile duct, small intestine and pancreas, with peak incidence occurring in premenopausal women from 30 to 49 years old. The key points in the diagnosis of Krukenberg tumor are history of GI cancers in re cent three years, bilateral solid ovarian tumors, increasing in serum CA-125, and CK7^-1/CK20^＋ or CK7^＋/CK20^＋ in tumor immunohistochemistry study. Curative resection of the primary and metastatic tumor is treatment of choice, although cisplatin and 5-fluoreuracil （5-Fu） based chemotherapy can also provide some clinical benefits. The prognosis of Krukenberg tumor remains poor, and radical resection is the key to improvc the clinical outcome. The significance of other factors including age, menopausal status, tumor size, clinical staging, histological types, radio chemotherapy, and recurrence-free survival time after treatment remains to be further investigated.

关 键 词：KRUKENBERG瘤 转移机制 临床病理特征 诊断 治疗 

分 类 号：R730.4[医药卫生—肿瘤]