胃肝样腺癌的诊断和治疗  

The diagnosis and treatment of hepatoid adenocarcinoma of the stomach.

作　　者：梁正[1] 孙晓光[1] 郑亮[1] 

机构地区：[1]南京医科大学附属无锡二院,江苏无锡214002

出　　处：《中外医学研究》2010年第23期4-5,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的 探讨胃肝样腺癌的诊断和治疗方法.方法 对2006～2009年收治的15例胃肝样腺癌患者的临床资料进行回顾性分析.结果 15例胃肝样腺癌中检出血清甲胎蛋白（AFP）阳性病例11例（73.3%）,癌胚抗原（CEA）阳性病例6例,12例为胃窦癌,13例为低分化腺癌,10例有肝转移,13例有淋巴结转移,13例进行根治性胃切除术,2例姑息性胃切除,术后11例接受化疗,但预后均较差,15例患者存活时间6～38个月,3年生存率20%.结论 胃肝样腺癌临床表现主要表现为消化道的一些症状,术前确诊困难,易误诊,血清AFP、CEA对诊断有帮助,确诊需剖腹探查和病理切片.目前胃肝样腺癌的治疗以手术切除＋辅助化疗的综合治疗为主.Objective To investigate the diagnosis and treatment of hepatoid adenoearcinoma of the stomach. Methods Clinical data of 15 hepatoid adenocarcinomas of the stomach, collected from 2006 to 2009, were analyzed retrospectively. Results In the 15 cases, there were 11 cases with AFP positive（73.3% ） ,6 cases with CEA positive , 12 cases with gastric antrum cancer , 13 cases with poorly differentiated adeno- carcinoma, 10 cases with hepatic metastasis, 13 cases with lymph node＇s metastasis, 13 cases with radical treatment of gastrectomy, 2 cases with palliation of gastrectomy, 11 cases with chemotherapy after operation. But the prognosis was poor. The survival time was from 6 to 38 months. The survival rate of 3 years was just 20%. Conclusion The clinical manifestation of hepatoid adenocareinoma of the stomach mainly manifest several synptoms of alimentary tract. It＇s difficult to make a definite diagnosis and there are many diagnostic errors. The AFP and CEA of serum are help- ful to the diagnosis, but the final diagnosis needs exploratory laparotomy and pathological section. Nowadays, to treat hepatoid adenocarcinoma of the stomach, surgical ablation combined with adjuvant chemotherapy is the main approach.

关 键 词：胃肝样腺癌 甲胎蛋白 癌胚抗原 诊断 治疗 

分 类 号：R735.2[医药卫生—肿瘤]