胃原发性绒毛膜癌的临床特点与治疗  

Analysis of the clinical characteristics and treatment of primary gastric choriocarcinoma

作　　者：王李杰[1] 白莉[1] 井方方[1] 苏丹[1] 张婷[1] 毛志远[1] 焦顺昌[1] 

机构地区：[1]中国人民解放军总医院肿瘤科北京市100853

出　　处：《中国肿瘤临床》2014年第3期189-193,共5页Chinese Journal of Clinical Oncology

摘　　要：目的：胃原发性绒毛膜癌（primarygastric choriocarcinoma ，PGC ）少见，汇总分析国内报道的病例，探讨PGC 的临床病理特点及诊治策略。方法：报道本院2 例患者，同时以“胃原发性绒毛膜癌”、“胃绒毛膜癌”、“异位绒毛膜癌”为检索词，电子检索中国生物医学期刊文献数据库和中国生物医学文献数据库，总结分析纳入文献的临床资料。结果：纳入14篇文献，结合本院2 例患者，共报道PGC 患者16例，男性12例，女性4 例，发病年龄42～79岁，平均年龄57.69岁；临床表现主要为腹部不适（12例）；11例患者肿瘤标志物检测，HCG-β均升高；13例患者可见器官或淋巴结转移，6 例患者可见2 个或2 个以上器官转移，转移主要器官为肝、胃周淋巴结、肺、脑、腹腔；PGC 以溃疡型为主，12例表现为溃疡，伴坏死、出血，4 例表现为肿物，病变可发生在胃小弯（5例），胃窦（6 例），贲门（2 例），胃体（3 例）；PGC 在组织学上常与多种肿瘤成份共同存在，其中合并腺癌7 例，腺、鳞癌2 例，腺癌及印戒细胞癌1 例，6 例为单纯的绒毛膜癌成分；手术切除联合化疗是PGC 的主要治疗方法，14例患者经历了手术治疗，7 例患者手术后行全身化疗，1 例患者行单纯化疗；10例患者进行随访，8 例患者在确诊后6 个月内死亡。结论：PGC 是一种罕见的胃恶性肿瘤，多发于老年男性，临床表现无特异性，HCG-β均升高，病理检查可确诊，早期以手术切除联合化疗为首选，晚期患者以全身化疗为主，预后极差。Objective：Primary gastric choriocarcinoma （PGC） is a rare tumor. This study aimed to analyze cases reported in Chi -nese and two cases in our hospital. This study was also conducted to investigate the clinical characteristics and treatment of PGC. Meth-ods： The Chinese Medical Current Contents and China Biology Medicine database was retrieved with the following terms： primary gas-tric choriocarcinoma, stomach choriocarcinoma, and ectopic choriocarcinoma. The clinical data in published literature were retrospec -tively analyzed. Two cases from our hospital were also retrospectively analyzed. Results：A total of 16patients with PGC （ 14case stud -ies and 2 cases from our hospital） were included in this study. The average age of the patients was 57.69years （ranging from 42years to 79years）. Among the 16patients, 4 were females and12were males. The main clinical manifestation was abdominal discomfort （ 12/16）. Laboratory and imaging tests were non-specific, but HCG-β in all of the patients increased （11 /11 ）. Organ or lymph node metasta -sis was found in 13patients, including 6 cases in which two or more organs showed metastasis. These organs were primarily the liver, the stomach lymph nodes, the lungs, the brain, and the abdominal cavity. Pathological examination results showed that 12of the 16cas-es displayed ulcers with necrosis and hemorrhage. The four remaining cases manifested lesions. Lesions may occur in the stomach less -er curvature （5 cases）, stomach sinus （6 cases）, cardiac （2 cases）, and gastric body （3 cases）. The histological components of PGC co-ex-isted with other factors, such as adenocarcinoma （ 7 cases）, adenocarcinoma and squamous （2 cases）, adenocarcinoma and a signet ring cell （1 case）, or pure choriocarcinoma （ 6 cases）. Surgery combined with chemotherapy was the main treatment. A total of14patients un-derwent surgical operations. Among these patients seven underwent chemotherapy after surgery and one underwent chemotherapy. Among th

关 键 词：胃癌 绒毛膜癌 临床特点 治疗 

分 类 号：R735.2[医药卫生—肿瘤]