以骨髓增生症为首发表现的胃癌一例并文献复习  

Gastric Cancer with Primary Manifestation of Myelodysplastic: A Case Report and Literatures Review

作　　者：代阳[1] 吴俣[1] 牟一[2] 易航[2] 

机构地区：[1]四川大学华西医院血液内科,成都6100411 [2]四川大学华西医院消化内科,成都6100411

出　　处：《华西医学》2014年第4期630-634,共5页West China Medical Journal

摘　　要：目的探讨实体瘤合并显著血象异常患者的临床表现、发病机制、预后价值及治疗。方法 2012年4月9日收治1例经消化道内窥镜及病理活检诊断为胃低分化/未分化癌患者,骨髓涂片、活检、染色体及骨髓增生症相关基因突变检查排除骨髓增生症。手术切除胃癌及腹腔内转移肿瘤。结果肿瘤病变切除后血象得以改善,但患者肿瘤负荷大,广泛转移,长期预后不良。结论实体瘤可以骨髓增生症类似的血象异常为首发表现,属于副肿瘤综合征,是肿瘤的预后不良因素。Objective To explore the clinical manifestations, pathogenesis, prognosis and the therapeutic modalities of the patients with solid tumors combined with remarkable hematologic abnormalities. Methods Gastric cancer in a paitnet was diagnosed by endoscopy as well as pathological biopsy and myeloproliferative neoplasms （MPNs） were excluded through bone marrow examinations. Therefore, the primary and metastatic malignancies were excised. Results Although surgical operation improved the hematologic changes, the high tumor load caused the poor prognosis. Conclusion The solid tumors may present with hematologic manifestations which is similar to the symptoms of MPNs; it belongs to the para-neoplastic phenomenon and may be an independent poor prognostic factors.

关 键 词：胃癌 实体瘤 贫血 白细胞增多 血小板增多 

分 类 号：R735.2[医药卫生—肿瘤]