胃癌腹腔冲洗细胞学阳性患者的治疗进展与争议  

Progress and controversy in treatment of gastric cancer patients with positive peritoneal lavage cytology

作　　者：康文哲 钟宇新 马福海 田艳涛 Wen-Zhe Kang;Yu-Xin Zhong;Fu-Hai Ma;Yan-Tao Tian(Department of Pancreatic and Gastric Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院胰胃外科,北京市100021

出　　处：《世界华人消化杂志》2021年第6期269-273,共5页World Chinese Journal of Digestology

基　　金：国家自然科学基金,蛋白酶活化受体-2(PAR2)参与残胃癌发生的机制研究,No.81772642.

摘　　要：胃癌是我国发病率最高的恶性肿瘤之一,腹膜转移是胃癌常见的转移方式.腹腔冲洗细胞学阳性是一种特殊类型的胃癌远处转移,治疗原则尚无明确定论.目前进展期胃癌治疗的基础依然是根治性手术结合术后辅助化疗,转化治疗对腹腔冲洗细胞学阳性胃癌患者有十分重要的意义,腹腔冲洗液转阴后可以有效改善预后.腹腔热灌注化疗与术中腹腔灌洗治疗为此类患者的治疗提供了新思路,可以有效杀灭腹腔游离癌细胞.目前对腹腔冲洗细胞学阳性胃癌患者治疗原则的临床研究多数属于回顾性且样本量较小,我们建议对这些患者进行多学科MDT讨论,制定个体化的治疗方案,并且鼓励此类患者参加相关临床研究.Gastric cancer is one of the most common malignant tumors in China,and peritoneal metastasis is common in patients with gastric cancer.Positive peritoneal lavage cytology indicates a special type of distant metastasis of gastric cancer,and its therapeutic principle is still unclear.At present,the cornerstone treatment for advanced gastric cancer is radical surgery combined with postoperative adjuvant chemotherapy,and conversion therapy is very important for gastric cancer patients with positive peritoneal lavage cytology.Negative conversion of peritoneal lavage can effectively improve the prognosis.Intraperitoneal hyperthermic perfusion chemotherapy and intraoperative intraperitoneal lavage provide new ideas for the treatment of such patients,which can effectively kill free cancer cells in the abdominal cavity.At present,most clinical studies on the principles of treatment of gastric cancer patients with positive peritoneal lavage cytology are retrospective with a small sample size.We recommend to conduct multidisciplinary MDT discussions and develop individualized treatment plans for these patients,and encourage them to participate in relevant clinical trials.

关 键 词：胃癌 腹腔冲洗 细胞学 治疗 进展 争议 

分 类 号：R735.2[医药卫生—肿瘤]