残胃癌的诊疗研究进展  

Review of research progress in the diagnosis and treatment of gastric stump cancer

作　　者：蔡丽君 田素芳[1] CAI Lijun;TIAN Sufang(Dept.of Pathology,Zhongnan Hospital of Wuhan University&Wuhan University Center for Pathology and Molecular Diagnostics,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院病理科/武汉大学病理中心,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2023年第1期121-126,共6页Medical Journal of Wuhan University

基　　金：武汉大学中南医院学科与平台建设支撑项目(编号:PTXM2020020)。

摘　　要：残胃癌(GSC)是指胃良性疾病行胃切除术后5年以上或胃癌行胃切除术后10年以上,残胃出现的新发癌。近年来,GSC发病率逐年上升,本文复习国内外相关文献,从GSC的定义及流行病学、病因及发病机制、临床病理特征、治疗及预后等研究进展作一综述。值得注意的是,GSC多发于BillrothⅡ式重建术后患者吻合口部位,其发生与血清胃泌素水平的降低、十二指肠肠液反流和黏膜去神经支配及幽门螺杆菌感染等相关。目前GSC的治疗仍以残胃全切除加淋巴结清扫为主,内镜切除、腹腔镜手术及机器人辅助治疗GSC的疗效仍有待多中心临床试验验证。胃癌切除术后患者需定期进行内镜检查,通过早发现、早诊断、早治疗提高GSC患者生存率及预后。Gastric stump cancer(GSC)is known as a primary carcinoma arising from the remnant gastric more than 5 years after partial gastrectomy for benign ulceration or more than 10 years after partial gastrectomy for gastric cancer.The incidence of GSC has gradually increased in recent years.This paper reviewed relevant literature at domestic and from abroad,and addressed the research progress of GSC in terms of its definition and epidemiology,etiology,pathogenesis,clinicopathologic features,treatment,and prognosis.It is worth noting that GSC tends to occur in anastomotic site in patients with BillrothⅡreconstruction.Its occurrence is associated with the reduction of serum gastrin level,gastroduodenal reflux,mucosal denervation,and helicobacter pylori infection,etc.Total gastrectomy and lymph node dissection is still the main treatment for GSC,and the efficacy of endoscopic resection,laparoscopic surgery,and robot⁃assisted treatment of GSC remains to be verified by multi⁃center clinical trials.Patients with gastric cancer resection should undergo regular endoscopic follow⁃up.The strategies of early detection,early diagnosis and early treatment of GSC will improve the survival rate and prognosis of patients.

关 键 词：残胃癌 远端胃切除术 病因 综述 

分 类 号：R735.2[医药卫生—肿瘤]