肿瘤细胞减灭术治疗消化道肿瘤腹膜转移的适应证研究进展  

Advances in indication of cytoreductive surgery of peritoneal metastasis in gastrointestinal cancer

作　　者：袁紫旭 林青锋 蔡建 吴志杰 王辉[1] YUAN Zi-xu;LIN Qing-feng;CAI Jian(Department of Colorectal Surgery,the Sixth Affiliated Hospital of Sun Yat-Sen University,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,Guangdong Institute of Gastroenterology,Guangzhou 510655,China;不详)

机构地区：[1]中山大学附属第六医院结直肠肛门外科,广东省结直肠盆底疾病研究重点实验室,广东广州510655 [2]深圳市第二人民医院肛肠外科,广东深圳518034

出　　处：《中国实用外科杂志》2023年第8期951-955,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金青年项目(No.82103038);广州市科技计划项目(No.202201011360)。

摘　　要：腹膜转移癌是消化道恶性肿瘤的终末期阶段,预后较差生存期短。近年来肿瘤细胞减灭术(CRS)联合腹腔热灌注化疗(HIPEC)成为腹膜转移治疗的国际标准推荐术式。腹膜癌指数(PCI)评分是目前评估能否行CRS的关键指标。在不同恶性肿瘤中,CRS适应证有所差异。PCI<20分是结直肠癌CRS的主要适应证,但是在腹膜假性黏液瘤(PMP)、阑尾来源肿瘤、卵巢癌中CRS适应证不受PCI评分的限制,术前转化和免疫治疗拓宽了消化道肿瘤腹膜转移的CRS适应证。Peritoneal metastasis(PM)is considered to be the terminal stage of gastrointestinal malignancies with poor prognosis and survival.Recently,cytoreductive surgery(CRS)and HIPEC have become the standard recommendations for PM.Peritoneal cancer index(PCI)is the main factor to select CRS.In different types of cancer,the indications of CRS are different.The indication of CRS for colorectal cancer is PCI<20,but PCI scores are not the indicators for CRS in pseudomyxoma peritonei(PMP),appendix tumors and ovary tumors.Preoperative chemotherapy and immunotherapy have extended the indication of CRS in gastrointestinal tumors with PM.

关 键 词：腹膜转移 肿瘤细胞减灭术 腹腔热灌注化疗 适应证 结直肠癌 胃癌 

分 类 号：R6[医药卫生—外科学]