残胃癌与残胃再发癌的手术治疗
陈俊强,陆云飞, 广西医科大学第一附属医院胃肠腺体外科 广西壮族自治区南宁市 530021
项目负责人:陈俊强, 530021, 广西壮族自治区南宁市双拥路22号, 广西医科大学第一附属医院胃肠腺体外科. gxhans@163.com
收稿日期: 2004-12-07 接受日期: 2004-12-18
摘要
目的: 探讨残胃癌和残胃再发癌有效的手术治疗方法.
方法: 回顾性研究了19例残胃癌和8例残胃再发癌患者的临床病理资料.
, http://www.100md.com
结果: 残胃癌和残胃再发癌的可切除率、根治性切除率分别是84.2%、78.9%和62.5%、25%.残胃癌的中数生存期是(19.3±2.4)mo，平均生存期是(29.8±6.0)mo，1、3、5 a生存率分别为61.8%、22.6%、13.8%;其中15例根治切除后1、3、5 a生存率分别为80.1%、28.8%、22.4%;4例姑息性手术存活均不到1 a.残胃再发癌的中数生存期是(13.0±4.3)mo，平均生存期是(17.5±4.1)mo，1、3、5 a生存率分别为60.8%、9.8%、0%;6例姑息性手术存活均不到2 a.残胃癌和残胃再发癌中根治性切除者的生存时间均显著长于非根治性切除者(P<0.05).残胃癌和残胃再发癌的生存时间统计学上无显著差异(P = 0.261).
结论: 根治性切除可提高残胃癌和残胃再发癌患者的生存时间，是有效的治疗方法.
陈俊强, 陆云飞. 残胃癌与残胃再发癌的手术治疗. 世界华人消化杂志 2005;13(5):677-679
, 百拇医药
Han SL, Hua YW, Wang CH, Ji SQ, Zhuang J. Metastatic pattern oflymph node and surgery for gastric stump cancer.
J Surg Oncol 2003;82:241-246
3 陈峻青. 残胃癌早期诊断与现代外科治疗. 中国实用外科杂志 2004;24:394-395
4 Zhang C, Liu ZK, Yu PW. Effects of bile reflux and intragastricmicroflora changes on lesions of remnant gastric
mucosa after gastric operation. WorldJ Gastroenterol 2004;10:1537-1539
, http://www.100md.com
5 Lorusso D, Linsalata M, Pezzolla F, Berloco P, Osella AR, Guerra V,Di Leo A, Demma I. Duodenogastric reflux and
gastric mucosal polyamines in thenon-operated stomach and in the gastric remnant after Billroth II gastricresection.
A role in gastric carcinogenesis? AnticancerRes 2000;20:2197-2201
6 朱永湘, 邱火良, 何博华, 谭国钳, 钱聚标, 肖兰凤. 残胃癌若干问题的探讨(附26例报道).
胃肠病学和肝病学杂志 2003;12:299-300
, 百拇医药
7 Nakagawara H, Miwa K, Nakamura S, Hattori T. Duodenogastric refluxsustains Helicobacter pylori infection in the
gastric stump. Scand JGastroenterol 2003;38:931-937
8 Fukuhara K, Osugi H, Takada N, Takemura M, Lee S, Morimura K,Taguchi S, Kaneko M, Tanaka Y, Fujiwara Y,Nishizawa S, Fukushima S, KinoshitaH. Effect of H pylori on COX-2 expression in gastric remnant afterdistal
gastrectomy. Hepatogastroenterology 2004;51:1515-1518
, http://www.100md.com
9 Baba M, Konno H, Tanaka T, Kamiya K, Baba S, Sugimura H, NakamuraS. Relationship of p53 and Helicobacter
pylori to clinicopathological featuresof human remnant stomach cancer after gastric surgery for primary gastriccancer.
Oncol Rep 2001;8:831-834
10 Tanigawa N, Nomura E, Niki M, Shinohara H, Nishiguchi K, Okuzawa M,Toyoda M, Morita S. Clinical study to
, 百拇医药 identify specificcharacteristics of cancer newly developed in the remnant stomach. GastricCancer 2002;5:23-28
11 Matsui N, Yao T, Akazawa K, Nawata H, Tsuneyoshi M. Differentcharacteristics of carcinoma in the gastric
remnant:histochemical andimmunohistochemical studies. Oncol Rep 2001;8:17-26
12 Piso P, Meyer HJ, Edris C, Jahne J. Surgical therapy of gastricstump carcinoma-a retrospective analysis of 109
, http://www.100md.com
patients. Hepatogastroenterology 1999;46:2643-2647
13 Bruno L, Nesi G, Montinaro F, Carassale G, Lassig R, Boddi V, BechiP, Cortesini C. Clinicopathologic findings and results
of surgical treatment incardiac adenocarcinoma. J Surg Oncol 2000;74:33-35
14 徐惠绵, 陈峻青, 王舒宝. 胃癌的淋巴结转移规律及其意义. 中国肿瘤临床 2001;28:465-468
15 Thorban S, Bottcher K, Etter M, Roder JD, Busch R, Siewert JR.Prognostic factors in gastric stump carcinoma.
Ann Surg 2000;231:188-194
编辑 张海宁, http://www.100md.com( 陈俊强,陆云飞)
项目负责人:陈俊强, 530021, 广西壮族自治区南宁市双拥路22号, 广西医科大学第一附属医院胃肠腺体外科. gxhans@163.com
收稿日期: 2004-12-07 接受日期: 2004-12-18
摘要
目的: 探讨残胃癌和残胃再发癌有效的手术治疗方法.
方法: 回顾性研究了19例残胃癌和8例残胃再发癌患者的临床病理资料.
, http://www.100md.com
结果: 残胃癌和残胃再发癌的可切除率、根治性切除率分别是84.2%、78.9%和62.5%、25%.残胃癌的中数生存期是(19.3±2.4)mo，平均生存期是(29.8±6.0)mo，1、3、5 a生存率分别为61.8%、22.6%、13.8%;其中15例根治切除后1、3、5 a生存率分别为80.1%、28.8%、22.4%;4例姑息性手术存活均不到1 a.残胃再发癌的中数生存期是(13.0±4.3)mo，平均生存期是(17.5±4.1)mo，1、3、5 a生存率分别为60.8%、9.8%、0%;6例姑息性手术存活均不到2 a.残胃癌和残胃再发癌中根治性切除者的生存时间均显著长于非根治性切除者(P<0.05).残胃癌和残胃再发癌的生存时间统计学上无显著差异(P = 0.261).
结论: 根治性切除可提高残胃癌和残胃再发癌患者的生存时间，是有效的治疗方法.
陈俊强, 陆云飞. 残胃癌与残胃再发癌的手术治疗. 世界华人消化杂志 2005;13(5):677-679
, 百拇医药
Han SL, Hua YW, Wang CH, Ji SQ, Zhuang J. Metastatic pattern oflymph node and surgery for gastric stump cancer.
J Surg Oncol 2003;82:241-246
3 陈峻青. 残胃癌早期诊断与现代外科治疗. 中国实用外科杂志 2004;24:394-395
4 Zhang C, Liu ZK, Yu PW. Effects of bile reflux and intragastricmicroflora changes on lesions of remnant gastric
mucosa after gastric operation. WorldJ Gastroenterol 2004;10:1537-1539
, http://www.100md.com
5 Lorusso D, Linsalata M, Pezzolla F, Berloco P, Osella AR, Guerra V,Di Leo A, Demma I. Duodenogastric reflux and
gastric mucosal polyamines in thenon-operated stomach and in the gastric remnant after Billroth II gastricresection.
A role in gastric carcinogenesis? AnticancerRes 2000;20:2197-2201
6 朱永湘, 邱火良, 何博华, 谭国钳, 钱聚标, 肖兰凤. 残胃癌若干问题的探讨(附26例报道).
胃肠病学和肝病学杂志 2003;12:299-300
, 百拇医药
7 Nakagawara H, Miwa K, Nakamura S, Hattori T. Duodenogastric refluxsustains Helicobacter pylori infection in the
gastric stump. Scand JGastroenterol 2003;38:931-937
8 Fukuhara K, Osugi H, Takada N, Takemura M, Lee S, Morimura K,Taguchi S, Kaneko M, Tanaka Y, Fujiwara Y,Nishizawa S, Fukushima S, KinoshitaH. Effect of H pylori on COX-2 expression in gastric remnant afterdistal
gastrectomy. Hepatogastroenterology 2004;51:1515-1518
, http://www.100md.com
9 Baba M, Konno H, Tanaka T, Kamiya K, Baba S, Sugimura H, NakamuraS. Relationship of p53 and Helicobacter
pylori to clinicopathological featuresof human remnant stomach cancer after gastric surgery for primary gastriccancer.
Oncol Rep 2001;8:831-834
10 Tanigawa N, Nomura E, Niki M, Shinohara H, Nishiguchi K, Okuzawa M,Toyoda M, Morita S. Clinical study to
, 百拇医药 identify specificcharacteristics of cancer newly developed in the remnant stomach. GastricCancer 2002;5:23-28
11 Matsui N, Yao T, Akazawa K, Nawata H, Tsuneyoshi M. Differentcharacteristics of carcinoma in the gastric
remnant:histochemical andimmunohistochemical studies. Oncol Rep 2001;8:17-26
12 Piso P, Meyer HJ, Edris C, Jahne J. Surgical therapy of gastricstump carcinoma-a retrospective analysis of 109
, http://www.100md.com
patients. Hepatogastroenterology 1999;46:2643-2647
13 Bruno L, Nesi G, Montinaro F, Carassale G, Lassig R, Boddi V, BechiP, Cortesini C. Clinicopathologic findings and results
of surgical treatment incardiac adenocarcinoma. J Surg Oncol 2000;74:33-35
14 徐惠绵, 陈峻青, 王舒宝. 胃癌的淋巴结转移规律及其意义. 中国肿瘤临床 2001;28:465-468
15 Thorban S, Bottcher K, Etter M, Roder JD, Busch R, Siewert JR.Prognostic factors in gastric stump carcinoma.
Ann Surg 2000;231:188-194
编辑 张海宁, http://www.100md.com( 陈俊强,陆云飞)
