中国实用外科杂志

中国实用外科杂志

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胃癌腹膜转移诊治策略

梁    品，胡    祥   

  1. 大连医科大学附属第一医院胃肠外科，辽宁大连 116011
  • 出版日期:2017-10-01 发布日期:2017-10-11

  • Online:2017-10-01 Published:2017-10-11

摘要：

胃癌腹膜转移是最常见的胃癌复发和转移形式，预后极差，是病人死亡的主要原因之一。由于缺乏特异临床症状，其早期诊断困难，影像学检查是胃癌腹膜转移的常用诊断方法，但其准确率较低，而腹腔镜探查或腹腔灌洗细胞学检查准确率较高。目前，对胃癌腹膜转移尚无标准的治疗方案，治疗仍以化疗为主，但常规治疗不能有效地改善胃癌腹膜转移病人的预后。近年来，积极的治疗方案如腹腔热灌注化疗、肿瘤减灭术和转化治疗等已开始应用于临床。已有研究证实，转化治疗后行肿瘤减灭术能够显著延长病人生存时间。转化治疗以其较好的疗效被越来越多地应用于临床。

关键词: 胃癌, 腹膜转移, 转化治疗, 腹腔灌注化疗

Abstract:

Treatment strategy for gastric cancer with peritoneal metastasis        LIANG Pin，HU Xiang. Department of Gastrointestinal Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
Corresponding author: HU Xiang，E-mail: sunnyliangpin@163.com
Abstract    Peritoneal metastasis is the most common pattern of recurrence or metastasis for gastric cancer. Associated with poor prognosis，peritoneal metastasis remains one of the main causes of gastric cancer related deaths. As is lack of specific symptom，peritoneal metastasis is hard to detect. Image examination is usually performed to detect the metastasis lesions，but the accuracy rate remains low. Laparoscopy or laparoscopic cytological examination is the reliable diagnosis method with relatively high accuracy. So far，no standard theraputic regimen has been established，chemothrapy remains the major treatment method. However，conventional treatment strategy can not improve the survival outcomes of the patients. Recently，active treatment strategy such as intraperitoneal chemotherapy，cytoreductive surgery and conversion chemotherapy have been conducted. Studies have proved that cytoreductive surgery following the conversion chemotherapy significantly prolonged the survival time of the patients. Therefore，conversion chemotherapy has been increasingly applied in the treatment of gastric cancer with peritoneal metastasis.

Key words: gastric cancer, peritoneal metastasis, chemotherapy, intraperitoneal chemotherapy