中国实用外科杂志 ›› 2024, Vol. 44 ›› Issue (06): 709-713.DOI: 10.19538/j.cjps.issn1005-2208.2024.06.21

• 文献综述 • 上一篇    下一篇

胃转移性肿瘤研究进展

罗丹东,熊志中,钟    彬,练    磊   

  1. 中山大学附属第六医院普通外科(胃外科)    广东省结直肠盆底疾病研究重点实验室 广州市黄埔区中六生物医学创新研究院,广东广州 510655
  • 出版日期:2024-06-01 发布日期:2024-06-19

  • Online:2024-06-01 Published:2024-06-19

摘要: 胃癌是最常见的恶性肿瘤之一,但转移性肿瘤累及胃部者较为罕见。在不了解既往病史、原发肿瘤形态学特征等情况下,胃转移性肿瘤常会被误诊为原发性胃恶性肿瘤。除诊断困难外,胃转移性肿瘤的临床管理、预后等相关知识尚未达成共识。胃转移性肿瘤的临床症状不典型,其原发恶性肿瘤多为乳腺癌或恶性黑色素瘤,在规律的随访策略下,结合原发肿瘤史、内镜检查和病理活检是诊断胃转移性肿瘤的重要手段。胃转移性肿瘤的预后较差,因而往往需要结合原发肿瘤的临床特征、生物学行为以及分子特征进行个体化治疗进一步改善病人的预后。对于伴随出血、肿瘤穿孔或单发转移等并发症的病人,手术治疗是必要的。尽管手术切除可以缓解症状和减轻肿瘤负荷,但整体预后仍较差。恶性黑色素瘤和乳腺癌等高侵袭性肿瘤的胃转移病人中位生存期较短,多项研究表明胃转移性肿瘤病人的预后较差,整体生存期通常≤1年。未来的研究方向包括深入了解原发肿瘤和胃转移性肿瘤的临床特征和分子特征,通过多组学测序数据揭示其发生机制,发现新的治疗靶点和预测标记物,以改善个体化治疗策略,提高病人的生存率和生活质量。

关键词: 胃转移性肿瘤, 临床特征, 原发肿瘤, 分子特征, 个体化治疗

Abstract: Progress of metastatic neoplasms involving the stomach             LUO Dan-dong, XIONG Zhi-zhong, ZHONG Bin,et al. Department of General Surgery (Department of Gastrointestinal Surgery), the Affiliated Sixth Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital, Sun Yat-sen University, Biomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
Corresponding author: LIAN Lei,E-mail:lianlei2@mail.sysu.edu.cn
Abstract    Gastric cancer is one of the most common malignancies, but metastatic tumors involving the stomach are rare. Metastatic gastric tumors are often misdiagnosed as primary gastric malignancies due to a lack of understanding of past medical history and morphological features of the primary tumor. In addition to the challenges in diagnosis, the clinical management and prognosis of gastric metastatic tumors have not been fully summarized. The clinical symptoms of metastatic gastric tumors are atypical, and the primary malignant tumors are mostly breast cancer or malignant melanoma. History of primary tumor, endoscopy, and pathological biopsy are the best means to confirm gastric metastatic tumors. The prognosis of gastric metastatic tumors is poor, so individualized treatment based on the clinical, biological, and molecular characteristics of the primary tumor is often needed to improve the survival of patients further. For patients with complications such as bleeding, tumor perforation, or solitary metastasis, surgical treatment is necessary. Although surgical resection can alleviate symptoms and reduce tumor burden, the overall prognosis remains poor. The median survival time for patients with gastric metastases from highly invasive tumors such as malignant melanoma and breast cancer is short. Multiple studies have shown that the prognosis for patients with metastatic gastric tumors is poor, with an overall survival time of usually ≤1 year. Future research directions include an in-depth understanding of the clinical and molecular characteristics of primary tumors and gastric metastatic tumors. Utilizing multi-omics sequencing data to reveal the occurrence mechanisms and identify new therapeutic targets and predictive biomarkers could improve personalized treatment strategies and enhance patient survival rates and quality of life.

Key words: gastric metastatic tumors, clinical characteristics, primary tumors, molecular characteristics, personalized therapy