原发性胃状细胞癌:治疗策略的挑战
Manh Thang Hoang1,2, Anh Hoang1,2, Van Vu Kim1,2
1Hanoi Medical University, Hanoi, Vietnam.
European journal of case reports in internal medicine
|December 11, 2025
概括
初级胃状细胞癌 (GSCC) 是罕见的,预后不佳. 彻底的手术和化疗为这种晚期恶性瘤提供了最佳的生存机会.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 初级胃状细胞癌 (GSCC) 是一种极其罕见的恶性瘤,仅占所有胃瘤的0.04-0.07%.
- 这种罕见的癌症预后不好,全球缺乏标准化的治疗方案.
研究的目的:
- 为了呈现一种先进的初级胃状细胞癌 (GSCC) 的病例.
- 讨论这种罕见实体的诊断和治疗策略.
主要方法:
- 一名59岁的女性患者患上胃上疼痛,通过胃镜和活检诊断出GSCC.
- 阶段包括CT扫描,食管胃管透镜,结肠镜和体检.
- 患者接受了彻底的手术 (全胃切除术,远部胰腺切除术,脊髓切除术,D2+淋巴切除术),随后进行辅助化疗 (XELOX疗法).
主要成果:
- 组织病理学证实差差分化的状细胞癌与血清侵袭,大瘤侵袭,淋巴血管侵袭 (LVI+) 和周围神经侵袭 (PNI+).
- 手术后的分期是pT4bN3aM0与7/25淋巴结转移阳性.
- 免疫组织化学显示p63,CK5/6和CK7的阳性,负的p16.
结论:
- 准确诊断原发性GSCC需要排除其他原发性状细胞癌部位.
- 激光切除 (R0) 与积极的辅助化疗相结合,是高级GSCC的最佳治疗方法.
- 由于GSCC的罕见性,个性化治疗至关重要,根据可切除性和多学科讨论,决定新辅助 vs 前期手术.
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