引用本文:侯国旗,唐 燕,李英明.胃肠道腺癌腹壁种植性转移患者的临床病理特征及预后分析[J].中国临床新医学,2022,15(5):436-440.
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胃肠道腺癌腹壁种植性转移患者的临床病理特征及预后分析
侯国旗,唐 燕,李英明
264003 烟台,滨州医学院(侯国旗);264400 山东,青岛大学附属威海市中心医院病理科(侯国旗,唐 燕,李英明)
摘要:
[摘要] 目的 分析胃肠道腺癌腹壁种植性转移患者的临床病理特征及预后。方法 回顾性分析青岛大学附属威海市中心医院2017年7月至2020年12月收治的11例胃肠道腺癌腹壁种植性转移患者的临床资料,总结其病理检查结果及临床预后情况。结果 11例患者中,原发病为胃癌4例,肠癌7例。4例胃癌病变部位均为远端胃。7例肠癌中病灶位于右半结肠5例,左半结肠1例,乙状结肠1例。11例患者中10例原发肿瘤组织病理学检查结果均显示为中-低分化腺癌,9例患者病理学分期为T3期及以上。11例患者发现腹壁转移癌复发距首次手术时间为2~49个月,中位时间为17.9个月,与患者术后是否行放疗、化疗无明显关联。转移性肿瘤与原发肿瘤病理组织学形态几乎一致。腹壁转移术后患者生存时间为2~20个月,中位生存时间为8.7个月。1例失访,1例至今存活,其余患者均因肿瘤广泛转移而死亡。结论 腹壁种植性转移肿瘤的组织学形态与原发肿瘤几乎一致。原发肿瘤分化差、病理学分期较晚,提示肿瘤发展进入晚期阶段,建议患者术后定期复诊体检,及早发现种植性转移病灶。临床医师应根据患者的组织病理学检查结果和全身情况等制定适宜的治疗方案。
关键词:  腹壁  种植性转移  胃肠道腺癌  临床病理特征  预后
DOI:10.3969/j.issn.1674-3806.2022.05.13
分类号:R 735.5
基金项目:
Clinicopathological features and prognosis analysis of patients with abdominal wall implantation metastasis of gastrointestinal adenocarcinoma
HOU Guo-qi, TANG Yan, LI Ying-ming
Binzhou Medical University,Yantai 264003, China; Department of Pathology, Weihai Central Hospital Affiliated to Qingdao University, Shandong 264400, China
Abstract:
[Abstract] Objective To analyse the clinicopathological features and prognosis of patients with abdominal wall implantation metastasis of gastrointestinal adenocarcinoma. Methods The clinical data of 11 patients with abdominal wall implantation metastasis of gastrointestinal adenocarcinoma who were admitted to Weihai Central Hospital Affiliated to Qingdao University from July 2017 to December 2020 were retrospectively analyzed, and their pathological findings and clinical prognosis were summarized. Results The primary diseases of the 11 patients were gastric cancer in 4 cases and intestinal cancer in 7 cases. The lesion site of gastric cancer in the 4 cases was distal stomach. Among the 7 cases of intestinal cancer, the focus was located in the right colon in 5 cases, the left colon in 1 case and the sigmoid colon in 1 case. Among the 11 patients, the histopathological examination results of the primary tumors in 10 patients showed moderately to poorly differentiated adenocarcinoma, and the pathological stage of 9 patients was T3 and above. When the 11 patients were found to have recurrence of abdominal wall metastatic cancer, the time from their first operation was 2-49 months, and the median time was 17.9 months, which had no significant correlation with whether the patients underwent radiotherapy and chemotherapy after operation. The histopathological morphology of the metastatic tumors was almost identical to that of the primary tumors. The survival time of the patients with abdominal wall metastasis was 2-20 months, and the median survival time was 8.7 months. One patient was lost to follow-up, and another patient survived so far, and the rest of the patients died due to extensive tumor metastasis. Conclusion The histological morphology of the implanted metastatic tumors in the abdominal wall is almost identical to that of the primary tumors. Poor differentiation and later pathological staging of the primary tumors indicate that the tumors have entered an advanced stage. It is recommended that the patients undergo regular follow-up and physical examination after surgery to detect implanted metastatic lesions as soon as possible. Clinicians should formulate an appropriate treatment plan according to a patient′s histopathological findings and systemic conditions.
Key words:  Abdominal wall  Implantation metastasis  Gastrointestinal adenocarcinoma  Clinicopathological feature  Prognosis