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早期胃癌切除术后肾转移:一例报告

Kidney metastasis of resected early gastric carcinoma: report of a case.

作者信息

Wada Yoshiyuki, Yoshida Kazuhiro, Hihara Jun, Tanabe Kazuaki, Ukon Kei

机构信息

Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Hiroshima 734-8553, Japan.

出版信息

Surg Today. 2007;37(3):248-50. doi: 10.1007/s00595-006-3364-9. Epub 2007 Mar 9.

Abstract

We report a rare case of kidney metastasis of resected early gastric cancer in a 67-year-old man. We performed distal gastrectomy with D2 lymph node dissection for early gastric cancer, which was histologically diagnosed as moderately differentiated adenocarcinoma (T1N0M0, stage IA). Preoperatively, his serum carcinoembryonic antigen (CEA) level was 9.5 ng/ml, and this dropped to 7.0 ng/ml postoperatively. However, 1 year 10 months after the operation, we performed partial kidney resection and the lesion was confirmed to be a metastasis of the gastric cancer. Unfortunately, 5 months later, multiple liver metastasis was found, accompanied by a further increase in the serum CEA level to 2 650.8 ng/ml. This case illustrates the poor prognosis associated with a high preoperative serum CEA level, even if early gastric cancer is resected curatively.

摘要

我们报告了一例67岁男性早期胃癌切除术后发生肾脏转移的罕见病例。我们对早期胃癌患者实施了远端胃切除术及D2淋巴结清扫术,组织学诊断为中分化腺癌(T1N0M0,IA期)。术前,他的血清癌胚抗原(CEA)水平为9.5 ng/ml,术后降至7.0 ng/ml。然而,术后1年10个月,我们进行了部分肾切除术,证实该病变为胃癌转移灶。不幸的是,5个月后发现了多发肝转移,同时血清CEA水平进一步升高至2650.8 ng/ml。该病例表明,即使早期胃癌得到根治性切除,术前血清CEA水平升高仍预示预后不良。

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