Issam Beyrouti Mohamed, Beyrouti Ramez, Ben Amar Mohamed, Frikha Foued, Beyrouti Rahma, Abid Mohamed, Ben Salah Khalil, Boujelben Salah
Service de chirurgie générale, EPS Habib Bourguiba, 3029 Sfax, Tunisie.
Presse Med. 2007 Dec;36(12 Pt 2):1782-6. doi: 10.1016/j.lpm.2007.03.004. Epub 2007 Jun 22.
Linitis plastica accounts for 3-19% of gastric cancers. Its diagnosis requires morphology findings of an infiltrating stomach tumor and pathology findings including signet-ring cells and fibrous stroma. Its etiology is not known, and it has no particular features. Diagnostic sensitivity of endoscopy is poor because of the difficulty of biopsies: "Forceps slide on the infiltrated walls." Its characteristic radiologic appearance is due to the infiltration and stiffness that causes it to be known as "leather-bottle stomach". Endosonography is currently the reference examination and has made it possible to identify localized linitis. Unlike other stomach cancers, it frequently extends into the peritoneum and lymphatic system. Curative treatment remains radical surgical resection. Modern chemotherapy protocols based on oral derivatives of 5-FU (TS-1) and of paclitaxel appear promising. The severity of its prognosis is explained by the frequency of peritoneal dissemination, lymphatic invasion and extension toward neighboring organs.
皮革胃占胃癌的3%-19%。其诊断需要有浸润性胃肿瘤的形态学表现以及包括印戒细胞和纤维性间质在内的病理学表现。其病因不明,且无特殊特征。由于活检困难,内镜检查的诊断敏感性较差:“钳子在浸润的壁上滑动”。其特征性的放射学表现是由于浸润和僵硬,使其被称为“皮革胃”。超声内镜检查目前是参考检查,已能够识别局限性皮革胃。与其他胃癌不同,它常蔓延至腹膜和淋巴系统。根治性治疗仍然是根治性手术切除。基于5-氟尿嘧啶(替吉奥)口服衍生物和紫杉醇的现代化疗方案似乎很有前景。其预后的严重性可通过腹膜播散、淋巴浸润以及向邻近器官蔓延的频率来解释。