Fujita Toshitada, Kawasaki Kentaro, Ohno Masakazu, Kanaji Shingo, Kobayashi Iwao, Ueno Kimihiko, Tsuchida Shinobu, Osawa Masato, Fujino Yasuhiro, Kanbara Yoshihiro, Nakamura Takeshi
Department of Surgery, Hyogo Cancer Center.
Gan To Kagaku Ryoho. 2009 Apr;36(4):663-6.
A sixties-man had complained of melena. Colonoscopy revealed type 2 tumor at rectum. Computed tomography (CT)demonstrated lymph node metastasis in front of sacrum and two low density areas which were suspected metastases in the liver. The patient was diagnosed stageIV rectal cancer and resected primary focus and lymph node metastasis.[ Ra-RS, ant, type 2, moderately differentiated adenocarcinoma, ly1, v3, pSE, pN2, sH1(Grade C), sP0, pM1(No. 270)]without liver resection. It was due to high level of CEA and remote lymph node metastasis. The patient was treated with mFOLFOX6 and bevacizumab after the operation. The level of CEA decreased to normal level and CT revealed a partial response after 4 cycles of systemic chemotherapy. Liver resection was performed safely. Histological response was Grade 2 at liver metastases.
一名60多岁的男性主诉有黑便。结肠镜检查发现直肠有2型肿瘤。计算机断层扫描(CT)显示骶骨前方有淋巴结转移,肝脏有两个低密度区,怀疑为转移灶。该患者被诊断为IV期直肠癌,切除了原发灶和淋巴结转移灶。[Ra-RS,前,2型,中分化腺癌,ly1,v3,pSE,pN2,sH1(C级),sP0,pM1(270号)],未进行肝脏切除。原因是癌胚抗原(CEA)水平高和远处淋巴结转移。患者术后接受了mFOLFOX6和贝伐单抗治疗。4个周期的全身化疗后,CEA水平降至正常,CT显示部分缓解。安全地进行了肝脏切除。肝转移灶的组织学反应为2级。