Department of Surgery, Odaira Memorial Tokyo Hitachi Hospital, Yushima, Bunkyo-ku, Tokyo 113-0034, Japan.
Eur J Gastroenterol Hepatol. 2010 Feb;22(2):228-33. doi: 10.1097/MEG.0b013e328312ebac.
We report a male patient with double advanced tumors in the jejunum and descending colon and multiple lung tumors. The intestinal cancers were surgically resected. Immunoprofiling of the specimens revealed a rare phenotype: the jejunal cancer was positive for cytokeratin (CK) 7, partially positive for CK20, and Cdx-2-negative, whereas the colon cancer was CK7(+), CK20(-), and Cdx-2(-). Biopsied lung tumor was diagnosed as tubular adenocarcinoma, and CK7(+)/CK20(+)/Cdx-2(-). Together with clinical information, we deduced that the jejunal adenocarcinoma had presumably metastasized to the lung. Moreover, postoperative oxaliplatin, including chemotherapy, significantly reduced the lung metastases, suggesting that this regimen is a promising treatment option for advanced small bowel adenocarcinoma.
我们报告了一例男性患者，其空肠和降结肠均存在高级别肿瘤，且肺部有多个肿瘤。肠部癌症已通过手术切除。免疫组化分析显示一种罕见表型：空肠肿瘤 CK7（+），部分 CK20（+），Cdx-2（-），而结肠肿瘤 CK7（+），CK20（-），Cdx-2（-）。经活检的肺部肿瘤诊断为管状腺癌，CK7（+）/CK20（+）/Cdx-2（-）。结合临床信息，我们推断空肠腺癌可能已转移至肺部。此外，奥沙利铂（包括化疗）的术后治疗显著减少了肺部转移，提示该方案是治疗晚期小肠腺癌有前途的选择。
