晚期胃癌患者灌洗细胞学检查的意义。
Significance of lavage cytology in advanced gastric cancer patients.
机构信息
Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
出版信息
World J Surg. 2010 Mar;34(3):563-8. doi: 10.1007/s00268-009-0355-1.
BACKGROUND
Lavage cytology positive (Cy1) is well known as a poor prognostic factor in advanced gastric cancer patients. However, the optimal therapeutic strategy for patients with Cy1 has not yet been established. The aim of this study was to evaluate the clinical significance of Cy1 for the purpose of establishing a suitable therapeutic strategy.
METHODS
The data of 996 consecutive advanced gastric cancer patients who underwent gastrectomy between 1992 and 1998 at the National Cancer Center Hospital were retrospectively studied.
RESULTS
The 2- and 5-year survival rates of the patients who underwent gastrectomy without any other noncurative factors besides Cy1 were 25.3 and 7.8%, respectively. When the analysis was limited to type 4 advanced gastric cancer patients, none of the patients with Cy1 survived for more than 40 months.
CONCLUSIONS
The prognosis of gastric cancer patients with Cy1 is very poor. Some patients show long survival after standard gastrectomy with D2 lymph node dissection; however, the prognosis of type 4 gastric cancer patients with Cy1 is so poor that multimodality therapy, including perioperative chemotherapy, is essential.
背景
细胞学阳性（Cy1）冲洗液是晚期胃癌患者预后不良的一个众所周知的因素。然而，对于 Cy1 患者的最佳治疗策略尚未建立。本研究旨在评估 Cy1 的临床意义，以便制定合适的治疗策略。
方法
回顾性分析了 1992 年至 1998 年在国家癌症中心医院接受胃切除术的 996 例连续晚期胃癌患者的数据。
结果
除 Cy1 外无其他非治愈因素的患者行胃切除术的 2 年和 5 年生存率分别为 25.3%和 7.8%。当分析仅限于 4 型晚期胃癌患者时，Cy1 患者无一例存活超过 40 个月。
结论
Cy1 胃癌患者的预后非常差。一些患者在接受标准的 D2 淋巴结清扫胃切除术治疗后显示出长期生存；然而，4 型 Cy1 胃癌患者的预后如此之差，以至于包括围手术期化疗在内的多模式治疗是必要的。
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