Hu C, Li J Y, Jin M L, Yang B Q
Beijing Cancer Institute.
Zhonghua Zhong Liu Za Zhi. 1988 May;10(3):197-9.
42 patients with carcinoma of gastric cardia treated by HPD are reported. The endoscopic biopsy specimens of these patients were classified histologically before treatment. There were 2 papillary adenocarcinoma (PAC), 14 well differentiated adenocarcinoma (WDAC), 11 moderate differentiated adenocarcinoma (MDAC), 5 poor differentiated adenocarcinoma (PDAC), 6 mucinous adenocarcinoma (MAC), 1 undifferentiated carcinoma (UDC) and 3 squamous cell carcinoma (SCC). After four weeks' treatment, reexaminations by endoscopy and biopsy were done in 39 patients and operation were performed on three. Histologic changes following the treatment were degeneration, necrosis of tumor cells, and infiltration of lymphocytes and plasmacytes in the stroma to different degrees. The histologic changes were graded into H0, H1, H2 and H3 by the authors. Grades H0, H1 are considered as noneffective and grades H2, H3 as effective. Of 42 patients, 10 were H0, 21 H1, 8 H2 and 3 H3. The overall effective rate was 26.2% (11/42) which was correlated with the histologic type of carcinoma. Thus, 21.4% (3/14) of WDAC, 18% (2/11) of MDAC, 40% (2/5) of PDAC, 50% (3/6) of MAC and 100% (1/1) of UDC responded well to the treatment, but all SCC and PAC were refractory. It should also be noted that the HPD treatment was effective in patients with tumor infiltrations relatively limited and superficial in the gastric wall, but was unsatisfactory in patients with wider and deeper infiltrations.
报告了42例接受高功率聚焦超声（HPD）治疗的贲门癌患者。这些患者的内镜活检标本在治疗前进行了组织学分类。其中有2例乳头状腺癌（PAC）、14例高分化腺癌（WDAC）、11例中分化腺癌（MDAC）、5例低分化腺癌（PDAC）、6例黏液腺癌（MAC）、1例未分化癌（UDC）和3例鳞状细胞癌（SCC）。治疗四周后，39例患者接受了内镜复查和活检，3例患者接受了手术。治疗后的组织学变化包括肿瘤细胞变性、坏死，以及基质中淋巴细胞和浆细胞不同程度的浸润。作者将组织学变化分为H0、H1、H2和H3级。H0、H1级被认为无效，H2、H3级被认为有效。42例患者中，10例为H0级，21例为H1级，8例为H2级，3例为H3级。总有效率为26.2%（11/42），且与癌的组织学类型相关。因此，高分化腺癌的有效率为21.4%（3/14），中分化腺癌为18%（2/11），低分化腺癌为40%（2/5），黏液腺癌为50%（3/6），未分化癌为100%（1/1），但所有鳞状细胞癌和乳头状腺癌均难治。还应注意的是，HPD治疗对胃壁浸润相对局限和浅表的患者有效，但对浸润范围更广、更深的患者效果不佳。
