Chen Lin
Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2018 May 25;21(5):498-501.
Gastric stump cancer was initially defined as a carcinoma of the stomach occurring more than 5 years after surgery for gastric or duodenal benign disease. In recent years, as the number of total gastrectomy for benign disease has gradually decreased and the gastric cancer detection and operation rate have annually increased, residual recurrence of primary gastric cancer more than 10 years after gastric cancer surgery has also been considered as gastric stump cancer. The incidence of gastric stump cancer is increasing annually. The epidemiological characteristics of this form of cancer are also developing, and they show a higher incidence in males compared to females. The incidence has been affected following digestive tract reconstruction, and the risk increases in patients who undergo Billroth II( reconstruction. The interval of onset is related to the benign and malignant condition of primary disease, and the incidence increases after 10 years of early gastric cancer surgery. Lymph node metastasis pattern in gastric stump cancer is different from that in primary gastric cancer as the primary operation may destroy normal lymph flow. Many factors are known to cause gastric stump cancer, mainly duodenal gastric reflux, Helicobacter pylori infection, and gastric mucosal barrier dysfunction; however, the mechanism is not clear. It is expected to reduce the incidence of gastric stump cancer by taking precautionary measures against different inducements, which also has some guiding significance for the treatment and prognosis of gastric cancer.
胃残端癌最初被定义为在胃或十二指肠良性疾病手术后5年以上发生的胃癌。近年来,随着良性疾病全胃切除术数量逐渐减少,胃癌的检出率和手术率逐年上升,胃癌手术后10年以上原发性胃癌的残留复发也被视为胃残端癌。胃残端癌的发病率逐年上升。这种癌症的流行病学特征也在演变,男性发病率高于女性。消化道重建后发病率受到影响,毕Ⅱ式重建患者的风险增加。发病间隔与原发性疾病的良恶性状况有关,早期胃癌手术后10年发病率上升。胃残端癌的淋巴结转移模式与原发性胃癌不同,因为初次手术可能破坏正常淋巴引流。已知许多因素可导致胃残端癌,主要是十二指肠胃反流、幽门螺杆菌感染和胃黏膜屏障功能障碍;然而,其机制尚不清楚。通过针对不同诱因采取预防措施有望降低胃残端癌的发病率,这对胃癌的治疗和预后也具有一定的指导意义。