Xiao Shuo-Meng, Xu Rui, Tang Xiao-Li, Ding Zhi, Li Ji-Man, Zhou Xiang
Department of Gastrointestinal Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan 610041, P.R. China.
Department of Pathology, Sichuan Cancer Hospital, Chengdu, Sichuan 610041, P.R. China.
Oncol Lett. 2018 Aug;16(2):2085-2090. doi: 10.3892/ol.2018.8942. Epub 2018 Jun 11.
Gastric cancer is a common cancer of the gastrointestinal tract and the second most prevalent cause of cancer-associated mortality globally. Gastric cancer-associated mortality is increased in China compared with that in other countries. Key contributors to the poor prognosis of gastric cancer include late clinical presentation and genetic heterogeneity. Treatment based on the subtype of gastric cancer is important for effective therapy. The overexpression of the erb-b2 receptor tyrosine kinase 2 (ERBB2) gene and protein is associated with gastric cancer in humans. Chemotherapy and targeted therapy may control tumor growth and recurrence, which is an important function of conversion surgery. The present study reported a patient diagnosed with gastric cancer with multiple abdominal cavity and retroperitoneal lymph node metastases. ERBB2 amplification and overexpression were identified in both case reports presented. The patients were treated with four cycles of oxaliplatin, capecitabine and trastuzumab. Computed tomography revealed the lymph node metastases decreased in size following treatment, and surgical resection was performed. The four cycles of oxaliplatin, capecitabine and trastuzumab were continued subsequent to surgical resection at the administered dose. No recurrence was observed for >1 year after surgery. Trastuzumab combined with oxaliplatin and capecitabine as a conversion therapy regime for ERBB2-overexpressing advanced gastric adenocarcinoma increased the likelihood of successful surgical resection, and prolonged progression-free survival.
胃癌是胃肠道常见的癌症，也是全球癌症相关死亡的第二大常见原因。与其他国家相比，中国胃癌相关死亡率有所上升。胃癌预后不良的主要因素包括临床表现较晚和基因异质性。基于胃癌亚型的治疗对有效治疗很重要。erb-b2受体酪氨酸激酶2（ERBB2）基因和蛋白的过表达与人类胃癌有关。化疗和靶向治疗可以控制肿瘤生长和复发，这是转化手术的一项重要功能。本研究报告了一名被诊断为胃癌且伴有多处腹腔和腹膜后淋巴结转移的患者。在两个病例报告中均发现了ERBB2扩增和过表达。患者接受了四个周期的奥沙利铂、卡培他滨和曲妥珠单抗治疗。计算机断层扫描显示治疗后淋巴结转移灶缩小，随后进行了手术切除。手术切除后，继续按给药剂量进行四个周期的奥沙利铂、卡培他滨和曲妥珠单抗治疗。术后超过1年未观察到复发。曲妥珠单抗联合奥沙利铂和卡培他滨作为ERBB2过表达晚期胃腺癌的转化治疗方案，增加了成功手术切除的可能性，并延长了无进展生存期。
