新辅助治疗后局部晚期胃癌病理完全缓解后的肿瘤复发：两例报告
Tumor recurrence after pathological complete response in locally advanced gastric cancer after neoadjuvant therapy: Two case reports.
作者信息
Xing Yu, Zhang Zi-Li, Ding Zhi-Ying, Song Wei-Liang, Li Tong
机构信息
Department of Surgery, The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China.
Department of Surgery, The Third Central Hospital of Tianjin, Tianjin 300170, China.
出版信息
World J Clin Cases. 2023 Sep 26;11(27):6483-6490. doi: 10.12998/wjcc.v11.i27.6483.
BACKGROUND
The pathological complete response (ypCR) rate following neoadjuvant chemotherapy for advanced gastric cancer remains low and lacks a universally accepted treatment protocol. Immunotherapy has achieved breakthrough progress.
CASE SUMMARY
We report two female patients with gastric cancer defined as clinical stage cT4N1-2M0. Detection of mismatch repair protein showed mismatch repair function defect, and perioperative treatment with programmed death protein 1 inhibitor combined with S-1+oxaliplatin achieved ypCR. Surprisingly, the patients underwent clinical observation after surgery but developed different degrees of metastasis at ~6 mo after surgery.
CONCLUSION
PD-1 inhibitor combined with chemotherapy provides a more strategic choice for comprehensive perioperative treatment of gastric cancer.
背景
晚期胃癌新辅助化疗后的病理完全缓解（ypCR）率仍然较低，且缺乏普遍接受的治疗方案。免疫治疗已取得突破性进展。
病例摘要
我们报告了两名女性胃癌患者，临床分期为cT4N1-2M0。错配修复蛋白检测显示错配修复功能缺陷，围手术期使用程序性死亡蛋白1抑制剂联合S-1+奥沙利铂治疗实现了ypCR。令人惊讶的是，患者术后接受临床观察，但术后约6个月出现不同程度的转移。
结论
PD-1抑制剂联合化疗为胃癌围手术期综合治疗提供了更具策略性的选择。
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