伴有成肠细胞分化的IV期胃腺癌经D2胃切除及化疗后5年无复发生存：一例报告
Stage IV gastric adenocarcinoma with enteroblastic differentiation with 5-year relapse-free survival after D2 gastrectomy and chemotherapy: A case report.
作者信息
Nakayama Hiroshi, Ida Tomonori, Hasegawa Yui, Sakamoto Atsuhiko, Umezawa Yoko, Inaba Yuki, Nakada Hiroshi
机构信息
Department of Gastroenterological Surgery, Digestive Disease Center, NHO Tokyo National Hospital, 3-1-1 Takeoka, Kiyose-shi, Tokyo, 204-8431, Japan.
Department of Surgery, Omori Red Cross Hospital, 4-30-1 Chuo, Ota-ku, Tokyo, 143-8527, Japan.
出版信息
Surg Case Rep. 2024 May 15;10(1):123. doi: 10.1186/s40792-024-01921-x.
BACKGROUND
Gastric adenocarcinoma with enteroblastic differentiation (GACED), a rare subtype of gastric cancer, is associated with a more aggressive behavior than conventional gastric adenocarcinomas. We report a rare case of stage IV GACED treated with D2 gastrectomy and postoperative chemotherapy.
CASE PRESENTATION
A 39-year-old woman with acute upper abdominal pain immediately underwent surgery for gastric perforation. Afterward she was diagnosed with adenocarcinoma of the pylorus. D2 gastrectomy was performed and the final pathological diagnosis was stage IV GACED with positive peritoneal cytology. Postoperative chemotherapy was initiated with S1 plus oxaliplatin for 1 year, which was ceased thereafter to enhance her quality of life. The patient survived more than 5 years without relapse after gastrectomy.
CONCLUSIONS
Stage IV GACED, determined by positive spalt-like transcription factor 4, can be successfully treated with surgery and chemotherapy.
背景
具有成肠细胞分化的胃腺癌（GACED）是胃癌的一种罕见亚型，与传统胃腺癌相比，其行为更具侵袭性。我们报告一例罕见的IV期GACED病例，该病例接受了D2胃切除术和术后化疗。
病例介绍
一名39岁急性上腹痛女性因胃穿孔立即接受手术。术后她被诊断为幽门腺癌。实施了D2胃切除术，最终病理诊断为IV期GACED伴腹腔细胞学阳性。术后开始使用S1加奥沙利铂进行化疗，为期1年，此后为提高生活质量而停止化疗。该患者胃切除术后存活超过5年且无复发。
结论
由成对样转录因子4阳性确定的IV期GACED可通过手术和化疗成功治疗。
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