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5-氟尿嘧啶、亚叶酸钙、奥沙利铂和多西他赛围手术期化疗后腹腔镜根治性切除术及其对晚期胃或胃食管交界腺癌中Claudin18.2表达的影响：两例报告

Laparoscopic curative resection following perioperative chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel and its influence on Claudin18.2 expression in advanced gastric or gastroesophageal junction adenocarcinoma: a two-case report.

作者信息

Takahashi Tohru, Ishii Takahiro, Maejima Taku, Aimono Eriko, Miyazaki Dai, Fukahori Susumu, Kimura Taichi, Yanai Mitsuru, Ono Yusuke, Hagiwara Masahiro, Mizukami Yusuke

机构信息

Department of General Surgery, Sapporo Higashi Tokushukai Hospital, 3-1, North 33 East 14, East District, Sapporo, Hokkaido, 065-0033, Japan.

Department of Gastroenterology, Sapporo Higashi Tokushukai Hospital, 3-1, North 33 East 14, East District, Sapporo, Hokkaido, 065-0033, Japan.

出版信息

Discov Oncol. 2025 Apr 27;16(1):623. doi: 10.1007/s12672-025-02424-3.

DOI:10.1007/s12672-025-02424-3
PMID:40289059
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12034610/
Abstract

BACKGROUND

Perioperative chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel has improved survival in patients with locally advanced resectable gastric or gastroesophageal junction adenocarcinomas in Europe.

METHODS

We report two cases of laparoscopic curative resection with perioperative docetaxel-based chemotherapy for advanced gastroesophageal junction or gastric adenocarcinoma and investigated variations in Claudin18.2 expressions associated with chemotherapy.

RESULTS

Preoperative four-cycle docetaxel-based chemotherapy enabled laparoscopic total gastrectomy with distal esophagectomy via trans-hiatal approach or laparoscopic distal gastrectomy with extensive lymph node dissection. Postoperative left inferior pulmonary arterial thrombosis and chylous ascites recovered with pharmacotherapy and lipiodol lymphatic embolization. Despite discontinuing postoperative one-cycle chemotherapy, no recurrence was observed for over 1.5 and 1 year. Immunohistochemical staining showed increased Claudin18.2 expression in undifferentiated adenocarcinomas in the resected specimens than in pre-chemotherapeutic biopsies.

CONCLUSION

Perioperative docetaxel-based chemotherapy was effective for Japanese patients with gastroesophageal junction and gastric adenocarcinoma, suggesting a combination treatment with anti-Claudin18.2 antibody as neoadjuvant or first-line chemotherapy.

摘要

背景

在欧洲，采用氟尿嘧啶、亚叶酸钙、奥沙利铂和多西他赛进行围手术期化疗可提高局部晚期可切除胃或胃食管交界腺癌患者的生存率。

方法

我们报告了2例晚期胃食管交界或胃腺癌患者接受基于多西他赛的围手术期化疗后行腹腔镜根治性切除术的病例，并研究了与化疗相关的Claudin18.2表达变化。

结果

术前进行四个周期的基于多西他赛的化疗后，可行经裂孔途径的腹腔镜全胃切除术加远端食管切除术或腹腔镜远端胃切除术加广泛淋巴结清扫术。术后左下肺动脉血栓形成和乳糜腹水通过药物治疗和碘油淋巴栓塞得以恢复。尽管术后停止了一个周期的化疗，但在超过1.5年和1年的时间里均未观察到复发。免疫组织化学染色显示，与化疗前活检相比，切除标本中未分化腺癌的Claudin18.2表达增加。

结论

基于多西他赛的围手术期化疗对日本胃食管交界和胃腺癌患者有效，提示可联合抗Claudin18.2抗体作为新辅助或一线化疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f63/12034610/f6351ca4490f/12672_2025_2424_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f63/12034610/fce8309bf9ad/12672_2025_2424_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f63/12034610/d46aa7a73ff7/12672_2025_2424_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f63/12034610/f1e164741d32/12672_2025_2424_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f63/12034610/f6351ca4490f/12672_2025_2424_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f63/12034610/fce8309bf9ad/12672_2025_2424_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f63/12034610/d46aa7a73ff7/12672_2025_2424_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f63/12034610/f1e164741d32/12672_2025_2424_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f63/12034610/f6351ca4490f/12672_2025_2424_Fig4_HTML.jpg

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