Sellin J, Levin B, Reckard C, Riddell R
Cancer. 1980 Mar 1;45(5):996-1000. doi: 10.1002/1097-0142(19800301)45:5<996::aid-cncr2820450527>3.0.co;2-w.
Gastric adenocarcinoma developed in a 45-year-old man 13 years after he had undergone resection of a gastric lymphoma (large cleaved cell type, diffuse) and two courses of radiation therapy to the upper abdomen to a total dose of 6300 rad. Three factors involved in possibly increasing risk for the second malignancy, namely lymphoma, extensive radiation therapy, and gastric resection, are discussed. Degenerative and premalignant histologic changes occur in the gastric remnant after partial gastrectomy. These contribute to the pathogenesis of adenocarcinoma after surgical therapy of peptic ulcer or other disorders. Periodic endoscopic surveillance and the use of multiple biopsies are important in achieving early diagnosis.
一名45岁男性在接受胃淋巴瘤（大裂细胞型，弥漫性）切除及上腹部两疗程放射治疗（总剂量6300拉德）13年后发生胃腺癌。文中讨论了可能增加第二原发恶性肿瘤风险的三个因素，即淋巴瘤、广泛放射治疗和胃切除术。部分胃切除术后胃残端会出现退行性和癌前组织学改变。这些改变促成了消化性溃疡或其他疾病手术治疗后腺癌的发病机制。定期内镜监测及多次活检对于实现早期诊断很重要。
