Ito H, Ogawa T, Murayama M, Fujino K, Horii H, Imai J, Kobayashi H, Yamada S, Watanabe C, Ishiyama M
Dept. of Surgery, Self Defense Forces Central Hospital.
Gan To Kagaku Ryoho. 1995 Jun;22(7):953-6.
The patient was a 79-year-old man who underwent extensive gastrectomy and Billroth-II reconstruction for gastric ulcer in 1974. He complained of heartburn in November, 1992, and endoscopy for the residual stomach revealed IIb + IIa-like lesion mainly in the posterior wall of the anastomosed site, which was diagnosed as well differentiated adenocarcinoma. As the patient refused to be operated, 150 mg/day of 5-FU was administered. For 4 months before he decided to undergo operation, 12.9 g of 5-FU was administered in total. After rehospitalization, endoscopy of the residual stomach showed shrinkage of the lesion, and biopsy revealed no malignant findings. The pathological examination after total resection of the residual stomach showed atypism, but no evidence to support malignancy. He has continued to be well without sign of recurrence for 1 year since the operation. The administration of 5-FU is widely used as preoperative adjuvant chemotherapy. This case it is rare for 5-FU to cause the disappearance or falling off of malignant cells.
该患者为一名79岁男性,1974年因胃溃疡接受了广泛胃切除术及毕Ⅱ式重建术。1992年11月,他主诉烧心,对残胃进行内镜检查发现吻合口后壁主要为Ⅱb + Ⅱa样病变,诊断为高分化腺癌。由于患者拒绝手术,给予5-氟尿嘧啶(5-FU)150mg/天。在他决定接受手术前的4个月里,共给予5-FU 12.9g。再次入院后,残胃内镜检查显示病变缩小,活检未发现恶性征象。残胃全切除术后的病理检查显示有异型性,但无支持恶性肿瘤的证据。自手术以来,他持续状况良好,无复发迹象已达1年。5-FU给药作为术前辅助化疗被广泛应用。在此病例中,5-FU导致恶性细胞消失或脱落的情况较为罕见。