胃腺癌膀胱转移一例并文献复习

目的：探讨胃癌膀胱转移的临床特征及治疗方法。方法：对1例胃癌术后发生膀胱转移的病例进行临床影像学特征、病理学特征及免疫表型的观察，并结合临床资料、随访观察治疗效果、复习国内外相关文献。结果：该患者影像学 CT 表现为膀胱壁广泛新生物，活检病理结合免疫组化确诊为胃癌转移。采用静脉草酸铂＋口服替吉奥＋顺铂膀胱灌注双周方案化疗。化疗2次后临床症状就有好转，化疗4次后疗效评价为PR，化疗12次后疗效评价仍为 PR。无进展生存期达10个月以上。结论：胃癌膀胱转移临床罕见，需与原发性膀胱癌鉴别。其生存时间短、预后差，无公认标准治疗方法。该患者采用草酸铂＋替吉奥＋顺铂膀胱灌注化疗后临床症状改善，无进展生存期延长。

Bladder metastasis of gastric adenocarcinoma:A case report and review of literature

Objective:To investigate the clinical characteristics and treatment of bladder metastasis of gastric ade-nocarcinoma.Methods:To report one case of bladder metastasis after gastric adenocarcinoma operation.Its clinical imaging and pathological features,immunological phenotypes were observed.The clinical feature was analyzed,the therapeutic effects were followed up,and the relevant literatures were reviewed.Results:The CT image showed there was neoplasm in the bladder wall.The diagnosis of bladder metastasis of gastric cancer was confirmed by pathological biopsy with histology and immunohistochemical staining.The patient received oxaliplatin and S -1chemotherapy with cisplatin bladder perfusion per double weeks.His clinical symptoms relieved after 2 cycles of chemotherapy.After 4 cycles of chemotherapy,objective efficacy evaluation of therapies was partial remission,after 12 cycles of chemothera-py,objective efficacy evaluation of therapies was still partial remission.Progression -free survivial reached 10 months.Conclusion:Metastasis of gastric adenocarcinoma to the bladder is very rare,which has a short survival time and poor prognosis.Primary bladder cancer must be considered in the differential diagnosis.There is no generally ac-cepted standard treatment.The patient received personalized chemotherapy with bladder perfusion chemotherapy which relieved the symptoms and prolonged the progression -free survivial.