胃小细胞癌六例并文献复习

目的 探讨胃小细胞癌的诊断及治疗方法,以提高诊疗水平.方法 总结1997至2007年间收治的6例胃小细胞癌的临床及病理资料,并复习分析国内外报道的胃小细胞癌的临床资料.结果 本组6例患者均为男性,平均年龄56.5岁(40～66岁);肿瘤位于贲门3例,胃底2例,胃体1例;溃疡型5例,隆起型1例;6例均行手术治疗,其中4例接受术后化疗.本组2例获得随访,1例术后4年仍生存无复发,1例于术后9个月因广泛复发转移死亡.胃小细胞癌国内外报道共223例,男164例,女59例;平均年龄64.2岁(42～84岁);肿痛位于贲门及胃底97例,胃体55例,胃窦54例;大体分型溃疡型137例,隆起型47例;肿瘤直径平均6.23 cm(0.8～17.0 cm).生存时间超过1年者43例,仅占19.3%.结论 胃小细胞癌术前、术中常不易确诊,手术范嗣可同胃癌而淋巴结清扫的范围可适当简化,术后采用针对肺小细胞癌的化疗方案可能有助于提高疗效.

Gastric small cell carcinoma: 6 cases report and review of literature

Objective To report the management experiences of of gastric small cell carcinoma.Methods The clinicopathological data of 6 cases of gastric small cell carcinoma treated from 1997 to 2007 were retrospectively reviewed.And meanwhile review the relevant literature.Results All the 6 cases were male with an average age of 56.5 years(range,40-66 years).All the patients received surgery and 4 of them received postoperative adjuvant chemotherapy.Two cases were followed up,one lived without recurrence for 4 years all along,the other one died of recurrence and extensive metastasis 9 months after operation.In the literature,164 male and 59 female patients have been reported to date,with an average age of 64.2 yrs (range,42-84 years).Tumor located in the fundus in 97 cases,55 in gastric body,54 in gastric antrum.In gross,137 cases were classified as ulcerative type,47 were protruded type.The average tumor diameter was 6.23 cm(range,0.8-17.0 cm).Among 223 cases,only 43 survived more than 1 year.Conclusions It is difficult to make a definite diagnosis before or during the operation for gastric small cell carcinoma.The radical operation could be done according to other gastric cancer and the lymph node dissection could be simplified.Postoperative chemotherapy with the same scheme as lung small cell carcinoma may help improving the outcome.