以转移性卵巢癌为首发表现的胃癌25例临床分析

Clinical Analysis of 25 Cases of Gastric Cancer with Metastatic Ovarian Cancer as the Initial Presentation

目的探讨胃癌伴卵巢转移（krukenberg瘤）的临床特点、诊断及治疗经验，以减少误诊。方法回顾性分析经手术和病理证实的25例胃癌伴卵巢转移患者的临床资料。结果25例患者年龄27～56岁，平均37．5岁，绝经前21例，占84．0％。首发的主要临床症状为腹胀、腹痛及下腹部包块。病理类型以印戒细胞癌为主，共14例，占56．0％。侵及双侧卵巢者15例，占60．0％。术前误诊为卵巢原发肿瘤者9例，占36．0％。la生存率为51．9％，2a生存率为21．3％。结论胃癌伴卵巢转移常以转移性卵巢癌为首发表现，好发于绝经前中青年妇女，易误诊，预后差；发现卵巢肿瘤的患者，应常规行胃肠道检查以排除转移瘤的可能。

Objective To evaluate the characteristics, clinical diagnosis and treatments of gastric cancer with metastatic ovarian cancer （krukenberg tumor） and to reduce the false diagnosis. Methods The clinical data of 25 cases of gastric cancer with metastatic ovarian cancer confirmed by surgery and pathology was retrospectively ana- lyzed. Results The median age of the 25 patients was 37.5 years （27-56 years）. Twenty-one cases （84.0%） of＂ them were premenopansal. The initial presentation was abdominal distension, stomachache or mass in hypogastric zone. Signet-ring cell cancer was the main type, accounting for 14 cases （56.0%）. Bilateral ovaries were involved in 15 cases （60.0%）. Nine cases （36.0%） were mistaken for the primary ovarian tumors before operation. The 1- and 2-year survival rates of the patients were respectively 51.9% and 21.3%. Conclusion Metastatic ovarian cancer is often the initial presentation in the patients of gastric cancer with ovarian metastasis. The patients of the middle-aged and young,pre-menopausal women are easy to occur ovarian metastasis from gastric cancer. This tumor may be mistaken for a benign ovarian tumor. The prognosis of this disease is poor. When the ovarian tumor was found, the examination of the gastrointestinal tract should be emphasized to exclude firstly the possibility of metastat- ic tumor.