胃肝样腺癌的研究进展

Research progression of gastric hepatoid adenocarcinoma

目的胃肝样腺癌是一种特殊类型的胃癌,确诊多为晚期,治愈率极低。本研究综述胃肝样腺癌的临床研究进展,为诊断治疗提供参考。方法应用PubMed、万方期刊全文数据库检索系统、CNKI期刊全文数据库检索系统,以“胃肝样腺癌、诊断、治疗预后”为关键词,检索1999-07-2019-10发表有关胃癌辅助放疗相关文献。纳入标准:(1)胃肝样腺癌临床表现;(2)胃肝样腺癌诊断和治疗研究进展及现状;(3)胃肝样腺癌的鉴别诊断。根据纳入标准,符合分析的文献共40篇。结果胃肝样腺癌属于胃癌亚型的一种,发病率偏低,该病的发病部位为胃黏膜,临床观察发现往往呈现出肝细胞样以及腺体样分化的病理特征,容易误诊漏诊,常伴有甲胎蛋白升高,患病期间有大概率出现肝转移以及淋巴结转移,并且该病预后极差。胃肝样腺癌的分化程度极低,组织病理学是诊断金标准,目前没有标准治疗方案,分子机制不明确。结论深入了解胃肝样腺癌的分子机制和准确发病机理,可为基因研究和靶向治疗研究开启新方向,为临床治疗提供新方案,改善患者预后。

OBJECTIVE Gastric hepatoid adenocarcinoma is a special type of gastric cancer,most of which are diagnosed late and the cure rate is extremely low.This study aimed to understand the clinical status of gastric hepatoid adenocarcinoma and provide reference for the diagnosis and treatment in the future.METHODS PubMed,Wanfang journal fulltext database retrieval system and CNKI journal full-text database retrieval system were searched.The relevant literatures of gastric hepatoid adenocarcinoma published on July 1999and October 2019with the keywords of"gastric hepatoid adenocarcinoma,diagnosis,prognosis".Inclusion criteria:(1)clinical characteristics of gastric hepatoid adenocarcinoma;(2)research progress and status of diagnosis and treatment of gastric hepatoid adenocarcinoma;(3)differential diagnosis for gastric hepatoid adenocarcinoma.According to the inclusion criteria,a total of 40articles were analyzed.RESULTS The gastric hepatoid adenocarcinoma belongs to a subtype of gastric cancer.The incidence rate is very low.The location of the disease is gastric mucosa.Clinical observation show that the pathological features of hepatocyte like and adenoid differentiation often occurrs.It is easy to misdiagnose and missed diagnosis,and it often accompanies with elevated alpha fetoprotein.There is a possible rate of liver metastasis and lymph node metastasis during the period of illness,and the prognosis of the disease is very poor.The degree of differentiation of gastric hepatoid adenocarcinoma is very low,histopathology is the gold standard for diagnosis,and there is no standard treatment plan at present.CONCLUSION Gene research and targeted treatment are the new research direction,providing a new plan for clinical treatment.