阿帕替尼联合免疫检查点抑制剂治疗晚期胃肝样腺癌1例并文献复习

Apatinib Combined with Immune Checkpoint Inhibitor for Advanced Gastric Hepatoid Adenocarcinoma: A Case Report and Review of Literature

胃肝样腺癌是一种极其罕见病理类型的恶性肿瘤,大约占全部胃癌的0.17%。其细胞形态和免疫表型与肝细胞癌完全相同。胃肝样腺癌侵袭性高,患者确诊时通常已处于晚期阶段,常见淋巴转移和肝转移。由于其较低的发病率,目前缺乏规范的治疗方案,主要治疗方式包括手术治疗和化疗,但效果不理想。靶向治疗和免疫治疗改变了传统的治疗方法,为肿瘤治疗带来了新的途径。因此我们报告1例胃肝样腺癌伴肝转移晚期患者使用阿帕替尼联合PD-L1抑制剂治疗的病例并回顾了现有的文献和相关知识,为这种罕见类型疾病提供新的治疗思路。

Gastric hepatoid adenocarcinoma is an extremely rare pathological type of malignant tumor, ac-counting for about 0.17% of all gastric cancer. Its morphology and immunophenotype are exactly similar to hepatocellular carcinoma. Gastric hepatoid adenocarcinoma is highly aggressive, and usually at an advanced stage when diagnosed with lymphatic metastases and liver metastases. Due to its low incidence, there is a lack of standardized treatment options. At present, the main treat-ment methods include surgery and chemotherapy, but the treatment effect is not satisfactory. Tar-geted therapy and immunotherapy have changed the traditional treatment methods and brought new approaches for the tumor treatment. Therefore, we reported a case of advanced gastric hepatoid adenocarcinoma patient with liver metastases receiving apatinib combined with PD-L1 inhibitors, and reviewed the current literature and relevant knowledge to provide original treat-ment ideas for this rare malignant tumor.