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Ann Surg:推荐CDH1基因突变携带者预防性全胃切除

2016-10-30 MedSci MedSci原创

本研究的目的是描述遗传性弥漫型胃癌(HDGC)患者接受全胃切除术后的结果。HDGC,主要是通过E-cadherin基因(CDH1)种系突变引起,胃癌的终生风险高达70%,推荐预防性全胃切除术。前瞻性胃癌数据库发现41例在2005~2015年接受全胃切除术的CDH1突变患者。收集围手术期、组织病理学和长期的数据。全胃切除的41例患者中,年龄中位数为47岁(范围20至71岁)。男14例,女27例,开放

本研究的目的是描述遗传性弥漫型胃癌(HDGC)患者接受全胃切除术后的结果。

HDGC,主要是通过E-cadherin基因(CDH1)种系突变引起,胃癌的终生风险高达70%,推荐预防性全胃切除术。

前瞻性胃癌数据库发现41例在2005~2015年接受全胃切除术的CDH1突变患者。收集围手术期、组织病理学和长期的数据。

全胃切除的41例患者中,年龄中位数为47岁(范围20至71岁)。男14例,女27例,开放手术25例,微创手术16例。平均住院天数为7天(范围4至50天)。总共有11例(27%)发生了并发症,需要干预,并有1例(2.5%)围手术期死亡。35例(85%)显示1个或更多胃粘膜胃印戒细胞癌检查标本。中位随访16个月,中位体重减轻为4.7公斤(术前体重的15%)。术后6~12个月,体重稳定。据报道,总的结果是“如预期”一样的患者有40%,“比预期好”的患者有45%。病人报告的临床结局与其他全胃切除患者是相似的。

应考虑对所有CDH1基因突变携带者进行术,应为侵袭性弥漫型胃癌的高风险和缺乏监测方案。虽然大多数患者在全胃切除术后出现体重下降,但是6至12个月后体重稳定,术后和患者报告的结果比他们的术前预期要好。没有患者切除后复发胃癌。

原始出处:

Strong, Vivian et,al.Total Gastrectomy for Hereditary Diffuse Gastric Cancer at a Single Center: Postsurgical Outcomes in 41 Patients.Annals of Surgery:Post Author Corrections: October 17, 2016

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    2017-02-04 qblt
  2. [GetPortalCommentsPageByObjectIdResponse(id=2004905, encodeId=805120049055a, content=<a href='/topic/show?id=2f48569264d' target=_blank style='color:#2F92EE;'>#携带者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56926, encryptionId=2f48569264d, topicName=携带者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=640c454, createdName=qblt, createdTime=Sat Feb 04 16:39:00 CST 2017, time=2017-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2034761, encodeId=0f832034e615c, content=<a href='/topic/show?id=69c910030635' target=_blank style='color:#2F92EE;'>#预防性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100306, encryptionId=69c910030635, topicName=预防性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45b2276, createdName=839640778, createdTime=Mon Feb 27 06:39:00 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1518561, encodeId=cba8151856114, content=<a href='/topic/show?id=324183166ad' target=_blank style='color:#2F92EE;'>#胃切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83166, encryptionId=324183166ad, topicName=胃切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3cc11160823, createdName=bshuang, createdTime=Tue Nov 01 07:39:00 CST 2016, time=2016-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=152430, encodeId=f313152430a0, content=不错,很有帮助, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo4jbias8haG43qWXQUefZI4aYLDxZjibZYAiba9rD9vuiau7CFDSgcq1v4MXnjic0IIo2LNlLDkpfxQdJA/0, createdBy=512e1971494, createdName=晨曦欲语, createdTime=Mon Oct 31 18:20:47 CST 2016, time=2016-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=152409, encodeId=1419152409b3, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon Oct 31 16:06:31 CST 2016, time=2016-10-31, status=1, ipAttribution=)]
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    2016-11-01 bshuang
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    2016-10-31 晨曦欲语

    不错,很有帮助

    0

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    2016-10-31 忠诚向上

    继续努力

    0

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