The Development of Peritoneal Metastasis from Gastric Cancer and Rationale of Treatment According to the Mechanism.
The Development of Peritoneal Metastasis from Gastric Cancer and Rationale of Treatment According to the Mechanism.
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胃癌的腹膜转移和根据该机制的治疗基本原理的发展。
DOI：
10.3390/jcm11020458
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发表时间：
2022-01-17
影响因子：
3.9
通讯作者：
Miura M
中科院分区：
文献类型：
--
作者：
Yonemura Y;Ishibashi H;Mizumoto A;Tukiyama G;Liu Y;Wakama S;Sako S;Takao N;Kitai T;Katayama K;Kamada Y;Taniguchi K;Fujimoto D;Endou Y;Miura M
本文就胃癌腹膜的正常结构和胃癌腹膜转移的机制作一综述。用碱性磷酸酶和5′-核苷酸酶双酶染色法、扫描电镜和免疫组织化学方法研究腹膜的结构。基本结构由三层组成，间皮细胞和基底膜（第1层），筛状斑（MC）（第2层），和含有血管和初始淋巴管的间皮下结缔组织，附着在MC中的孔（第3层）。大分子和巨噬细胞通过MC中的孔从间皮细胞气孔迁移到初始淋巴管。这些结构特征性地存在于隔膜、网膜、结肠旁沟、盆腔腹膜和镰状韧带中。PM的第一步是癌细胞（腹膜游离癌细胞; PFCs）从原发性肿瘤的浆膜表面溢出到腹膜腔中，或者来自外科手术期间撕裂的淋巴管和血管的癌细胞污染。在PFCC粘附到腹膜表面后，PM通过三个过程形成，即，(1)经间皮转移，（2）经淋巴转移，和（3）浅表生长转移。由于IP化疗产生的腹腔内（IP）剂量强度显著高于全身化疗，因此IP化疗在治疗PFCC、浅表生长转移、跨淋巴管转移和跨间皮转移的早期阶段中具有重要作用。然而，已建立的经间皮转移具有其自身的间质组织和脉管系统，其产生高间质压。因此，通过IP和全身化疗的双向化疗来治疗已建立的经间皮转移是合理的。
In the present article, we describe the normal structure of the peritoneum and review the mechanisms of peritoneal metastasis (PM) from gastric cancer (GC). The structure of the peritoneum was studied by a double-enzyme staining method using alkaline-phosphatase and 5′-nucreotidase, scanning electron microscopy, and immunohistological methods. The fundamental structure consists of three layers, mesothelial cells and a basement membrane (layer 1), macula cribriformis (MC) (layer 2), and submesothelial connective tissue containing blood vessels and initial lymphatic vessels, attached to holes in the MC (layer 3). Macro molecules and macrophages migrate from mesothelial stomata to the initial lymphatic vessels through holes in the MC. These structures are characteristically found in the diaphragm, omentum, paracolic gutter, pelvic peritoneum, and falciform ligament. The first step of PM is spillage of cancer cells (peritoneal free cancer cells; PFCCs) into the peritoneal cavity from the serosal surface of the primary tumor or cancer cell contamination from lymphatic and blood vessels torn during surgical procedures. After PFCCs adhere to the peritoneal surface, PMs form by three processes, i.e., (1) trans-mesothelial metastasis, (2) trans-lymphatic metastasis, and (3) superficial growing metastasis. Because the intraperitoneal (IP) dose intensity is significantly higher when generated by IP chemotherapy than by systemic chemotherapy, IP chemotherapy has a great role in the treatment of PFCCs, superficial growing metastasis, trans-lymphatic metastasis and in the early stages of trans-mesothelial metastasis. However, an established trans-mesothelial metastasis has its own interstitial tissue and vasculature which generate high interstitial pressure. Accordingly, it is reasonable to treat established trans-mesothelial metastasis by bidirectional chemotherapy from both IP and systemic chemotherapy.
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影响因子：
--
作者：
Arita T;Ichikawa D;Konishi H;Komatsu S;Shiozaki A;Ogino S;Fujita Y;Hiramoto H;Hamada J;Shoda K;Kosuga T;Fujiwara H;Okamoto K;Otsuji E
通讯作者：
Otsuji E
影响因子：
4
作者：
Casey, RC;Skubitz, APN
通讯作者：
Skubitz, APN
影响因子：
3.4
作者：
Ishikawa, Masashi;Iwasa, Satoru;Boku, Narikazu
通讯作者：
Boku, Narikazu
DOI：
10.1111/j.1349-7006.1992.tb02356.x
发表时间：
1992-01
期刊：
Japanese journal of cancer research : Gann
影响因子：
--
作者：
Ito M;Yasui W;Nakayama H;Yokozaki H;Ito H;Tahara E
通讯作者：
Tahara E
影响因子：
3.8
作者：
Brandl, Andreas;Yonemura, Yutaka;Rau, Beate
通讯作者：
Rau, Beate