Mesogastrium: A fifth route of metastasis in gastric cancer?
Mesogastrium: A fifth route of metastasis in gastric cancer?
复制标题
胃系膜：胃癌的第五种转移途径？
DOI：
10.1016/j.mehy.2012.12.020
复制
发表时间：
2013-04-01
影响因子：
4.7
通讯作者：
Gong, Jianping
中科院分区：
文献类型：
--
作者：
Xie, Daxing;Osaiweran, Hasan;Gong, Jianping
胃癌根治性切除术合并D2淋巴结清扫术在晚期胃癌中得到广泛应用。认为该手术应彻底清除局部肿瘤组织和癌细胞，彻底防止肿瘤原位复发。然而，对于大多数晚期胃癌患者，肿瘤局部复发已被证明是不可避免的。本研究发现，切除胃癌标本的肠系膜中存在分离于原发灶和淋巴结外的孤立癌细胞，推测这些癌细胞可能通过第五种不同于其他四种经典转移途径的转移途径（此处命名为转移V）向肠系膜浸润，无法通过常规根治性胃切除术和D2淋巴结清扫术切除。局部复发可能与这些系膜内癌细胞密切相关，因此，全系膜切除（CME）势在必行，并成为根治性胃切除术的第三根治原则。(C) 2012 Elsevier Ltd.版权所有。
Radical gastrectomy for gastric cancer with D2 lymph node dissection has been widely applied in advanced gastric cancer. It is believed that such surgery should extremely sweep away local-regional tumor tissues and cancer cells and thoroughly prevent tumor recurrence in situ. However, for most patients with advanced gastric cancer, tumor local-regional recurrence has been proven unavoidable. This study has found that isolated cancer cells, separate from the primary lesion and lymph nodes, existed in the mesogastrium of resected gastric cancer specimens, leading to the hypothesis that these cancer cells may have infiltrated the mesogastrium through a fifth metastasis route (here named Metastasis V) which is distinct from the other four classic metastasis routes, and cannot be resected by conventional radical gastrectomy with D2 lymph node dissection. Local-regional recurrence might be closely associated with these cancer cells in the mesogastrium, and therefore, complete mesogastrium excision (CME) should be imperative and become the third radical principle for radical gastrectomy. (C) 2012 Elsevier Ltd. All rights reserved.