内容紹介
Summary
Gastric endocrine carcinoma is a comparatively rare type of gastric cancer, accounting for 0.6% of all gastric cancers. Six cases of gastric endocrine carcinomas that were identified from November 2011 to March 2017 were reviewed. The mean age of the patients was 73.3 years, and 1 patient had StageⅠA cancer, 1 had StageⅡB, 2 had Stage ⅢA, and 2 had Stage Ⅳ. Three patients had concomitant conventional adenocarcinoma. Four patients underwent total gastrectomy, 3 of whom showed liver metastases after surgery. The prognosis of gastric endocrine carcinoma is poor because it rapidly metastasizes to the liver and lymph nodes. When unresectable metastatic disease occurs, systemic therapy with cytotoxic chemotherapy can be introduced. Chemotherapy is performed in accordance with that for small cell lung cancer; however, the response rate of chemotherapy is very low, so further studies are needed to improve this treatment.
要旨
胃神経内分泌癌(neuroendocrine carcinoma: NEC)は胃悪性腫瘍全体の約0.6%とまれな疾患で,予後は極めて不良とされている。今回,2011年11月～2017年3月までに経験した胃NEC 6例に関して,臨床病理学的に検討を行った。年齢は平均73.3歳で,胃癌取扱い規約第14版に基づいて分類するとStageⅠA 1例,StageⅡB 1例,Stage ⅢA 2例,Stage Ⅳが2例で,3例に通常型腺癌との併存を認めた。手術は4例で施行し,全例で胃全摘術が行われた。手術を施行した4例のうち3例で術後に肝転移を認めた。NECはリンパ節転移や肝転移を伴うことが多く,根治術困難な症例が多い。化学療法は小細胞肺癌に準じて行うのが推奨されているが,腺癌に準じて行っている報告もあり未だ確立されていないのが現状である。手術と組み合わせた集学的な治療戦略を考える必要がある。
目次
Gastric endocrine carcinoma is a comparatively rare type of gastric cancer, accounting for 0.6% of all gastric cancers. Six cases of gastric endocrine carcinomas that were identified from November 2011 to March 2017 were reviewed. The mean age of the patients was 73.3 years, and 1 patient had StageⅠA cancer, 1 had StageⅡB, 2 had Stage ⅢA, and 2 had Stage Ⅳ. Three patients had concomitant conventional adenocarcinoma. Four patients underwent total gastrectomy, 3 of whom showed liver metastases after surgery. The prognosis of gastric endocrine carcinoma is poor because it rapidly metastasizes to the liver and lymph nodes. When unresectable metastatic disease occurs, systemic therapy with cytotoxic chemotherapy can be introduced. Chemotherapy is performed in accordance with that for small cell lung cancer; however, the response rate of chemotherapy is very low, so further studies are needed to improve this treatment.
要旨
胃神経内分泌癌(neuroendocrine carcinoma: NEC)は胃悪性腫瘍全体の約0.6%とまれな疾患で,予後は極めて不良とされている。今回,2011年11月～2017年3月までに経験した胃NEC 6例に関して,臨床病理学的に検討を行った。年齢は平均73.3歳で,胃癌取扱い規約第14版に基づいて分類するとStageⅠA 1例,StageⅡB 1例,Stage ⅢA 2例,Stage Ⅳが2例で,3例に通常型腺癌との併存を認めた。手術は4例で施行し,全例で胃全摘術が行われた。手術を施行した4例のうち3例で術後に肝転移を認めた。NECはリンパ節転移や肝転移を伴うことが多く,根治術困難な症例が多い。化学療法は小細胞肺癌に準じて行うのが推奨されているが,腺癌に準じて行っている報告もあり未だ確立されていないのが現状である。手術と組み合わせた集学的な治療戦略を考える必要がある。