胃癌卵巢转移的诊疗进展

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1、授予单位代码10089学号或申请号10010010069中国图书分类号R735.2HebeiMedicalUniversity硕士学位论文专业学位胃癌卵巢转移的诊疗进展研究生：黄徐晨导师：王贵英教授专业：外科学二级学院：第四医院2018年3月目录中文摘要········································································································1英文摘要····················································

2、····················································2英文缩写········································································································4综述胃癌卵巢转移的诊疗进展·····································································5致谢·········································

3、·······························································21个人简历································································································22中文摘要胃癌卵巢转移的诊疗进展摘要东亚是全球胃癌的高发地区，全球超过一半的胃癌患者集中在东亚，尤其集中在中国。胃癌较其他恶性肿瘤更容易发生卵巢转移。所以，胃癌卵巢转移的病患人数较西方国家多很多，而一旦发生胃癌卵巢转移，无论同时性还是异时性转移

4、，都意味着疾病进入晚期。这些患者大多比较年轻，很多在绝经期以前，不仅如此，同时性卵巢转移患者的年龄更小，预后也更差。目前学术界对于胃癌卵巢转移的机制尚无定论，通常认为经过淋巴转移可能性更大。如果患者胃部未表现出明显症状，患者多以卵巢转移瘤引起的症状就诊。血液中的肿瘤标志物并不能用来鉴别诊断卵巢原发恶性肿瘤与转移瘤。胃癌卵巢转移多累及双侧，胃癌卵巢转移瘤的大小不同，平均直径9-10厘米，在术中发现此病的腹膜转移率较高。胃癌卵巢转移的预后很差，中位总生存期（OS）为1年左右，而同时性卵巢转移的患者预后更差。目前对于胃癌卵巢转移患者的治疗尚无规范性条目指导诊疗，对于异时性的卵

5、巢转移，可行手术根治治疗。而对于同时性转移，是否行手术治疗仍然有争议。一般认为辅助化疗可以提高患者OS。因为术中发现伴有腹腔多发转移的几率较高，所以腹腔热灌注被认为具有一定的效果，但是这些结论需要进一步的研究证实。关键词：胃癌,卵巢转移,流行病学,诊断,治疗,预后1英文摘要ProgressinDiagnosisandTreatmentofOvarianMetastasisofGastricCancerABSTRACTEastAsiaownsahighincidenceofgastriccancerintheworld,andmorethanhalfoftheglobal

6、gastriccancerpatientsareconcentratedinEastAsia,especiallyinChina.Gastriccancerismorepronetodevelopovarymetastasisthanotheroriginalmalignancies.Therefore,thecasesofovarianmetastasisinChinaaremuchmorethanthatinthewesterncountries.Eithersynchronicorheterochronicovarianmetastasis,itmeansthat

7、thediseaseentersintotheterminalstage.Mostofthesepatientsareyoungandbeforethemenopause,andthepatientswithsynchronicovarianmetastasesareyoungerandhavepoorerprognosis.Atpresent,thereisnoconsensusonthemechanismoftheovarianmetastasisofgastriccancer,anditisgenerallybelievedthat