胃癌新辅助化疗的研究进展

FDG PET/CT diagnosis of clinically occult gastric cancer

AIM: To investigate the use of fluorodeoxyglucose (FDG) positron emission tomography ( PET)/CT imaging in diagnosis of clinically occult gastric cancer.

METHODS: The imaging data for 26 patients with clinically occult gastric cancer who underwent FDG PET/CT imaging were reviewed retrospectively. They were hospitalized for metastatic tumors and therefore underwent FDG PET/CT for detecting carcinoma of unknown primary origin. They were finally diagnosed with gastric cancer by endoscopy (n = 24) or laparoscopy (n = 2). Based on imaging manifestations, the patients were divided into three groups: easily diagnosed, suspected, and hardly diagnosed.

RESULTS: PET imaging showed 57.7% (15/26) of intensively positive cases, 23.1% (6/26) of positive cases, and 19.2% (5/26) of negative cases. CT imaging showed 76.9% (20/26) of intensively positive cases, 11.5% (3/26) of positive cases, and 11.5% (3/26) of negative cases. The percentages of easily diagnosed, suspected, and hardly diagnosed patients were 53.8% (14/26), 34.6% (9/26) and 11.5% (3/26), respectively.

CONCLUSION: FDG PET/CT imaging can help diagnose clinically occult gastric cancer in about 88.4% of patients.

Clinical value of laparoscopic exploration with peritoneal lavage in preoperative staging of advanced gastric cancer

AIM: To explore the clinical significance of laparoscopic exploration with peritoneal lavage in staging of gastric cancer and choice of surgical procedures.

METHODS: The clinical data for 43 patients with gastric cancer who underwent laparoscopic exploration and treatment of in the Peking University Cancer Hospital were retrospectively analyzed.

RESULTS: All the 43 patients with gastric cancer underwent successful laparoscopic exploration and peritoneal lavage. The procedures were performed in 30-45 min (average 32 min) with less bleeding. Fourteen cases of peritoneal metastasis were found during operation. There was once case of gastric tumor directly invading surrounding organs. Twenty-seven cases of gastric tumours penetrated through the serosa of the stomach, while the others still confined to the serosa. Endoscopic palpation was not obvious in four cases. All patients underwent peritoneal lavage, and 16 (37.2%) cases got positive cytologic findings in serous cavity effusions.

CONCLUSION: Laparoscopic exploration with peritoneal lavage has very important clinical significance in the staging of gastric cancer and choice of surgical procedures.