摘要
目的总结胃印戒细胞癌的临床病理特征及CT诊断研究进展,以助于对该病的进一步认识及早期临床诊治。方法搜索有关胃印戒细胞癌病理分型、临床表现、转移方式、预后及CT表现特征相关研究的文献并作综述。结果胃印戒细胞癌早期常无特殊临床症状及体征,出现类似胃溃疡等症状时往往已进入进展期。胃印戒细胞癌较其他类型胃癌更易出现腹膜及腹水转移,较为特殊转移方式包括沿着胆管和门静脉弥漫性浸润至肝门区并延伸至Glisson鞘内,较其他类型胃癌其预后并不存在优势,甚至更差。多层螺旋增强CT显示病灶多位于胃中下1/3、呈弥漫性浸润性大体外观、胃壁明显增厚强化、出现延迟强化尤其是出现低强化区的延迟强化。新兴的双能量/光谱CT对胃癌的诊断显示出良好的应用前景。结论胃印戒细胞癌的临床病理特征及CT诊断具有一定特征性,但尚存较多争议,与胃印戒细胞癌自身癌灶一些病理特征或浸润方式尚未研究明了有关,这都将是以后继续研究的方向。
Objective To summarize the pathological,clinical features and research progress of CT diagnosis of signet ring cell carcinoma of the stomach,in order to help further understanding and early clinical diagnosis and treatment of this disease.Method The literatures related to pathological classification,clinical manifestations,metastasis patterns,prognosis and CT features of gastric signet ring cell carcinoma were searched and reviewed.Results Gastric signet ring cell carcinoma often had no special clinical symptoms and signs in the early stage,and often entered the advanced stage when symptoms such as gastric ulcer appeared.Gastric signet ring cell carcinoma is more prone to peritoneal and ascites metastases than other types of gastric cancer.The more specific metastases include diffuse infiltration along the bile duct and portal vein to the hepatic hilar area and extension to the Glisson sheath.Compared with other types of gastric cancer,there is no prognostic advantage.even worse.CT showed that the lesions were mostly located in the middle and lower 1/3 of the stomach,with a diffuse infiltrating gross appearance,obvious thickening and enhancement of the gastric wall,and delayed enhancement,especially in the low-enhanced area.The emerging dualenergy/spectral CT has shown good application prospects for the diagnosis of gastric cancer.Conclusions The pathological clinical features and CT diagnosis of gastric signet ring cell carcinoma have certain characteristics,but there are still many controversies,which are related to the fact that some pathological characteristics or infiltration patterns of gastric signet ring cell carcinoma itself have not been clearly studied,which will be discussed in the future direction of continuing research.
作者
陈凌影
卢春燕
CHEN Lingying;LU Chunyan(Department of Radiology,West China Hospital of Sichuan University,Chengdu 610041,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2022年第3期376-381,共6页
Chinese Journal of Bases and Clinics In General Surgery
关键词
胃印戒细胞癌
分型
转移
预后
体层摄影技术/X线计算机
Gastric signet ring cell carcinoma
classification
metastasis
prognosis
tomography/X-ray comput
