本文選題：日本胃癌學(xué)會　切入點(diǎn)：胃癌　出處：《中國實(shí)用外科雜志》2017年04期 　論文類型：期刊論文

【摘要】：第5版日本《胃癌治療指南》縮小了胃癌標(biāo)準(zhǔn)手術(shù)的切除范圍,不推薦對近端非大彎側(cè)胃癌行脾切除,對于c T3/4期胃癌不推薦行網(wǎng)膜囊切除。對于IV期病例,不推薦手術(shù)+化療的治療模式,化療+手術(shù)可能是選項(xiàng)之一。擴(kuò)大了早期胃癌行內(nèi)鏡黏膜下剝離術(shù)(ESD)的絕對適應(yīng)證。增加了新的化療藥物、靶向藥物和化療方案,例如奧沙利鉑和RAM單抗被批準(zhǔn)用于胃癌的化療和靶向治療。擴(kuò)大了卡培他濱和奧沙利鉑用于圍手術(shù)期化療的適應(yīng)證。選擇了30~40個(gè)臨床問題,經(jīng)過討論后給予最可能的回答。第15版日本《胃癌處理規(guī)約》與第8版國際抗癌聯(lián)盟/美國癌癥聯(lián)合委員會(UICC/AJCC)胃癌分期系統(tǒng)進(jìn)行了整合,該分期是基于國際胃癌學(xué)會胃癌TNM分期項(xiàng)目的結(jié)果修訂的,第一次體現(xiàn)了國際化。第15版日本《胃癌處理規(guī)約》修訂了幽門下組淋巴結(jié),將其分成No.6a、No.6v和No.6i三個(gè)亞組。對腹膜轉(zhuǎn)移分級進(jìn)行修訂,將P1按轉(zhuǎn)移范圍進(jìn)一步分成P1a、P1b和P1c。如果胃竇癌侵犯十二指腸,No.13淋巴結(jié)發(fā)生轉(zhuǎn)移,應(yīng)該視為區(qū)域淋巴結(jié)轉(zhuǎn)移,不做為M1對待。傳統(tǒng)意義的R0不適用于對ESD手術(shù)質(zhì)量的評估。食管胃結(jié)合部癌的診斷標(biāo)準(zhǔn)應(yīng)該結(jié)合內(nèi)鏡所見、上消化道造影及病理診斷。對化療療效評價(jià)標(biāo)準(zhǔn)進(jìn)行修訂,確定了腫瘤消退的界值為10%。
[Abstract]:The fifth edition of Japan's guidelines for the treatment of gastric Cancer narrowed the scope of the standard surgical procedures for gastric cancer. Splenectomy for proximal non-large curved gastric cancer was not recommended. Omentum sac resection was not recommended for stage c T 3 / 4 gastric cancer. Surgery is not recommended for chemotherapy. Chemotherapy may be one of the options. It expands the absolute indication of endoscopic submucosal dissection of early gastric cancer. New chemotherapeutic drugs, targeted drugs, and chemotherapy protocols are added. For example, oxaliplatin and RAM monoclonal antibodies were approved for chemotherapy and targeted therapy for gastric cancer. The indications for capecitabine and oxaliplatin for perioperative chemotherapy were expanded. 30 to 40 clinical problems were selected. After discussion, the most likely answer was given. The 15th edition of Japan's gastric Cancer treatment Protocol was integrated with the 8th edition of the UICC / AJCC-UICC / AJCC gastric cancer staging system. The staging is based on the results of the International gastric Cancer Society's TNM staging project, which is the first to reflect internationalization. The 15th edition of Japan's gastric Cancer treatment Protocol revised the subpyloric lymph nodes. It was divided into three subgroups, No. 6aAU No. 6v and No.6i. The peritoneal metastasis classification was revised to further divide P1 into P1aAU P1b and P1c.If gastric antral carcinoma invades duodenal No. 13 lymph node metastasis, it should be regarded as regional lymph node metastasis. Not treated as M1. Traditional R0 is not suitable for evaluating the quality of ESD surgery. The diagnostic criteria for esophageal and gastric carcinoma should be combined with endoscopic findings, upper gastrointestinal angiography and pathological diagnosis. The criteria for evaluating the efficacy of chemotherapy should be revised. The cutoff value of tumor regression was determined to be 10.
【作者單位】： 天津醫(yī)科大學(xué)腫瘤醫(yī)院胃部腫瘤科國家腫瘤臨床醫(yī)學(xué)研究中心天津市腫瘤防治重點(diǎn)實(shí)驗(yàn)室;
【分類號】：R735.2
，

本文編號：1604590