【摘要】 目的 對原發性腸道非霍奇金淋巴瘤穿孔患者的臨床及病理特征、診治、預后進行探討。 方法 回顧性分析1999年1月-2008年12月診治的17例原發性腸道非霍奇金淋巴瘤穿孔患者的臨床資料。 結果 B細胞型9例，T細胞型8例。17例原發腸道非霍奇金淋巴瘤穿孔患者的穿孔部位:大腸7例，小腸7例，回盲部3例。所有患者均行手術治療。除2例穿孔前行化療的患者以外，其余患者術前均未明確診斷。有14例獲得隨訪結果，6例術后3個月內死亡，術后接受化療者7例，1、2、3年生存率分別為41.2%、 23.6%、11.7%，僅1例生存期超過5年。 結論 原發性腸道非霍奇金淋巴瘤穿孔術前診斷困難，預后極差。【Abstract】 Objective To analyze the clinical features, diagnosis, therapy and prognosis of primary intestinal non-hodgkin′s lymphoma perforation. Methods The clinical data of 17 patients with the primary intestinal non-Hodgkin′s lymphoma perforation from January 1999 to December 2008 were retrospectively analyzed. Results Nine patients had intestinal B-cell lymphoma, and eight had intestinal T-cell lymphoma. The sites of perforation were as follows: colon and rectum in 7 (41.2%), ileum and jejunum in 7 (41.2%), and ileocecal junction in 3 (17.6%). All patients had undergone the operations. The disease was not diagnosed before the operation in all of the patients except for the Two patients had a history of systemic chemotherapy before perforation. A total of 14 patients were followed up, in whom six died within three months after the operation; the survival rate 1, 2, and 3 years after the operation was 41.2%, 23.6%, and 11.7%, respectively in seven patients who had undergone the systemic chemotherapy before the operation; one patients lived more than 5 years. Conclusion The diagnosis of primary colonic malignant lymphoma perforation is difficult; the prognosis is miserable.
ObjectiveTo systematically review the current clinical research status of major therapeutic targets and research advances in emerging targets for targeted therapy in advanced gastric cancer, so as to provide a reference for clinical precision therapy. MethodThe key studies on major therapeutic targets for targeted therapy are reviewed, including HER2 (human epidermal growth factor receptor 2), VEGFR2 (vascular endothelial growth factor receptor 2), Claudin 18.2, FGFR2b (fibroblast growth factor receptor 2b), DKK1 (Dickkopf-related protein 1), and MET (mesenchymal to epithelial transition) factor. ResultsClinical research and application of anti-HER2 agents have been well established, and such agents have been utilized throughout the entire course from the first-line to later-line therapy. VEGFR2 inhibitors have been positioned as core treatments in the second-line and subsequent-line settings. The emergence of targeted therapy against Claudin 18.2 has provided the new first-line option for patients with HER2-negative advanced gastric cancer. Investigations into agents targeting targets, including FGFR2b, DKK1, and MET, have been continuously intensified. Conclusions Currently, survival of patients with advanced gastric cancer can be improved by targeted therapy. However, several challenges remain to be addressed, including heterogeneous target expression, complex resistance mechanisms, and uncertainty regarding the optimal treatment strategy. Further investigations are warranted in dynamic monitoring and standardization of target detection, clarification of resistance mechanisms and optimization of combination strategies, as well as sequencing of therapeutic agents and individualized treatment selection.