切换至 "中华医学电子期刊资源库"

中华普通外科学文献(电子版) ›› 2011, Vol. 05 ›› Issue (02) : 124 -129. doi: 10.3877/cma.j.issn.1674-0793.2011.02.009

所属专题: 经典病例 文献

论著

Krukenberg瘤27例临床特点和预后分析
马晋平1, 吴恺明1, 陈剑辉1, 蔡世荣1, 陈创奇1, 张信华1, 石汉平1, 何裕隆1,(), 詹文华1   
  1. 1. 510080 广州,中山大学附属第一医院胃肠胰外科 中山大学胃癌诊治中心
  • 收稿日期:2010-09-01 出版日期:2011-04-01
  • 通信作者: 何裕隆
  • 基金资助:
    广东省科技计划资助课题(2010B031600223)

Clinical characters and survival analysis of twenty-seven cases with Krukenberg tumors

Jin-ping MA1, Kai-ming WU1, Jian-hui CHEN1, Shi-rong CAI1, Chuang-qi CHEN1, Xin-hua ZHANG1, Han-ping SHI1, Yu-long HE1,(), Wen-hua ZHAN1   

  1. 1. Department of Gastrointestinal & Pancreatic Surgery, The First Affiliated Hospital of Sun Yat-Sen Universtiy, Guangzhou 510080, China
  • Received:2010-09-01 Published:2011-04-01
  • Corresponding author: Yu-long HE
  • About author:
    Corresponding author: HE Yu-long, Email:
引用本文:

马晋平, 吴恺明, 陈剑辉, 蔡世荣, 陈创奇, 张信华, 石汉平, 何裕隆, 詹文华. Krukenberg瘤27例临床特点和预后分析[J]. 中华普通外科学文献(电子版), 2011, 05(02): 124-129.

Jin-ping MA, Kai-ming WU, Jian-hui CHEN, Shi-rong CAI, Chuang-qi CHEN, Xin-hua ZHANG, Han-ping SHI, Yu-long HE, Wen-hua ZHAN. Clinical characters and survival analysis of twenty-seven cases with Krukenberg tumors[J]. Chinese Archives of General Surgery(Electronic Edition), 2011, 05(02): 124-129.

目的

研究Krukenberg肿瘤的临床病理特点,分析影响其预后的因素,探讨改善预后的方法。

方法

回顾性分析我院从1996年1月至2008年8月收治的27例Krukenberg肿瘤患者的临床资料。

结果

Krukenberg肿瘤中位发病年龄为34岁。15例检测消化肿瘤五项(CEA、AFP、CA125、CA19-9、鳞癌抗原),其中肿瘤标记物有阳性者8例(53.3%)。原发肿瘤来源于胃14例,结直肠癌11例,阑尾者1例,未确定原发灶者1例。16例(59.3%)为双侧卵巢转移,11例(40.7%)为单侧卵巢转移。25例有完整生存资料,生存期最长46个月,中位生存期11.7个月。单因素分析结果显示年龄以及治疗方案均为影响预后的主要因素(χ2=11.450,P<0.05),手术联合化疗能改善生存(P<0.05,β=-3.294),而原发肿瘤的直径、部位、浸润深度、淋巴转移以及卵巢转移瘤的肿瘤大小、部位、分化程度等因素并非影响生存的预后因素。

结论

Krukenberg瘤多出现于原发病灶初次手术2年内,手术联合化疗为首选治疗方式,50岁以上的患者预后较佳。建议原发胃肠道恶性肿瘤术后,随访必须包括卵巢相关检查。

Objective

To investigate the clinical characteristics and prognostic factors of Krukenberg tumors, in order to improve clinical survival.

Methods

Twenty-seven patients diagnosed with Krukenberg tumors from January 1996 to Auguest 2008 were investigated retrospectively.

Results

The median age at diagnosis was 34 years old. Eight cases(53.3%) got positive result in tumor markers(ex. CEA, AFP, CA125, CA199, squamous cell carcinoma antigen) among 15 cases. The tumors number of gastric origin, colorectal origin, appendiceal origin, and other origins were 14, 11, 1 and 1, respectively. Tumors involved bilateral in 16 cases and unilateral in 11 cases. Among 25 patients with full follow-up data, the maximum survival time was 46 months and the median survival time was 11.7 months. Univariateanalysis showed that prognostic factors were treatment modality and age, likelihood ratio χ2=11.450, P<0.05. Surgery plus chemotherapy could improve survival, P<0.05, β=-3.294. The diameter, origins, deep of tumor invasion, lymph node status of primary tumor as well as the tumor size, location, differentiation of ovary metastatic tumor were not the prognostic factors.

Conclusions

Krukenberg tumor usually occurred within 2 years after the primary tumor resection. Patients of GI tract tumors should be follow-up including ovary status. Surgery plus chemotherapy may be the first choice treatment, and cases over 50 years old have better survival.

表1 不同来源的27例Krukenberg瘤原发瘤部位和偏侧性分布[n(%)]
表2 原发肿瘤的临床病理特点(例)
图1 1例Krukenberg瘤图片
图2 Krukenberg瘤光学显微镜下病理表现(HE染色)
图3 25例Krukenberg瘤患者生存曲线
表3 Krukenberg瘤预后COX多因素回归分析
1
McGill FM, Ritter DB, Rickard CS, et al. Krukenberg tumors: can management be improved?. Gynecol Obstet Invest, 1999, 48(1): 61-65.
2
Csomor S Jr, Melczer Z, Kazy Z. Data to the clinical manifestation of the Krukenberg tumour. Acta Chir Hung, 1998, 37(1-2): 101-106.
3
马向涛, 付静, 张在兴, 等. 表现为Krukenberg瘤的胆管癌卵巢转移一例. 中华普通外科杂志, 2006, 11(21): 765
4
Russel P, Bannatyne P. Surgical Pathology of the ovaries. Churchill Livingstone, Edinburgh 1989.
5
Qiu L, Yang T, Shan XH, et al. Metastatic factors for Krukenberg tumor: a clinical study on 102 cases. Med Oncol, 2010 Jul 7.
6
杨婷, 邱力, 山雪华, 等. 139例Krukenberg瘤的临床病理分析. 武汉大学学报(医学版), 2010, 2(31): 204-207
7
Sakakura C, Hagiwara A, Yamazaki J, et al. Management of postoperative follow-up and surgical treatment for Krukenberg tumor from colorectal cancers. Hepatogastroenterology, 2004, 51(59): 1350-1353.
8
Sánchez Lihón J. Krukenberg ovary tumor pathological clinical study of 56 cases in the Instituto Nacional de Enfermedades Neoplasicas (National Cancer Institute). Rev Gastroenterol Peru, 2009, 29(3): 209-217.
9
Tan KL, Tan WS, Lim JF, et al. Krukenberg tumors of colorectal origin: a dismal outcome-experience of a tertiary center. Int J Colorectal Dis, 2010, 25(2): 233-238.
10
Man M, Cazacu M, Oniu T. Krukenberg tumors of gastric origin versus Krukenberg tumors of colorectal origin. Chirurgia (Bucur), 2007, 102(4): 407-410
11
Cheong JH, Hyung WJ, Chen J, et al. Surgical management and outcome of metachronous Krukenberg tumors from gastric cancer. J Surg Oncol, 2004, 87(1): 39-45.
12
Jiang R, Tang J, Cheng X, et al. Surgical treatment for patients with different origins of Krukenberg tumors: outcomes and prognostic factors. Eur J Surg Oncol, 2009, 35(1): 92-97.
13
McGill FM, Ritter DB, Rickard CS, et al. Management of Krukenberg tumors: an 11-year experience and review of the literature. Prim Care Update Ob Gyns, 1998, 5(4): 157-158.
14
Ben Brahim E, Chatti S, Ayachi M et al. Krukenberg tumour: a clinico- pathological study of 5 cases. Tunis Med, 2007, 85(9): 806-810.
15
Januszewska M, Emerich J, Dibniak J, et al. Clinical analysis of patients with Krukenberg tumor of the ovary. Ginekol Pol, 2006, 77(3): 203-208.
16
Lee SJ, Lee J, Lim HY, et al. Survival benefit from ovarian metastatectomy in colorectal cancer patients with ovarian metastasis: a retrospective analysis. Cancer Chemother Pharmacol, 2010, 66(2): 229-235.
[1] 李越洲, 张孔玺, 李小红, 商中华. 基于生物信息学分析胃癌中PUM的预后意义[J]. 中华普通外科学文献(电子版), 2023, 17(06): 426-432.
[2] 李凤仪, 李若凡, 高旭, 张超凡. 目标导向液体干预对老年胃肠道肿瘤患者术后血流动力学、胃肠功能恢复的影响[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 29-32.
[3] 杨倩, 李翠芳, 张婉秋. 原发性肝癌自发性破裂出血急诊TACE术后的近远期预后及影响因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 33-36.
[4] 栗艳松, 冯会敏, 刘明超, 刘泽鹏, 姜秋霞. STIP1在三阴性乳腺癌组织中的表达及临床意义研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 52-56.
[5] 马伟强, 马斌林, 吴中语, 张莹. microRNA在三阴性乳腺癌进展中发挥的作用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 111-114.
[6] 江振剑, 蒋明, 黄大莉. TK1、Ki67蛋白在分化型甲状腺癌组织中的表达及预后价值研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 623-626.
[7] 晏晴艳, 雍晓梅, 罗洪, 杜敏. 成都地区老年转移性乳腺癌的预后及生存因素研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 636-638.
[8] 鲁鑫, 许佳怡, 刘洋, 杨琴, 鞠雯雯, 徐缨龙. 早期LC术与PTCD续贯LC术治疗急性胆囊炎对患者肝功能及预后的影响比较[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 648-650.
[9] 姜明, 罗锐, 龙成超. 闭孔疝的诊断与治疗:10年73例患者诊疗经验总结[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 706-710.
[10] 钟广俊, 刘春华, 朱万森, 徐晓雷, 王兆军. MRI联合不同扫描序列在胃癌术前分期诊断及化疗效果和预后的评估[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 378-382.
[11] 胡宝茹, 尚乃舰, 高迪. 中晚期肝细胞癌的DCE-MRI及DWI表现与免疫治疗预后的相关性分析[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 399-403.
[12] 陆萍, 邹健. 凝血和纤维蛋白溶解标志物的动态变化对急性胰腺炎患者预后的评估价值[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 427-432.
[13] 李永胜, 孙家和, 郭书伟, 卢义康, 刘洪洲. 高龄结直肠癌患者根治术后短期并发症及其影响因素[J]. 中华临床医师杂志(电子版), 2023, 17(9): 962-967.
[14] 王军, 刘鲲鹏, 姚兰, 张华, 魏越, 索利斌, 陈骏, 苗成利, 罗成华. 腹膜后肿瘤切除术中大量输血患者的麻醉管理特点与分析[J]. 中华临床医师杂志(电子版), 2023, 17(08): 844-849.
[15] 索利斌, 刘鲲鹏, 姚兰, 张华, 魏越, 王军, 陈骏, 苗成利, 罗成华. 原发性腹膜后副神经节瘤切除术麻醉管理的特点和分析[J]. 中华临床医师杂志(电子版), 2023, 17(07): 771-776.
阅读次数
全文


摘要