病例讨论（晚期胃癌）教材-课件.pptVIP

病例分析讨论上海交大医学院附属新华医院肿瘤科;Patient W, Female, 53 years old 王某, 女,53岁 Apr. 2005 received endoscopy for abdominal pain 2005年4月因“反复嗳气、腹胀6年,中上腹痛半年伴消瘦”行胃镜检查 Pathological Report: Gastric Adenocarcinoma, low differentiated 病理报告:胃窦中度慢性浅表性胃炎,胃底低分化腺癌 Physical examination: left supraclavicular LN enlargement :about 2cm 体检:左锁骨上扪及多枚淋巴结,2cm大小;CT Scan: Multi-lymph nodes behind posterior peritoneum involved 上腹部CT:胃底部及胃体上部癌,腹腔巨大转移淋巴结,并与原发灶融合,后腹膜淋巴结转移 Tumor Markers 肿瘤标记物:CA125:18.84U/ml CA199: 13.75U/ml CA724: 300U/ml CEA: 7.5ng/L AFP: 10.69ng/L Stage: cTxNxM1 Stage Ⅳ (WHO