微卫星稳定的进展期胃癌行免疫联合化疗后完全缓解1例

A Case of Microsatellite-Stabilized Advanced Gastric Cancer with Complete Remission after Immunotherapy Combined with Chemotherapy

摘要: 目的：探讨微卫星稳定的进展期胃癌的治疗方案，为此类疾病的治疗提供参考。方法：通过收集一例微卫星稳定的进展期胃癌患者的病历资料并结合相关临床实验及文献进行探讨。结果：患者为51岁中年男性，通过结合影像学、胃镜及病理结果，该患者临床诊断为进展期胃癌、肝继发恶性肿瘤、腹腔淋巴结转移。根据实际情况，该患者首先行2程免疫联合化疗，具体方案：信迪利单抗联合白蛋白结合型紫杉醇、奥沙利铂、替吉奥。经治疗后评估肿瘤大小较前明显缩小，达到手术指征，遂实施手术治疗，术后病理示送检各组织均未检测出肿瘤组织。结论：患者治疗过程中具体用药应根据患者实际情况决定，对于微卫星稳定的胃癌患者，可通过行免疫联合化疗的方式改善肿瘤组织的免疫微环境，提高其对于免疫治疗的敏感性，改善疾病预后。

Abstract: Objective: To explore the microsatellite stable treatment of advanced gastric cancer, and provide reference for the treatment of this disease. Methods: The medical records of a microsatellite stable patient with advanced gastric cancer were collected and discussed in combination with relevant clinical experiments and literature. Results: The patient was a 51-year-old middle-aged male. Through the combination of imaging, gastroscopy and pathological results, the patient was clinically diagnosed as advanced gastric cancer, secondary malignant tumor of liver, and abdominal lymph node metastasis. According to the actual situation, the patient was first treated with two courses of immunotherapy combined with chemotherapy, and the specific program was Xindilimab combined with albumin-binding paclitaxel, oxaliplatin, and tegeo. After treatment, the tumor size was significantly smaller than before, reaching the surgical indication, so the surgical treatment was carried out. Postoperative pathology showed that no tumor tissue was detected in the tissues submitted for examination. Conclusion: The specific drug use in the treatment of patients should be determined according to the actual situation of the patients. For patients with gastric cancer with microsatellite stability, the immune microenvironment of tumor tissue can be improved, the sensitivity of tumor tissue to immunotherapy can be improved, and the prognosis of the disease can be improved.