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目的探讨实体瘤合并显著血象异常患者的临床表现、发病机制、预后价值及治疗。方法 2012年4月9日收治1例经消化道内窥镜及病理活检诊断为胃低分化/未分化癌患者,骨髓涂片、活检、染色体及骨髓增生症相关基因突变检查排除骨髓增生症。手术切除胃癌及腹腔内转移肿瘤。结果肿瘤病变切除后血象得以改善,但患者肿瘤负荷大,广泛转移,长期预后不良。结论实体瘤可以骨髓增生症类似的血象异常为首发表现,属于副肿瘤综合征,是肿瘤的预后不良因素。
Objective To investigate the clinical manifestations, pathogenesis, prognostic value and treatment of patients with solid tumor complicated with significant blood abnormalities. Methods One patient with poorly differentiated gastric carcinoma and gastric cancer diagnosed by gastrointestinal endoscopy and pathological biopsy was admitted to our hospital on April 9, 2012. Marrow smear, biopsy, chromosomal and myeloproliferative gene mutations were excluded to exclude myeloproliferative disease. Surgical removal of gastric cancer and intra-abdominal metastases. Results After resection of tumor lesion blood images can be improved, but patients with large tumor load, extensive metastasis, long-term prognosis. Conclusion Solid tumor can be a myelodysplastic syndrome similar to the abnormal blood as the first manifestation of paraneoplastic syndrome, is a poor prognosis of the tumor.