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目的 通过比较中国医科大学 (中国医大 )和日本东京大学 (东大 )胃癌诊疗成绩 ,探讨提高胃癌治疗方法。方法 比较两大学之间胃癌的临床病理特征、手术方式的分布特点及其对术后长期生存影响。结果 东大的治愈性切除率为 85 9% (914 10 6 4 ) ,高于中国医大的 6 7 5 % (75 6 112 0 )。中国医大高度进展期癌 (se ,si)占治愈性切除的 5 2 1% (394 75 6 ) ,远高于东大的 16 6 % (15 2 914 ) ;中国医大治愈性切除病例的早期癌占 17 3% (131 75 6 ) ,低于东大的 5 7 2 % (5 2 3 914 )。东大的胃癌治愈性切除术后总生存率明显高于中国医大 (77 2 % ,5 7 1% ,P <0 0 0 0 1)。两大学资料都显示 ,癌浸润深度越深 ,预后越差 ;D2 ,D3根治术 5年生存率均高于D1 根治术 ;手术方式不同 ,其生存率顺序为远切 >全切 >近切 >联合切 ;浸润型胃癌预后差。结论 提高早期癌的检出率和规范化根治手术是改善胃癌治疗成绩的关键
Objective To compare the gastric cancer diagnosis and treatment between China Medical University (China Medical University) and Tokyo University (Dongdaemun) in Japan to explore ways to improve the treatment of gastric cancer. Methods The clinicopathological features, the distribution of surgical methods and their effect on postoperative long-term survival were compared between the two universities. Results The curative resection rate of Dong Tai was 85 9% (914 10 6 4), which was higher than 67 5% (75 6 112 0) of China Medical University. China Medical University highly advanced cancer (se, si) accounting for curative resection of 521% (394 756), much higher than 16 6% of Dongda (15 2 914); China Medical University curative resection of early cancer Accounting for 17.3% (131,756), down from 57.2% (52,914) of Dongdaemun. The overall survival rate after curative resection of gastric cancer in Dongda was significantly higher than that in China Medical University (77.2%, 57.1%, P <0.01 01). Data from both universities showed that the deeper the depth of invasion, the poorer the prognosis. The 5-year survival rates of D2 and D3 were higher than that of D1. Survival rates of D2 and D3 were significantly higher than that of D1 Combined cut; poor prognosis of gastric cancer. Conclusion Increasing the detection rate of early cancer and standardizing radical surgery are the keys to improve the outcome of gastric cancer