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作者对２５６例进行期胃癌的浆膜改变与病期、生物学行为的关系及临床意义进行探讨。结果表明：Ｐｓ（－）胃癌多为Ⅰ、Ⅱ期的限局型癌，分化程度高，淋巴管癌栓、淋巴结转移率及腹腔脱落癌细胞的阳性率低。Ｐｓ（＋）胃癌多为Ⅲ、Ⅳ期的浸润型癌，弥漫性生长，分化不良，淋巴管癌栓、淋巴结转移率及脱落癌细胞的检出率较Ｐｓ（－）胃癌显著增加。Ｐｓ（＋）较Ｐｓ（－）癌根治术后５年生存率明显为低，主要与手术后腹膜转移复发有关。Ｒ＿３扩大根治术适用于Ｐｓ（－）胃癌，而Ｐ＿ｓ（＋）胃癌在根治手术同时尚需辅助化疗，尤其应采取消灭腹腔脱落癌细胞的措施。浆膜分型是手术中判定浆膜是否受侵的简易、可靠的指标。
The authors explored the relationship between plasma membrane changes, stage of disease, and biological behavior in 256 patients with advanced gastric cancer and their clinical significance. The results showed that Ps(-) gastric cancers were mostly stage I- and stage-II cancers with high degree of differentiation. Lymphangioma tumor thrombus, lymph node metastasis rate, and positive rate of exfoliative cancer cells in abdominal cavity were low. Ps(+) gastric cancers were mostly invasive carcinomas of stage III and IV. Diffuse growth, poor differentiation, lymphatic vessel thrombosis, lymph node metastasis, and the detection rate of exfoliated cancer cells were significantly increased compared with Ps(-) gastric carcinoma. The 5-year survival rate of Ps(+) was significantly lower than that of Ps(-) cancer after radical resection, which was mainly related to postoperative peritoneal metastasis and recurrence. R_3 extended radical mastectomy is suitable for Ps(-) gastric cancer, while P_s(+) gastric cancer needs adjuvant chemotherapy for radical surgery. In particular, measures should be taken to eliminate exfoliative cancer cells in the abdominal cavity. Serous membrane typing is a simple and reliable indicator of whether or not the serosa is affected during surgery.