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目的:探讨Borrmann Ⅳ型胃癌的生物学行为特点及其在诊断和治疗上的意义。方法:对1985～1999年收治的31例Borrmann Ⅳ型胃癌病例进行回顾性分析。结果:生长方式90.9%为弥漫性生长,组织学分型多为低分化腺癌、粘液腺癌、印戒细胞癌及未分化癌,多侵透浆膜,淋巴结多为多个远距离转移,腹水(28%)及腹膜转移(36%)多见。胃镜活检诊断率(85.7％)低于X线钡餐检查(95％)。手术25例,切除率及根治切除率分别为44%及36%。根治术后均在3年内死于复发。结论:BorrmannⅣ型胃癌具有独特的生物学行为特点,诊断上不应完全依赖胃镜活检,治疗上应重视腹腔亚临床病灶的处理。
Objective: To investigate the biological behavior of Borrmann type Ⅳ gastric cancer and its significance in diagnosis and treatment. Methods: 31 cases of Borrmann type Ⅳ gastric cancer admitted to our hospital from 1985 to 1999 were retrospectively analyzed. Results: 90.9% of the growth pattern was diffuse growth. Most of the histological types were poorly differentiated adenocarcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma and undifferentiated carcinoma, more invading the serosa, more lymph node metastasis and distant ascites (28%) and peritoneal metastasis (36%) more common. The diagnostic rate of endoscopy biopsy (85.7%) was lower than that of X-ray barium meal examination (95%). Surgery in 25 cases, resection rate and radical resection rate were 44% and 36%. Radical surgery died of recurrence within 3 years. Conclusion: Borrmann type Ⅳ gastric cancer has the unique biological behavior characteristics, the diagnosis should not be completely dependent on endoscopic biopsy, the treatment should pay attention to the treatment of subclinical subclinical lesions.