论文部分内容阅读
目的探讨早期胃癌(early gastric carcinoma,EGC)的诊断、治疗及影响预后的因素。方法回顾性分析1995年6月至2002年6月我院EGC的临床资料。结果本组EGC共72例,肿瘤部位:贲门部1例,胃体13例,胃窦56例,双原发癌2例(胃窦加胃体,胃窦胃大弯加胃小弯)。黏膜内癌42例,黏膜下癌30例。肿瘤病理分型:低分化腺癌24例,中分化腺癌17例,高分化腺癌 5例,印戒细胞癌12例,低分化腺癌部分印戒细胞癌12例,局部黏膜癌变2例。淋巴结转移10例。 EGC患者多因上腹疼痛首诊。上消化道X线造影、B超、CT的EGC检出率分别为57％、3％和15％。胃镜检查68例,病理确诊率94％。全部患者接受D2胃癌根治术,18例术后化疗。1例肝、肺转移行导管介入治疗,1例骨转移。随诊0．5-9年,随诊率85％,5年生存率90％,死亡率3％。结论根治性手术治疗是EGC取得良好疗效的最佳途径。D2胃癌根治术是治疗EGC的标准术式。胃镜病理活检是EGC诊断的金标准。淋巴结转移率是影响EGC预后的主要因素。
Objective To investigate the diagnosis, treatment and prognostic factors of early gastric carcinoma (EGC). Methods The clinical data of EGC in our hospital from June 1995 to June 2002 were retrospectively analyzed. Results There were 72 cases of EGC in this group. There were 1 tumor of cardia, 13 gastric body, 56 gastric antrum and 2 primary gastric carcinoma (gastric antrum plus gastric antrum and gastric lesser curvature). 42 cases of mucosal cancer, 30 cases of submucosal cancer. Tumor pathological classification: poorly differentiated adenocarcinoma in 24 cases, 17 cases of moderately differentiated adenocarcinoma, 5 cases of well-differentiated adenocarcinoma, signet ring cell carcinoma in 12 cases, poorly differentiated adenocarcinoma part of signet ring cell carcinoma in 12 cases, local mucosal carcinogenesis in 2 cases . Lymph node metastasis in 10 cases. EGC patients mostly due to abdominal pain first diagnosis. Upper gastrointestinal radiography, B ultrasound, CT of the EGC detection rates were 57%, 3% and 15%. Gastroscopy in 68 cases, the pathological diagnosis rate of 94%. All patients underwent D2 gastric cancer radical surgery and 18 postoperative chemotherapy. A case of liver and lung metastases catheter interventional treatment, 1 case of bone metastases. Follow-up 0.5-9 years, follow-up rate of 85%, 5-year survival rate of 90%, the mortality rate of 3%. Conclusions Radical surgery is the best way for EGC to obtain good curative effect. D2 radical gastrectomy is the standard surgical treatment of EGC. Endoscopic biopsy is the gold standard for the diagnosis of EGC. Lymph node metastasis rate is the main factor affecting the prognosis of EGC.