早期胃癌的诊治体会(附61例报告)  

Diagnosis and treatment of early gastric cancer: an experience from 61 cases

作　　者：张保宁[1] 蔡建强[1] 陈国际[1] 高继东[1] 吴铁成[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院,北京100021

出　　处：《中华肿瘤杂志》1999年第5期383-385,共3页Chinese Journal of Oncology

摘　　要：目的　提高早期胃癌检出率，改善胃癌预后，并探讨其临床特点。方法　回顾分析６１例早期胃癌的临床表现、病灶大小、部位、分型、检测方法、治疗及预后。结果　６１ 例患者平均年龄近５０ 岁，占同期胃癌手术病例的５－７％ 。Ｘ 线双重造影检出率为５８－７％ ，胃镜肉眼检出率为４４－３％ ，胃镜下活检检出率可提高为９５－１％ 。病理诊断凹陷型者（Ⅱｃ、Ⅲ）居多，平坦型者（ Ⅱｂ） 易误诊。术后５９例均无瘤生存，其中生存１～４ 年者２１ 例，５ 年以上者３８ 例，１０ 年以上者１２ 例。结论　上腹不适及疼痛是早期胃癌的常见症状；Ｘ线双重造影及纤维胃镜是提高胃癌早诊率的主要方法；Objective To review the clinical signs of diagnostic significance and treatment of early gastric cancer Methods Sixty one gastric cancer patients were collected for this study They were surgically treated and pathologically confirmed to be in the early stage of disease The x ray and gastroscopic findings of these patients were reviewed Results Double contrast barium meal examination was performed in 46 cases and 27 of them were diagnosed as gastric cancer with a detection rate of 58 7% Superficial type of tumor was easily misdiagnosed as superficial gastritis and concave type of tumor misdiagnosed as benign gastric ulcer under x ray imaging All the patients were gastroscopically examined With examiner′s naked eyes, diagnosis of cancer was made in 27 cases (44 3%) Visual diagnosis was difficult when the tumor was small Attention should be focused on the gastric incisura angularis, antrum and lesser curvature to perform site directed biopsy Final diagnosis depended on the pathological diagnosis of the biopsied materials Pathologic diagnosis would be correct provided the biopsy material was taken from the proper site It was correct in 58 of the 61 cases (95 1) Surgical treatment consisted of radical gastrectomy and D 2 lymph node dissection All but 2 were tumor free after surgical treatment Prognosis was good in this series of early gastric cancer patients, 38 of them were alive over 5 years and 12 patients survived over 10 years Conclusion Careful x ray and gastroscopic examinations of patients with epigastric symptoms are indicated not to miss any early case of gastric cancer

关 键 词：胃肿瘤 诊断 治疗 病例报告 

分 类 号：R735.2[医药卫生—肿瘤]