10年间早期胃癌手术率演变及经验  

The trend of surgical proportion of early gastric cancer for the recent ten years:our experience

作　　者：朱燕华[1] 吴云林[1] 李晨[1] 吴巍[1] 程时丹[1] 郭滟[2] 蔚青[2] 燕敏[3] 胡伟国[3] 

机构地区：[1]上海交通大学医学院附属瑞金医院消化科,上海200025 [2]上海交通大学医学院附属瑞金医院病理科,上海200025 [3]上海交通大学医学院附属瑞金医院外科,上海200025

出　　处：《胃肠病学和肝病学杂志》2012年第1期9-12,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：上海市科委医学重大项目(09DZ1950102)

摘　　要：目的总结上海交通大学医学院附属瑞金医院10年间早期胃癌手术率演变。方法统计2001年1月～2010年12月间瑞金医院经外科手术治疗的胃癌患者例数,分析其中病理证实的早期胃癌数及其占胃癌总数的比例;按国际标准对确诊的早期胃癌进行形态分型。结果 10年间共行胃癌切除术4 197例,经手术确认早期胃癌727例。2001年～2004年间早期胃癌手术率为12.3%;在建立了多学科联合的胃肠肿瘤学科群后,2005年～2010年的早期胃癌手术率上升至19.0%,年手术率最高达20.7%,检出的早期胃癌中以凹陷型病灶多见,其中0-Ⅱc型327例(54.8%),0-Ⅲ型92例(15.4%),复合型63例(10.6%)。结论早期胃癌的检出有赖于多学科协作,我国早期胃癌手术率的提高仍需进一步开展无症状人群的筛查及高危人群的随访。Objective To sum up experience by analyzing the trend of surgical proportion of early gastric cancer in Ruijin Hospital Affiliated to Shanghai Jiaotong University within the recent 10 years.Methods The clinical information of surgical gastrectomy cases and surgery-proven early gastric cancer from January 2001 to December 2010 were collected,the latter were also classified with the international consensus on morphology of gastric neoplastic lesions.Results 727 cases out of 4 197 cases of gastrectomy carried out in the recent 10 years showed early gastric cancer.The surgical proportion of early gastric cancer was 12.3% from 2001 to 2004.After establishment of the multi-disciplinary collaboration in diagnosis and treatment of gastrointestinal tumors,the proportion had grown to 19.0% from 2005 to 2010 and hit a historical high at 20.7%.The depressed type of lesions were most commonly observed with 327 cases（54.8%） of 0-Ⅱc lesions,92 cases（15.4%） of 0-Ⅲ lesions and 63 cases（10.6%） of complex type of lesions.Conclusion The detection of early gastric cancer depends on the multi-disciplinary collaboration.To improve the surgical proportion of early gastric cancer,nationwide screening in asymptomatic patients and regular follow-up in high-risk groups should be carried out.

关 键 词：胃癌 早期胃癌 临床诊断 手术率 

分 类 号：R735.2[医药卫生—肿瘤]