胃癌切除术切端癌残留的特点及预防  

CHARACTERISTICS AND PREVENTION OF INCISAL MARGIN POSITIVE FOR CANCER CELL IN GASTRECTOMY FOR GASTRIC CARCINOMA

作　　者：胡建昆[1] 陈志新[1] 陈佳平[1] 彭德恕[1] 陈咏梅[1] 

机构地区：[1]华西医科大学附属第一医院普外科,成都610041

出　　处：《中国普外基础与临床杂志》2000年第1期37-39,共3页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的　探讨胃癌切除术切端癌残留的原因及预防手段，以减少癌残留的发生。方法　对我院１９８８ 年１ 月至１９９３ 年４ 月胃癌切除术切端癌残留３２ 例进行回顾性分析。结果　胃癌切除术切端癌残留率为７ ．５ ％ （３２／４２８） ，其中近端癌残留１１ 例，远端癌残留１７ 例，近远端均有癌残留４ 例。根治性胃癌切除术癌残留率为５ ．５ ％ （１７／３０９） ，姑息性胃癌切除术癌残留率为１２ ．６ ％ （１５／１１９） ，两者比较差异有显著性意义（ Ｐ＜ ０ ．０５） 。远、近端胃切除术切端癌残留率分别为５ ．９ ％ 及１３ ．０ ％ ，两者间差异也有显著性意义（ Ｐ＜ ０ ．０５） 。癌残留与癌肿的大体类型、大小、分化程度及浸润深度有关（ Ｐ＜ ０ ．０５） 。结论　浅表广泛型早癌，弥漫浸润型进展癌，癌肿直径＞ ５ ｃｍ ，分化程度低或不良，以及癌肿浸破浆膜者，易发生癌残留。警惕切端癌残留，术中重视切端冰冻活检，有助于减少胃癌切除术切端癌残留的发生率。Objective To investigate the cause of the positive cancer cell incisal margin in gastrectomy for gastric carcinoma. Methods Thirty two cases with positive incisal margin in gastrectomy for gastric carcinoma from 1988-1993 in this hospital were retrospectively studied. Results The overall cancer cell positive rate (CCPR) was 7.5%, and that of radical and palliative resection were 5.5% and 12.6%, respectively ( P <0.05). The CCPR of distal and proximal incisal margin were 5.9% and 13.0% respectively ( P <0.05), which was related to the gross type, size of cancer, and the degree of differentiation and infiltration. Conclusion The CCPR is high in the infiltrating type, lesions larger than 5 cm in diameter and undifferentiated cancer. To prevent the incisal margin positive for cancer cell in gastrectomy, frozen biopsy should be done if possible.

关 键 词：胃肿瘤 胃切除术 残留癌 

分 类 号：R735.2[医药卫生—肿瘤]