老年人胃癌前黏膜癌变的胃镜随访  

Gastroscopy followup study of premalignant gastric lesions in senile patients

作　　者：王孟薇[1] 杨少波[1] 张子其[1] 祝庆孚[2] 王刚石[1] 李晖[3] 姚晨[3] 吴本俨[1] 尤纬缔[1] 

机构地区：[1]中国人民解放军总医院南楼消化科,北京市100853 [2]中国人民解放军解放军总医院病理科,北京市100853 [3]中国人民解放军解放军总医院医学统计教研室,北京市100853

出　　处：《世界华人消化杂志》2003年第9期1279-1281,共3页World Chinese Journal of Digestology

基　　金：全军"十五"医学科研基金重点课题资助项目;No.01Z035

摘　　要：目的:研究胃癌前黏膜变化发展演变的规律,以及胃镜检查随访对胃癌早期发现的意义。方法:对1417例患者进行胃镜检查,其中对750例进行了胃镜随访检查。结果:在1417例中首次胃镜检查即诊断为胃癌者64例,发现率4.5％;在以后随访检查中又先后发现胃癌82例(10.9％),随访中检出的胃癌中早癌占62.2％(51/82),显著高于首次检出胃癌的早癌率35.9％(23/64)。胃癌组的异型增生检出率(37.0％)显著高于非癌组(13.1％),同样随访发现的胃癌的累积肠上皮化生率(67.1％)显著高于非癌组(58.1％)。结论:对胃黏膜异型增生和肠上皮化生等病变的检查随访有利于胃癌(尤其是早期胃癌)的发现。AIM: To discover the incidence of gastric cancer in pre- malignant gastric lesions and to evaluate the importance of gastroscopy follow-up for gastric cancer at an early stage. METHODS: A total of 1417 patients received endoscopy. Among them,750 patients who agreed to undergo annual surveillance endoscopy were studied. RESULTS: Among the 1417 patients who received endoscopy, 64 had gastric cancer (4.5 %). 35.9 % of them were at their early stage. 82 cancers were detected (10.9 %) during the follow up period. 62 % of them were at their early stage (62.2% vs 35.9 %; P<0.005). Gastric dysplasia was fre- quent in gastric cancers than in non-cancer group (37.0 % vs 13.1 %; P<0.01) Intestinal metaplasia was also more frequent in gastric cancer group than in non-cancer group (67.1 % vs 58.1 %; P<0.01). CONCLUSION: In patients with intestinal metaplasia or dysplasia, endoscopic surveillance can detect most new tumors at an early stage.

关 键 词：老年人 胃癌 胃黏膜 癌前病变 胃镜 随访 

分 类 号：R735.2[医药卫生—肿瘤]