老年早期胃癌病理特征及预后分析

The clinicopathologic features and factors of early gastric cancer in elderly patients

目的 :研究老年早期胃癌的病理特征及预后因素。方法 :收集本院南楼有完整随访资料的老年早期胃癌 5 2例 ,分析其临床病理特征与淋巴结转移关系及其对预后影响。结果 :5 7.7%老年早期胃癌无症状 ,大体类型Ⅱc居多 ,多灶癌占 9.6 % ( 5 /5 2 ) ,老年早期胃癌以中高分化腺癌为主 ,黏膜内癌无淋巴结转移 ,黏膜下癌淋巴结转移发生率为 15 % ( 3/2 0 ) ,5例复发死亡患者多为黏膜下癌、有淋巴结转移、组织分化差。老年早期胃癌 5年生存率 98.1% ,10年生存率 96 .1% ,15年生存率 92 .3% ,2 0年生存率 90 .3% ,内镜治疗对黏膜内癌有较好疗效。结论 :影响老年早期胃癌生存的关键因素是淋巴结转移、肿瘤侵及黏膜下层和组织分化差 ,如术后 2 0年内不发生复发或转移 。

Objective:To study the clinicopathlogic factors and survival in elderly patients with early gastric cancer(EGC).Methods:The relationship between lymph node metastasis and clinicopathologic factors were analysed in 52cases EGC. Results:EGC was no symptom in 57.7% elderly patients,Gross typeⅡc had a high incidence,Multiple EGC were found in 9.6% patients,The mumber of well or moderately differentiated adenocarcinoma was higher than that poorly differentiated adenocarcinoma in EGC,The lymph node metastasis was found in 15% petients in submucosal cancer,but no lymph node metastasis in the mucosal cancer.Ricurrence was seen in five patients,the incidence of ricurrence was significantly higher in submucosal,poorly differentiated adenocarcinoma.5year survival rate was 98.1%,10year survival rate was 96.1%,15year survival rate was 92.3%,20 year survival rate was 90.3%.Endoscopic mucosal resection is recommended for mucosal cancer in elderly patients. Conclusion:The presence of lymph node metastasis and invasion of submucosal layer and poorly differentiated carcinoma are critical factors in the prognosis of gastric cancer.