青年人胃癌35例临床内镜病理分析

Clinic, Endoscopic and Pathological Analysis of 35 Cases with Gastric Carcinoma in the Young Adult

1972年1月～1992年1月,我院胃镜检查发现35岁以下胃癌35例,占同期胃镜检出胃癌(644例)的5.42％。本组男24例,女11例。弥漫型胃癌20例,溃疡型胃癌15例,其中早期胃癌2例(5.71％)。手术切除率37.2％,5年生存率11.4％。青年人胃癌预后差的主要原因:①在组织学类型上,分化差或弥漫型胃癌居多;②多数病人确诊延误。为了改善其预后,应重视青年人胃癌的早期诊断。本文讨论了青年人胃癌与胃溃疡的关系以及十二指肠溃疡与胃癌共存问题。强调对青年人胃溃疡患者应积极进行胃镜与病理学追踪检查;在胃镜检查时,如发现十二指肠溃疡,仍需对整个胃部进行仔细检查。

Thirty-five cases of gastric carcinoma in patients 35-year-old and younger, found by gastroscopy from Jan. 1972 to Jan. 1992 were analyzed. They comprised 5.42% of 644 cases of gastric carcinoma detected by gastroscopy for the same period at Beijing Hospital. Twenty-four of the patients were male and eleven fe- mals. There were twenty diffuse and fifteen ulcerated types of carcinoma, 2 of them were in early stage(5.71%). The resectability rate was 37.2% and five year survival rate 11.4%. The major reasons for poor prognosis of gastric carcinoma in the young adult were: (1) the diffuse or pooly differentiated form of carcinoma was the predomi- nant histologic pattern in these patients; (2) the diagnosis of majority patients was de- layed. In order to improve the distal prognosis, great attention should be paid to the early diagnosis of gastric carcinoma in young adult. This paper also discussed the re- lationship between gastric ulcer and carcinoma in this age group and the entity of duo- denal ulcer coexisting with gastric carcinoma. It was emphasized that gastric ulcer in the young adult should be followed up closely by gastroscopy and pathology, and still, all areas of the stomach must be examined carefully when duodenal ulcer was found by gastroscopy.