41例IIb型早期胃癌临床及生物学特征分析

Analysis of the clinical and biological characters of early gastric cancer type Ⅱb

目的:了解Ⅱb型早期胃癌的临床和生物学特性。方法:回顾分析1990～2002年我院经手术切除和病理检查证实的早期胃癌203例。结果:203例中,Ⅱb型早期胃癌41例,男女比例为1.05∶1(21比20)。在Ⅱb型早期胃癌中,女性的平均发病年龄早于男性[(47±14)岁比(52±12)岁,P<0.05],且男性的分化程度高于女性(高分化12例、低分化9例比高分化3例、低分化17例,P<0.05)。在分化型病例中,12例为黏膜内癌,3例为黏膜下癌,而未分化型病例中21例为黏膜内癌,5例为黏膜下癌。41例Ⅱb早期胃癌中,5例发生淋巴结转移,其中3例为黏膜内癌,2例为黏膜下癌,所有病例均未发现远处转移。结论:在Ⅱb型早期胃癌,女性发病早于男性,肿瘤的分化程度低于男性;而Ⅱb早期胃癌肿瘤的浸润深度与其分化程度有关;淋巴结转移与肿瘤的浸润深度有关。

Objective To analyze the clinical and biological characters of early gastric cancer （EGC） type Ⅱb. Methods The EGC cases that underwent the resection and were confirmed by pathology in our hospital from 1990 to 2002 were retrospectively analyzed. Results There were 203 cases of EGC, among whom 41 belonged to type Ⅱ b.The ratios of males to females were 2.03 （136 vs 67） in the EGC and 1.05 （21 vs 20） in the EGC type Ⅱb. In the EGC type Ⅱb, the age of episode in females was earlier than that in males （47±14 vs 52±12, P〈0.05）, and the differentiation in males was better than that in females （12 with well-differentiation and 9 with poor-differentiation in males vs 3 well-differentiation and 17 poor-differentiation in females, P〈0.05）. In the well-differentiated cancers, 12 were intramucosal and 3 were submucosal, while in the poor-differentiated ones, 21 were intramucosal and 5 were submocosal. Five out of 41 EGC type Ⅱb had the lymph node metastasis, among which 3 were intramucosal and 2 were submucosal. No distant metastasis was found in the EGC type Ⅱb. Conclusions In the ECG type Ⅱb, the age of episode in females is earlier than that in males, the differentiation in males is better than that in females, and the lymph node metastasis is associated with the invasive depth of the cancer.