胃类癌33例诊治分析

Gastric carcinoid:a retrospective analysis of 33 cases

目的探讨胃类癌的诊断和治疗方法。方法对1987至2007年期间收治并经病理证实的33例胃类癌患者的临床资料进行回顾性分析。结果33例患者中Ⅰ型类癌8例,Ⅲ型类癌25例。病变位于胃体10例,胃底贲门18例,胃窦5例。临床症状无特异性。全组共31例行手术治疗,1例行内镜下黏膜切除,1例行肝转移灶放疗。25例患者获得随访,时间5～173个月。总体1,3,5年生存率分别为76.2%、47.1%和25.0%。其中Ⅰ型患者全部存活。Ⅲ型患者中9例死亡,其1,3,5年生存率分别为66.7%、30.8%和18.2%。结论胃镜是早期发现胃类癌的重要手段,免疫组化有助于提高类癌的诊断率。胃类癌的治疗以及预后与准确的分型密切相关。

Objective To explore the diagnosis and treatment of gastric carcinoid. Methods Thirty-three gastric carcinoid patients confirmed pathologically were treated from 1987 to 2007. Their clinical records were retrospectively analyzed. Results Of the 33 patients, 8 （24. 2% ） were diagnosed as type Ⅰ gastric carcinoid and 25（75.8% ） were diagnosed as type Ⅲ. Tumor sites were corpus in 10 cases, fundus and cardia in 18 cases, and sinus in 5 cases. There was no special clinical symptom for gastric carcinoid patients. Thirty-one patients were treated with operation, 1 patient with endoscopic mucosa resection and 1 patient with radiotherapy for liver metastasis. Twenty-five patients were followed up for 5-173 months. Overall 1-year, 3-year and 5-year survival rates were 76.2%, 47. 1% and 25.0% respectively. No patient of the type Ⅰ died. 9 patients of type Ⅲ died, and 1-year, 3-year and 5-year survival rates of type Ⅲ were 66. 7% , 30. 8% and 18. 2% respectively. Conclusions Gastroscopic examination plays an important role in the early diagnosis of gastric carcinoid. Immunohistochemical stain can improve diagnosis rate. Treatment and prognosis of gastric carcinoid depend on the accurate classification.