早期胃癌的内镜诊断及临床分析（附36例报告）

Endoscopic diagnosis and clinical analysis of early gastric cancer （36 cases report）

目的分析早期胃癌（EGC）内窥镜下表现及病理特点，提高EGC的诊断率。方法总结2002年8月至2006年10月经手术证实的EGC36例临床资料。结果36例术前均由胃镜确诊为EGC，病灶分布以胃窦部和胃角部为主，占72．2％（26／36）。病理示低分化腺癌14例，占38．9％，管状腺癌11例，占30．6％。病灶周围组织示萎缩性胃炎19例，占52．8％，中重度不典型增生17例，占47．2％，幽门螺旋杆菌阳性33例，占91．7％。结论EGCII型病变多见，胃窦部为好发部位，胃镜检查加黏膜多点活检为其主要确诊手段，黏膜内癌与黏膜下癌发生淋巴转移的几率相比差异无统计学意义（P〉0．1），Hp感染与EGC关系密切。

Objective To analyze the feature of endoscopic diagnosis and pathological characteristic of early gastric cancer, and raise the correct rate of diagnosis. Methods Clinical data on 36 patients with early gastric cancer confirmed by operation were collected and analyzed from August, 2002 to October, 2006. Resuits All of 36 patients with early gastric cancer were diagnosed by gastroscope examination before operation. 72.2 % （26/36） of the tumors were located in the antrum and angulus. 14 cases （38.9%） were poorly dif- ferentiated adenocarcinoma, 11 （30.6%） were tubular adenocarcinoma, atrophic gastritis, middle or heavy atypical hyperplasia and positive helicobacter pylori were found 19 eases （52.8%）, 17 eases （47.2%） and 33 eases （91.7%） in periphery tissue respectively. Conclusion Type Ⅱ is common and the predilection site is in the antrum and angulus. The main diagnosis method is gastroscope examination combining multiple punch biopsy. Early gastric cancer has intimately relation to infection of helicobacter pylori.