青年人胃癌的特点

Morphological cure of cerebral arteriovenous malformations by endovascular therapeutics

目的探讨青年人胃癌的生物学特点，评价不同手术方法与预后的关系。方法对８９例青年人胃癌患者的临床特点、治疗方法及预后进行了回顾性分析。结果本组患者肿瘤切除率７３０％（６５／８９），其中根治切除率４８３％（４３／８９），姑息性切除率２４７％（２２／８９）；５年生存率２４７％（２２／８９），其中胃癌根治术后５年生存率为４８８％（２１／４３）。青年人胃癌大体类型以浸润型为主，并具有胃壁浸润深、组织学生长方式弥漫、淋巴结转移程度高、临床症状隐匿、女性患者相对较多等特点。结论青年人胃癌进展快、生物学行为恶。加强以根治手术为主的综合治疗可以提高治疗效果。

Objective To sum up the clinical characteristics and typical manifestation by analysing clinical materials from total embolized cerebral arteriovenous malformations (AVM) via endovascular embolization. Methods We reviewed clinical and image materials of 50 patients whose cerebral AVM were embolized entirely and found the cerebral AVM morphological cure by endovascular embolization after studying the size, position, artery supply, therapeutics and follow up. Results 50 patients with cerebral AVM were embolized by endovascular therapy, accounting for 17% of all patients. Malformation lesions were medium or small type, with a diameter less than 3 cm, 95% of them were located in the tentorium superior. Terminal end blood supply was common to AVM and especially medium cerebral artery (MCA) or its branchs. 97% of the patients were graded Ⅲ or below by spectzler grading system. 70% of them had a history of intracranial hemorrhage and were cured by one therapy. Conclusions It is a reliable and feasible method for morphological cure in cerebral AVM via endovascular therapeutics only, but case selection is important, that is, medium or small AVM with single branch terminal end blood supply in the tentorium superior.