胃癌侵袭浆膜层与其他特征的相关性分析

Correlations between invasion of gastric cancer to serosal layer and other relevant factors

目的 了解胃癌侵袭深度与胃癌分型、肿瘤大小、溃疡深度、胃壁挛缩、病理类型诸相关因素间的相关程度。方法 总结陕西省人民医院１９９２ 年３ 月～１９９７ 年３ 月间经手术治疗的相关资料完整的胃癌病例１５０ 例，进行单因素分析，χ２ 检验。结果 Ｂｏｒｒｍａｎｎ １ 型Ｓ＋ （Ｓ＋ 表示肿瘤已侵及浆膜层） 发生率最低（８ ．３％ ） ，与２ ，３，４ 型间差异均有显著性（ Ｐ＜ ０．０１） 。Ｂｏｒｒｍａｎｎ ４ 型Ｓ＋ 发生率最高（７６．２ ％ ） ，与１，２ ，３ 型间差异均有显著性（ Ｐ＜０ ．０１） 。２ ，３ 型Ｓ＋ 发生率分别为２３．４％ 和３２．９ ％ ，两型间差异无显著性（ Ｐ＞ ０．０５） 。肿瘤最大径≤３ ．０ ｃｍ 时，Ｓ＋ 发生率为１３ ．６ ％ ，明显低于＞ ３．０ ｃｍ 组（Ｓ＋发生率平均３６．２ ％ ，Ｐ＜０ ．０１） 。溃疡深度≥４ ｍｍ 者其Ｓ＋ 发生率为６２．３％ ，明显高于深度＜ ４ ｍｍ 者（Ｓ＋ 发生率１２．５ ％ ，Ｐ＜ ０．００１） 。有胃壁挛缩者其Ｓ＋ 发生率为７８．１ ％ ，无挛缩者Ｓ＋ 发生率为２０．７ ％ ，两组间差异有极显著性（Ｐ＜ ０ ．００１） 。在病理相关因素中，高中分化腺癌Ｓ＋ 发生率最小，为１０．３ ％ ，显著低于其他组（ ?

Objective To study correlations between invasion of stomach cancer to serosal layer and such factors as size and type of tumor, depth of ulcer, gastric wall contraction, etc. Methods Gastric cancer specimens from 150 patients admitted to the hospital in March 1993 through March 1997 were examined. Results The frequency of tumor invasion to the serosa in gastric cancer of Borrmann type Ⅰ, Ⅱ, Ⅲ and Ⅳ was 8.3%, 23.4%, 32.9% and 76.2%, respectively. The frequency of serosal involvement was 13.6% in tumors with a diameter ≤3.0 cm which was significantly less frequent than in tumors with a diameter >3.0 cm. The frequency of serosal involvement increased with the increase in depth of ulcer and with spastic contraction of gastric wall as observed in pre operative barium meal examination. That of serosal involvement varied with degree of differentiation of the tumor, being much lower in well and moderately well differentiated adenocarcinomas (10.3%) than in poorly differentiated ones (62.8%). The serosa was frequently invaded by mucinous adenocarcinoma (42.9) and signet cell carcinoma (83.3%). Conclusion Invasion of gastric cancer to serosal layer correlates, to various extents, with the tumor size and type, status of cell differentiation, and depth of ulcer.