早期胃癌的临床及内镜诊断探讨

STUDY ON THE CLINICAL AND GASTROSCOPIC DIAGNOSIS OF EARLY GASTRIC CANCER

目的探讨早期胃癌（ＥＧＣ）的临床及内镜特征，以提高ＥＧＣ的早诊率。方法总结分析我院近２０年４２例ＥＧＣ的临床及内镜特征的资料。结果早期胃癌４２例，占同期手术胃癌的５．０％，其中一点癌１例（２．４％），小胃癌６例（１４．３％）。隆起型６例（１４．３％），凹陷型２４例（５７．１％），平坦型２例（４．８％，即Ⅱｂ型），混合型１０例（２３．８％）。病理显示粘膜层癌（Ｍ癌）１１例（２６．１％），粘膜下层癌（ＳＭ）３１例（７３．８％）。全部病例均有上腹部不适等临床表现，但症状无特异性，４０岁以上者占８３．３％。结论凡在临床上遇有上腹不适的４０岁以上病人，应尽可能行胃镜检查，胃镜遇有粘膜色泽改变，特殊边缘的凹陷或表面不平隆起的病变，均应加强活检。

Objective To study the clinical and gastroscopic characters of early gastric cancer (EGC) in order to increase the positive diagnosis rate of EGC.MethodThe clinical and endoscopic characters of 42 cases of EGC were summarized and analysed in 20 years.Results 42 cases of EGC were found and nearly 5.0% of operative gastric cancer with one case of spot cancer in situ (2.4%),and 6 small gastric cancer (14.3%).The gastroscopoic examination was characterized with 6 protrusion type (14.3%),24 depression type(57.3%),2 flat type(4.8%)and 10 mixed type(23.8%).The pathological examination showed that mucosal cancer was 11 cases(26.1%) and submucosal cancer 31 cases (73.8%).83.3% of patients were more than 40 years old and all patients had non specific clinical manifestation.Conclusion The patients of more than 40 years old with non specific manifestation of upper abdomen should perform gastroscopy.The changes of mucosal color and lustre and the depression and protrusion mucosal lesions of special border are carried out biopsy and pathological examination.