早期胃癌50例临床诊治的回顾性研究

Diagnosis and treatment of 50 patients with early gastric carcinomas

目的 评价早期胃癌的诊断及治疗合理性。方法 回顾性分析2004年3月-2008年5月南京军区福州总医院第一附属医院普外科收治的50例早期胃癌患者的临床资料。结果 全部病例均经胃镜检查诊断，其中2例分别有6、10年萎缩性胃窦炎病史；肿瘤位于胃窦幽门处24例，胃角12例，胃体14例；行D1根治术9例，D2根治术41例；肿瘤直径〈1cm10例，1～2cm17例，2～3cm14例，〉3cm9例；淋巴结累及5例（10％），淋巴结阴性者45例。随访48例，术后随访至今，其中3例分别在术后10、12、19个月发生复发转移死亡，生存45例。另外2例失访。结论 尽管目前缩小的微创手术可用于治疗某些早期胃癌，但D2根治术标准的清扫术仍适用于多数早期胃癌的治疗。

Objective To evaluate the factors implicated in the diagnosis and treatment of early gastric caner. Methods Fifty Patients early gastric caner with diagnosed from March 2004 to May 2006, were investigated in the study retrospectively. Results All of the patients were diagnosed accurately by the gastroscopy, among which 2 had atrophic gastritis history for 6 or 10 years, respectively. Twenty-four masses were located in gastric pylorus, 12 in gastic angular incisure, 14 in gastric body. D2 radical mastectomy was performed in 41 cases , and D1 radical mastectomy in 9 cases. In 10 cases the diameter of tumors was 〈 1 cm, 17 cases 1 -2 cm, 14 cases 2-3 cm, 9 cases 〉3 cm. Lymph node involvements were observed in five cases （10%）. Follow data were available in 48 cases. Among them, 3 died from local recurrence and metastasis at postoperative 10, 12, 19 months respectively. Conclusions Although endosopic mucosal resection or limited surgical resection is a reasonable treatment for some early gastric caner patients, D2 radical mastectomy is necessary for most early gastric caner patients.