早期胃癌癌周背景病变临床病理特征分析

Analysis of clinicopathologic features of the paracarcinomatous mucosal background leisions in patients with early gastric cancer

目的:调查早期胃癌癌周背景病变临床病理特征。方法:对308例早期胃癌患者进行回顾性分析,评估癌旁黏膜萎缩、肠化情况,并对年龄、性别、肿瘤大小、部位、大体类型、分化程度、浸润深度、淋巴管癌栓、淋巴结转移进行单因素、多因素分析。结果:多因素分析显示老年(66.7%,OR=2.763)、分化良好型(60.7%,OR=1.953)、远端胃(57.6%,OR=1.824)癌旁黏膜萎缩明显高于非老年(39.6%)、分化不良型(42.3%)、近端胃(46.8%);老年(62.6%,OR=2.395)、分化良好型(59.2%,OR=2.804)、远端胃(57.6%,OR=3.373)、肿瘤≤4cm(54.9%,OR=2.459)者癌旁黏膜肠化明显高于非老年(38.1%)、分化不良型(36.1%)、近端胃(35.1%)、肿瘤>4cm者(32.5%)。结论:年龄、分化程度、肿瘤部位、肿瘤大小影响早期胃癌背景黏膜病变,这可能与胃癌起源的不同有关。

Objective：To investigate clinicopathologic features of the paracarcinomatous mucosal basic leisions in patients with early gastric cancer. Methods： Total of 308 patients with early gastric cancer were analyzed retrospec- tively. The paracarcinomatous mucosal background leisions such as atrophy and intestinal metaplasia were estimated. Clinicopathologic variables such as age, sex, tumor size, location, gross type, histological type, depth of invasion, lymphatic vessel involvement and lymph node metastasis were analyzed. Results： The paracarcinomatous mucosal middle - severe atrophy rate in ≥ 60 years （66.7 %, OR = 2. 763 ）, well - differentiated type （ 60.7 %, OR = 1. 953 ）, or distal stomach （57.6%, OR = 1. 824） group was significantly higher than that in 〈 60 years （39.6%）, poor - dif- ferentiated type （42.3 % ）, or proximal stomach （46.8 % ） group. The paracarcinomatous mucosal middle - severe in- testinal metaplasia rate in≥60 years （62.6%, OR = 2. 395 ）, well - differentiated type （59.2%, OR = 2. 804 ）, distal stomach（57.6%, OR = 3. 373 ） or ≤ 4cm （ 54.9%, OR = 2. 459 ） group was significantly higher than that in 〈 60 years（38.1% ） ,poor -differentiated type （36.1%） ,proximal stomach（35.1% ）or 〉4cm（32.5% ）group. Conclu- slon：Age,histological type, location and tumor size affect background mucosal lesion in patients with early gastric cancer. It may be associated with different types of gastric cancer.