694例胃癌临床病理学特征分析

Clinical pathological features analysis of 694 gastric cancer cases

目的探讨胃癌临床病理特点，为胃癌的研究和治疗提供基础。方法收集2001至2004年行胃癌根治术的病例共694例，回顾性分析性别、年龄、肿瘤部位、肿瘤大小、WHO组织学分型和分级、Lauren分型、脉管侵犯、淋巴结转移、肿瘤浸润深度（pT）、病理TNM分期（pTNM）。结果694例胃癌中，男女比为3．96：1；41～70岁组有644例，占92．80％，51～70岁为高发年龄段。胃癌好发部位依次为贲门（33．43％）、胃窦（28．96％）、胃体（21．76％）。常见的wH0组织学类型依次是管状腺癌（70．32％）、印戒细胞癌（24．50％）。常见的组织学分级依次为Ⅱ、Ⅲ、Ⅰ级。Lauren分型以肠型最常见，占58．93％，其次是弥漫型，占22．33％。手术时438例（63．11％）有脉管侵犯，504例（72．62％）有淋巴结转移，319例（45．97％）处于pT3期，241例（34．73％）处于pTNMⅢ期。结论近年胃癌在贲门、胃窦好发，管状腺癌和印戒细胞癌常见，提示胃癌发病机制存在多元性。

Objective To explore the clinical pathological features of gastric cancer and to provide a basis for research and treatment of gastric cancer. Methods From 2001 to 2004, a total of 694 cases of gastric cancer with radical gastrectomy were collected. Gender, age, tumor location, tumor size, World Health Organization （WHO） histological type and grade, Lauren type, blood/ lymphatic vessel invasion, lymph node metastasis, depth of tumor invasion （pT） and pathological TNM staging （pTNM） were retrospectively analyzed. Results Among 694 gastric cancer cases, male to female ratio was 3.96：1; a total of 644 cases （92.8%） were aged from 41 to 70, and cases aged from 51 to 70 had a high incidence of gastric cancer. The predilection site for gastric cancer was cardia （33.43%）, antrum （28.96%） and the body （21.76%） accordingly. The common WHO histological types were tubular adenocarcinoma （70.32 % ） and signet ring cell carcinoma （24.50 % ）. The common histological grades were Ⅱ , Ⅲ and Ⅰ The intestinal type was most common in Lauren classification, accounting for 58.93 % ; followed by the diffuse type, accounting for 22.33 %. Blood/lymphatic vessel invasion was detected in 438 cases （63.11%）, lymphnode metastasis in 504 cases （72.62%）. Atotal of 319 cases （45.97%） were pT3 stage, 241 cases （34.73%） were on pTNM Ⅲ stage. Conclusions In recent years, cardia and antrum are the predilection sites of gastric cancer. Tubular adenocarcinoma and signet ring cell carcinoma are common which indicate that the mechanism of gastric cancer pathogenesis is varied.