摘要
目的 探讨残胃癌的临床及病理特点。方法 对 43例残胃癌临床病理资料进行回顾性分析。结果 43例残胃癌患者临床症状以腹痛、腹胀、黑便、吞咽困难为主要表现 ;首次手术方式 :胃切除毕Ⅱ式吻合 32例 ( 74.4% ) ,胃切除毕Ⅰ式吻合 11例( 2 5 .6% ) ;距首次手术发生残胃癌时间为 5～ 2 5年 ,平均 12年 ;发生部位 :残胃吻合口 2 5例 ( 5 8.1% ) ,残胃贲门 15例 ( 34 .9% ,其中3例同时侵犯食管下段 ) ,残胃小弯侧癌 3例。组织学类型 :高分化腺癌 6例 ( 13.9% ) ,中分化腺癌 6例 ( 13.9% ) ,低分化腺癌 2 1例( 48.8% ) ,未分化癌 6例 ( 13.9% ) ,黏液腺癌 4例 ( 9.3% )。 2 5例出现邻近脏器、组织 (肝、胰、脾、肠系膜、网膜 )转移 ( 5 8.1% ) ,无转移者 18例 ( 41.9% ) ,其中 5例癌组织局限在黏膜层及黏膜下层。结论 残胃癌多发生于胃切除毕Ⅱ式吻合术后 ,胃大部切除术后定期随访 ,必要时做胃镜检查及病理活检可早期发现残胃癌 ,有效的治疗能延长残胃癌患者的生存期。
Objective To study the clinico pathological characteristics of gastric stump cancer.Methods The clinical and pathologic data of 43 patients with gastric stump cancer were analyzed.Results The melena and difficulty of swallow were as the chief complaint.32 patients have been operated of Biluoshi 2,11 patients have been operated of Biluoshi 1.There was an interval of 5～25 years from operation to recurrence(average 12 years).25 patients with gastric stump cancer on anastomatic opening,15 on cardia, among them 3 cases have been invaded on the lower part of esophagus also.Histology types:6 cases had high differentiated adenocarcinoma,6 cases middle differentiated adenocarcinoma,21 cases low differentiated adenocariaoma,6 cases non differentiated adenocarcinoma,4 cases mucous adenocarcinoma.25 cases of gastric stump cancer had metastasis of organs nearby.13 cases didn′t have metastasis 5 cases had only submucosa invaded.Conclusion Gastric stump cancer mainly occurre after operation of biluoshi 2.Postgastrectomy patients should be regularly examined by gastroscope and biopsy for early diagnosis of the gastric stump cancer. The effecfive treatment methods is the key of prolonging life.
出处
《实用癌症杂志》
2002年第2期199-200,共2页
The Practical Journal of Cancer
