类似早期胃癌的进展期癌——附14例分析报道

ADVANCED CANCER SIMULITING EARLY GASTRIC CANCER——A REPORT OF 14 CASES

1981年以来,经手术及病理确诊类似早期胃癌的进展期癌14例,占同期手术切除胃癌的6.2％。发病部位以贲门部最多,占57.1％,内镜检查凹陷型(Ⅱ_c、Ⅲ+Ⅱ_c)5例(35.7％),隆起型(Ⅰ、Ⅱ_a)7例(50％),12例疑诊早期胃癌,2例诊断为慢性胃炎。病理组织学特点以低分化型腺癌最多,占64.3％,11例浸润至肌层,仅3例超过肌层,淋巴结转移亦较少。本病介于早期与进展期之间,预后较好。经随访2～8年,11例存活,3例死亡。

14 cases of Advanced Cancer Simulating Early Gastric Cancer (ACSEGC) were proved surgically and pathologically which accounted for 6.2％ of the resected gastric cancer during the same period. As to the location, the cardia was the most common region (57.1％). Among them 5 cases (35.7％) were pouch-type (Ⅱc. Ⅲ+Ⅱc), and 7 cases protrusion-type; 12 cases were misdiagnosed as early gastric cancer and 2 cases as gastritis under visual endoscopic observation. As to histology, there were more poorly differentiated adenocarcinomas (64.3％) . In most of cases, the infiltration to muscular layer was observed, and infiltration to serosa and subserosa was found only in 3 cases. Metastasis to the lymphonodes was less. ACSEGC is between early and advanced cancer, and prognosis was better. The follow-up study for 2—8 years revealed that 11 cases are survival and 3 dead.