早期胃癌胃镜下特征及病理特点

Gastroscopy and pathological features of early gastric cancer

目的探讨早期胃癌胃镜下特征及病理特点。方法随机抽取2015年8月至2018年12月侯马市人民医院收治的早期胃癌患者80例,均行胃镜检查,参考胃癌胃镜临床诊断标准、日本内镜学会早期胃癌分型标准进行镜下评定,提取病灶组织进行病理检查,并参考病理分类标准进行分型。结果80例早期胃癌患者临床症状以上腹隐痛(71例,占88.75%)为主要表现,其次是恶心、呕吐、上消化道出血,镜下分型情况由高到低依次为Ⅱ型(32例,占40.00%)、Ⅲ型(27例,占33.75%)、Ⅰ型(21例,占26.25%),病变部位情况由高到低依次为胃窦(68例,占85.00%)、胃体(52例,占65.00%)、胃角(41例,占51.25%)、贲门(29例,占36.25%)。早期胃癌病理特点以乳头状腺癌最常见(31例,占38.75%),其次是高分化管状腺癌、中分化腺癌、低分化腺癌、黏液腺癌、印戒细胞癌。结论早期胃癌临床症状不典型,胃镜下较易定位病灶及分型,胃镜下提取标本的病理结果可明确胃癌性质。

Objective To investigate the gastroscopy and pathological features of early gastric cancer diagnosed by gastroscope.Methods Eighty patients with early gastric cancer admitted to Houma People’s Hospital from August 2015 to December 2018 were randomly selected. All patients underwent gastroscopic, and were evaluated microscopically with reference to the clinical diagnosis criteria for gastric cancer and the classification criteria for early gastric cancer classification of the Japanese Endoscopic Society, the lesion tissue for pathological examination was extracted, and referred to the pathological classification criteria for typing.Results The 80 patients with early gastric cancer had abdominal pain above clinical symptoms (71 cases, accounting for 88.75%) as their main manifestation, followed by nausea, vomiting, and upper gastrointestinal bleeding. The type of microscopic classification was high in order from type Ⅱ (32, accounting for 40.00%), type III (27 cases, accounting for 33.75%), type I (21 cases, accounting for 26.25%), the position of the lesion from high to low was the gastric antrum (68 patients, accounting for 85.00%), (52 cases, accounting for 65.00%), gastric angle (41 cases, accounting for 51.5%), and cardiac (29 cases, accounting for 36.25%). Papillary adenocarcinoma was the most common pathological feature of early gastric cancer (31 cases, accounting for 38.75%), followed by highly differentiated tubular adenocarcinoma, moderately differentiated adenocarcinoma, poorly differentiated adenocarcinoma, mucinous adenocarcinoma, and signet ring cell carcinoma.Conclusions The clinical symptoms of early gastric cancer are atypical. It is easier to locate lesions and types under gastroscopy. The pathological results of specimens extracted under gastroscopy can clarify the nature of gastric cancer.