11例外生型胃癌的临床病理特征及诊治分析

Clinicopathological characteristics,diagnosis and treatment of 11 patients with exophytic cancer of the stomach

目的探讨外生型胃癌的临床病理特征、诊断、治疗及预后。方法回顾性分析2010年1月至2022年2月11例外生型胃癌患者的临床资料,对一般资料、CT影像学及胃镜表现、病理特征、治疗和预后进行分析。结果11例患者中,男性6例,女性5例;中位年龄68岁;初诊时上腹痛为常见临床表现;腹部增强CT表现为凸出于胃壁外生长的肿块,肿块中央可观察到低密度灶、坏死,3例患者的肿块位于胃窦、胃体部,5例位于贲门、胃体部,3例位于胃体部。10例患者接受了胃癌根治性切除术,术后病理提示淋巴结转移3例;5例行术后辅助化疗。4例患者的生存时间小于1年,6例无病生存时间超过3年。结论外生型胃癌较罕见,通过症状、影像学检查难以与胃黏膜下肿瘤鉴别。外生型胃癌淋巴结转移率不高,对化疗不敏感,根治性手术切除是改善患者预后的重要手段。

Objective To investigate the clinicopathological manifestations,treatment and prognosis of exophytic cancer of the stomach.Methods The clinical feature,computed tomography(CT)and endosocpic findings,pathology,diagnosis,treatment and prognosis of 11 patients from January 2010 to February 2022 were retrospectively analyzed.Results Of the 11 patients,6 were male and 5 were female.The median age was 68 years.Abdominal pain was the most common clinical manifestation.CT scan showed that masses lay beyond the confines of the stomach with internal low destiny representing necrosis.Three cases located in the antrum body,5 cases located in the cardia body,and 3 cases located in the body.Ten patients received partial or total resection of the stomach.Of the 10 patients who underwent surgery,3 patients had lymph node metastasis,and 5 patients received postoperative adjuvant chemotherapy.Four of 11 patients survived less than 1 year,and there were 6 cases with disease-free survival of more than 3 years.Conclusion The exophytic growth of gastric cancer is rare,it may be confused with submucosal tumor.The degree of lymph node metastasis is low.It is insensitive to chemotherapy,and radical surgical resection is an important method to improve the prognosis of exophytic growth of gastric cancer.