早、中期胃癌临床特征的研究

Study on Clinical Features of Early Stage and Middle Stage Gastric Carcinoma

目的 :通过对早、中期胃癌病例的临床表现、胃镜、X线检查、手术和病理所见等综合性研究 ,找出早、中期胃癌的发病特点 ,提高胃癌的早期诊断率。方法 :从 2 0 4 6例经手术治疗的胃癌患者中筛选 2 0 7例早、中期胃癌进行回顾分析。结果 :2 0 7例中 ,早期胃癌发病率为 2 .2 0 % ,中期胃癌为 7.92 %。主要表现为上腹痛 ,主要体征为上腹压痛。 12 2例患者术前进行了胃镜及活组织检查 ,113例 (92 .6 % )确诊为胃癌。 12 7例术前进行了X线钡餐检查 ,10 3例 (81.1% )确诊为胃癌。术后病理发现 :(1) 4 4 .9%的早、中期胃癌生长在贲门部 ,38.6 %生长在胃窦部 ;(2 )肿瘤大小对于肿瘤浸润深度的判断有一定意义 ;(3) 71例(34.3% )发生淋巴结转移 ,13例 (6 .3% )有远处转移 ;(4)组织学类型以管状腺癌为主 (6 8.2 % )。结论 :早、中期胃癌好发于 5 0～ 70岁 ,男性多于女性 ,主要症状为上腹痛。胃镜及活组织检查对于早。

Objective: In order to find the features of early stage and middle stage gastric carcinoma and elevate the diagnosis degree of gastric carcinoma in early stage, we studied the clinical presentation,gastroscopy,X-ray barium series, operation and pathology of early stage and middle gastric carcinoma cases. Methods: We studied 207 patients with early stage and middle stage gastric carcinoma from 2046 patients with gastric carcinoma who had been treated with operation. Results: In 207 cases ,the incidence of early stage gastric carcinoma was 2.20% and the incidence of middle stage gastric carcinoma was 7.92%. The frequent symptom was epigastric pain and the frequent sign was epigastric tenderness.122 patients were performed with gastroscopy with biopsy before operation and 113 patients(92.6%) were diagnosed as gastric carcinoma . 127 patients were performed with X-ray barium series before operation and 103 patients(81.1%) were diagnosed as gastric carcinoma . The pathology features after operation showed①44.9% of the tumors were in the cardia and 38.6% in the gastric antrum;②tumor size had some significance in judging depth of tumor invasion;③71 patients(34.3%) had lymph node metastasis and 13 patients( 6.3 %)had distant metastasis;④ the most frequent histological type was tubular adenocarcinoma. Conclusion: early stage and middle stage gastric carcinoma had been found most commonly in patients 50 to 70 years of age. The numbers of male cases were more than female cases. The frequent symptom was epigastric pain. The degree of accuracy of gastroscopy with biopsy for the detection of early stage and middle stage gastric carcinoma is higher than that of X-ray barium series.