贲门癌术前切除可能性的估计——附285例报告

Preoperation Evaluation for Cardia Cancer

目的 :探讨贲门癌 ,特别是晚期贲门癌的临床特点 ,术前较正确的估计手术切除的可能性 ,减少不必要的探查手术。方法 :回顾性分析 2 85例贲门癌手术患者 ,在无术前化疗及放射介入等治疗的情况下 ,对患者年龄、性别、临床表现、X线表现、病理检查及胃切除术后再复发贲门癌等方面进行分析。结果 :平均年龄 5 4岁以上者手术切除率较年轻者高 ,女性切除率达 90 %以上 ;吞咽困难时间在 5个月以内者高 ;X线示贲门区充盈缺损、黏膜破坏和中断、明显的胃体缩小、胃底广泛增厚、贲门或小弯部巨大的软组织阴影是晚期贲门癌的表现 ,切除机会少 ;病理诊断肿瘤的恶性程度越高 ,切除率越低 ;残胃贲门癌缺乏特异性症状 ,X线诊断困难。结论 :提高切除率的关键是早期诊断、及时正确的手术治疗和术前正确的估计手术切除的可能性 ,对术后患者采用综合性治疗措施提高了 5年生存率。

Objective To explore the clinical features of the cardia cancer,especially the advanced cardia cancer for preoperation evaluation.Methods Two hundred and eighty five operational cases of cardia cancer were analyzed retrospectively.Patients'age,sex,clinical manifestations,X ray findings,pathological types and the recurrent rate were included without preoperative chemotherapy and radiotherapy.Results The complete resection rate of elderly cases(>54 years)was higher than that of the young cases.The complete resection rate of females exceed 90%.The complete resection rate of later and high malignant cardia cancer was lower.Conclusions Early preoperation diagnosis and early operation is the key of improving the complete resection rate.Preoperation evaluation and comprehensive therapy after operation could increase survival rate. China J Cancer Prev Treat,2003,10(5):514-515