54例早期胃癌术后临床病理分析

Clinico-pathological Analysis of 54 Cases of Early Gastric Carcinoma

本文报告手术治疗早期胃癌54例,Ⅰ型5例;Ⅱ、Ⅲ各6例,Ⅱ19例、Ⅲ1例、Ⅱ+Ⅲ1例、Ⅱ+Ⅱ4例;Ⅲ型12例。54例均作R_2术式,7例有淋巴结转移,第1站转移率为12.96％,第站转移率为3.7％.随访率100％。5年生存率为94.5％,其中粘摸内癌5年生存率100％.粘膜下癌为87.5％。本文着重讨论早期胃癌诊断应重视癌前病变的纤维胃镜随访观察。对早癌的手术治疗.术前如能确定为粘膜内癌.可行R1术式。否则以R2术式为宜。

A reltospective study of 54 patients with early gastric carcinoma(pT 1 )who underwent surgical resection at our de-Dartment from 1977 to 1988 was presented. The location ,size,symptom duration,clinical symptoms,preoperative exami-nation,operative modality lymphnode status,pericancerous lesion and pathological type were evaluated. The 5-year survival rate was 94.5%. The group of early gastric carcinoma accounted for 9.8% of the total number of cases of gastric carcinoma admitred during the period 1987-1988. It is important to pay more attention to the non-specific symptoms of the digestive system,to the follow-up of the precancerous lesion,and preferably gastroendoscopic findings conducted at regular intervals in order to discover early gastric carcinoma. A careful examination should be given to such cases so as not to miss multifocus and superficial diffuse type of carcinoma both before and during the surgical operation. A pathological frozen section is recommended for a clear margin in some cases. A R2 radical procedure is required unless intra mucous carcinoma is confirmed under which circumstance a R1 procedure is advisable.