胃癌的病理形态与浸润深度的关系

Relationship between the Pathomorphology of Stomach Carcinoma and Its Infiltrating Depth

目的探讨胃癌的病理形态学指标与生物学行为之间的关系。方法收集本院自 1985年以来所做 2 5 5例胃癌手术根治标本 ,经肉眼检查后取样 ,常规切片 ,HE染色 ,部分病例加做VG及银染 ,光镜观察。分别观测其肿块大小、肉眼类型、组织学类型和癌组织的浸润深度 ,分析浸润深度与其他几项指标之间的关系。结果经秩和检验分析 ,证实癌的浸润深度与肿块的大小有一定的关系 ,<2 .0cm者和 >8.0cm者分别与其它几组比较 ,差异均具有显著性 (P <0 .0 5 ,P <0 .0 1) ;癌的浸润深度与肉眼观类型及组织学类型也有一定的相关性 ,浅表型和局限溃疡型分别与浸润溃疡型、结节型、弥漫浸润型比较 ,它们之间差异显著 (P <0 .0 1) ;管状腺癌、低分化腺癌与印戒细胞癌和未分化癌等其它类型比较 ,它们的浸润深度不尽一致 ,差别具有显著性 (P <0 .0 1)。结论浸润深度与癌的分化程度关系密切 ,分化差者 ,浸润得较深 ;随着肿块的增大 ,浸润深度有增加的趋势 ,但当肿块达到一定的大小时 ,浸润深度不再有差别。

Objective To explore the relationship between the pathomorphologic indexes and infiltrating depth of stomach carcinoma. Methods 255 Specimens of stomach carcinoma from radical gastrectomy since 1985 in our hospital were collected. After gross examination, the samples were taken for making routine sections stained with HE, partly with VG and argentation. All the slides were observed under light microscopy. The gross and histological types and infiltrating depth of lesions were determined respectively. The relationships between the infiltrating depth and other indexes were analysed. Results The rank sum test of the data showed that: In comparison with other groups, in groups where the tumors were<2.0cm or >8.0cm in diameter, there was a definite depth of tumors (P<0.05,P<0.01). There was a definite relationship between the infiltrating depth and the carcinoma types either macros-or microscopically. It showed obvious differences between the depths of superficial and local-ulcerative types and the infiltration-ulcerative, nodular and diffuse-infiltrative types respectively(P<0.01). Between the tubular and low-differentiated adenocarcinomas and the signet cell and undifferentiated carcinomas there was an obvious difference in respect of infiltrating depth too(P<0.01).Conclusion The infiltrating depth of stomach carcinoma closely relates to its differentiation: the poorer is differentiated degree, the deeper is infiltrating depth. The depth will gradually increase with the tumor size, but this relationship no more exists once the tumor has grown to a definite size.