中国医学科学院学报2011，Vol.33Issue(3)：325-329,5.DOI:10.3881/j.issn.1000-503X.2011.03.022
166例早期胃癌的诊治分析
Diagnosis and Treatment of 166 Patients with Early Gastric Cancer
李小毅 1王常珺 1钟定荣 2高维生 1刘洪沨1
作者信息
- 1. 中国医学科学院,北京协和医学院,北京协和医院基本外科,100730
- 2. 中国医学科学院,北京协和医学院,北京协和医院病理科,北京,100730
- 折叠
摘要
Abstract
Objective To summarize our experiences in the diagnosis and treatment of early gastric cancer (EGC). Methods The clinicopathological data of the 166 EGC inpatients who were treated in our hospital from January 1999 to January 2009 were retrospectively analyzed and their treatment outcomes were followed up. Results Surgical treatment for ECG accounted for 9.04％ ( 176/1946 ) among all the surgeries performed for gastric cancers. Among the analyzed 166 cases, 9 asymptomatic patients were diagnosed by routine examination, 29 ( 17.47 ％ ) had a history of gastric ulcer or chronic gastritis, and 20 ( 12.05％ ) had a family history of esophageal or gastric cancer. Of 64 patients who received double-contrast gastric X-ray examination, 57 patients (89.06％) were found to be with abnormalities. Endoscocpy revealed lesions in lower third, middle third, and upper third of the stomach in 115 patients (69.28％), 26 patients ( 15.66％ ), and 25 patients ( 15.06％ ) , respectively. A total of 126 patients received DO or D1 operations and 40 patients received operations more than D1+ operation. As shown by post-operative pathological examinations, the mean diameter of the lesions was (2.52 ± 1.62) cm; 75 patients (45.18％) had mucosal gastric cancer, 91 (54.82％) had submucosal gastric cancer, 20 patients with submucosal gastric cancer had lymph node metastasis, and 8 patients had lymphatic vessel involvement. The overall 5-year survival rate was 70.0％ and 89.7 ％ among patients with or without lymph node metastasis (P= 0. 002) . Univariate analysis revealed that depth of tumor invasion (submucosa) and lymphatic vessel involvement were significantly correlated with lymph node metastasis ( P =0. 000, P =0.001 ). Multivariate analysis showed that lymphatic vessel involvement was significantly correlated with lymph node metastasis (odds ratio: 15.67; 95％ confidence interval, 3.40-72. 14). Conclusions The proportion of EGC patients undergoing gastrectomy is relatively low among all gastric cancer patients. Lymph node metastasis is a key prognostic factor for EGC. A proper staging of gastric cancer, a precise evaluation of the depth of infiltration, and appropriate and standardized treatment are important to improve the outcomes.关键词
早期胃癌/诊断/治疗Key words
early gastric cancer/ diagnosis/ treatment分类
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李小毅,王常珺,钟定荣,高维生,刘洪沨..166例早期胃癌的诊治分析[J].中国医学科学院学报,2011,33(3):325-329,5.
