早期胃癌临床病理特征与浸润深度的关系

目的探讨早期胃癌临床病理特征与浸润深度的关系,为早期胃癌个体化治疗的选择提供依据。方法回顾性分析2008年1月-2013年1月经外科手术及术后病理证实18例早期胃癌患者的临床、病理资料,对其年龄、性别、有无消化道出血、有无幽门螺杆菌感染及肿瘤部位、大小、内镜分型、分化程度与肿瘤浸润深度的关系进行单因素分析。结果 18例早期胃癌患者中,黏膜下层浸润9例,其中淋巴结转移3例;黏膜内癌9例,均无淋巴结转移。病理类型为未分化型9例,其中癌细胞浸润至黏膜下层7例,伴淋巴结转移3例;分化型9例,仅有2例浸润至黏膜下层,但无淋巴结转移。患者性别、年龄、肿瘤部位、大小及有无幽门螺杆菌感染与浸润深度无关（P〉0.05）,内镜分型为Ⅲ型提示黏膜下浸润可能性大（P〈0.05）。结论内镜下大体分型为Ⅲ型的早期胃癌,因多有黏膜下层的浸润,淋巴结转移率高,不适合内镜下治疗。

Relationship between Clinicopathological Characteristics and Invasion Depth of Early Gastric Cancer

Objective To investigate the relationship between clinicopathological characteristics and invasion depth of early gastric cancer（EGC）, in order to put forward suitable regimens for EGC with different clinicopathological characteristics. Methods The clinicopathological data of 18 patients with EGC diagnosed from January 2008 to January 2013 were retrospectively analyzed. Clinicopathologic variables such as age, gender, tumor size and location, Helicobacter pylori infection, melaena, macroscopic type, and histopathological type were investigated by using chi-square test for their possible relationship with the depth of invasion. Results Lymph node metastasis was more common in patients with submucous cancer（3/9, 33.3%） than in those with mucous cancer（0/9, 0%）. Submucosal invasion was found in 77.8%（7/9） of undifferentiated adenocarcinoma cases, whereas only 22.2%（2/9） of differentiated adenocarcinoma had submucosal invasion. Type Ⅲ EGC had a significant association with submucosal invasion（P 〈 0.05）. Conclusion Endoscopic treatment is unsuitable for patients with Type Ⅲ EGC.