胃溃疡癌组织学诊断标准的探讨

通过对良、恶性胃溃疡的系列切片观察,证明修改后的Hauser标准对诊断溃疡癌是基本适用的,但尚不能将进展期溃疡癌与癌溃疡区分。本文观察到山峰状疤痕为早、晚期溃疡癌共同的组织学特征,凭此可检出进展期溃疡癌。为便于区分,建议胃溃疡癌的诊断标准为:①将溃疡做不同方位“＊”形多切片,证明溃疡周围1cm以内粘膜无癌灶,以除外溃疡与先在的癌碰合的可能性。②溃疡底全层由山峰状疤痕所代替,其中既无癌浸润亦无肌残留,常见厚壁血管、神经纤维增生和神经节细胞变性。③溃疡周边多见粘膜肌与肌层靠近甚至融合。④癌以早期或进展期状态存在于溃疡一侧、周边或侵至山峰状疤痕底部。     

胃溃疡癌44例临床病理分析

胃溃疡癌是指在良性胃溃疡基础上发生的癌变。这一概念尚存着争议。本文报告44例,并进行分析和讨论。 临床资料 我院外科自1971—1986年来,胃切除标本经病理检查认定为胃溃疡癌者44例,占同期外科胃癌住院病人的15.6％,占胃溃疡病人总数的12.3％。男性30例,女14例,男女比2.14∶1。年龄最小20岁,最大72岁,平均53.9岁。男性平均年龄52.5岁,女性57.2岁。均     

胃癌胃溃疡并存9例

胃癌、胃溃疡并存罕见,近年国内仅见零星报道,我院到1990年为止共诊断9例,报道如下。 临床资料 本组男6例,女3例;年龄19～70岁;病程1个月至3年,平均8个月。9例均有上腹痛,反酸2例,嗳气6例,呕吐3例,消瘦5例,1例有上消化道出血史。     

胃肿瘤误诊为胃溃疡八例报告

胃粘膜活检组织学上见有炎性坏死组织常被诊断为胃溃疡,实际上某些具有溃疡组织特征的病例常伴有其他疾病。本文报告胃肿瘤误诊为胃溃疡8例,旨在探讨、分析其误诊原因,以期提高对疾病诊断的正确率。1　材料和方法　　本文收集我院1996年1月～1997年10月60例经胃镜活检,病理检查曾诊断为胃溃疡的病例,后经手术、特殊染色及免疫组化证实为胃肿瘤者8例。免疫组化试剂由福州迈新生物公司提供:即用型单克隆抗体,采用SP法。2　临床资料2.1　本组男性35例,女性25例,平均年龄45岁(23～67岁),多数病人有上腹部疼痛、返酸、呕吐和身体消瘦等症状。2.2…     

胃癌细胞的DNA倍体与组织学类型和预后的关系

流式细胞分光光度术(Flow cytometry,FCM)是近年发展起来的定量分析细胞学新技术,已广泛用于恶性肿瘤的诊断,特别是石腊包埋组织制备单细胞悬液方法的建立,使FCM在肿瘤诊断及回顾性研究中的应用更加广泛。本文目的是用FCM测定胃癌石腊包埋组织的细胞DNA倍体并观察病理组织学类型及预后之间的关系。     

烧伤疤痕癌病理组织学观察

本文对5例烧伤疤痕癌从组织结构和细胞分化方面进行了较详细的观察,看到假上皮瘤性增生向癌的移行过程,癌组织从病变浅层到深层由高分化向中分化、低分化的演变过程。对鳞癌的组织学分级提出以Ⅰ、Ⅱ、Ⅲ级为基础并分别以a、b、c标出其分化程度。对假上皮瘤性增生与高分化鳞癌的鉴别进行了探讨,并对疤痕癌与预后的关系进行简要讨论,同意Engler认为要比一般皮肤癌更具有恶性度的观点。     

胃癌间质病理组织学临床特点（附9例临床分析）

目的 观察胃癌间质病理组织学的变化规律。方法 光镜下、ＨＥ染色，观察胃癌术后病理间质状况。结果 胃癌间质主要以淋巴细胞为主，浆细胞次之。粘液癌巢内基本上无炎性细胞浸润。胃癌粘膜下层、肌层可见淋巴细胞，但无生发中心。     

胃癌与胃溃疡病人血液及胃液中癌胚抗原（CEA）的定量研究

应用放免的方法对２１７例肠型胃癌，２５例胃溃疡病人分别于手术前，后测定胃液及血液中的ＣＥＡ含量。结果表明：（１）手术前，后胃液中的ＣＥＡ均高于血液中的ＣＥＡ含量（Ｐ＜０．０１）。（２）胃癌组手术前血液及胃液中ＣＥＡ含量分别高于胃溃疡组手术前血液及胃液中ＣＥＡ含量（Ｐ＜０．０１）。（３）在胃癌组中手术前血液ＣＥＡ阳性率为３３．３３％，而胃液ＣＥＡ阳性率为６３．６３％（Ｐ＜０．０１）。因此，对胃癌病人     

胃十二指肠血吸虫病与癌肿发生关系的初探

本文报道30例胃十二指肠血吸虫病合并胃癌,均为手术病理证实。主要从组织学方面进行分析。其中胃窦部28例窦贲门部2例。癌灶处虫卵沉积为33.3％(10/30),十二指肠切缘处为66.7％(20/30)。虫卵均已钙化。癌灶处虫卵周围未见癌变的移行过渡现象,故虫卵诱发癌肿之说,证据不足。十二指肠处虫卵周围无特异性变化,提示十二指肠并未因虫卵沉积而使癌肿发生率增多。推测虫卵只有在其它因素参与下才有可能诱发癌肿。因胃血吸虫病与胃癌的好发部位相同,二者关系有待进一步探讨。十二指肠血吸虫病合并胃癌可认为是偶然并存。     

Second Primary Cancer after Diagnosis of Stomach Cancer in Osaka, Japan

The risk of developing a second primary cancer following stomach cancer was estimated from data accumulated in the Osaka Cancer Registry. Of the 38,777 male patients and 22,391 female patients newly diagnosed in the period 1966–1986 who were followed up until the end of 1986, 778 and 267 developed a second cancer other than stomach cancer, respectively, whereas the expected numbers had been 928.8 (RR=0.84, 95%CI=0.78-0.90) and 297.7 (RR = 0.90, 95%CI = 0.79-1.01). The risks were higher among younger patients (aged 30–54 at the diagnosis of stomach cancer) than among older patients (aged 55–69 at the diagnosis of stomach cancer). Significantly elevated risks were observed for cancers of the oral cavity & pharynx (RR=l.56), colon (RH = 1.61) and rectum (RR = 1.56) for males, and oral cavity & pharynx (RR = 2.59) for females as second cancers. Results were substantially similar among the localized stomach cancer patients. Among younger male patients with gastrectomy, the risk of developing pancreatic cancer was elevated 10 or more years after stomach cancer diagnosis. The present study suggests the necessity of following up stomach cancer patients in order to enable the early diagnosis of digestive tract cancer.     

Atrophic Gastritis and Stomach Cancer Risk: Cross-sectional Analyses

The relationship between atrophic gastritis and stomach cancer risk was investigated in case-control analyses involving 387 cases with stomach cancer and 5,422 control subjects who received gastroscopic examination at Aichi Cancer Center Hospital from April, 1985 to March, 1989. The presence of atrophic gastritis, the degree and extension of the atrophy and the presence of granularity and erosion were diagnosed endoscopically by six gastroenterologists. The prevalence of atrophic gastritis increased with age and was higher in males than in females. The relative risk (RR) of stomach cancer was S.13 (95% confidence interval (CI): 2.79–9.42) if a subject had any type of atrophic gastritis. The risk further increased with advancing degree of atrophy and increasing extension on the greater and lesser curvatures. The RR associated with severe atrophy was 7.73 (95% CI: 3.95–15.12). These associations remained significant when analyzed by sex and age. The presence of granularity and erosion did not much affect the estimated risks. A clear difference in risk appeared in the analyses by histological type of cancer. The RR associated with atrophic gastritis was 24.71 (95% CI: 3.46–176.68) for the intestinal type and 3.49 (95% CI: 1.77–6.87) for the diffuse type. These findings may suggest a need for intensive follow-up of patients with severe atrophic gastritis.     

胃癌胃粘膜形态、DNA、cAMP、微量元素改变的临床与实验研究

本文检测67例脾虚证胃病患者胃粘膜超微结构、肠化生亚型、DNA、cAMP、微量元素及其氧化物如~3H TdR LcT,发现不完全性结肠型肠化生率、非病灶处“背景病变”发生率随着脾气虚证至脾虚气滞证、良性胃病至胃癌的顺序递增.组间均有显著性差异.P<0.05～0.001。胃粘膜不完全性结肠型肠化生组织内DNA、cAMP、Zn、Cu、ZnO与CuO含量与胃癌组织间无显著性差异。认为脾虚气滞证胃病伴不完全性结肠型肠化生,及cAMP、Zn、Cu、ZnO与CuO含量降低,而DNA含量异常增高时,有癌变倾向。     

全胃切除术30年经验总结（附89例报告）

本文通过89例全胃切除的临床资料分析。总结了我院近30年全胃切除的经验体会。对如何掌握手术适应症、胃周淋巴结的清除以及消化道的重建方式等提出自己的见解,通过分析对比5种消化道重建的方式,认为“9”字形空肠代胃优点居多。随着外科手术经验的积累和其它有关方面的进展,全胃切除由过去较为保守态度转为积极态度,5年治愈率逐渐提高,而手术死亡率及合并症、术后远期后遗症相应下降。     

胃癌多药耐药细胞株的建立及其生物学特征

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Isolation of an Amplified DNA Sequence in Stomach Cancer

By use of the in-gel DNA renaturation method, the presence of amplified DNA sequences was demonstrated in KATO-III, a cell line established from a signet ring cell carcinoma of the stomach. A DNA fragment from one of these amplified regions in KATO-III cells was cloned and designated SAM_0.2; the locus containing the SAM_0.2 fragment was referred to as SAM. The SAM locus was shown to be amplified not only in KATO-III cells, but also in three of 24 surgical specimens of stomach cancers and in two of 13 xenografts of human stomach cancers, all of these specimens being poorly differentiated adenocarcinoma or mucinous adenocarcinoma of the stomach. The SAM locus was not amplified in 14 cell lines of cancers of other organs or in 42 surgical specimens of lung cancers.     

Comparison of the Anatomic Distribution of Stomach Cancer and Precancerous Gastric Lesions

The anatomic distribution of precancerous gastric lesions among 3,400 residents in Linqu, Shandong Province of China, was compared with the anatomic distribution of stomach cancer (SC) among 959 patients in Tokyo, Japan. The incidence of SC is high in both areas, and locations within the stomach of the precancerous and malignant lesions were classified using similar criteria. Chronic atrophic gastritis (CAG) affected 98% of the population in Linqu, with intestinal metaplasia (IM) the most severe diagnosis in 33% and dysplasia (DYS) in 20%. Neither the SC nor precancerous lesions were uniformly distributed in the stomach. Among the DYS 3% were along the greater curvature of the body, 15% along the lesser curvature of the body, 25% in the angulus, 22% along the lesser curvature of the antrum, and 34% elsewhere in the antrum. Among the SC the corresponding percentages were 2, 16, 28, 25 and 29. The similarity to the SC distribution increased gradually from CAG to IM to DYS, providing further evidence for the multistage progression of precancerous gastric lesions.     

抑癌蛋白与胃癌细胞增殖和凋亡的关系

为了探讨抑癌蛋白对胃癌细胞增殖和凋亡的影响，以阐明胃癌恶性生长的可能机理，选择８８例手术切除的胃溃疡和胃癌的蜡块标本，将ＢｒｄｕＴＰ掺入到ＤＮＡ的断端，结合抗Ｂｒｄｕ抗体放大信号，再用免疫组化的方法检测组织中的凋亡细胞。同时采用免疫组化方法检测这些组织中的ｐ２１、ｐ５３及ＰＣＮＡ的表达。结果显示，胃癌组织中的细胞增殖水平高而凋亡细胞减少。癌巢中很少有凋亡细胞。胃溃疡组织中凋亡的细胞明显多于胃癌组织。ｐ５３蛋白在胃癌中的检出率为３８．０％。ｐ２１蛋白在胃粘液腺癌及低分化、未分化型腺癌中检出率很低。结果表明，尽管胃癌组织中发现抑癌基因ｐ５３突变蛋白的表达水平增高，但并不能促使胃癌细胞的增殖，却可以增加癌细胞的凋亡。胃粘液腺癌和低分化、未分化型腺癌的抑癌蛋白ｐ２１的表达水平低下可能是该类癌细胞过度增生的原因之一。胃癌细胞凋亡机制障碍和增殖失控是胃癌细胞增生失控的基础