甘肃省河西地区33年胃镜检出胃癌的流行病学分析

目的探讨甘肃省胃癌高发区近33年经内镜检出胃癌的流行病学特点,为该疾病的预防和控制提供科学的依据。方法选择甘肃省河西地区36所医院33年间胃镜检出并经病理确诊的胃癌患者病历资料。对其主要的内镜下改变、临床及组织学特点进行回顾性分析。结果33年来甘肃省河西地区胃癌总检出率为5.57%,胃癌高发于50~69岁,男性多见,好发于贲门、胃体及胃窦部,且以低分化腺癌为主,武威地区检出率最高（6.39%）。结论甘肃省河西地区33年中胃癌检出率呈逐年下降趋势,早期胃癌的检出率较低,在当地开展胃癌早期防治意义重大。     

120例胃癌临床和病理分析

我院自1982年4月至1987年2月,对2400例胃病患者进行了胃镜检查,经病理检查和手术确诊为胃癌者120例,检出率为5%,其中贲门癌20例,占胃癌16%;早期胃癌4例,占胃癌3.3%,本文重点对贲门癌和早期胃癌进行分析。     

上海、洛阳两地胃癌发生部位分析

目的　比较上海、洛阳两地胃癌的发生部位、年龄分布有何异同。方法　选择上海市新华医院和洛阳市第一人民医院 1998年到 1999年门诊胃镜检查病人为统计对象。胃镜影像和病理细胞学结合诊断胃癌 ,按胃癌发生部位分为 :贲门胃底部癌、胃体部癌、幽门窦部癌。同时用HE银染法检查胃癌病人的幽门螺杆菌感染情况。结果　洛阳市第一人民医院在选择时间段内 ,检出胃癌 115例 ,贲门癌 47例 ,胃体部癌 43例 ,胃窦部癌 19例 ,其它 6例 ;上海新华医院查出胃癌 91例 ,贲门癌 18例 ,胃体部癌 3 4例 ,胃窦部癌3 3例 ,其它 6例。两地胃癌发生部位比较 ,有显著差异 ,P <0 0 5。随年龄增长贲门胃底部癌所占比例从 15 %上升到 3 6 7% ,而胃窦部癌所占比例从 5 5 %下降到 2 5 %左右。两地胃癌病人HP感染情况相似 ,胃窦 -胃体部癌HP阳性率明显高于贲门部癌。结论　胃癌的发生部位有显著的地区特点、年龄特点、时期特点。上海市胃窦部癌较贲门部多见 ,洛阳地区贲门部癌较胃窦部多见 ;随年龄增长 ,贲门部癌比例增高 ,胃窦部癌比例减少 ;在过去 2 0年到 3 0年之间 ,贲门部癌呈上升趋势 ,胃窦部癌呈下降趋势。HP感染与胃窦 -胃体部癌关系密切相关。不同部位胃癌发生病因可能不同     

胃癌高发区武威市胃癌检出及趋势分析

[目的]探讨胃癌高发区武威市胃癌检出情况及可能的演变趋势。[方法]收集整理1997年1月～2006年12月底胃镜检查病历、临床资料及病理诊断结果。研究对象为胃癌,将胃癌区分为贲门癌,非贲门胃癌,多部位癌和残胃及吻合口癌。对性别、年龄、病变部位及其演变趋势进行分析。[结果]10年间胃镜检查20304例,经病理学证实的胃癌2511例,胃癌的平均年检出率为12.4%。贲门癌962例(38.3%)、非贲门胃癌1380例(55.0%)。分析10年间胃癌发生部位—时间趋势预测,贲门癌(P<0.01)和胃体癌(P<0.01)呈上升趋势,而胃窦癌(P<0.01)和胃角癌(P<0.01)则呈下降趋势。男性1973例,女性538例,男女之比为3.67﹕1。男女之比在贲门癌与非贲门胃癌,近端胃癌与远端胃癌之间具有显著性差异(P<0.01)。50～69岁1958例,占总检出数的78.0%;贲门癌中位年龄为62.6岁,非贲门胃癌为58.3岁,具有显著性差异(P<0.01)。[结论]武威市胃癌检出较高,贲门癌发病呈上升趋势,胃窦癌则呈下降趋势;男性贲门癌显著高于女性;且贲门癌的发病年龄显然高于非贲门胃癌。     

120例胃癌临床和病理分析

我院自1983年4月至1987年2月,对2400例胃病患者进行了胃镜检查,经病理检查和手术确诊为胃癌者120例,检出率为5％。其中贲门癌20例,占胃癌16％;早期胃癌4例,占胃癌3.3％。本文重点对贲门癌和早期胃癌进行分析。     

2006~2020年1025例早期胃癌临床病理学特征及年代变化趋势分析

目的;分析1025 例早期胃癌患者的临床病理学特征及 15 年来的年代变化趋势,以期为早期胃癌的人群研究提供参考。方法∶收集巴中市中心医院2006 年1月至2020年12 月诊断的早期胃癌病例,回顾性分析患者的临床病理特征资料,采用卡方检验分析不同人口学因素、不同年代与各临床病理特征间的关系。结果∶166 260 例行胃镜检查患者中,共检出胃癌患者4 846 例,检出率为2.91%,早期胃癌患者1 025 例,早期胃癌检出率为0.62%,早期胃癌占全部胃癌比例 21.2%。男性检出率明显高于女性（0.78% s 0.44%;x²=78.924,P<0.001）。早期胃癌检出率的年龄分布中,<40岁、40～49 岁、50～59 岁、≥60 岁4个年龄组的检出率分别为0.20%,0.48%,0.60%, 0.92%,胃癌的检出率随着年龄增长而增加,差异有统计学意义（xas= 191.635,P<0.001）。临床病理特征分布∶肿瘤最大径≤2cm者占64.20% 、肿瘤浸润至黏膜层638 例（62.24%）、分化型611 例（59.61%）、合并溃疡者467 例（45.56%）、胃窦（48.00%）、胃体（30.73%）、贲门/胃底（21.27%）、肿瘤标记物检测阳性 182 例（17.16%）、淋巴结转移 174 例（16.98%）、幽门螺杆菌检测阳性 127 例（12.96%）、神经侵犯99 例（9.66%）、脉管浸润44 例（4.29%）。近 15 年来胃镜检查早期胃癌的检出率呈逐年上升趋势。2010 年代以后增加明显,年代变化趋势分析发现≤2 cm 小胃癌的检出例数及构成比逐年增加,差异有统计学意义（P<0.001）;早期胃癌未伴淋巴结转移的检出数量和比例逐年增加（P=0.003）,黏膜内癌的检出比例逐年上升（P=0.007）。结论∶早期胃癌检出率逐年升高,直径≤2 cm 胃癌、黏膜内癌、未出现淋 巴转移早期胃癌检出率升高。     

河北省食管癌和胃癌高发区居民胃癌发生部位的变化及趋势分析

目的 探讨河北省食管癌和胃癌高发区居民胃癌发生部位的变化.方法 回顾性分析1993-2006年河北省食管癌高发区磁县和胃癌高发区赞争县伞部首诊为胃癌的4334例患者的临床资料,比较不同地区、不同年份、不M性别和不同年龄患者贲门、胃体和胃窦部位胃癌的构成比,分析当地胃癌发生部位的变化及趋势.结果 两地伞部旨诊胃癌患者巾,贲门癌占68.0%,明显高于胃体痛(24.2%)和胃窦癌(7.9%;X2=124.396,P＜0.0001).1993-2006年间,贲门痛在胃癌中所占的比例呈逐渐增高的趋势.磁县患者中,贲门癌所占的比例为71.2%,明显高于赞皇县(51.2%;X2=109.648,P＜0.0001).磁县贲门癌比例逐渐增多的同时,胃体癌比例呈逐渐减少的趋势;而赞争县胃癌构成比的变化主要体现在胃窦癌逐渐减少.性别对胃癌发生部位的变化无明显影响;但不同部位胃癌患者的年龄构成比存在着差异(X2=58.380,P＜0.0001),其中＜50岁组胃体癌所占的比例在所有年龄组中最高,为34.2%,而贲门癌在61～70岁组中所占的比例最高,为71.6%.结论 贲门是河北省胃癌高发区磁县和食管癌高发区赞皇县居民胃癌发生的主要部位.在流行病学因素不变的条件下,磁县胃癌患者中,贲门痛的构成比将继续上升,胃体癌的构成比将继续下降;而赞皇县患者中,胃窦癌的构成比将继续下降.     

早期胃癌1 61例的临床及预后研究

目的研究早期胃癌的临床特点及影响其预后的因素.方法对161例早期胃癌的临床特点和15年的随访结果加以统计和分析.结果早期胃癌的临床表现无特异性,内镜检查有明显优势,其中小胃癌19例,微小胃癌5例,一点癌1例.部位以贲门最多89例(59.28%)依次为胃体部、胃角部和胃窦部,粘膜内癌和粘膜下癌的五年以上生存率分别为98.36%、77.55%.结论早期胃癌的预后仅与其浸润深度相关,而与肿瘤的生长部位,肉眼分型和组织学类型无关,故对有消化系症状人群作内镜检查是改善早期胃癌预后的关键措施.     

41例早期胃癌内窥镜及临床诊断分析

  目的 分析早期胃癌的内窥镜下表现及临床特点，提高早期胃癌的诊断率。方法 总结1986年至2005年5月经手术证实的早期胃癌41例临床资料。结果 41例均经术前胃镜及术后病理证实为早期胃癌。病灶分布以窦部和胃角部为主，占73.2 ％（30／41）。病理示低分化腺癌16例占39.0 ％，管状腺癌11例占26.8 ％。Hp阳性率92.3 ％（24／26）。结论 早期胃癌Ⅱc和Ⅲ型病变多见。胃窦部和胃角部是胃癌好发部位。胃镜检查加黏膜多点活检是早期胃癌的主要确诊手段，Hp感染与早期胃癌关系密切。     

桂西少数民族地区332例胃癌内镜病理分析

目的：探讨胃癌的内镜及病理特点。方法：回顾性分析本院经胃镜检查并经病理确诊的胃癌患者临床资料。结果：胃癌检出率为1.4％（332/23545），男女之比为2.8：1。BorrmannⅢ型胃癌最常见，发病部位以胃窦为主，占46.7％。组织学类型以高分化腺癌占大多数。病理特点在各年龄组及不同性别之间有明显差异（P＜0.05）。结论：本地区胃癌以中老年为主，年龄、性别与胃癌的内镜分型、组织学类型及癌细胞分化程度有关，对不同类型的病人应根据其内镜及病理特点提高胃癌的检出率。     

The role of gastric mucosal dysplasia in the development of Gastric Carcinoma

It is widely acknowledged that most stomach carcinomas developed from dysplastic lesions of gastric mucosa. They can be found in known precancerous conditions as chronic gastritis, gastric adenoma, giant rugal hypertrophy, chronic peptic ulcer, gastric stump after partial resection and pernicious anemia. Several grading systems of gastric dysplasia have been suggested. Nagayo’s or the ISGGC classification was applied to 367 biopsy specimens of 258 patients between 1979–1995. The frequency of moderate and severe dysplasia was 0,84% regarding all gastric endoscopies in the same period of time. Follow-up studies were performed in 56 cases in a period of 1–7 ys. In this group cancer developed during 14 patients. The authors’ recommendation is to follow up the patients gastric dysplasia for least 10 ys after with diagnosis. In memoriam dr. Albert I FIGUS     

人体胃液内真菌还原硝酸盐作用的研究及其意义

目的研究人体胃液内所带真菌是否具有还原硝酸盐的作用,从而探讨人类胃癌病因中,真菌因素的可能作用及作用机理.方法对正常8例,浅表性胃炎(CSG)26例,萎缩性胃炎(CAG)22例,胃溃疡(CU)18例,胃癌(GC)19例,共93份胃液进行真菌培养和pH值及硝酸盐、亚硝酸盐含量的测定,并对分离出的真菌进行了还原硝酸盐作用的实验.结果胃液真菌"污染"的情况较严重,不同的pH值范围内,胃液真菌培养的阳性率无明显差异,各种胃病患者的胃液内,真菌的阳性率与正常对照也无差异,但是具有还原硝酸盐作用的真菌的阳性率和胃液中亚硝酸盐的含量,GC组高于CSG组.结论胃内真菌可通过还原硝酸盐为亚硝酸盐而与胃癌有关.     

Factors influencing survival in 242 cases of primary gastric carcinoma

Two hundred and forty-two patients who underwent curative surgery for primary gastric cancer between 1965 and 1979 were reviewed, and the influence on survival of the type of surgical treatment, primary tumor location, operative mortality, and stage of disease was analyzed. Operative mortality was significantly increased in patients with multicentric primaries compared to all other sites (P less than .001) and in patients undergoing total gastrectomy versus subtotal gastric resection (P less than 0.001). Stage III-IV lesions had a significantly worse prognosis than stage I-II tumors (P less than .001). Our data confirm that early diagnosis could lead to increased survival.     

胃息肉中PTEN基因编码产物的变化

目的：探讨胃息肉和胃腺癌中抑癌基因PTEN编码产物的变化。方法：选取中国医科大学附属一院内镜中心活检标本和肿瘤外科术后大体标本,其中炎性息肉、增生性息肉、腺瘤型息肉、胃腺癌,每组60例,SP免疫组化检测PTEN基因编码产物的表达。结果：PTEN蛋白质表达在正常胃黏膜为100%,在炎性息肉、增生性息肉、腺瘤型息肉PTEN蛋白质的表达分别为98.3%,91.6%,78.3%;在胃腺癌中PTEN蛋白质的表达为61.6%。炎性息肉、增生性息肉和腺瘤型息肉之间差异有统计学意义（P〈0.05）,腺瘤型息肉与胃腺癌之间差异有统计学意义（P〈0.05）。结论：在炎症性息肉、增生性和腺瘤型息肉以及胃腺癌中,PTEN蛋白呈下调性表达。     

近侧胃癌胃裸区受侵及淋巴结转移的手术前判断及临床价值

目的:研究近侧胃癌(PGC)侵犯胃裸区(GBA)的术前诊断及临床意义。方法:回顾性分析37例PGC病人的CT、B超及病理等临床资料,并经手术证实是PGC侵犯GBA,观察其术前影像特征,分析其解剖基础。结果:37例CT及B超表现为肿瘤侵犯GBA内可见不均匀强化的软组织肿块,腹膜后淋巴结肿大或融合成团,左膈肌脚或胃膈韧带不规则增厚并与肿瘤分界不清。结论:PGC侵犯GBA术前能够作出正确判断对于手术方案的制订及术中癌灶的完整切除、相关淋巴结的彻底清扫有重要的临床价值,从而改善PGC的预后。     

Expression of HLA-DR and secretory component antigens and lymphocyte infiltration in human gastric nonmalignant and malignant tissues: an immunohistochemical study

The relation between HLA-DR and secretory component (SC) expression and the degree of lymphocyte infiltration was immunohistochemically examined in human gastric mucosa with or without intestinal metaplasia and gastric carcinoma tissues. Gastric mucosa without obvious inflammation showed neither expression of HLA-DR or SC nor remarkable lymphoid infiltration. In contrast, gastric mucosa with chronic inflammation, tissues with incomplete type of intestinal metaplasia, and carcinoma demonstrated both HLA-DR and SC in almost the same area and also prominent lymphoid infiltration in the surrounding stroma. This simultaneous expression of HLA-DR and SC was not observed in complete type of intestinal metaplasia. The results indicate a close relationship between expression of HLA-DR and SC and the presence of lymphocyte infiltration in gastric mucosa, areas of incomplete type of intestinal metaplasia and in gastric carcinomas.     

Gastroscopic cytology and biopsies in diagnosis of gastric malignancies

The outcome in gastric malignancy has changed in recent years owing to its early and accurate diagnosis employing fiber-optic endoscopy and histocytology. One hundred and two subjects with endoscopic demonstration of various gastric lesions were subjected for brush cytology and multiple biopsies. Observing a high degree of specificity, the accuracy of brush cytology was 81% and histology 72% with cumulative diagnostic yield of 91%. There was no false-positive report with cytology; histology, however, gave three false-positive results. The present study thus confirms the high diagnostic accuracy of brush cytology combined with multiple biopsies in gastric malignancies.     

Potential role of aquaporin 3 in gastric intestinal metaplasia

Gastric intestinal metaplasia (GIM) is a pre-cancerous condition and a pivotal step in the formation of gastric cancer (GC). Aquaporin 3 (AQP3) has been found to be expressed in goblet cells rather than mucus-secreting glands. To investigate the characteristics of GIM in non-cancerous tissues adjacent to GC, as well as the expression and role of AQP3 in GIM tissues, 16 patients diagnosed with gastric adenocarcinoma of intestinal type located in the lesser curve of the antrum were consecutively enrolled in this study. A new pathological technology called “gastric mucosal sausage roll” was introduced. GIM was determined according to the updated Sydney system, and AQP3 expression in goblet cells was determined by immunohistochemistry. GIM was found in all stomach specimens, and its incidence increased with progression to GC (P < 0.001). GIM prevalence displayed remarkable association with the distance to GC in the anterior gastric wall tissues (P = 0.016) and tissues toward the cardia (P = 0.014), such that GIM was more common in the areas closer to GC (P < 0.001). AQP3 was found to be expressed in 67.71% of parts with GIM, and AQP3 immunoreactivity was identified more frequently in severe GIM areas (P < 0.001). In short, the incidence and severity of GIM correlated with the distance from GC, and AQP3 was differentially expressed in goblet cells, with most AQP3-positive goblet cells presenting in severe GIM. Together, this study suggests that AQP3 may play an important role in gastric carcinogenesis from GIM.     

Carcinoembryogenic antigen and lysosomal enzymes in gastric juice as an aid in the diagnosis of gastric cancer

Malignant transformation in cells is accompanied by enzymatic changes that may be useful markers of malignancy. Studies of oncofetal antigens in gastric juice show an increased concentration in patients with gastric carcinoma. The object of the present study was to test if the concentration of lysosomal enzymes and carcinoembryonic antigen (CEA) were altered in patients with gastric carcinoma compared to patients earlier operated with gastric resection--a supposedly premalignant condition. The results show that no differences could be found in CEA and beta-hexosaminidase levels between the patients with gastric carcinoma and those with gastric resection. However, lysozyme content was significantly higher in gastric carcinoma and might prove useful for screening of patients after gastric resection. Both CEA, beta-hexosaminidase, and lysozyme levels were significantly higher in patients with gastric carcinoma than in a control population, and can therefore have a role in screening of asymptomatic patients.