胃粘液腺癌149例临床病理学特点

目的: 比较胃粘液腺癌(Mucinous gastric carcinoma,MGC)不同分期的临床病理学差异,探讨影响MGC预后的临床病理学特征。 方法: 分析1982年1月～1997年12月收治的MGC患者149例的临床病理及其预后。 结果: MGC更易发生浆膜浸润(Ⅲ、Ⅳ期S₂+S₃:67.5%);浸润性更强(Ⅰ+Ⅱ期T₃:6.2%;Ⅲ+Ⅳ期T₃:44.4%);中晚期更易腹膜种植(P₂+P₃:30.7%);中晚期更易发生淋巴结转移(N₁+N₂:80.3%);根治性切除率早期明显高于中晚期(P<0.005);Ⅰ+Ⅱ期5年生存率早期明显提高(53.1%),中晚期仅为13.7%,两者之间比较有明显差别(P<0.005)。 结论: 不同时期MGC临床生物学行为不尽相同,其预后不良的原因与确诊时病期晚,发生浆膜浸润率、淋巴结转移率、腹膜播散率高和根治性切除率低有关。

Clinicopathological Characteristics of 149 Patients with Mucinous Gastric Carcinoma

Objective : To evaluate clinicopathological difference in varying stage of patients with mucinous gastric carcinoma (MGC) and to study clinico -pathological characteristics, which influenced the prognosis of MGC. Methods : A total of 149 cases with MGC were admitted for treatment from January 1982 to December 1997. Their clinicopathological examination and prognosis were analyzed. Results : Infiltration of serosa occurred easily in the patients with MGC (intermediate and advanced stage S₂+S₃: 67.5%), and MGC had stronger infiltration( I + II stage T₃6.2%; III + IV stage T₃ 44.4%). Inplantation of peritoneum occurred easily in intermediate and advanced stage (P₂+P₃: 30.7%). Metastasis of lymph occurred easily in intermediate and advanced stages (N₁+N₂ 80.3%); The rate of radical resection in early stage was higher than it in intermediate and advanced stage (P<0.005). Survival rate for five years in early stage was higher than it in intermediated and advanced stages. There was a significant difference between early stage and another two stages. Conclusion : Biological action is different in every stage of Mgc . Bad prognosis is related with the time of correct diagnosis, infiltration of serosa,metastasis of lymph node and a lower rate of radical resection.