早期胃癌的诊治体会（附61例报告）

目的 提高早期胃癌检出率，改善胃癌预后，并探讨其临床特点。方法 回顾分析６１例早期胃癌的临床表现，病灶大小，部位，分型，检测方法，治疗及预后。结果 ６１例患者平均年龄近５０岁，占同期胃癌手术病例的５．７％，Ｘ线双重造影检出率为５８．７％，胃镜肉眼检出率为４４．３％，胃镜下活检检出率可提高为９５．１％，病理诊断凹陷型者（Ⅱｃ，Ⅲ）居多，平坦型者（Ⅱｂ）易误诊，术后５９例均无瘤生存，其中生存１－４年者

Diagnosis and treatment of early gastric cancer: an experience from 61 cases

OBJECTIVE: To review the clinical signs of diagnostic significance and treatment of early gastric cancer. METHODS: Sixty-one gastric cancer patients were collected for this study. They were surgically treated and pathologically confirmed to be in the early stage of disease. The x-ray and gastroscopic findings of these patients were reviewed. RESULTS: Double-contrast barium meal examination was performed in 46 cases and 27 of them were diagnosed as gastric cancer with a detection rate of 58.7%. Superficial type of tumor was easily misdiagnosed as superficial gastritis and concave type of tumor misdiagnosed as benign gastric ulcer under x-ray imaging. All the patients were gastroscopically examined. With examiner's naked eyes, diagnosis of cancer was made in 27 cases (44.3%). Visual diagnosis was difficult when the tumor was small. Attention should be focused on the gastric incisura angularis, antrum and lesser curvature to perform site-directed biopsy. Final diagnosis depended on the pathological diagnosis of the biopsied materials. Pathologic diagnosis would be correct provided the biopsy material was taken from the proper site. It was correct in 58 of the 61 cases (95.1). Surgical treatment consisted of radical gastrectomy and D2 lymph node dissection. All but 2 were tumor free after surgical treatment. Prognosis was good in this series of early gastric cancer patients, 38 of them were alive over 5 years and 12 patients survived over 10 years. CONCLUSION: Careful x-ray and gastroscopic examinations of patients with epigastric symptoms are indicated not to miss any early case of gastric cancer.