121例早期胃癌的临床诊断

探讨如何识别早期胃癌并提高其诊断水平。方法对本院内镜室近１０年来经内镜和手术病理诊断的１２１例早期胃癌作一回顾性分析。对性别年龄构成、临床表现、病变部位、内镜分型、肿瘤大小、病理类型、浸润深度、淋巴结转移、生存率等资料作了统计分析。结果本组资料中早期胃癌检出率为１４．７５％，其好发于５０～６９岁男性，临床症状缺乏特异性，６０％以上好发于胃窦部和胃角。其中凹陷型最多见，浅表型较少见，小胃癌与微小胃癌共占２７．２％。青年组中病理示分化不良者较老年组中为多。肿瘤浸润深度与其大小及分化程度密切相关。淋巴结转移与其浸润深度及分化程度相关。早期胃癌５年生存率为９０．１％。结论应重视胃癌癌前期病变的随访，改进设备并努力提高内镜检查技术以不断提高早期胃癌的诊断水平，改善预后。

A Retrospective Study of Diagnosis in 121 Cases of Early Gastric Cancer

Purpose To identify the characteristics of early gastric cancer and improve the accuracy of early diagnosis. Methods A retrospective study of diagnoses in 121 cases of early gastric cancer was made.All of the diagnoses were confirmed by gastroscopy and postoperative histological examination.A series of relevant factors were taken into account,including the age distribution,clinical manifestations,lesion sites,endoscopic classifications,tumor sizes,pathological classifications,infiltration depth,lymph nodes involvement and survival rates. Results Early gastric cancer accounts 14.75% of all the gastric cancer cases.The male aging from 50 69 is predisposed to early gastric cancer.The clinical manifestations are non specific.More than 60% of the tumors are located in the antrum and angulus.The depressed type is common while the superficial type is rare.The small gastric cancer and the minimal gastric cancer cases account 27.2% altogether.The well differentiated ca ses are commoner in the old group than in the young group.The tumor size and the differentiation degree are closely relevant to the infiltration depth while the infiltration depth and the differentiation degree are relevant to the lymph nodes metastasis.The five year survival rate in these 121 patients is 90.1%. Conclusions We should pay a close follow up to the precancerous state of gastric cancer,improve the gastroscopy technique and apply advanced instruments,so as to improve the early diagnosis and ameliorate the prognosis.