45例残胃癌诊治的临床分析

目的:探讨残胃癌的临床病理特征,诊治方法及预后相关因素。方法:分析我院近20年来收治的45例残胃癌的临床病理资料。结果:残胃癌位于吻合口28例,贲门9例,其它部位8例;组织学类型:未分化腺癌1例;低分化腺癌36例;中分化腺癌7例;高分化腺癌1例。根治性切除组1、3、5年生存率分别为100%、78.8%、47.2%;非根治性切除组非治愈性切除患者的1、3、5年生存率分别为62.5%、25.0%和0。未切除的10例患者,均于2年内死亡,平均生存时间为12个月。各期病例5年生存率分别为Ⅰ期100.0%、Ⅱ期75.0%、Ⅲ期17.8%、Ⅳ期0。结论:残胃癌多发生于BillrothⅡ式胃大部切除术后10年以上。残胃癌的预后与病理分期和能否行根治性切除密切相关。

Clinical Analysis for Diagnosis and Treatment of Remnant Gastric Cancer: A Report of 45 Cases

Objective: To study the clinicopathological characteristics, the procedure of diagnosisand treatment, as well as the related factors influencing prognosis of remnant gastric cancer.Methods:The clinicopathological data and prognoses of 45 cases with remnant gastric cancer were analyzed ret-rospectively.Results: A total of 28 lesions were located at the stomas, among which 9 were at cardiaand 8 at other locations. In the study there were 19 cases of radical resection, among which 16 werepalliative resection, 8 exploring operations and 1 anatomasis of remnant stomach and jejunum per-formed. The histology types of these patients showed that there was 1 cases with non-differentiatedadenocarcinoma, 36 with poorly-differentiated adenocarcinoma, 7 moderately-differentiated adenocarci-noma and 1 well-differentiated adenocarcinoma. The 1-, 3-, 5-year survival rate of the patients withradical resection were significantly better than those with palliative resection (100% vs 62.5%, 78.8%vs 25% and 47.2% vs 0, P<0.05, repectively). All cases without resection died within 2 years. The 5-year survival rate for Stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ was 100%, 75%, 17.8% and 0, respectively (P<0.05).Conclusion: The remnant gastric cancer prevalently occurs in male patients 10 years later after Bir-roth II gastrectomy. The prognosis of remnant gastric cancer has a close correlation with pTNM stageand with the probability of the radical resection.