弥漫浸润型胃癌生物学行为及临床意义

目的探讨弥漫浸润型胃癌的生物行为特点及临床意义.方法将390例行术治疗的胃癌病人分为弥漫浸润型胃癌和非弥漫浸润型胃癌两组,比较两组的肿瘤组织病理分级、腹腔游离癌细胞、术后病理分期(PTNM分期)以及术后癌残留情况.结果弥漫浸润型胃癌肿瘤组织病理分级多为恶性度级别较高的病理类型(P＜0.05),肿瘤易侵犯邻近脏器并发生远处转移(P＜0.05),早期诊断困难,确诊时PTNM分期多为Ⅲ期、Ⅳ期(P＜0.05),手术治疗效果相对较差,术后癌残留比例较高(P＜0.05).结论弥漫浸润型胃癌具有与其他类型胃癌不同的生物行为学特点,临床上应注重多种影像学方法结合应用提高确诊,并且更应注重术前和术后的腹腔化疗和手术治疗相结合改善弥漫浸润型胃癌的治疗效果.

The Biological Behavior and Its Clinical Significance of Borrmann Type IV Gastric Carcinoma

Objective To assess the biological behavior and its clinical significance of widespread and invasive gastric carcinoma (Borrmann Type IV).Methods The case group including 44 patients with Borrmann Type IV gastric carcinoma was compared with the control group including 246 patients with other Borrmann gastric carcinoma in the indexes of tumor histopathological grades, intraperitoneal free cancer cells, the tumor pathologic classification (according to the International Union Against Cancer TNM Classification of 1978) and surgical effect.Results The Borrmann Type IV gastric carcinoma demonstrated a distinctive biological behavior that included poor histopathological differentiation (P<0.05), a higher incidence of surrounding adjacent viscera invasion and distant metastasis (P<0.05), low detecting rate at early stages of the disease, and poor prognosis after surgical resection.Conclusions The Borrmann Type IV gastric carcinoma has a distinctive biological behavior. To improve detecting rate and decrease misdiagnosis rate, various image analysis should be combined in use. Surgical resection combined with adjuvant chemotherapy in abdominal cavity is likely necessary to improve therapeutic effect.