摘要
目的探讨早期胃癌术后易复发的病理因素。方法回顾性分析 1984～ 1995年139例早期胃癌外科治疗的结果和病理情况。结果本组有 13例死于胃癌复发转移 ,其中血源性转移 7例 ,淋巴结转移 3例 ,残胃再发癌 3例。R1+No7淋巴清扫与R2 清扫术后复发率均为 9%。在早期胃癌中 ,粘膜下层癌 (14 1% )较粘膜层癌 (1 9% )、血管淋巴管受累 (37 5 % )较未受累 (7 6 % )、淋巴结受累 (31 3% )较未受累 (6 5 % )及多发癌灶 (33 3% )较单发癌灶 (7 9% )的复发率高 (P值均 <0 0 5 )。癌灶直径≥ 2cm与 <2cm、高中分化与低未分化及隆起型与凹陷型病变在复发率上差异无显著意义。粘膜下层癌的术前淋巴结转移率 (16 4% )较粘膜层癌的 (3 7% )高 (P <0 0 5 )。结论早期胃癌存在易致术后复发的病理因素 。
Objective To explore the relationship between the pathologic features of the cancer and postoperative recurrence in patients with early stage gastric carcinoma.Methods 139 patients with early stage gastric carcinoma underwent radical resection in our hospital from 1984 to 1995. All cases were followed up for more than 5 years. χ 2 test was used for statistical analysis.Results 7 cases died of hematogenic metastasis, 3 cases died of lymph node metastasis, and stump carcinoma was found in the other 3 cases. The recurrent rate was significantly higher in submucosal tumors (14.1%) than in mucosal tumors (1.9%), in lymphatic and vascular vessel invasion-positive cases (37.5%) than in negative cases (7.6%), in lymph node positive (31.3%) than in negative (6.5%), in synchronous multiple gastric cancer (33.3%) than in solitary tumors (7.9%)(P<0.05). There was no statistical difference in recurrence between tumors less than 2.0 cm in diameter and 2.0 cm and larger, between histologically differentiated and undifferentiated, between macroscopically depressed and elevated. The incidence of node positive prior to surgery was significantly higher in submucosal tumors (16.4%) than in mucosal (3.7%).Conclusions There are several pathologic factors incurring postoperative recurrence in early gastric cancer. Hematogenic metastasis is a main pattern of recurrence.
出处
《中华普通外科杂志》
CSCD
北大核心
2002年第2期104-106,共3页
Chinese Journal of General Surgery
关键词
胃肿瘤
复发
肿瘤转移
Stomach neoplasms
Recurrence
Neoplasm metastasis
