BorrmannⅣ型胃癌的临床特征和外科治疗.pdfVIP

· 论 著· 2007年12月第45卷第24期 BorrmannlV 特征和外科治疗 周 毅 张善忠 (江西省景德镇市第一人民医院，江西景德镇333000) I摘要】目的探讨BorrmannIV型胃癌的临床特征和治疗方法。方法 回顾性总结29例BorrmannIV型胃癌的临床资料，分析 本型胃癌的临床表现、病理特点以及手术治疗的特殊性。结果 全部患者均有上腹饱胀、隐痛不适、食欲不振，同时伴有明显 的进行性消瘦，短期内体重明显减轻等临床症状。术前病理确诊为本型胃癌者24例。5例患者胃镜诊断为浅表型胃炎。获根 治性切除22例，姑息性远侧胃切除者3例，放弃手术者4例。其1、2．3年生存率分别为38．9％、8．3％、O％。结论 (1)Borrmann Ⅳ型胃癌是一种恶性程度极高的胃癌，其具有独特的生物学特性，治疗效果差，生存期短，预后不佳。(2)对BorrTnannIV型胃 癌应强调以根治性全胃切除和联合脏器切除为主的综合治疗方法。 ^【关键词】弥漫浸润型；胃癌；病理；治疗 _【中圈分类号】R735．2 【文献标识码】A 【文章编号】1673—9701(2007)24-24一O2 Clinical Feature and Surgical Therapy of Borrmann’S Type Ⅳ Gastric Cancer u la唱 Shan~ong Department of General Surgery，The Fh-st People’s Hospital，Jingdezhen，Jiangxi 333000 IA~traetl Objective To explore clinical feature and therapeutic process of Borrmann type IVgastric carcinoma．Methods Retrospective analysis was performed On 29 e~ase of palie~ts with Borrmann type IV gastric carcinoma,in order to annie clinical feature，pathological characreristic and specificity ofoperative tbempy BorlmlannbgelV gastric carcinoma．Results Allpatients havegas pains of superiorbelly． vague pare and anepithymia,meanwhile,c~nical symptoms ofgradually emaciation and weight reduction w眦 shown in cimmin．24 patients were diagnosedfrompreoperativepathologicalexanlina ,~berfive Cas6~3weremisdiagnosisas superficial gastritisbygastoscope．22 out of29patients were performed radical total gastrectomy；Three e珏主s performed palliative distal gastreetomy and four patit~ts rejected surgical therapy． Survival rateofoneyear,twoyear andthreeyearis3K9percen_t,g3percentandmm respectively．Conclusion (1)Borrm柚ntype1V gastric cancer is high maliganant carcinoma,which have biological pecubaJi母．Its therapeutic effect,survival time and prognosis is pOOl．(2)Radical total