早期胃癌的内镜诊断及临床分析（附36例报告）.pdfVIP

· 32· 2008年6月第35卷第12期 Chinese Journal of Practical Medicine June．2008，Vo1．35，No．12 早期胃癌的内镜诊断及临床分析(附36例报告) 秦炳照 陈 锋 (1．湖北省裹樊市第一人民医院消化内科，裹樊 441000；2．河南省煤炭总医院) 【摘要】 目的 分析早期胃癌(EGC)内窥镜下表现及病理特点，提高EGC的诊断率。方法 总结2002年8月至2006 年10月经手术证实的EGC 36例临床资料。结果 36例术前均由胃镜确诊为EGC，病灶分布以胃窦部和胃角部为主， 占72．2％(26／36)。病理示低分化腺癌14例，占38．9％，管状腺癌1l例，占30．6％。病灶周围组织示萎缩性胃炎19 例，占52．8％，中重度不典型增生17例，占47．2％，幽门螺旋杆菌阳性33例，占91．7％。结论 EGC 1I型病变多见，胃窦 部为好发部位，胃镜检查加黏膜多点活检为其主要确诊手段，黏膜内癌与黏膜下癌发生淋巴转移的几率相比差异无统计 学意义(P0．1)，Hp感染与EGC关系密切。 【关键词】 早期胃癌；胃镜；病理类型；诊断 Endoscopic diagnosis and clinical analysis of early gastric cancer(36 cases report) Qm Bingzhao ， CHEN ．1．Department of Gastroenterology，the Fimt People’S Hospital ofXiangfan，Xiangfan 441000， Hubei；2．The Coal General Hospital ofHenan Province 【Abstract】 Objective To analyze the feature of endoscopic diagnosis and pathological characteristic of early gastric cancer，and raise the correct rate of diagnosis．Methods Clinical data on 36 patients with early gastric cancer confirmed by operation were collected and analyzed from August，2002 to October，2006．Re- suits All of 36 patients with early gastric cancer were diagnosed by gastroscope examination before operation． 72．2％(26／36)of the tunloFS were located in the antrum and angulus．14 cases(38．9％)were poorly dif- ferentiated adenocarcinoma，11(30．6％)were tubular adenocarcinoma．atrophic gastritis，middle or heavy atypical hyperplasia and positive helicobacter pylori were found 19 cases(52．8％)，17 cases(47．2％)and 33 cases(91．7％)in periphery tissue respectively．Conclusion TypeⅡ is common and the predilection site is in the antrum and angulus．The main diagnosis method is gastroscope examination combining multiple punch biopsy．Early gastric cancer has intimately relation to infection of helicobacter pylori． 【Key words】 Earl