Imai Masato, Kondo Yukifumi, Osawa Shohei, Nishida Yasunori, Okada Kuniaki, Ishizu Hiroyuki, Masuko Hiroyuki, Hata Tsunetake, Uemura Kazuhito, Kina Masaya, Honda Shohei, Ishiyama Gentaro, Takahashi Toru, Hino Atsushi
Department of Surgery, Sapporo Kosei General Hospital, Sapporo, Japan.
J Surg Oncol. 2003 Jun;83(2):94-8. doi: 10.1002/jso.10229.
Superficial spreading type early gastric cancer is characterized by its atypical growth pattern and occasionally indistinct tumor margin. Because it is a rare form of early gastric cancer, the clinicopathological details are not apparent. The aim of this study was to clarify the clinicopathological features of the superficial spreading type of early gastric cancer.
A retrospective study was conducted in 1,062 surgically resected patients with early gastric cancer. Hospital records were compared between patients with superficial spreading type early gastric cancer and those with more common types of early gastric cancer.
Sixty-nine patients (6.9%) had superficial spreading lesions. The male to female ratio was 1.2:1. The most frequent histological type was signet-ring cell carcinoma (32%). The distinguishing histopathological features were submucosal invasion (67%), lymphatic invasion (32%), and lymph node metastasis (30%). There were discrepancies in tumor area between surgical findings and pathological diagnosis in 24 patients (35%) with superficial spreading type. More extensive lymph node dissection was performed and all patients survived in the group with superficial spreading lesions.
The most appropriate treatment for the superficial spreading type of early gastric cancer is wide surgical resection with extensive lymph node dissection.
浅表扩散型早期胃癌具有非典型的生长模式，肿瘤边界偶尔不清晰。由于它是早期胃癌的一种罕见形式，其临床病理细节尚不明确。本研究的目的是阐明浅表扩散型早期胃癌的临床病理特征。
对1062例行手术切除的早期胃癌患者进行回顾性研究。比较浅表扩散型早期胃癌患者与更常见类型早期胃癌患者的医院记录。
69例患者（6.9%）有浅表扩散性病变。男女比例为1.2:1。最常见的组织学类型是印戒细胞癌（32%）。显著的组织病理学特征是黏膜下浸润（67%）、淋巴浸润（32%）和淋巴结转移（30%）。24例（35%）浅表扩散型患者的手术所见与病理诊断在肿瘤面积上存在差异。对浅表扩散性病变组进行了更广泛的淋巴结清扫，所有患者均存活。
浅表扩散型早期胃癌最恰当的治疗方法是广泛手术切除并进行广泛的淋巴结清扫。
