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[早期胃癌]

[Early cancer of stomach].

作者信息

Chernousov A F, Chernousov F A, Selivanova I M, Fishkova Z P

出版信息

Khirurgiia (Mosk). 2006(7):4-9.

PMID:16883245
Abstract

Results of surgical treatment of 170 patients with early cancer of the stomach are analyzed. There were 113 patients with tumor invasion within the bounds of the mucous membrane (m -- 113), the others had invasion within the bounds of the submucous membrane (sm -- 57 patients). Impressed and ulcered macroscopic types of early cancer (IIc + III) were diagnosed most often: 57% m+sm (97 of 170), 58.4% m+sm (97 of 170), 54.4% sm (31 of 57), respectively. Poorly differentiated tumors prevailed over moderate- and well-differentiated tumors - 68.8% (117 of 170) and 31.2 (53 of 170) patients, respectively. Subtotal distal resection of the stomach has been performed in 118 (69,4%) patients, subtotal proximal resection -- in 13 (7.7%), gastrectomy -- in 22 (12.9%), resection of 2/3 stomach -- in 14 (8.2%), resection of the cardia - in 3 (1,8%). Lymphadenectomy has been performed in 156 patients including 1 (0.6%) patient with D0-lymphadenectomy, 88 (56.4%) - D1, 62 (39.7%) -- D2, and 5 (3.2%) -- D3. Metastases to the regional lymph nodes have been revealed in 8 (5%) cases -- 2 m and 6 sm. Extended lymphodissections (D2 and D3) have improved significantly long-term results. Five-year survival among the patients who had undergone extended operations with D2 and D3 lymphadenectomies was higher compared with patients after limited and standard operations (D0 and D1) -- 96.0+/-2.5 and 87.0+/-3.5%, respectively.

摘要

分析了170例早期胃癌患者的手术治疗结果。其中113例患者的肿瘤侵犯局限于黏膜层(m期——113例),其余患者的肿瘤侵犯局限于黏膜下层(sm期——57例)。早期胃癌最常诊断出的大体类型为凹陷型和溃疡型(IIc + III):m期+ sm期患者中分别占57%(170例中的97例)、58.4%(170例中的97例),sm期患者中占54.4%(57例中的31例)。低分化肿瘤多于中分化和高分化肿瘤——分别为68.8%(170例中的117例)和31.2%(170例中的53例)患者。118例(69.4%)患者进行了远端胃次全切除术,13例(7.7%)进行了近端胃次全切除术,22例(12.9%)进行了胃切除术,14例(8.2%)进行了胃2/3切除术,3例(1.8%)进行了贲门切除术。156例患者进行了淋巴结清扫术,其中1例(0.6%)患者进行了D0淋巴结清扫术,88例(56.4%)进行了D1清扫术,62例(39.7%)进行了D2清扫术,5例(3.2%)进行了D3清扫术。8例(5%)病例发现区域淋巴结转移——2例m期和6例sm期。扩大淋巴结清扫术(D2和D3)显著改善了长期结果。与接受有限和标准手术(D0和D1)的患者相比,接受D2和D3淋巴结清扫术的扩大手术患者的五年生存率更高——分别为96.0±2.5%和87.0±3.5%。

相似文献

1
[Early cancer of stomach].[早期胃癌]
Khirurgiia (Mosk). 2006(7):4-9.
2
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