Iuliano R, Arrigoni A, Recchia S, Andriulli A, Canavese V, Rodinò S, Giglio A, Verme G
Servizio di Gastroenterologia ed Endoscopia Digestiva, Ospedale Ciaccio, Catanzaro.
Minerva Gastroenterol Dietol. 1991 Oct-Dec;37(4):205-9.
In order to characterize prognostic factors and therapeutic strategies for EGC, we have studied 95 patients operated on from 1980 to 1988. EGC was limited to the mucosa in 36% and extended to the submucosa in 64% of the cases. Lymph nodes involvement was observed in 13 patients; in 12 of them EGC extended to the submucosa. Gastric resection was performed in 73 and total gastrectomy in 22 patients with a postoperative mortality of 6% and 16% respectively. During the follow-up 8 patients died for causes related to EGC, 8 for unrelated causes. The 5 years survival rate was 79, without differences according to site, type, size and histology of EGC, lymph nodes involvement, type of gastrectomy; only EGC limited to the mucosa was associated with a better survival experience (96% vs 70% of tumors extended to the submucosa p less than 0.05). The prognosis of EGC is good and a curative surgery may be accomplished, especially if the lesion is limited to the mucosa. In EGC extended to the submucosa an accurate lymphadenectomy may further improve the prognosis, while total gastrectomy--de principe--carries a higher postoperative mortality, without significant improvement of the long term prognosis.
为了明确早期胃癌（EGC）的预后因素和治疗策略，我们研究了1980年至1988年期间接受手术治疗的95例患者。EGC局限于黏膜层的病例占36%，侵犯至黏膜下层的病例占64%。13例患者出现淋巴结转移；其中12例EGC侵犯至黏膜下层。73例行胃切除术，22例行全胃切除术，术后死亡率分别为6%和16%。随访期间，8例患者死于与EGC相关的原因，8例死于无关原因。5年生存率为79%，EGC的部位、类型、大小、组织学、淋巴结转移情况、胃切除术类型对此无差异；仅局限于黏膜层的EGC患者生存情况较好（96%对比侵犯至黏膜下层肿瘤的70%，p<0.05）。EGC预后良好，可通过根治性手术治愈，尤其是病变局限于黏膜层时。对于侵犯至黏膜下层的EGC，精确的淋巴结清扫术可能进一步改善预后，而全胃切除术原则上术后死亡率较高，对长期预后无显著改善。
