Mitruţ P, Enescu Aurelia, Streba Letitia Adela, Burada F, Cojocaru G, Simionescu Cristiana, Mărgăritescu Cl, Genunche-Dumitrescu Amelia
Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania.
Rom J Morphol Embryol. 2007;48(4):373-9.
The early gastric cancer is an endoscopic notion in which gastric cancer is strictly placed to mucosis and submucosis without extensive manifestations. It is the form with favorable prognosis and better survival at 5 and 10 years. Our study tries to systematize the debut forms of early gastric cancer and their association with the lesions with malignisation risk. We also try to evaluate the incidence of endoscopic and histopathologic forms of early gastric cancer found in an internal medicine division. Our study included 435 patients with gastric cancer endoscopic and histologic diagnosed. Statistically, 64.36% were men and 35.64% were women, the mean age 48 +/- 7 years. The endoscopic forms of early gastric cancer were type I: protruded in 19 cases, type II: superficially in eight cases, type III: excavated in six cases. Early gastric cancer is diagnosed with difficulty, it represents in 7.58% of the gastric cancer, being most frequently asymptomatic. The endoscopic forms frequently found in early gastric cancer in the population were type I: protruded and type IIa: superficially elevated. The histopathological examination is compulsory at this form of gastric cancer, while in advanced gastric cancer endoscopy is often sufficient for diagnosis. Analysing the histopathological results of cases diagnosed with early gastric cancer we found: 22 cases with intestinal type and 11 cases diffuse type. Microscopically, 15 were intramucosal and 18 had submucosal invasion. I and IIa lesions were predominantly located at the antrum and are histologically differentiated adenocarcinoma. Differentiated carcinoma frequently produces an elevated lesion and the border is well demarcated. There are frequent opportunities to detect gastric cancer in the early phase and the patient can expect a complete cure by the surgical operation or endoscopical mucosal resection.
早期胃癌是一种内镜概念，即胃癌严格局限于黏膜层和黏膜下层，无广泛表现。它是预后良好、5年和10年生存率较高的一种形式。我们的研究旨在将早期胃癌的首发形式及其与有恶变风险病变的关联系统化。我们还试图评估在内科病房发现的早期胃癌的内镜和组织病理学形式的发生率。我们的研究纳入了435例经内镜和组织学诊断为胃癌的患者。统计学上，男性占64.36%，女性占35.64%，平均年龄48±7岁。早期胃癌的内镜形式为：I型：隆起型19例，II型：浅表型8例，III型：凹陷型6例。早期胃癌诊断困难，占胃癌的7.58%，最常见的是无症状。人群中早期胃癌常见的内镜形式为I型：隆起型和IIa型：浅表隆起型。对于这种形式的胃癌，组织病理学检查是必需的，而对于进展期胃癌，内镜检查通常足以诊断。分析早期胃癌诊断病例的组织病理学结果，我们发现：肠型22例，弥漫型11例。显微镜下，15例为黏膜内癌，18例有黏膜下浸润。I型和IIa型病变主要位于胃窦，组织学上为分化型腺癌。分化型癌常产生隆起性病变，边界清晰。早期发现胃癌的机会很多，患者有望通过手术或内镜黏膜切除术实现完全治愈。
