Luukkonen P, Kalima T, Kivilaakso E
Second Department of Surgery, Helsinki University Central Hospital, Finland.
Hepatogastroenterology. 1990 Dec;37 Suppl 2:171-3.
The exact incidence of gastric stump cancer is not known. The reported incidence figures vary greatly, even in studies using similar methods. The aim of this study was to re-evaluate the risk of gastric stump cancer after gastric surgery for peptic ulcer in the Finnish population. A total of 285 patients (252 men and 33 women) operated on for benign peptic ulcer between 1948 and 1954 were followed-up till the end of 1984 (mean for men = 19.4 years, for women = 22.9 years). At the end of 1984 58 patients (20%) were still alive with no verified gastric cancer. One patient developed gastric cancer within five years after the operation and was excluded from the series. Nine patients (3%) were lost to follow-up. Six patients (four men and two women) of the total 285 had developed gastric cancer 6, 7, 8, 21, 25 and 27 years after operation. The risk of getting gastric cancer in a control population (no operation) of equal size and age during a similar follow-up period was 6.71 cases for men and 0.86 cases for women (total = 7.57). The observed number (6 patients) does not differ significantly (P greater than 0.5) from the expected number (7.57). According to this study the risk of gastric cancer is not significantly increased by partial gastrectomy for benign peptic ulcer.
胃残端癌的确切发病率尚不清楚。即使在采用相似方法的研究中，所报告的发病率数据也差异极大。本研究的目的是重新评估芬兰人群中因消化性溃疡接受胃手术后发生胃残端癌的风险。对1948年至1954年间因良性消化性溃疡接受手术的285例患者（252例男性和33例女性）进行随访，直至1984年底（男性平均随访19.4年，女性平均随访22.9年）。到1984年底，58例患者（20%）仍存活且未确诊胃癌。1例患者在术后5年内发生胃癌，该患者被排除在本系列研究之外。9例患者（3%）失访。在285例患者中，有6例患者（4例男性和2例女性）在术后6、7、8、21、25和27年发生了胃癌。在相似的随访期内，相同规模和年龄的未手术对照人群中男性患胃癌的风险为6.71例，女性为0.86例（总计7.57例）。观察到的病例数（6例）与预期病例数（7.57例）相比无显著差异（P大于0.5）。根据本研究，因良性消化性溃疡行胃部分切除术不会显著增加患胃癌的风险。
