Chattopadhyay Sankar Das, Singhamahapatra Raj Kumar, Biswas Ravi Shankar, Sengupta Tamal Kanti, Bandopadhyay Arka, Nath Nemai Chandra, Roy Shilpa Basu
Department of General Surgery, NRS Medical College and Hospital, Kolkata 700014.
J Indian Med Assoc. 2011 May;109(5):336-8.
Carcinoma stomach still remains a major killer cancer all over the world. Delay in early diagnosis or lack of awareness, infrastructure etc. is the major factor for late presentation in developing countries. This work was carried out to study the prevalence of carcinoma stomach in a tertiary referral centre in Eastern India and its corroboration with endoscopic findings. The aim is to create an awareness regarding early diagnosis of this monstrous killer. The study was conducted on 8706 symptomatic patients attending for upper GI endoscopy, of which 165 patients were found to have adenocarcinoma of stomach and 8 patients with other stomach neoplasms. The age, sex, religious status and economic background were analysed. The endoscopic findings, histological nature and grading, site of the lesions vis-à-vis clinical signs and symptoms were analysed and statistically reviewed. Of the total 165 cases of carcinoma stomach, highest number of cases (24.8%) were among 40-49 years of age, followed by 50-59 years (23.7%). The male sex (67.6%) and patients with low socio-economic background (75.7%) were the worst sufferer. On gross microscopic findings of endoscopy, ulcero-proliferative lesions were highest (80.8%) and antrum was the commonest (46.8%) site of neoplastic lesions. Histologically, adenocarcinoma (95.4%) was commonest. The significant symptoms of presentation were pain abdomen (84%), weight loss (89%), anorexia (86%), gastric outlet obstruction (40%) while signs were anaemia (100%), epigastric tenderness (60%), lump abdomen and gastric outlet obstruction (40%). We found a large number of neoplastic lesions in endoscopy series with the highest number in males at forty. This implies a gross economic fall out on the family. The interesting finding of antral growth differs from western series. Liberal use and availability of endoscopy may help in detecting the lesions early with better outcome.
胃癌仍然是全球主要的致命癌症。在发展中国家，早期诊断延迟或缺乏认识、基础设施等是导致晚期就诊的主要因素。本研究旨在探讨印度东部一家三级转诊中心胃癌的患病率及其与内镜检查结果的相关性，目的是提高对这种可怕杀手早期诊断的认识。该研究对8706名因上消化道内镜检查前来就诊的有症状患者进行，其中165例被诊断为胃腺癌，8例为其他胃部肿瘤。对患者的年龄、性别、宗教信仰和经济背景进行了分析。对内镜检查结果、组织学性质和分级、病变部位与临床症状和体征进行了分析，并进行了统计学回顾。在165例胃癌病例中，40 - 49岁年龄段的病例数最多（24.8%），其次是50 - 59岁（23.7%）。男性（67.6%）和社会经济背景较低的患者（75.7%）受影响最严重。在内镜检查的大体微观发现中，溃疡增生性病变最多（80.8%），肿瘤病变最常见的部位是胃窦（46.8%）。组织学上，腺癌最常见（95.4%）。主要的症状表现为腹痛（84%）、体重减轻（89%）、厌食（86%）、胃出口梗阻（40%），体征为贫血（100%）、上腹部压痛（60%）、腹部肿块和胃出口梗阻（40%）。我们在内镜检查系列中发现了大量肿瘤病变，40岁男性中数量最多。这意味着家庭经济遭受重大损失。胃窦部生长这一有趣的发现与西方系列不同。内镜检查的广泛应用和可及性可能有助于早期发现病变并取得更好的结果。
