Huguier M, Msika S, Lacaine F, Houry S
Service de Chirurgie Digestive, Hôpital Tenon, Paris.
Ann Chir. 1990;44(6):455-8.
It may be better to use the term of "superficial carcinoma" than "early gastric carcinoma". Out of 194 patients operated on for gastric carcinoma, 37 had a superficial carcinoma (19%). Seventeen had previously been treated for duodenal (n = 10) or gastric (n = 7) ulcer. Out of 23 barium meal examinations, 3 were normal. The macroscopic appearance at endoscopic examination was normal in 4 patients. In these cases the carcinoma was identified in biopsies. At laparotomy the gastric wall was normal in 16 patients. Gastric resection was subtotal (n = 28), total (n = 6), or partial (n = 1). The tumor was multifocal in 8 cases, and associated with intestinal metaplasia in 24 cases. The five-year actuarial survival rate was 77%. It is important to do not miss superficial carcinoma even in patient treated for peptic ulcer, and to perform biopsies even if endoscopic examination is normal. A subtotal gastrectomy may be performed with excellent results.
使用“浅表性癌”这一术语可能比“早期胃癌”更好。在194例接受胃癌手术的患者中，有37例为浅表性癌（19%）。其中17例曾接受过十二指肠溃疡（n = 10）或胃溃疡（n = 7）的治疗。在23次钡餐检查中，3次结果正常。4例患者内镜检查时肉眼外观正常。在这些病例中，癌是通过活检确诊的。剖腹手术时，16例患者胃壁正常。胃切除术包括次全切除（n = 28）、全切除（n = 6）或部分切除（n = 1）。肿瘤为多灶性的有8例，伴有肠化生的有24例。五年精算生存率为77%。即使在接受消化性溃疡治疗的患者中，也不能漏诊浅表性癌，即使内镜检查正常也应进行活检，这一点很重要。次全胃切除术可能会取得很好的效果。
