Adloff M, Schloegel M, Arnaud J P, Ollier J C
CMCO, Service de Chirurgie, Schiltigheim/Strasbourg.
Ann Chir. 1990;44(9):713-7.
We have studied a total of 395 patients with gastric cancer during the past 16 years 57 of whom presented with superficial gastric cancer. The most frequent symptom was gastric pain in 47 patients. Barium weal was not helpful in the diagnosis and failed to define the nature of this disease in 43 patients. Endoscopy enabled visualization of an abnormality in 55 patients, the lesion seen was considered to be compatible with a diagnosis of superficial gastric cancer in 42 cases. The combined results of endoscopy and biopsy diagnosed malignancy in all cases, but a sufficient number of endoscopic biopsy specimens must be taken (5 to 7). Cases of superficial gastric cancer had an 24% incidence of other non gastric malignancies in our series. All patients were treated by surgical resection. The tumor was confined to the mucosa in 38 patients and had infiltrated the submucosa in 19 patients. Four patients had lymph node metastases. The five year actuarial survival was 75% for all the patients and 85% when the lesion was confined to the mucosa. In contrast, the five year survival for the 283 patients with resected gastric cancer was only 23%. Although the prognosis of superficial gastric cancer is remarkably good, patients should be carefully followed over a long period for late recurrent (one patient in our series) of the primary cancer and possible metachronous cancer of other organs.
在过去16年中，我们共研究了395例胃癌患者，其中57例为早期胃癌。最常见的症状是胃痛，有47例患者出现该症状。钡餐检查对诊断没有帮助，43例患者未能明确该疾病的性质。内镜检查使55例患者的异常情况得以可视化，其中42例所见病变被认为与早期胃癌的诊断相符。内镜检查和活检的综合结果在所有病例中都诊断出了恶性肿瘤，但必须采集足够数量的内镜活检标本（5至7个）。在我们的系列研究中，早期胃癌患者中有24%并发其他非胃癌恶性肿瘤。所有患者均接受了手术切除。肿瘤局限于黏膜层的有38例患者，浸润至黏膜下层的有19例患者。4例患者有淋巴结转移。所有患者的5年实际生存率为75%，病变局限于黏膜层时为85%。相比之下，283例接受胃癌切除术患者的5年生存率仅为23%。尽管早期胃癌的预后非常好，但仍应长期密切随访患者，以防原发性癌症晚期复发（我们系列中有1例患者）以及其他器官可能出现异时性癌症。
