Iwai Tomohiro, Yoshida Masao, Ono Hiroyuki, Kakushima Naomi, Takizawa Kohei, Tanaka Masaki, Kawata Noboru, Ito Sayo, Imai Kenichiro, Hotta Kinichi, Ishiwatari Hirotoshi, Matsubayashi Hiroyuki
Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan .
J Gastric Cancer. 2017 Mar;17(1):88-92. doi: 10.5230/jgc.2017.17.e9. Epub 2017 Mar 10.
Early detection and treatment decrease the mortality rate associated with gastric cancer (GC). However, the natural history of GC remains unclear. An 85-year-old woman was referred to our hospital for evaluation of a gastric tumor. Esophagogastroduodenoscopy identified a 6 mm, flat-elevated lesion at the lesser curvature of the antrum. A biopsy specimen showed a well-differentiated tubular adenocarcinoma. The depth of the lesion was estimated to be intramucosal. Although the lesion met the indications for endoscopic resection, periodic endoscopic follow-up was performed due to the patient's advanced age and comorbidities. The mucosal GC invaded into the submucosa 3 years later, and finally progressed to advanced cancer 5 years after the initial examination. The patient died of tumor hemorrhage 6.4 years after the initial examination. In this case, mucosal GC progressed to advanced GC, eventually leading to the patient's death from GC. Early and appropriate treatment is required to prevent GC-related death.
早期发现和治疗可降低胃癌（GC）相关的死亡率。然而，GC的自然病史仍不清楚。一名85岁女性因胃肿瘤评估被转诊至我院。食管胃十二指肠镜检查发现胃窦小弯处有一个6毫米的扁平隆起病变。活检标本显示为高分化管状腺癌。病变深度估计为黏膜内。尽管该病变符合内镜切除指征，但由于患者年龄较大且合并多种疾病，故进行了定期内镜随访。3年后，黏膜GC侵犯至黏膜下层，最终在初次检查5年后进展为进展期癌症。初次检查6.4年后，患者死于肿瘤出血。在本病例中，黏膜GC进展为进展期GC，最终导致患者死于GC。需要早期且适当的治疗以预防GC相关死亡。
