Bedossa P, Lemaigre G, Martin E D
Laboratoire d'Anatomie Pathologique, Hopital Antoine Beclere, Clamart, France.
Cancer. 1987 Nov 1;60(9):2224-7. doi: 10.1002/1097-0142(19871101)60:9<2224::aid-cncr2820600920>3.0.co;2-1.
Twenty patients with carcinoma of the gastric remnant after surgery for benign disease have been studied. The histologic and histochemical data on gastric mucosa surrounding the carcinoma have been compared with data from 60 biopsy samples taken from gastric stumps without carcinoma in an age-and sex-matched group. There was a high incidence of intestinal metaplasia in the gastric stumps (24 of 60); it was even higher in the cases with a carcinoma (17 of 18). Intestinal metaplasia Type III, which is closely related to the carcinoma in a stomach not surgically treated, was rare in cases of cancer in the gastric stump (1 in 18). This finding is correlated to the high frequency of the diffuse type of carcinomas that occur in the gastric stump (15 of 20), which are rarely associated with intestinal metaplasia. Therefore, identifying intestinal metaplasia types does not always point to the fact that affected patients will also be at high risk for cancer in their gastric remnant.
对20例良性疾病手术后发生残胃癌的患者进行了研究。将癌灶周围胃黏膜的组织学和组织化学数据与60例取自年龄和性别匹配的无癌胃残端活检样本的数据进行了比较。胃残端肠化生发生率很高(60例中有24例);在有癌的病例中甚至更高(18例中有17例)。在未接受手术治疗的胃癌中与癌密切相关的III型肠化生在胃残端癌病例中很少见(18例中有1例)。这一发现与胃残端发生的弥漫型癌的高频率相关(20例中有15例),弥漫型癌很少与肠化生相关。因此,识别肠化生类型并不总是意味着受影响的患者胃残端患癌风险也会很高。