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48例早期胃癌内镜与组织学的相关性研究

[Correlation between endoscopy and histology of 48 cases of superficial stomach cancer].

作者信息

Realini S, Gonvers J J, Saraga E, Fontolliet C, Pedrinis E, Luscieti P

出版信息

Schweiz Med Wochenschr. 1985 Jun 22;115(25):858-62.

PMID:4023674
Abstract

The relationship between different endoscopic (gross appearance, diameter, localization, morphological type according to the Japanese Endoscopic Society) and histological parameters (type of cancer according to Lauren, tumor infiltration, association with metaplastic chronic gastritis) were analyzed retrospectively in 48 patients operated on for early gastric cancer. Endoscopy and histology provided a preoperative diagnosis of malignancy in 89.6% of the cases. With endoscopy alone the results were 23% malignancy, 44% suspicious and 33 benign. The antrum was the preferential site and type III the most frequent form. 62% of early gastric cancers were of the intestinal type and the average age of the patients was higher than for the diffuse type. Metaplastic chronic gastritis was associated in 67% of the intestinal type and in 21.5% of the infiltrating type. The degree of tumor infiltration was related to the diameter of the lesion, irrespective of the histological type. Since a malignant or suspicious lesion was diagnosed in only 67% by endoscopy alone, it is imperative to perform several biopsies of all gastric lesions, including even the smallest: 11 cancers of type III and IIc in this series had a diameter inferior to 1 cm and had been classified endoscopically as benign.

摘要

回顾性分析了48例早期胃癌手术患者的不同内镜检查参数(肉眼外观、直径、位置、根据日本内镜学会的形态学类型)与组织学参数(根据劳伦分型的癌症类型、肿瘤浸润、与化生型慢性胃炎的关系)。内镜检查和组织学检查在89.6%的病例中提供了术前恶性肿瘤诊断。仅通过内镜检查,结果为23%恶性、44%可疑和33%良性。胃窦是优先发生部位,III型是最常见的类型。62%的早期胃癌为肠型,患者的平均年龄高于弥漫型。化生型慢性胃炎在67%的肠型和21.5%的浸润型中存在。肿瘤浸润程度与病变直径相关,与组织学类型无关。由于仅通过内镜检查仅诊断出67%的恶性或可疑病变,因此对所有胃病变进行多次活检至关重要,即使是最小的病变:本系列中有11例III型和IIc型癌症直径小于1 cm,内镜检查分类为良性。

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