Schnapka G, Hofstaedter F, Schwamberger K, Reissigl H
Endoscopy. 1984 Sep;16(5):171-4. doi: 10.1055/s-2007-1018572.
40 gastric stump carcinomas have been investigated. The results are compared with 72 gastric carcinomas without preceding Billroth II resection. The aim of this study was to contribute to our knowledge about the pathogenesis of gastric stump carcinoma. The mean age of patients with gastric stump carcinoma and with carcinoma without preceding Billroth II resection is identical. The age distribution, too, is similar in both groups. Furthermore the time of the Billroth II resection for benign peptic ulcer shows no correlation with the appearance of the gastric stump carcinoma, which suggests that there is no constant time lag between Billroth II resection and stump carcinoma. The histological investigation of the tumor-free gastric mucosa shows similar alterations in the two groups compared. Intestinal metaplasia and cystic dilatation seems to be more common in the gastric mucosa after Billroth II resection as compared with the non-tumorous mucosa of patients without preceding Billroth II resection. But the grade of nuclear atypia in non-tumorous mucosa is identical in both groups. Interestingly enough, the frequency of the main types of gastric cancer, intestinal carcinoma and diffusely infiltrating carcinoma is very similar. Thus, both the epidemiological and histological data seem to indicate that the pathogenesis of gastric carcinoma is very similar to that of gastric carcinoma without preceding gastric surgery. The Billroth II resection does not seem to be a main factor in pathogenesis, but may have co-factorial significance.
对40例残胃癌进行了研究。将结果与72例未行毕Ⅱ式切除术的胃癌进行比较。本研究的目的是增进我们对残胃癌发病机制的了解。残胃癌患者和未行毕Ⅱ式切除术的胃癌患者的平均年龄相同。两组的年龄分布也相似。此外，因良性消化性溃疡行毕Ⅱ式切除术的时间与残胃癌的出现无相关性，这表明毕Ⅱ式切除术与残胃癌之间不存在固定的时间间隔。对无肿瘤的胃黏膜进行组织学研究发现，两组的改变相似。与未行毕Ⅱ式切除术患者的非肿瘤性黏膜相比，毕Ⅱ式切除术后胃黏膜中的肠化生和囊性扩张似乎更为常见。但两组非肿瘤性黏膜的核异型程度相同。有趣的是，胃癌的主要类型，即肠型癌和弥漫浸润性癌的发生率非常相似。因此，流行病学和组织学数据似乎都表明，残胃癌的发病机制与未行胃手术的胃癌非常相似。毕Ⅱ式切除术似乎不是发病机制中的主要因素，但可能具有协同因素的意义。
