Ohyama T, Tabuchi Y, Takiguchi Y, Nakamura T, Imanishi K, Kawasaki H, Murayama Y, Saitoh Y
Gan No Rinsho. 1984 Jan;30(1):43-52.
Ten carcinomas of the gastric stump reconstructed by Billroth I (one case) and Billroth II (9 cases) methods were treated an average of 20 (range: 7-46) years after partial gastrectomy. Because of highly advanced carcinoma, total gastrectomy with resection of invaded organs was performed. The 5-year survival rate was 33%, and was not different from that in patients with carcinoma of the cardia. Thus, the prognosis of gastric stump carcinoma was not poor if extended radical operation was carried out. The mucosa showed severe atrophic gastritis with intestinal metaplasia or atrophic and hypertrophic gastritis in patients with carcinoma. However, the mucosa was hyperplasia of the glands in almost all patients with stomal ulcer. Thus, our findings suggest that atrophic change with intestinalization plays a role in gastric carcinogenesis.
对10例采用毕Ⅰ式（1例）和毕Ⅱ式（9例）方法重建胃残端的残胃癌患者进行了研究，这些患者在胃部分切除术后平均20年（范围：7 - 46年）接受治疗。由于癌症高度进展，均行全胃切除术并切除受累器官。5年生存率为33%，与贲门癌患者的生存率无差异。因此，如果进行扩大根治手术，残胃癌的预后并不差。在患有癌症的患者中，黏膜表现为伴有肠化生的严重萎缩性胃炎或萎缩性与肥厚性胃炎。然而，几乎所有吻合口溃疡患者的黏膜均为腺体增生。因此，我们的研究结果表明，伴有肠化生的萎缩性改变在胃癌发生中起作用。
