Kitamura K, Yamaguchi T, Okamoto K, Nishida T, Takahashi T
First Department of Surgery, Kyoto Prefectural University of Medicine, Japan.
Br J Cancer. 1996 Dec;74(11):1834-7. doi: 10.1038/bjc.1996.639.
To determine the clinicopathological features of the superficial spreading type of early gastric cancer, which is defined as early gastric cancer in which the product of the longest diameter of the tumour and the diameter perpendicular to it is greater than 25 cm2, they were compared retrospectively with those of small-sized early gastric cancers, which are defined as tumours smaller than 2 x 2 cm2. The superficial spreading type accounted for 5.46% of all early gastric cancers. The distinguishing histopathological features of superficial spreading lesions were: a diffuse type of cancer, submucosal invasion and advanced lymph node involvement. Of the 32 patients with superficial spreading lesions, eight underwent an additional resection as a continuance of the first gastrectomy, because of an indistinct tumour margin. More extensive lymph node dissection was also performed on the group with superficial spreading lesions. There was no difference in 5 year survival rate between the two groups (superficial spreading type, 96.0% vs small-sized type, 95.1%). The most appropriate treatment for superficial spreading lesions is a wide surgical resection with extensive lymph node dissection.
为确定浅表扩散型早期胃癌的临床病理特征（该型早期胃癌定义为肿瘤最长径与其垂直径的乘积大于25 cm²），我们对其与小尺寸早期胃癌（定义为肿瘤小于2×2 cm²）的临床病理特征进行了回顾性比较。浅表扩散型占所有早期胃癌的5.46%。浅表扩散性病变独特的组织病理学特征为：弥漫型癌、黏膜下浸润和淋巴结转移。32例浅表扩散性病变患者中，8例因肿瘤边界不清，作为首次胃切除术的延续接受了再次切除。对浅表扩散性病变组也进行了更广泛的淋巴结清扫。两组的5年生存率无差异（浅表扩散型为96.0%，小尺寸型为95.1%）。对于浅表扩散性病变，最合适的治疗方法是广泛手术切除并进行广泛的淋巴结清扫。
