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目的分析原发病灶局限于黏膜或黏膜下层,但同时伴有远隔转移早期胃癌的临床病理特征。方法回顾性分析1973年4月至1998年11月,中日两家大学8所附属医院的4420例(每家医院220~1270例)早期胃癌,其中22例伴有远隔转移。分析伴远隔转移的早期胃癌(远转组)和不伴远隔转移的早期胃癌(无转组)在性别、年龄、肿瘤大小、浸润深度、分化类型、长期存活率等方面的差异。结果远转组肿瘤与无转组在性别、肿瘤大小、浸润深度、5年存活率(远转组34.7%,无转组91.3%)方面差异有非常显著性意义(P<0.01);两组在年龄、分化程度方面差异无显著性意义。结论早期胃癌也可能发生远隔转移并导致预后不佳。女性、肿瘤浸润至黏膜下层且肿瘤直径>4cm可能是早期胃癌发生远隔转移的危险因素。
Objective To analyze the primary lesion confined to the mucosa or submucosa, but with the clinicopathological features of early gastric cancer with distant metastasis. Methods From April 1973 to November 1998, 4420 early gastric cancers (220 ~ 1270 cases per hospital) in 8 affiliated hospitals of Chinese and Japanese universities were retrospectively analyzed. Twenty-two of them were associated with distant metastasis. The differences in gender, age, tumor size, depth of invasion, type of differentiation and long-term survival were analyzed in patients with distant metastasis of early gastric cancer (distant metastasis group) and those without advanced distant metastasis (no metastasis group). Results There were significant differences in the size of tumor, the depth of invasion, the 5-year survival rate (34.7% in distal group, 91.3% in non-transferred group) between far-transferred group and non-transfered group (P <0.01) There was no significant difference in age and differentiation. Conclusion Early gastric cancer may also be distant metastasis and lead to poor prognosis. Women, tumor infiltration to the submucosa and tumor diameter> 4cm may be distant gastric cancer risk of distant metastasis.