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目的:了解Ⅱb型早期胃癌的临床和生物学特性。方法:回顾分析1990～2002年我院经手术切除和病理检查证实的早期胃癌203例。结果:203例中,Ⅱb型早期胃癌41例,男女比例为1.05∶1(21比20)。在Ⅱb型早期胃癌中,女性的平均发病年龄早于男性[(47±14)岁比(52±12)岁,P<0.05],且男性的分化程度高于女性(高分化12例、低分化9例比高分化3例、低分化17例,P<0.05)。在分化型病例中,12例为黏膜内癌,3例为黏膜下癌,而未分化型病例中21例为黏膜内癌,5例为黏膜下癌。41例Ⅱb早期胃癌中,5例发生淋巴结转移,其中3例为黏膜内癌,2例为黏膜下癌,所有病例均未发现远处转移。结论:在Ⅱb型早期胃癌,女性发病早于男性,肿瘤的分化程度低于男性;而Ⅱb早期胃癌肿瘤的浸润深度与其分化程度有关;淋巴结转移与肿瘤的浸润深度有关。
Objective: To understand the clinical and biological characteristics of type Ⅱb early gastric cancer. Methods: A retrospective analysis of 203 cases of early gastric cancer confirmed by surgical resection and pathological examination in our hospital from 1990 to 2002. Results: Of the 203 cases, 41 cases of type IIb early gastric cancer had a ratio of male to female of 1.05: 1 (21: 20). In type IIb early gastric cancer, the average age of onset of women was earlier than that of men [(47 ± 14) vs. (52 ± 12) years, P <0.05], and the differentiation was higher in males than in females Differentiation in 9 cases than in high differentiation in 3 cases, poorly differentiated in 17 cases, P <0.05). Among the differentiated cases, 12 were mucosal carcinomas and 3 were submucosal carcinomas, whereas in undifferentiated cases, 21 were mucosal carcinomas and 5 were submucosal carcinomas. In 41 cases of early stage IIb gastric cancer, 5 cases had lymph node metastasis, 3 cases were intramucosal carcinoma and 2 cases were submucosal carcinoma. No distant metastasis was found in all cases. CONCLUSION: In type IIb early gastric cancer, the incidence of the female is earlier than that of the male, and the differentiation degree of the tumor is lower than that of the male. However, the depth of invasion of early stage IIb gastric cancer is related to its differentiation degree. The lymph node metastasis is related to the depth of tumor invasion.