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目的:分析胃炎样早期胃癌临床诊治情况并总结经验。方法:收集2009年上海市3所医院内科门诊的早期胃癌筛查结果,同时收集2009年本院手术切除并经病理检查证实的早期胃癌中的胃炎样早期胃癌病例。结果:上海市3所医院施行胃镜检查41993例,胃癌805例,早期胃癌为158例,占胃癌手术患者19.6%,其中符合胃炎样早期胃癌8例,占早期胃癌患者5.1%。内镜下表现为充血(绯红)3例,表浅糜烂5例。手术病理证实Ⅱa型(浅表隆起型)1例,Ⅱb型(浅表平坦型)7例;黏膜下层1例,黏膜层7例。结论:加强对胃炎样早期胃癌的临床研究,尤其是提高胃镜下识别能力,以及开展色素胃镜、胃镜电子染色以及共聚焦激光显微内镜诊断胃炎样早期胃癌,有望进一步提高胃癌临床诊治水平。
Objective: To analyze the clinical diagnosis and treatment of gastritis-like early gastric cancer and to summarize the experience. Methods: The early gastric cancer screening results of internal medicine clinics of 3 hospitals in Shanghai were collected in 2009, and the cases of gastritis-like early gastric cancer in early gastric cancer confirmed by pathology and surgically resected in our hospital in 2009 were collected. Results: 41,993 cases of gastric cancer, 805 cases of gastric cancer and 158 cases of early gastric cancer were found in 3 hospitals in Shanghai, accounting for 19.6% of the patients with gastric cancer surgery, of which 8 were gastritis-like early gastric cancer and 5.1% were early gastric cancer. Endoscopic showed congestion (crimson) in 3 cases, superficial erosion in 5 cases. Surgical pathology confirmed Type IIa (superficial bulge) in 1 case, Type IIb (superficial flat) in 7 cases; 1 in submucosa and 7 in mucosa. Conclusion: It is expected to further improve the clinical diagnosis and treatment of gastritis-like early stage gastric cancer, especially to enhance the ability to recognize gastroscope, to develop gastroscopy, gastroscope electron microscopy and confocal laser microendoscopy for the diagnosis of gastritis-like early stage gastric cancer.