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一、内窥镜在胃癌早期发现方面的进展 1962年日本胃肠学内窥镜学会提出“早期胃癌”肉眼分类和定义以来,在日本内窥镜诊断,应用普及,有了惊人进步,从而使早期患者发现数字增加。更重要的能发现很多更平坦、更小甚至恶性征象不明显的病变。日本国立癌中心(NCCH)的经验是(吉田教授报告): 1.已切除的早期胃癌(EGC)978例的分析,自1976年Ⅰ型者明显减少,而Ⅱc则相对地增加;自1978年非溃疡性平坦病变(Ⅱb或Ⅱb样型)增加;1980年内窥镜下恶性表现较少的患者迅速增加。另外,1976年以降<1cm的小胃癌和ⅡC型中等分化型腺癌均见增加。 1979年NCCH对进行期胃癌进行回顾性调研,发现非溃疡性病变,那些易被认为良性胃炎样改变,常常即已是早期胃癌,有些在1～2年内迅速
First, the advancement of endoscopy in the early detection of gastric cancer In 1962, the Japanese Society of Gastrointestinal Endoscopy proposed the “early stomach cancer” macroscopic classification and definition, since the endoscopic diagnosis in Japan, the application of popularization has made amazing progress, so that early The number of patients found increased. More importantly, we can find many lesions that are flatter, smaller, and have no obvious signs of malignancy. The experience of the National Cancer Center (NCCH) of Japan (Report by Professor Yoshida): 1. The analysis of 978 cases of resected early-stage gastric cancer (EGC) has been significantly reduced since 1976, while IIc has been relatively increased; since 1978 Non-ulcerative flat lesions (type IIb or IIb) increased; patients with less malignant endoscopic manifestations increased rapidly in 1980. In addition, in 1976, a small gastric cancer with a drop of 1 cm and a moderately differentiated adenocarcinoma of IIC were increased. In 1979, the NCCH conducted a retrospective study of gastric cancer in progress, found that non-ulcer lesions, those that are considered benign gastritis-like changes, often that is early gastric cancer, some in 1 to 2 years quickly