早期胃癌及胃炎样早期胃癌诊治

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。

The clinical screening study of gastrtis-like early gastic cancer

Objective To study the gastritis-like early gastric cancer （EGC）. Methods EGC screening results from 3 hospitals in 2009 were collected, especially gastritis-like EGC confirmed by postoperative pathological results. Results A total of 41 993 esophageo-gastroduodenoscopies was carried out in these 3 hospitals, of which 159 cases （19.6% of gastric cancer） were early gastric cancer confirmed by post-operative pathologic examination. Of patients with EGC, 8 cases （5.1%） were confirmed as gastritis-like EGC. The endoscopic appearance of the 8 cases was mucosal hyperemia in 3 cases and superficial erosion in 5 cases. The 8 cases were verified to be type Ⅱ a in 1 case and type Ⅱ b in 7 cases; 1 case with submucosal invasion and 7 with mucosal invasion. Conclusions It will help to enhance our clinical management level of gastric cancer if we strengthen our study on gastritis-like EGC by improving endoscopic identification with chromoendoscopy,electronic dye endoscopy and confocal laser endomicroscopy.