胃镜检出胃恶性病变3460例分析

目的:探索胃镜检出胃恶性病变患者的发病及胃镜、病理特点。方法:对我院1990～2009年胃镜诊断的3460例胃恶性病变患者按不同年龄分组进行胃镜及病理资料的回顾性分析、总结。结果:3460例胃恶性病变患者中,男性多于女性(2.26∶1),但年龄≤40岁组男女差别不大。50岁以上发病明显增高,特别是60～70岁发病率最高。胃窦部为胃癌的高发部位,年龄≤40岁组以胃体和胃窦为主,而60岁以上患者胃贲门食管连接部癌的发病率显著上升。年龄≤40岁组病理类型以分化差、恶性程度高的低分化腺癌和印戒细胞癌为主,随着年龄增长,病理类型逐渐趋向于以中分化管状腺癌、高分化管状腺癌为主。胃淋巴瘤多发于胃体、胃窦部,胃镜下表现以多发性溃疡病灶为主。结论:胃恶性病变的发病与年龄、性别密切相关,不同年龄组胃癌的发生部位、病理特点各不相同,应引起重视,同时应提高对青年人胃癌的认识,提倡和重视胃镜检查普及,做到早期发现、早期诊断、早期治疗。

Analysis of 3 460 cases of gastric malignant lesion detected by endoscopy

Objective To investigate the epidemiological, endoscopic and pathologic features of gastric malignant lesions detected by endoscopy. Methods The data of 3 460 patients with gastric malignant lesion detected by endoscopy were retrospectively analyzed for their endoscopic and pathologic features. Results The ratio of male to female in the overall 3 460 patients was 2.26：1, male more than female, but no significant difference was seen for ratio of male to female in patients less than 40 years of age. The incidence of gastric malignant lesion increased with age, especially over 50 years old, and the highest was seen between 60-70 years old. The location of the malignant lesion was mainly in gastric antrum in patients under 40 years of age, but mainly in gastroesophageal junction in patients over age of 60 years. Undifferentiated carcinomas such as poorly differentiated adenocarcinoma and signet-ring cell carcinoma were more commonly found in patients under age of 40 years old, but moderately differentiated and highly differentiated gastric tubular adenocarcinomas were more commonly found in patients over the age of 40 years. Gastric lymphoma located mainly in gastric antrum and gastric body, the endoscopic feature of gastric lymphoma was predominantly multiple ulcer lesions. Conclusions The morbidity of gastric malignant lesion has close relationship to age and sex; location of tumor and endoscopic and pathologic features are different for different age groups,which is important to be known by the physician. And we also have to improve our awareness of gastric cancer in young patients and pay attention to endoscopic examination, try our best to diagnosis and treat the patients early.