目的 回顾性分析早期胃癌(early gastric cancer,EGC)内镜、病理检查特征及其与浸润深度的关系。方法 选择经胃镜下诊断+活组织病理检查及手术后病理确诊为EGC的72例患者资料,分析内镜诊断及其临床病理特征,探讨EGC的内镜、临床病理特征及其与浸润深度相关性。结果 EGC患者的性别、年龄、主要症状、分化程度、内镜下形态学分型均与浸润深度无相关性。病灶大小直径≥2 cm者,15例侵及黏膜下层,占60.0%,病灶大小与浸润深度存在统计学关联(χ2＝22.273,P=0.000, Cramer’s V=0.556);病灶部位与浸润深度存在统计学关联(χ2＝17.743,P=0.000,Cramer’s V =0.496),上部侵及黏膜下层占77.78%,而中部及下部仅12例侵及黏膜下层(19.05%)。结论 EGC的病灶部位、病变大小与肿瘤浸润深度密切相关,探索EGC浸润深度相关的内镜及病理表现规律,可为EGC的检出、治疗与预后判断提供进一步指导依据。
Abstract
Objective To study the correlation between endoscopy, pathologic characteristics and tumor invasion in early gastric cancer (EGC) by a retrospective analysis. Methods Endoscopic and clinicopathological features in 72 patients by endoscopy, pathological and post-operative EGC diagnosis were analyzed. Results Gender, age, main symptoms, differentiation, and endoscopic morphology typing of patients was not correlated with depth of invasion (P>0.05). 15 cases with submucosal tumor invasion and the lesion size diameter≥2 cm accounted for 60.00% (χ2=22.273, P=0.000, Cramer’s V coefficient=0.556). Lesion site is associated with depth of invasion (χ2=17.743, P=0.000, Cramer’s V coefficient=0.496). The upper lesion invading the submucosa accounted for 77.78%, while the middle and lower lesion invading the submucosa, only in 12 cases, accounted for 19.05%. Conclusions Lesion site and lesion size in EGC are closely related to the depth of invasion. It will provide further guidance for EGC in detection, treatment and prognosis.
关键词
早期胃癌 /
内镜 /
病理特征 /
浸润深度
Key words
early gastric cancer /
endoscop /
pathological features /
depth of infiltration
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Ferlay J, Shin H, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008[J]. Int J Cancer, 2010, 127(12): 2893-2917.
[2] Qu H M,Bai Y N,Cheng N, et al. Trend analysis of cancer mortality in the Jinchang Cohort, China, 2001-2010[J]. Biomed Environ Sci, 2015, 28(5): 364-369.
[3] Choi J, Kim S G, Im J P, et al. Long-term clinical outcomes of endoscopic resection for early gastric cancer [J]. Surg Endosc, 2015, 29(5):1223-1230.
[4] Ali Z, Deng Y, Ma C. Progress of research in gastric cancer [J]. J Nanosci Nanotechnol, 2012, 12(11): 8241-8248.
[5] Chiu P W. Novel endoscopic therapeutics for early gastric cancer [J]. Clin Gastroenterol Hepatol, 2014, 12(1): 120-125.
[6] Participants in the Paris Workshop. The Paris endoscopic classification of superficial neoplastic lesions: esophagus,stomach, and colon: November 30 to December 1, 2002 [J]. Gastrointest Endos, 2003, 58(6 Suppl): S3-S43.
[7] Li Z, Li Q. The latest 2010 WHO classification of tumors of digestive system [J]. Zhonghua Bing Li Xue Za Zhi, 2011, 40(5): 351-354.
[8] De Martel C, Forman D, Plummer M. Gastric cancer epidemiology and risk factors [J]. Gastroenterol Clin North Am, 2013, 42(2): 219-240.
[9] Dawood S. Updates from Gastrointestinal ASCO 2015[J]. Indian J Med Paediatr Oncol, 2015, 36(2): 133-136.
[10] Gotoda T, Jung H Y. Endoscopic resection (endoscopic mucosal resection/ endoscopic submucosal dissection) for early gastric cancer [J]. Dig Endosc, 2013, 25(Suppl 1): 55-63.
[11] Zhao B W, Chen Y M, Jiang S S, et al. Lymph node metastasis, a unique independent prognostic factor in early gastric cancer[J]. PLoS One, 2015, 10(7): e0129531.
[12] Shin N, Jeon T Y, Kim G H, et al. Unveiling lymph node metastasis in early gastric cancer[J]. World J Gastroenterol, 2014, 20(18): 5389-5395.
[13] Kim D Y, Joo J K, Ryu S Y, et al. Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma [J]. World J Gastroenterol, 2004, 10(5): 737-740.
PDF(498 KB)
