CAJ | 학술논문

目的提高胃癌术前诊断的准确性,评价血管造影(DSA)在胃癌浸润深度诊断中的作用；观察胃窦癌淋巴结转移规律与血供的关系。方法根据胃周的主要血管在进入胃壁各层的同时逐级分支的原理,通过识别走行于不同层次的血管所发生的变化判断胃癌的浸润深度。观察101例胃癌患者血管造影结果，与手术及病理结果进行对比,得出准确率并进行评价；观察35例经肝总动脉及腹腔动脉血管造影的胃窦癌的主要供血血管。结果 101例患者血管造影结果对胃癌浸润深度诊断的准确率为79.2%；胃窦癌的主要供血血管是胃网膜右动脉。结论血管造影对胃癌浸润深度诊断的准确性较高，为胃癌浸润深度的术前诊断提供了新的途径；胃窦癌的主要供血血管与淋巴结转移的主要方向存在着一致性，这可能是胃窦癌易出现幽门下淋巴结转移的原因。
목적제고위암술전진단적준학성,평개혈관조영(DSA)재위암침윤심도진단중적작용；관찰위두암림파결전이규률여혈공적관계。방법근거위주적주요혈관재진입위벽각층적동시축급분지적원리,통과식별주행우불동층차적혈관소발생적변화판단위암적침윤심도。관찰101례위암환자혈관조영결과，여수술급병리결과진행대비,득출준학솔병진행평개；관찰35례경간총동맥급복강동맥혈관조영적위두암적주요공혈혈관。결과 101례환자혈관조영결과대위암침윤심도진단적준학솔위79.2%；위두암적주요공혈혈관시위망막우동맥。결론혈관조영대위암침윤심도진단적준학성교고，위위암침윤심도적술전진단제공료신적도경；위두암적주요공혈혈관여림파결전이적주요방향존재착일치성，저가능시위두암역출현유문하림파결전이적원인。
Objectives　To increase the accuracy of preoperative diagnosis of gastric cancer and to evaluate the approach for detecting the invasion depth by of gastric cancer with digital substaction angiography (DSA).　Methods　Gastric vessels were divided and subdivided into branches in different layers of the gastric wall. The vessels were first divided into parietal branch in the muscle layer. The parietal branch was then subdivided into subsidiary anastomotic channels in the mucosal layer. Invasion of gastric cancer made corresponding vessel branches narrow or obliterated for detecting its depth by vascular changes in different vessel branches. Analysis of 101 patients showed that, the accuracy rate was obtained by comparing the DSA results with postoperative pathological findings. Hepatica communis DSA was performed at in 35 cases of lower third gastric careinoma focusins on the main blood supply vessels.　Results　The accuracy rate of DSA diagnosis in the 101 patients was 79.2%; most lower third gastric carcinomas had blood supply from the right artery in the gastric omentum.　Conclusions　DSA for detecting the invasion depth of gastric cancer is practical and accurate. For lower third gastric cancer, the runing of major blood supply vessels is as the same as lymph flow. This may contribute to the metastasis of lower third gastric carcinoma.