中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2009年
4期
354-356
,共3页
李威%孙晓卫%詹友庆%关远祥%陈映波%徐大志
李威%孫曉衛%詹友慶%關遠祥%陳映波%徐大誌
리위%손효위%첨우경%관원상%진영파%서대지
胃肿瘤%肿瘤%残余%切缘%胃切除术
胃腫瘤%腫瘤%殘餘%切緣%胃切除術
위종류%종류%잔여%절연%위절제술
Stomach neoplasms%Neoplasm,residual%Incisal edge%Gastreetomy
目的 了解胃癌手术切缘癌残留的病理特点,以探讨相应预防对策.方法 整理分析1964年12月至2004年12月间胃癌术后108例发生切端残留癌患者的临床资料.结果 108例手术切端残留癌患者占同期有完整资料的胃癌手术患者1670例的6.5%.男女比例为1.4:1.0:年龄23～82(中位年龄54)岁.根治性、姑息性胃癌切除术切端残留癌发生率分别为3.6%(48/1333)和17.8%(60/337)(P=0.000).早期和进展期胃癌切除术切端残留癌发生率分别为2.3%(3/129)和6.8(105/1541)(P=0.046).远、近端胃癌切除术切端癌残留率分别为4.5%(37/815)和8.0%(55/689)(P=0.000).胃上部癌、Borrmann Ⅲ、Ⅳ型、进展期癌、癌肿直径大于或等于5 cm、低和未分化癌以及癌肿侵破浆膜者,易发生癌残留(均P<0.05).结论 癌残留与患者病期及肿瘤的Borrmann分型、大小、分化程度和浸润深度有关.
目的 瞭解胃癌手術切緣癌殘留的病理特點,以探討相應預防對策.方法 整理分析1964年12月至2004年12月間胃癌術後108例髮生切耑殘留癌患者的臨床資料.結果 108例手術切耑殘留癌患者佔同期有完整資料的胃癌手術患者1670例的6.5%.男女比例為1.4:1.0:年齡23～82(中位年齡54)歲.根治性、姑息性胃癌切除術切耑殘留癌髮生率分彆為3.6%(48/1333)和17.8%(60/337)(P=0.000).早期和進展期胃癌切除術切耑殘留癌髮生率分彆為2.3%(3/129)和6.8(105/1541)(P=0.046).遠、近耑胃癌切除術切耑癌殘留率分彆為4.5%(37/815)和8.0%(55/689)(P=0.000).胃上部癌、Borrmann Ⅲ、Ⅳ型、進展期癌、癌腫直徑大于或等于5 cm、低和未分化癌以及癌腫侵破漿膜者,易髮生癌殘留(均P<0.05).結論 癌殘留與患者病期及腫瘤的Borrmann分型、大小、分化程度和浸潤深度有關.
목적 료해위암수술절연암잔류적병리특점,이탐토상응예방대책.방법 정리분석1964년12월지2004년12월간위암술후108례발생절단잔류암환자적림상자료.결과 108례수술절단잔류암환자점동기유완정자료적위암수술환자1670례적6.5%.남녀비례위1.4:1.0:년령23～82(중위년령54)세.근치성、고식성위암절제술절단잔류암발생솔분별위3.6%(48/1333)화17.8%(60/337)(P=0.000).조기화진전기위암절제술절단잔류암발생솔분별위2.3%(3/129)화6.8(105/1541)(P=0.046).원、근단위암절제술절단암잔류솔분별위4.5%(37/815)화8.0%(55/689)(P=0.000).위상부암、Borrmann Ⅲ、Ⅳ형、진전기암、암종직경대우혹등우5 cm、저화미분화암이급암종침파장막자,역발생암잔류(균P<0.05).결론 암잔류여환자병기급종류적Borrmann분형、대소、분화정도화침윤심도유관.
Objective To explore the reason, features and preventive measures of residual carcinoma at incisal edge after gastric cancer operation. Methods Clinical data of 108 cases with positive incisal margin (6.47%) from December 1964 to December 2004 in Cancer Center of Sun Yat-sen were summarized and analyzed retrospectively. Results Positive incisal margin patients accounted for 6.5%(108/1670) of total gastric carcinoma cases during above period. There were 62 men and 46 women with median age of 54 years (ranged from 23 to 82). The residual carcinoma rates of incisal edge were 3.6%(48/1333) in radical resection group and 17.8%(60/337) in palliative resection group respectively (P=0.000). Also, the residual carcinoma rates were 2.3%(3/129) in early group, 6.8 (105/1541) in advanced group (P=0.046), 4.5%(37/815)in distal gastrectomy group and 8.0%(55/689) in proximal group respectively (P=0.000). Residual carcinomas were related with pTNM stage, Borrmann type, tumor size, differentiation and invasion depth (P<0.05).Conclusions Superior gastric carcinoma, Borrmann Ⅲ,Ⅳ type advanced cancer, tumor diameter ≥5cm, poor differentiation or undifferentiated type and serosa invaded easily result in residual carcinoma at incisal edge. The radical preventive measure is to ensure that incisal edge ought to exceed 5 cm apart from the tumor.
