中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2013年
3期
225-229
,共5页
黄帅%郑朝旭%徐泉%袁兴华
黃帥%鄭朝旭%徐泉%袁興華
황수%정조욱%서천%원흥화
胃肿瘤%癌,小细胞%病理学,外科%预后
胃腫瘤%癌,小細胞%病理學,外科%預後
위종류%암,소세포%병이학,외과%예후
Stomach neoplasms%Carcinoma,small cell%Pathology,surgery%Prognosis
目的 探讨胃小细胞癌(SCC)的临床病理特征和影响其预后的因素.方法 回顾性分析2000年1月至2012年1月间41例胃SCC患者的临床病理及随访资料.男性35例,女性6例；确诊年龄39 ～ 84岁,中位年龄62岁；胃上部病变31例(75.6％),胃中部3例(7.3％),胃下部7例(17.1％).结果 41例胃SCC患者出现不适症状至最终确诊的时间间隔1～13个月,中位时间为3个月；肿瘤最大径2.5～15.0 cm,平均6.5 cm;38例(92.7％)以手术为初始治疗方案,其中25例(61.0％)行根治性肿瘤切除术,13例(31.7％)行姑息性手术,3例(7.3％)仅行化疗.初始的Ⅱ、Ⅲ、Ⅳ期患者分别为2、31和8例.所有患者的中位生存期为19个月,中位无病生存期11个月,1、2、5年生存率分别为70.7％、46.3％和36.6％.患者的总体生存期与肿瘤最大径(x2=5.565)、体重变化(x2=3.688)、手术的根治程度(x2=11.747)以及是否复发(x2=17.966)有关(P＜0.05).结论 胃SCC是胃恶性肿瘤中的罕见病理类型,临床误诊率较高,其病情进展迅速且预后较差,根治性手术切除肿瘤可以显著提高患者的生存期,以手术为主的综合治疗仍是胃SCC的主要治疗手段.
目的 探討胃小細胞癌(SCC)的臨床病理特徵和影響其預後的因素.方法 迴顧性分析2000年1月至2012年1月間41例胃SCC患者的臨床病理及隨訪資料.男性35例,女性6例；確診年齡39 ～ 84歲,中位年齡62歲；胃上部病變31例(75.6％),胃中部3例(7.3％),胃下部7例(17.1％).結果 41例胃SCC患者齣現不適癥狀至最終確診的時間間隔1～13箇月,中位時間為3箇月；腫瘤最大徑2.5～15.0 cm,平均6.5 cm;38例(92.7％)以手術為初始治療方案,其中25例(61.0％)行根治性腫瘤切除術,13例(31.7％)行姑息性手術,3例(7.3％)僅行化療.初始的Ⅱ、Ⅲ、Ⅳ期患者分彆為2、31和8例.所有患者的中位生存期為19箇月,中位無病生存期11箇月,1、2、5年生存率分彆為70.7％、46.3％和36.6％.患者的總體生存期與腫瘤最大徑(x2=5.565)、體重變化(x2=3.688)、手術的根治程度(x2=11.747)以及是否複髮(x2=17.966)有關(P＜0.05).結論 胃SCC是胃噁性腫瘤中的罕見病理類型,臨床誤診率較高,其病情進展迅速且預後較差,根治性手術切除腫瘤可以顯著提高患者的生存期,以手術為主的綜閤治療仍是胃SCC的主要治療手段.
목적 탐토위소세포암(SCC)적림상병리특정화영향기예후적인소.방법 회고성분석2000년1월지2012년1월간41례위SCC환자적림상병리급수방자료.남성35례,녀성6례；학진년령39 ～ 84세,중위년령62세；위상부병변31례(75.6％),위중부3례(7.3％),위하부7례(17.1％).결과 41례위SCC환자출현불괄증상지최종학진적시간간격1～13개월,중위시간위3개월；종류최대경2.5～15.0 cm,평균6.5 cm;38례(92.7％)이수술위초시치료방안,기중25례(61.0％)행근치성종류절제술,13례(31.7％)행고식성수술,3례(7.3％)부행화료.초시적Ⅱ、Ⅲ、Ⅳ기환자분별위2、31화8례.소유환자적중위생존기위19개월,중위무병생존기11개월,1、2、5년생존솔분별위70.7％、46.3％화36.6％.환자적총체생존기여종류최대경(x2=5.565)、체중변화(x2=3.688)、수술적근치정도(x2=11.747)이급시부복발(x2=17.966)유관(P＜0.05).결론 위SCC시위악성종류중적한견병리류형,림상오진솔교고,기병정진전신속차예후교차,근치성수술절제종류가이현저제고환자적생존기,이수술위주적종합치료잉시위SCC적주요치료수단.
Objective To summarize and analyze the clinical feature,therapeutic methods and prognosis of gastric small cell carcinoma (SCC).Methods The clinical and pathological data of 41 patients diagnosed of gastric SCC were analyzed in this research.Also,the factors which may potentially affect the patients' survival outcome were evaluated.There were 35 male and 6 female patients.The age at diagnosis was 39-84 years,median age was 62 years.The 31 cases (75.6％) of gastric SCC patients were involved in the upper third of the stomach,3 cases (7.3％) in the middle,7 cases (17.1％) in the lower third.Results The time from the event of symptoms to final confirmation was 1 to 13 months,the median time was 3 months.The longest diameter of tumors was from 2.5 to 15.0 cm,the average was 6.5 cm.The 38 cases (92.7％) chosed surgery as the first treatment,among which 25 cases (61.0％) were performed radical tumor resection,13 cases (31.7％) went through palliative resection,and 3 cases (7.3％) just employed chemotherapy.The initial Ⅱ,Ⅲ,Ⅳ stage were 2,31 and 8 cases,respectively.The overall median survival time was 19 months,median disease free survival time was 11 months,1-,2-,5-years survival rates were 70.7％,46.3％ and 36.6％,respectively.In univariate survival analysis,the tumor size (x2 =5.565),change of the body weight (x2 =3.688),type of operation (x2 =11.747) and relapse or not (x2 =17.966) were obviously correlaed with the prognosis (P ＜ 0.05).Conclusions Gastric SCC is a rare disease of the gastrointestinal tract,the misdiagnosis rate is high,and the prognosis is dismal.Muti-modality management,with radical surgical resection of the primary lesion followed by standard adjuvant-chemotherapy,affords better local disease control and a better survival outcome.
