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目的 总结老年人早期胃癌临床病理特征 ,探讨其预后及影响患者生存质量的因素。 方法 分析 1973～ 1999年我院收治的 71例早期胃癌患者临床病理特点及术后随诊资料。 结果 常规胃镜检查发现早期胃癌 46例 ,占 6 4 8%。 71例中粘膜癌 5 3例 ,占 74 6 % ,无淋巴结转移 ;粘膜下癌 18例 ,占 2 5 4% ,淋巴结转移 2例。病变部位以胃窦部最多 ,为 32例 (4 5 1% )。组织学分型 :管状腺癌 43例 (6 0 6 % ) ,多原发癌 5例 (7 0 % )。术后残胃吻合口炎 31例 (4 3 7% ) ,残胃排空障碍 7例 ,吻合口糜烂 6例 ,吻合口溃疡 4例 ,反流性食管炎 3例 ,残胃癌 3例。体重下降 14例 ,贫血 9例。近端胃切除患者术后并发症多于远端胃切除者。 结论 增加老年慢性萎缩性胃炎患者胃镜随诊频度 ,可提高胃粘膜癌检出率。淋巴结转移、多原发癌及残胃癌是影响预后的重要因素。术后残胃病变发生率高。
Objective To summarize the clinical and pathological features of the elderly patients with early gastric cancer, to explore its prognosis and factors that affect the quality of life of patients. Methods The clinicopathological features and follow-up data of 71 patients with early gastric cancer admitted to our hospital from 1973 to 1999 were analyzed. Results Conventional gastroscopy found 46 cases of early gastric cancer, accounting for 64.8%. In 71 cases, 53 cases of mucosal cancer accounted for 74.6%, no lymph node metastasis, 18 cases of submucosal cancer, accounting for 25.4%, and 2 cases of lymph node metastasis. The largest number of lesions in the gastric antrum was 32 cases (45.1%). Histological classification: 43 cases (66.6%) of tubular adenocarcinomas and 5 cases (70%) of multiple primary cancers. Postoperative residual gastrostomy had 31 cases (43.7%), residual gastric emptying in 7 cases, anastomotic erosion in 6 cases, anastomotic ulcer in 4 cases, reflux esophagitis in 3 cases, and residual gastric cancer in 3 cases. There were 14 cases of weight loss and 9 cases of anemia. Patients with proximal gastrectomy had more postoperative complications than distal gastrectomy. Conclusion Increasing the frequency of gastroscopy in patients with chronic atrophic gastritis in the elderly can increase the detection rate of gastric cancer. Lymph node metastasis, multiple primary cancers and residual gastric cancer are important factors affecting prognosis. Postoperative residual gastric lesions have a high incidence.