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1.本文总结我院经纤维胃镜检查2000例中,胃镜直视下加活检和外科手术病理证实为胃癌共171例,占胃镜检查总数8.55%,仅次于慢性胃炎、溃疡病而居第三位。胃癌发病年龄从40岁开始即显著增高,尤以60～69岁年龄组占大半数,男性显著高于女性。临床表现依次为上腹隐痛,饱胀,食欲减退,消瘦乏力,呕血/黑便等一般胃病表现。临床检查缺乏特征性变化,病程长短亦甚悬殊,与伴存慢性胃炎有关。2.胃癌多发部位为胃窦部(47.4%),其次为贲门胃底(33.3%),胃体(18.1%)等,分型诊断按通用 Borrman 氏分型以Ⅳ型最多见(33.9%),本组早期胃癌检出率为7.6%,均经手术病理检查证实。本组除1例为少见的鳞状细胞外,其余均为腺癌。3.本组胃癌伴存萎缩性胃炎占36.8%,其中有半数有肠上皮化生,4例间变,浅表性胃炎16.4%,球部溃疡2例。4.本文对常用诊断胃癌的胃镜、活检、GI三者进行了比较,诊断正确率分别为92.4%,97.1%及79.5%,以活检阳性率最高,并对这三种诊断方法可能产生的假阴性进行初步讨论。5.本文对十二指肠溃疡伴存胃癌之所以少见的原因简要进行了说明。
1. This article summarizes our hospital by fiberoptic gastroscopy in 2000 cases, gastroscopy under direct vision plus biopsy and surgical pathology confirmed a total of 171 cases of gastric cancer, accounting for 8.55% of the total number of gastroscopy, second only to chronic gastritis, ulcer disease and third Bit. The onset age of gastric cancer was significantly increased from the age of 40, especially in the age group of 60-69 years, and males were significantly higher than females. The clinical manifestations were epigastric pain, fullness, loss of appetite, weight loss, weakness, vomiting/blackness and other general stomach symptoms. The lack of characteristic changes in clinical examinations and the length of the disease are also very different and are related to chronic gastritis. 2. Gastric cancer multiple sites were gastric antrum (47.4%), followed by cardia gastric fundus (33.3%), gastric body (18.1%), etc., and the most common type was diagnosed according to the general Borrman’s classification type IV (33.9%). The detection rate of early gastric cancer in this group was 7.6%. All of them were confirmed by pathological examination. In this group, except 1 case of rare squamous cells, the rest were adenocarcinoma. 3. In this group, atrophic gastritis accounted for 36.8%, of which half had intestinal metaplasia, 4 cases changed, superficial gastritis 16.4%, and bulbous ulcers in 2 cases. This article compares the gastroscope, biopsy and GI used in the diagnosis of gastric cancer. The diagnostic accuracy rate is 92.4%, 97.1% and 79.5% respectively. The highest rate of positive biopsy results in the false positives of these three diagnostic methods. Negative initial discussion. 5. This article briefly explains the reason why duodenal ulcer associated with gastric cancer is rare.