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美国外科医师学院(ACS)癌肿委员会收集美国700家以上ACS支持癌肿方案者的18365例胃癌统 计资料,其中1982年和1987年年度治疗分别占11264例和7101例,作为远期和近期研究组.63%系男性,中位值年龄68.4岁;37%系女性,中往值年龄71.9岁,全组51.3%病人的年龄超过70岁.两组的差别不大.(1)症状 消瘦占61.6%,腹痛51.6%,恶心34.3%,呕吐32.0%,吞咽困难26.1%,黑粪20.2%.以往史有胃溃疡达25.5%,十二指肠溃疡75%,恶性贫血5.9%,胃息肉3.5%,大肠息肉3.0%,小肠息肉病1.4%.(2)诊断方法1982年和1987年的胃肠钡餐检查分别占82%和66%,诊断阳性率分别为75%和74%;腹部CT为28%和G4%,诊断阳性率为65%和67%;胃镜检查为88%和93%,诊断阳性率为87.2%和87.0%.(3)病灶位置 位于胃上、中和下1/3分别占30.5%、13.9%和26%,占据全胃达10%.(4)治疗13295例(72.4%)进行了探查,其中胃上、中和下1/3病灶的切除率分别为79.9%、82.8%和85.0%,全胃侵犯者的切除率为50.3%.1/4病例的切除范围包括了食管,胃和胃周淋巴结清扫分别占47%和49%,其中67%为阳性.(5)合并脏器切除 同时切除食管29%、脾23%、胰7%和结肠7%.
The American College of Surgeons (ACS) Cancer Committee collected 18,365 cases of gastric cancer in more than 700 ACS-supporting cancer programs in the United States, of which 11264 cases and 7101 cases were treated in 1982 and 1987, respectively, as long-term and short-term studies. Group: 63% were males, median age 68.4 years; 37% were females, middle to old age 71.9 years, and 51.3% of all patients were older than 70 years. The difference between the two groups was not significant. (1) Symptoms of weight loss 61.6%, abdominal pain 51.6%, nausea 34.3%, vomiting 32.0%, dysphagia 26.1%, black feces 20.2%. Previous history of gastric ulcer was up to 25.5%, duodenal ulcer 75%, pernicious anemia 5.9%, gastric polyps 3.5 %, colorectal polyps 3.0%, intestinal polyposis 1.4%. (2) Diagnostic Methods 1982 and 1987 gastrointestinal barium examination accounted for 82% and 66%, respectively, the diagnostic positive rate was 75% and 74%; abdominal CT 28% and G4%, the diagnostic positive rate was 65% and 67%; gastroscopy was 88% and 93%, and the diagnostic positive rate was 87.2% and 87.0%. (3) The lesions were located on the upper, middle and lower 1/3 of the stomach. Occupied 30.5%, 13.9%, and 26% respectively, occupying 10% of total stomach. (4) 13295 cases (72.4%) were probed, among which the resection rates of upper, middle, and lower 1/3 lesions were 79.9% respectively. , 82.8% and 85.0% of total stomach infringers The removal rate of 50.3%.1/4 of the cases included esophageal, gastric, and gastric lymph node dissections, which accounted for 47% and 49%, respectively, of which 67% were positive. (5) 29% of the esophagus was resected with simultaneous organ resection. Spleen 23%, pancreas 7% and colon 7%.