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本组男37例,女9例,年龄48～74岁,平均59.7岁,50岁以上41例。表现为呕血和黑便者11例,便血34例。8例既往无慢性胃病史,以上消化道出血就诊。2例出血量>1000ml。39例曾行X线钡餐检查,20例与诊断相符或基本相符,19例误诊或漏诊。 结果:胃镜检查示病变位于贲门小弯侧24例,大弯侧3例,前壁4例,后壁2例,累及贲门四壁9例。隆起型12例,呈菜花样或不规则隆起,表面高低不平,充血糜烂伴有浅表溃疡;溃疡型23例,表面覆有污苔,边缘较隆起而不规则;浸润型11例(包括弥漫浸润型4例)。组织学检查(部分作细胞涂片检查)示腺癌33例,低分化腺癌9例,未分化腺癌2例,粘液腺癌2例。
This group of 37 males and 9 females, aged 48 to 74 years, an average of 59.7 years old, over the age of 41 in 41 cases. There were 11 cases of hematemesis and melena, and 34 cases of hematochezia. Eight patients had no previous history of chronic gastritis, and there was a diagnosis of gastrointestinal bleeding. 2 cases of blood loss> 1000ml. Thirty-nine patients had X-ray barium meal examination, 20 cases were consistent with the diagnosis or basically consistent, 19 cases were misdiagnosed or missed diagnosis. RESULTS: Gastroscopy showed that the lesions were located in 24 cases on the minor curve side of the cardia, 3 cases on the major curvature side, 4 cases on the anterior wall, and 2 cases on the posterior wall. There were 9 cases involving the posterior wall of the cardia. 12 cases of uplift type, with cauliflower or irregular uplift, uneven surface, congestive erosion accompanied by superficial ulcers; 23 cases of ulceration, covered with a dirty coating on the surface, the edge is more uplifting and irregular; 11 cases of infiltration (including diffuse Infiltrative type 4 cases). Histological examination (partial smear examination) showed 33 cases of adenocarcinoma, 9 cases of poorly differentiated adenocarcinoma, 2 cases of undifferentiated adenocarcinoma, and 2 cases of mucinous adenocarcinoma.