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近30年来日本的胃癌预后明显改善,由于放射学和内窥镜检查的改进,其早期确诊率提高,术后5年和10年生存率分别达90%和80%。本文作者重点复习了日本和西方国家现行的诊断和治疗方法,藉此找出治疗的最佳方案。早期胃癌的诊断:早期胃癌应根据下列情况再进一步分型:(1)病变局限于粘膜层或已浸润至粘膜下层;(2)大体表现;(3)单发或多发病灶;(4)其组织学类型,西方国家普遍认为内窥镜检可增加检出15%早期胃癌,较放射学检查更为敏感,列为首选方法,但日本某些报道改进摄片方法和双对比造影检查的诊
Over the past 30 years, the prognosis of gastric cancer in Japan has improved significantly. Due to improvements in radiology and endoscopy, the rate of early diagnosis has improved. Postoperative 5- and 10-year survival rates have reached 90% and 80%, respectively. The author of this article reviewed the current diagnostic and therapeutic methods in Japan and Western countries in order to find out the best treatment. Diagnosis of early gastric cancer: Early gastric cancer should be further classified according to the following conditions: (1) lesions confined to the mucosa or have infiltrated into the submucosa; (2) general manifestations; (3) single or multiple lesions; (4) Histologically, Western countries generally believe that endoscopy can increase the detection of 15% of early gastric cancer, which is more sensitive than radiological examination and is listed as the preferred method. However, some reports from Japan improve the methods of radiography and double contrast imaging.