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凡癌肿限于粘膜内或浸润及粘膜下,无论有无淋巴结转移均称早期胃癌。前者称粘膜内癌(M癌)或原位癌,后者称浸润癌(Sm癌)。此外,癌灶≤1.0cm称小胃癌,≤0.5cm者称微小胃癌。早期胃癌手术切除后五年生存率高达90%以上,故临床上致力于早期胃癌的检出。自纤维胃镜应用以来早期胃癌的检出率不断提高,尤其日本近年来早期胃癌的检出率有的报告已占胃癌的40%以上;国内最高有达29.5%者,但一般仍在4～9%左右,甚至更低。近十余年来华东医院共检出早期胃癌75例(占7.8%),其中小胃癌12例,微小胃癌6例;南方医院共检出16例(占5.4%),其中小胃癌5例。现就两院纤维胃镜检出早期胃癌的体会介绍如下: 一、要时刻想着早期胃癌的形态特点1962年日本内窥镜学会提出了早期胃癌形态分类法,分为三型。Ⅰ型为隆起型;Ⅱ型为浅表型,再分为三个亚型,即
Where the cancer is limited to the mucosa or infiltration and submucosa, with or without lymph node metastasis are called early gastric cancer. The former is called intramucosal cancer (M cancer) or carcinoma in situ, and the latter is called invasive cancer (Sm cancer). In addition, cancer lesions ≤ 1.0cm are called small gastric cancers, and ≤ 0.5cm are called tiny gastric cancers. The five-year survival rate of early gastric cancer after surgical resection is as high as 90%, so it is clinically dedicated to the detection of early gastric cancer. The detection rate of early gastric cancer since the application of fiberoptic gastroscope has been continuously improved. In particular, in recent years, the detection rate of early gastric cancer in Japan has accounted for more than 40% of gastric cancer; the highest in the country has reached 29.5%, but generally still 4 to 9 % is about or even lower. Over the past decade, East China Hospital has detected 75 cases of early gastric cancer (7.8%), including 12 cases of small gastric cancer and 6 cases of tiny gastric cancer; 16 cases (5.4%) were detected in Southern Hospital, including 5 cases of small gastric cancer. The experience of early detection of early gastric cancer by fiberoptic gastroscopy in the two hospitals is described below. First, we must always think about the morphological features of early gastric cancer. In 1962, the Japanese Endoscopy Society proposed the morphology classification of early gastric cancer, which is divided into three types. Type I is an uplift type; Type II is a superficial type and is subdivided into three subtypes: