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目的探讨老年人早期胃癌的诊断。方法将经手术及病理证实的老年人早期胃癌48例,予以临床分析。结果内镜检查早期胃癌分3型:Ⅰ(隆起型)12例(占25.0%),镜下可见息肉样隆起。Ⅱ(浅表型)21例(占43.8%),内镜下见黏膜平坦糜烂,局限性僵硬。Ⅲ(凹陷型)15例(占31.2%),可见凹陷性溃疡,边缘不清。X线检查表现:小龛影13例(符合内镜下凹陷型),黏膜充盈缺损10例(符合内镜隆起型),黏膜残缺不齐,黏膜壁僵硬9例。结论老年人早期胃癌多无消化道表现,内镜下活检是发现早期胃癌最可靠最重要的方法。多法结合的X线检查对早期胃癌的诊断有肯定的价值,与胃镜配合对胃癌的早期诊断有互补作用。
Objective To investigate the diagnosis of early gastric cancer in the elderly. Methods 48 cases of early gastric cancer confirmed by operation and pathology were analyzed clinically. Results Endoscopic examination of gastric cancer in early 3: Ⅰ (bulging) in 12 cases (25.0%), microscopic polyps can be seen uplift. Ⅱ (superficial) in 21 cases (43.8%), endoscopic mucosal flat erosion, the limitations of stiffness. Ⅲ (depressed type) 15 cases (31.2%), showing depressed ulcers, the edge is unclear. X-ray examination showed that there were 13 cases of niche shadow (in accordance with endoscopic concave type), 10 cases of mucosal filling defect (in line with endoscopic uplift type), incomplete mucosal mucosa, and 9 cases of mucosal wall stiffness. Conclusion There are no gastrointestinal manifestations of early gastric cancer in elderly patients. Endoscopic biopsy is the most reliable and important method for detecting early gastric cancer. Multiple X-ray examination combined with the diagnosis of early gastric cancer have a certain value, and gastroscopy with the early diagnosis of gastric cancer have a complementary effect.