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本文报告22例胃溃疡癌。男16例,女6例。手术时年龄为32～66岁,平均49.6岁。皆有典型胃溃疡症状,但X线印象,仅4例为溃疡癌。5年生存率为42％。溃疡最大直径,除1例1cm外,皆3～6.5cm,平均4.5cm。溃疡发生部位,计胃窦17例,胃体小弯侧3例,胃体大弯侧和贲门部各1例。镜下,皆有典型慢性胃溃疡的组织学改变。癌紧靠溃疡边缘,向内、外和深层侵犯。在溃疡底部,皆有一瘢痕组织区,既无残存的平滑肌,又无癌浸润。组织学类型,计管状腺癌10例,弥散性癌9例,乳头状腺癌、粘液腺癌和粘液细胞癌各1例。11例有淋巴结转移。影响预后的因素,依次为淋巴结转移、侵犯深度和组织学类型。胃溃疡癌,在临床、病理和预后上,与普通胃癌不同。同意暂列为特殊类型,以便深入研究。
This article reports 22 cases of gastric ulcer cancer. There were 16 males and 6 females. The age ranged from 32 to 66 years old, with an average of 49.6 years. There are typical symptoms of gastric ulcer, but X-ray impression, only 4 cases of ulceration. The 5-year survival rate was 42%. The maximum diameter of the ulcer, except 1 case 1cm, are all 3 ~ 6.5cm, an average of 4.5cm. The sites of ulceration occurred in 17 cases of gastric antrum, 3 cases of minor curvature of the corpus, and 1 case of the major curvature of the body and the cardia. Under the microscope, there are typical histological changes in chronic gastric ulcers. Cancer close to the edge of the ulcer, inward, external and deep violations. At the bottom of the ulcer, there is a scar tissue area with no residual smooth muscle and no cancer infiltration. Histological types included 10 cases of tubular adenocarcinoma, 9 cases of disseminated carcinoma, 1 case of papillary adenocarcinoma, mucinous adenocarcinoma, and 1 case of mucinous cell carcinoma. Eleven patients had lymph node metastasis. The factors affecting the prognosis were lymph node metastasis, depth of invasion, and histological type. Gastric ulcer cancer is different from normal gastric cancer in clinical, pathological and prognosis. Agree to be classified as a special type for further study.