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目的探讨了解妊娠期胃癌的特点和误诊原因,以提高临床医师对本病的认识,减少误诊,提高患者的生存率。方法回顾分析1997年7月～2007年6月我院收治的13例妊娠期胃癌患者的临床资料。结果患者均有恶心、呕吐、上腹部不适、腹痛并进行性加剧,2例出现消化道梗阻症状,3例有消化道出血征,包括呕血、黑便及严重的贫血。确诊后13例行手术治疗,其中低分化腺癌8例,黏液细胞癌3例,印戒细胞癌2例;确诊后1年内死亡8例,2年内死亡5例。结论妊娠期胃癌容易误诊且恶性程度高,死亡率高,预后差。临床医师应增强对本病的认识,减少误诊,提高诊断率,减少患者的死亡率。
Objective To investigate the characteristics and misdiagnosis of gestational gastric cancer in order to improve clinicians’ awareness of the disease, reduce misdiagnosis and improve the survival rate of patients. Methods The clinical data of 13 patients with gestational gastric cancer admitted to our hospital from July 1997 to June 2007 were retrospectively analyzed. Results All patients had nausea, vomiting, abdominal discomfort, abdominal pain and progressive exacerbations. Two patients had gastrointestinal obstruction symptoms and three had gastrointestinal bleeding symptoms including hematemesis, melena and severe anemia. After diagnosis, 13 cases underwent surgical treatment, including 8 cases of poorly differentiated adenocarcinoma, 3 cases of mucinous cell carcinoma and 2 cases of signet ring cell carcinoma; 8 cases died within 1 year after diagnosis and 5 cases died within 2 years. Conclusions Gestational gastric cancer is easily misdiagnosed and has a high degree of malignancy, high mortality and poor prognosis. Clinicians should enhance awareness of the disease, reduce misdiagnosis, improve the diagnostic rate and reduce patient mortality.