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目的对4451例消化道癌作病理学分析,提供基本资料.方洁对本院1983/1997间手术和检查并经病理诊断为消化道癌的所有病例作统计学分析,并按癌发部位将青(<30岁)、壮(30岁~40岁)、中老(40岁~70岁)、高年(>70岁)组作对比分析.结果本组男女之比约2:1;年龄7岁~87岁,平均61岁;各(青~高)年龄组占3.5%,9.5%,70%,17%;食管、贲门胃、小肠、大肠各占17.1%,50.7%,0.6%,31.6%;中老年组及高年组的食管高、低分化型鳞癌、大肠高、低分化型腺癌、粘液腺癌、乳头状腺癌均较青、壮年组的发生有显著性差异(x2检验,P<0.01,P<0.05).贲门部及胃病理类型相近,均以腺癌为极多,腺鳞癌及鳞癌罕见.贲门胃部低分化腺癌(占同部位79%)和印戒细胞癌(占所有同类型90%)的发生率高;其转移及残胃癌复发率(11%,8%),恶性度较高和预后差.癌前病变687例,与所有癌比为1:6.5;早期癌193例,占总数4.3%.结论普及筛查(如钡气造影、肛门指诊、内镜+活检等)和及时的病理学确诊有助于诊治,尤其是对青壮年人消化道癌和早期癌的治疗.
Objective To analyze the pathology of 4451 cases of gastrointestinal cancer and provide basic data. Fang Jie performed a statistical analysis of all cases of surgery and examination and pathological diagnosis of gastrointestinal cancer in our hospital during 1983/1997, and according to the location of cancer, will be young (<30 years old) and strong (30 to 40 years old), Middle-aged (40-70 years old), senior (> 70 years) group for comparative analysis. Results The ratio of male to female in this group was about 2:1; aged 7 to 87 years, mean 61 years old; each (blue to high) age group accounted for 3.5%, 9.5%, 70%, 17%; esophagus, fontanelle The stomach, small intestine and large intestine accounted for 17.1%, 50.7%, 0.6%, and 31.6% respectively; high and poorly differentiated squamous cell carcinoma of the esophagus, high and poorly differentiated type of the esophagus in the middle-aged and old-aged groups. The incidence of adenocarcinoma, mucinous adenocarcinoma, and papillary adenocarcinoma was significantly different from that of the young and adult (x2 test, P<0.01, P<0.05). The cardiac and gastric pathological types are similar, with adenocarcinoma as the most common, adenosquamous carcinoma and squamous cell carcinoma rare. Gastric low-differentiated adenocarcinoma of the cardia (accounting for 79% of the same site) and signet-ring cell carcinoma (accounting for 90% of all the same types) had a high incidence; the recurrence rates of metastatic and residual gastric cancer (11%, 8%) were more malignant High and poor prognosis. 687 cases of precancerous lesions, with all cancer ratio of 1:6.5; 193 cases of early cancer, accounting for 4.3% of the total. Conclusions Popular screening (such as hernia radiography, anal examination, endoscopy + biopsy, etc.) and timely pathological diagnosis are helpful for diagnosis and treatment, especially for the treatment of gastrointestinal cancer and early cancer in young adults.