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目的 :探讨如何提高对早期胃癌的诊断率。方法 :回顾性分析了 1996年～ 1998年间 95 0 9例胃镜检查及2 2 78例病理活检资料 ,结合手术记录。结果 :有症状患者胃癌的检出率为 6.77% ( 64 4 / 95 0 9例 ) ,其中≥ 40岁者( 9 97% )明显高于 <40岁者 ( 1 0 8% ) (P <0 0 1)。男性高于女性 (P <0 .0 1)。病理活检中胃癌的检出率达 2 8.2 7%( 64 4 / 2 2 78例 ) ,胃癌及癌前病变的病理检出总的阳性率高达 70 .85 % ( 1614 / 2 2 78例 ) ,其中 <40岁患者的阳性率为 43.47% ,而≥ 40岁者则高达 75 .86% (P <0 .0 1)。胃癌及癌前病变的平均年龄均高于炎症组 (P <0 .0 1)。胃癌高发年龄为5 0～ 69岁之间 ,占 68.2 %。各病变中男性均多于女性 ,但 40岁以前胃癌中女性多于男性 (P <0 .0 5 )。胃体及贲门部位的恶性病变多于良性病变 (P <0 .0 1)。结论 :40岁以上有症状者应常规行胃镜检查 ,尤其是 5 0岁以上男性有癌前病变者以及胃体、贲门部位病变应常规行胃镜下病理活检 ,以及定期复查胃镜。
Objective: To explore how to improve the diagnosis rate of early gastric cancer. Methods: A retrospective analysis of 95 0 9 cases of gastroscopy and 2 2 78 cases of pathological biopsy data from 1996 to 1998 was made, combined with the surgical records. Results: The detection rate of gastric cancer in symptomatic patients was 6.77% (64 4 95 9 cases), of which ≥40 years (9 97%) was significantly higher than that of <40 years old (10%) (P 0 0 1). Men were higher than women (P <0.01). The positive rate of gastric cancer in pathological biopsy was 2 8.27% (64 4/2 278). The positive rate of gastric cancer and precancerous lesions was 70.85% (1614/2788) Among them, the positive rate was 43.47% in patients <40 years old and 75.86% (P <0.01) in those 40 years and older. The average age of gastric cancer and precancerous lesions were higher than that of the inflammation group (P <0.01). High incidence of gastric cancer between the ages of 50 to 69 years, accounting for 68.2%. There were more males than females in each lesion, but there were more females in men than in males before the age of 40 (P <0.05). More malignant lesions in gastric body and cardia than in benign lesions (P <0.01). Conclusion: Patients with symptoms over 40 years old should be routine endoscopy, especially in patients over 50 years of age with precancerous lesions and gastric body, cardia lesions should routine biopsy under endoscopy, and regular review of gastroscopy.