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弥漫浸润型胃癌主要是在胃粘膜下浸润生长,胃镜检查往往缺乏特征性表现,容易误诊或漏诊。我们收集本院近10年来经手术病理证实的54例弥漫浸润型胃癌,将其中资料完整的48例患者的胃镜和B超检查总结如下,并与手术结果作对比,旨在探讨胃镜、B超联合诊断弥漫浸润型胃癌的价值。1 临床资料1.1 一般资料:48例中男30例,女18例。年龄26岁～74岁,平均54.72岁。48例患者均有上腹部不适和胀痛,并伴有恶心呕吐29例(60.4％),消瘦、体重减轻20例(41.7％),贫血10例(20.8%),黑便4例(8.3%),上腹部扪及肿块2例(4.2％)。病程7天～10年,以1～2个月就诊者居多。1.2 胃镜检查:(1)镜下表现:粘膜粗糙不平、颗粒样增生22例(45.8%),粘膜退色、附白苔或色泽发红8例(16.7%);胃壁僵硬、蠕动差10例(20.1％);浅表溃疡、浅表糜烂6例(12.5％);粘膜皱壁粗大2例(4.2％);(2)镜检次数及活检情况:1次胃镜确诊23例(47.9％),2次胃镜确诊18例(37.5％),3次胃镜确诊5例(10.4％),胃镜未确诊、B超提示、手术后病理确诊2例(4.2％);(3)病理类型:低分化腺癌25
Diffuse infiltrative gastric cancer is mainly infiltrated and grown in the gastric mucosa. Endoscopy often lacks characteristic features and is easily misdiagnosed or missed. We collected 54 cases of diffuse infiltrating gastric cancer confirmed by surgery and pathology in our hospital in the past 10 years. Gain endoscopy and B-ultrasound of the 48 patients whose data is complete are summarized as follows, and compared with the surgical results to investigate the gastroscope and B ultrasound. Combined diagnosis of diffuse invasive gastric cancer. 1 Clinical data 1.1 General information: 48 cases of 30 males and 18 females. Age 26 to 74 years old, average 54.72 years old. 48 patients had epigastric discomfort and pain, 29 cases (60.4%) with nausea and vomiting, 20 cases (41.7%) with weight loss and weight loss, 10 cases (20.8%) with anemia, and 4 cases (8.3%) with black stools. ), 2 cases (4.2%) of epigastric fistulas and lumps. The course of illness is from 7 days to 10 years, and the majority of patients are from 1 to 2 months. 1.2 Gastroscopy: (1) Microscopic findings: mucosal roughness, granular hyperplasia in 22 cases (45.8%), mucosal discoloration, white coating or color redness in 8 cases (16.7%); gastric wall stiffness, poor peristalsis in 10 cases ( 20.1%); superficial ulcers, superficial erosions in 6 cases (12.5%); mucous membrane thickening in 2 cases (4.2%); (2) microscopic examination times and biopsy: 1 gastroscopy confirmed in 23 cases (47.9%), Two gastroscopes were diagnosed in 18 cases (37.5%), three gastroscopes were diagnosed in 5 cases (10.4%), gastroscope was not diagnosed, B-ultrasound, and postoperative pathological diagnosis in 2 cases (4.2%); (3) pathological type: poorly differentiated glands Cancer 25