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近20年来,胃癌的诊断和治疗有很大的进步。1962年胃癌研究会正式成立,为早期胃癌下了定义并提出了胃癌的大体分型。同年,为了达到早期发现和早期治疗胃癌的目的,成立了日本胃癌普查学会。从1964年起胃内窥镜活检成为胃癌诊断的有力武器,这样在20年前就奠定了控制胃癌的基础。目前无论是男性还是女性胃癌都占恶性肿瘤死亡率的第一位,但其内容逐渐发生着变化。从调整死亡率来看,自1959年达顶峰之后逐渐有所下降,1960年男性为48.3/10万,女性为30.1/10万。到1980年,男性为30.5/10万,女性则降至18.2/10万。减少的原因是:第一,由于饮食习惯的改变,发病率下降,这是主要原因。第二是由于胃癌的早期发现和早期治疗的病例增加。早期胃癌占整个胃癌的比例显著增加,其永久治愈率在90%以上。第三是治疗方法,特别是外科手术疗效的提高。下面仅就第二、三点加以论述。
In the past 20 years, the diagnosis and treatment of gastric cancer have made great progress. The 1962 Gastric Cancer Research Society was formally established. It defined the early gastric cancer and proposed the general classification of gastric cancer. In the same year, in order to achieve early detection and early treatment of gastric cancer, the Japan Gastric Cancer Survey Society was established. Since 1964, gastroscopy biopsy has become a powerful weapon for the diagnosis of gastric cancer, which laid the foundation for the control of gastric cancer 20 years ago. At present, both male and female stomach cancers account for the first death rate of malignant tumors, but their contents gradually change. Judging from the adjustment of the death rate, it has gradually declined since reaching its peak in 1959. In 1960, the figure was 48.3 per 100,000 for men and 30.1 per 100,000 for women. By 1980, men were 30.5 per 100,000 and women were down to 18.2 per 100,000. The reasons for the decrease are: First, due to changes in eating habits, the incidence rate has decreased, which is the main reason. The second is the increase in cases of early detection and early treatment of gastric cancer. Early gastric cancer accounts for a significant increase in the proportion of gastric cancer, and its permanent cure rate is above 90%. The third is the treatment method, especially the improvement of surgical efficacy. Only the second and third points are discussed below.