71例老年早期胃癌的临床分析(1)
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[摘要] 目的:研究老年早期胃癌患者的临床病理特征、手术治疗方式及预后因素。方法:回顾性分析我院1996年1月~2005年12月干部病房收治的71例老年早期胃癌的临床病理资料。结果:本组病例占同时期收治胃癌患者的33.8%,57.7%的患者无症状;本组手术切除率为100.0%,手术死亡率为1.4%;术后5年生存率为94.1%,10年生存率为91.5%。单因素分析表明肿瘤浸润深度、淋巴结转移、淋巴管癌栓显著影响老年早期胃癌患者的预后(P<0.05)。结论:规律胃镜检查能有效提高早期胃癌发现率;年龄不是老年早期胃癌患者根治切除的禁忌证;浸润深度、淋巴结转移、淋巴管癌栓是影响老年早期胃癌预后的重要因素。
[关键词] 胃肿瘤;老年人;临床病理特点;预后
[中图分类号] R735.2 [文献标识码] A [文章编号] 1673-7210(2012)01(a)-051-03
Clinical analysis of 71 cases with early gastric cancer in elderly patients
ZHANG Yong, CHEN Lin
Department of General Surgery, the General Hospital of PLA, Beijing 100853, China
[Abstract] Objective: To study the clinic pathological characteristics, the operative method and prognosis actors of patients with early gastric cancer in elderly patients. Methods: The clinic pathological data of 71 patients with early gastric cancer in cadre ward from January 1996 through December 2005 was analyzed retrospectively. Results: This series accounted for 33.8% of all gastric cancer patients in cadre ward. 57.7% patients were no symptom. Resection rate was 100.0% and operative mortality rate was 1.4%. 5 year survival rate was 94.1% and 10 year survival rate was 91.5%. Univariate analysis demonstrated that the depth of invasion, lymph node metastasis and lymphatic cancer embolus significantly affected prognosis of the elderly patients with early gastric cancer (P<0.05). Conclusion: Regular gastroscope detection can effectively detect EGC. Age is not the surgical contraindication for patients with early gastric cancer in elderly patients. The depth of invasion, lymph node metastasis and lymphatic cancer embolus are crucial prognosis factors in the elderly patients with early gastric cancer.
[Key words] Stomach neoplasm; Aged; Clinic pathological characteristics; Prognosis
早期胃癌(early gastric cancer,EGC)是指无论病灶大小或有无淋巴结转移,癌肿仅限于黏膜或黏膜下层的胃癌。手术治愈率远高于进展期胃癌,但我国在早期胃癌手术率方面进步缓慢,早期胃癌手术率长期徘徊在10%左右[1-2]。我院干部病房采用规律胃镜检查及多学科的协作诊治,早期胃癌外科治疗病例已占同期胃癌手术病例的33.8%,在此笔者对老年患者早期胃癌的临床病理特点、治疗方式及预后进一步分析,探讨其诊治规律。
1 资料与方法
1.1 一般资料
我院干部病房自1996年1月~2005年12月收治老年早期胃癌患者71例。其中,男67例,女4例;年龄60~69岁23例,70~74岁43例,>80岁5例,平均(71.2±6.0)岁。复习全部临床资料、病理资料并随访观察 ......
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