【摘要】 目的了解上海市13家医院2007年早期胃癌手术情况及发展趋势;比较不同等级医疗机构检出早期胃癌的情况。方法统计上海市6家三级医院、7家二级医院的外科手术例数、经手术证实的早期胃癌数及早期胃癌的浸润深度、局部淋巴结转移情况。结果上海13家医院2007年共施行胃癌外科切除手术1 500例,手术病理检查证实早期胃癌198例,早期胃癌手术率13.2%。其中黏膜内癌70例(35.4%),黏膜下癌128例(64.6%);早期胃癌形态分类中,0-Ⅰ型11例(5.6%)、0-Ⅱa型14例(7.1%)、0-Ⅱb型16例(8.1%)、0-Ⅱc型92例(46.4%)、0-Ⅲ型65例(32.8%);手术病理证实胃周及淋巴结转移的22例(11.1%)。上海瑞金医院等6家三级医院1 084例胃癌患者中,检出早期胃癌157例(14.5%);上海闵行区中心医院等7家二级医院416例胃癌患者中,检出早期胃癌41例(9.9%)。上海二级医院与三级医院在早期胃癌手术率方面的差异具有显著性(14.48%vs9.86%,P=0.018)。结论上海市早期胃癌手术率正在逐步提高,其中三级医院明显高于二级医院。早期胃癌的治疗应高度重视对局部淋巴结的处理。更多还原

【Abstract】 Objective To investigate the trend of early gastric cancer detection from thirteen hospitals in Shanghai in 2007,and to compare the diagnostic ability of different levels of medical facilities.Methods The annual gastrectomy,surgery-proven early gastric cancer and histopathological characters of early gastric cancer including invasion depth and lymph node metastasis were analyzed in six tertiary and seven secondary medical facilities in Shanghai in 2007. Results Gastrectomy was performed on 1 500 gastric cancer patients.One hundred and ninety-eight patients(13.2%) were proven as early gastric cancer,including 70(35.4%) intramucosal and 128(64.6%) submucosal cancer with a total of 22 cases(11.1%) lymph node metastasis.Macroscopically,11(5.6%),14(7.1%),16(8.1%),92(46.4%),65(32.8%) lesions were confirmed as type 0-Ⅰ,0-Ⅱa,0-Ⅱb,0-Ⅱc,0-Ⅲ,respectively.One hundred and fifty-seven(14.5%) cases of early gastric cancer were diagnosed in 1 084 patients from 6 tertiary medical center compared with 41(9.9%) in 416 patients from 7 secondary medical facilities,indicating a significant difference in surgical rate of early gastric cancer(P=0.018). Conclusion The surgical rate of early gastric cancer has achieved gradual progress in Shanghai with significant advantage in tertiary medical center compared with secondary medical facilities.Attention should be paid in the regional metastatic risk in early gastric cancer.更多还原