• 南京醫(yī)科大學(xué)附屬南京第一醫(yī)院普外科(江蘇南京 210006);

目的了解近6年來就診于我院的胃癌患者流行病學(xué)及臨床病理資料的特點(diǎn)，為疾病的診斷與評估提供幫助。方法將2004年1月至2009年12月期間于我院進(jìn)行手術(shù)治療的958例胃癌患者作為研究對象，對其一般資料、腫瘤病理類型、發(fā)生部位、臨床分期等進(jìn)行回顧性分析。結(jié)果958例胃癌患者中，男697例(72.8%)，女261例(27.2%)。年齡26~91歲，平均62.6歲; 高發(fā)年齡為46~65歲組，占49.4%(473/958)，其后依次為≥66歲組及≤45歲組，分別為42.3%(405/958)和8.3%(80/958)。 病理的大體分型上，Borrmann Ⅱ型占大多數(shù)(70.1%); 病理類型以腺癌居多，占82.3%，印戒細(xì)胞癌占7.8%; 分化程度以低分化為主，占46.9%。發(fā)生部位以賁門居多，占53.0%。TNM臨床分期中以Ⅲ期為主，占47.4%。結(jié)論①胃癌多見于中老年男性患者，以賁門部低分化腺癌多見，賁門癌發(fā)病率明顯高于胃竇癌; ②在胃癌患者中，惡性程度較高的低分化、印戒細(xì)胞癌中所占比例最高者為相對較年輕的患者(≤45歲組); ③行手術(shù)治療的大部分為中晚期患者，胃癌的早期診斷有待進(jìn)一步提高。

引用本文： 謝洪虎,呂成余,陳維,王蓓. 958例胃癌臨床病理資料分析. 中國普外基礎(chǔ)與臨床雜志, 2011, 18(2): 153-158. doi: 復(fù)制

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1. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002 [J]. CA Cancer J Clin, 2005, 55(2): 74108.
2. Lambert R, Guilloux A, Oshima A, et al. Incidence and mortality from stomach cancer in Japan, Slovenia and the USA [J]. Int J Cancer, 2002, 97(6): 811818.
3. Cunningham SC, Kamangar F, Kim MP, et al. Survival after gastric adenocarcinoma resection: eighteenyear experience at a single institution [J]. J Gastrointest Surg, 2005, 9(5): 718725.
4. Hamilton SR, Aaltonen LA. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Digestive System [M]. Lyon: IARC Press, 2000: 3839.
5. Washington K. 7th Edition of the AJCC Cancer Staging Manual: Stomach [J]. Ann Surg Oncol, 2010: DOI: 10.1245/s104340101362z.
6. Dassen AE, Lemmens VE, van de PollFranse LV, et al. Trends in incidence, treatment and survival of gastric adenocarcinoma between 1990 and 2007: a populationbased study in the Netherlands [J]. Eur J Cancer, 2010, 46(4): 11011110.
7. Bertuccio P, Chatenoud L, Levi F, et al. Recent patterns in gastric cancer: a global overview [J]. Int J Cancer, 2009, 125(3): 666673.
8. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Tobacco smoke and involuntary smoking [M]. IARC Monogr Eval Carcinog Risks Hum, 2004, 83: 11438.
9. Furukawa H, Iwanaga T, Koyama H, et al. Effects of sex hormones on carcinogenesis in the stomach of rats [J]. Cancer Res, 1982, 42(12): 51815182.
10. Sipponen P, Correa P. Delayed rise in incidence of gastric cancer in females results in unique sex ratio (M/F) pattern: etiologic hypothesis [J]. Gastric Cancer, 2002, 5(4): 213219.
11. Lee SA, Kang D, Shim KN, et al. Effect of diet and Helicobacter pylori infection to the risk of early gastric cancer [J]. J Epidemiol, 2003, 13(9): 162168.
12. La Vecchia C, Negri E, Franceschi S, et al. Casecontrol study on influence of methionine, nitrite, and salt on gastric carcinogenesis in northern Italy [J]. Nutr Cancer, 1997, 27(1): 6568.
13. Shikata K, Kiyohara Y, Kubo M, et al. A prospective study of dietary salt intake and gastric cancer incidence in a defined Japanese population: the Hisayama study [J]. Int J Cancer, 2006, 119(1): 196201.
14. Negri E, La Vecchia C, D’Avanzo B, et al. Salt preference and the risk of gastrointestinal cancers [J]. Nutr Cancer, 1990, 14(34): 227232.
15. Hassan HA, Sharma VK, Raufman JP. Changing trends in gastric carcinoma at a university medical center: a twelveyear retrospective analysis [J]. J Clin Gastroenterol, 2001, 32(1): 3740.
16. Hansen S, Vollset SE, Derakhshan MH, et al. Two distinct aetiologies of cardia cancer, evidence from premorbid serological markers of gastric atrophy and Helicobacter pylori status [J]. Gut, 2007, 56(7): 918925.
17. Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer [J]. N Engl J Med， 2001, 345(11): 784789.
18. Merry AH, Schouten LJ, Goldbohm RA, et al. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: a prospective cohort study [J]. Gut， 2007, 56(11): 15031511.
19. 趙晨燕, 張祥宏, 薛麗英, 等. 河北省食管癌和胃癌高發(fā)區(qū)居民胃癌發(fā)生部位的變化及趨勢分析 [J]. 中華腫瘤雜志, 2008, 30(11): 817820.
20. 荊曉岳， 王建國， 周兵, 等. 10年豫北地區(qū)胃癌臨床流行病學(xué)特征 [J]. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(1): 2933.
21. 王喜, 吳春曉, 鄭瑩, 等. 上海市區(qū)胃癌發(fā)病的時(shí)間趨勢和特點(diǎn)分析 [J]. 中華流行病學(xué)雜志, 2007, 28(9): 875880.
22. Hosokawa O, Kaizaki Y, Watanabe K, et al. Endoscopic surveillance for gastric remnant cancer after early cancer surgery [J]. Endoscopy, 2002, 34(6): 469473.
23. Tanigawa N, Nomura E, Lee SW, et al. Current state of gastric stump carcinoma in Japan: based on the results of a nationwide survey [J]. World J Surg, 2010, 34(7): 15401547.
24. Nozaki I, Nasu J, Kubo Y, et al. Risk factors for metachronous gastric cancer in the remnant stomach after early cancer surgery [J]. World J Surg, 2010, 34(7): 15481554.
25. Arai T, Esaki Y, Inoshita N, et al. Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients [J]. Gastric Cancer, 2004, 7(3): 154159.
26. Kim DY, Joo JK, Ryu SY, et al. Clinicopathologic characteristics of gastric carcinoma in elderly patients: a comparison with young patients [J]. World J Gastroenterol, 2005, 11(1): 2226.
27. Inoshita N, Yanagisawa A, Arai T, et al. Pathological characteristics of gastric carcinomas in the very old [J]. Jpn J Cancer Res, 1998, 89(10): 10871092.
28. Ishigami S, Natsugoe S, Saihara T, et al. Clinical and pathologic features of early gastric cancer in elderly patients [J]. Hepatogastroenterology, 1997, 44(16): 11641168.
29. Fujiya T, Endoh K, Mikuni J, et al. Clinicopathological characteristics and surgical outcome of gastric carcinoma with regard to aging [J]. Jpn J Gastroenterol Surg, 1997, 30(7): 16991705.
30. Kitamura K, Yamaguchi T, Taniguchi H, et al. Clinicopathological characteristics of gastric cancer in the elderly [J]. Br J Cancer, 1996, 73(6): 798802.
31. Kunisaki C, Kobayashi S, Kido Y, et al. Clinicopathological evaluation of senile patients with gastric cancer [J]. Jpn J Clin Surg, 1996, 57(6): 18311837.
32. Sho M, Imagawa A, Hosoi T, et al. Clinical study of surgical cases of gastric cancer in patients over 80 years old [J]. Jpn J Soc Clin Surg, 1996, 57(9): 18381843.
33. AlRefaie WB, Tseng JF, Gay G, et al. The impact of ethnicity on the presentation and prognosis of patients with gastric adenocarcinoma. Results from the National Cancer Data Base [J]. Cancer, 2008, 113(3): 461469.
34. 王正林, 胡祥. 老年胃癌特點(diǎn)及手術(shù)治療進(jìn)展 [J]. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(1): 3739.
35. Siewert JR, Bttcher K, Stein HJ, et al. Relevant prognostic factors in gastric cancer: Tenyear results of the German Gastric Cancer Study [J]. Ann Surg, 1998, 228(4): 449461.
36. Yokota T, Kunii Y, Teshima S, et al. Significant prognostic factors in patients with early gastric cancer [J]. Int Surg, 2000, 85(4): 286290.
37. Chukwuemeka U, Ihemelandu RL, DeWitty, et al. Trends in clinicopathologic characteristics and prognostic predictors of survival outcome in black patients with gastric carcinoma: a single institution’s experience [J]. J Surg Res, 2009, 156(2): 325332.
  1. 1. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002 [J]. CA Cancer J Clin, 2005, 55(2): 74108.
  2. 2. Lambert R, Guilloux A, Oshima A, et al. Incidence and mortality from stomach cancer in Japan, Slovenia and the USA [J]. Int J Cancer, 2002, 97(6): 811818.
  3. 3. Cunningham SC, Kamangar F, Kim MP, et al. Survival after gastric adenocarcinoma resection: eighteenyear experience at a single institution [J]. J Gastrointest Surg, 2005, 9(5): 718725.
  4. 4. Hamilton SR, Aaltonen LA. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Digestive System [M]. Lyon: IARC Press, 2000: 3839.
  5. 5. Washington K. 7th Edition of the AJCC Cancer Staging Manual: Stomach [J]. Ann Surg Oncol, 2010: DOI: 10.1245/s104340101362z.
  6. 6. Dassen AE, Lemmens VE, van de PollFranse LV, et al. Trends in incidence, treatment and survival of gastric adenocarcinoma between 1990 and 2007: a populationbased study in the Netherlands [J]. Eur J Cancer, 2010, 46(4): 11011110.
  7. 7. Bertuccio P, Chatenoud L, Levi F, et al. Recent patterns in gastric cancer: a global overview [J]. Int J Cancer, 2009, 125(3): 666673.
  8. 8. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Tobacco smoke and involuntary smoking [M]. IARC Monogr Eval Carcinog Risks Hum, 2004, 83: 11438.
  9. 9. Furukawa H, Iwanaga T, Koyama H, et al. Effects of sex hormones on carcinogenesis in the stomach of rats [J]. Cancer Res, 1982, 42(12): 51815182.
  10. 10. Sipponen P, Correa P. Delayed rise in incidence of gastric cancer in females results in unique sex ratio (M/F) pattern: etiologic hypothesis [J]. Gastric Cancer, 2002, 5(4): 213219.
  11. 11. Lee SA, Kang D, Shim KN, et al. Effect of diet and Helicobacter pylori infection to the risk of early gastric cancer [J]. J Epidemiol, 2003, 13(9): 162168.
  12. 12. La Vecchia C, Negri E, Franceschi S, et al. Casecontrol study on influence of methionine, nitrite, and salt on gastric carcinogenesis in northern Italy [J]. Nutr Cancer, 1997, 27(1): 6568.
  13. 13. Shikata K, Kiyohara Y, Kubo M, et al. A prospective study of dietary salt intake and gastric cancer incidence in a defined Japanese population: the Hisayama study [J]. Int J Cancer, 2006, 119(1): 196201.
  14. 14. Negri E, La Vecchia C, D’Avanzo B, et al. Salt preference and the risk of gastrointestinal cancers [J]. Nutr Cancer, 1990, 14(34): 227232.
  15. 15. Hassan HA, Sharma VK, Raufman JP. Changing trends in gastric carcinoma at a university medical center: a twelveyear retrospective analysis [J]. J Clin Gastroenterol, 2001, 32(1): 3740.
  16. 16. Hansen S, Vollset SE, Derakhshan MH, et al. Two distinct aetiologies of cardia cancer, evidence from premorbid serological markers of gastric atrophy and Helicobacter pylori status [J]. Gut, 2007, 56(7): 918925.
  17. 17. Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer [J]. N Engl J Med， 2001, 345(11): 784789.
  18. 18. Merry AH, Schouten LJ, Goldbohm RA, et al. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: a prospective cohort study [J]. Gut， 2007, 56(11): 15031511.
  19. 19. 趙晨燕, 張祥宏, 薛麗英, 等. 河北省食管癌和胃癌高發(fā)區(qū)居民胃癌發(fā)生部位的變化及趨勢分析 [J]. 中華腫瘤雜志, 2008, 30(11): 817820.
  20. 20. 荊曉岳， 王建國， 周兵, 等. 10年豫北地區(qū)胃癌臨床流行病學(xué)特征 [J]. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(1): 2933.
  21. 21. 王喜, 吳春曉, 鄭瑩, 等. 上海市區(qū)胃癌發(fā)病的時(shí)間趨勢和特點(diǎn)分析 [J]. 中華流行病學(xué)雜志, 2007, 28(9): 875880.
  22. 22. Hosokawa O, Kaizaki Y, Watanabe K, et al. Endoscopic surveillance for gastric remnant cancer after early cancer surgery [J]. Endoscopy, 2002, 34(6): 469473.
  23. 23. Tanigawa N, Nomura E, Lee SW, et al. Current state of gastric stump carcinoma in Japan: based on the results of a nationwide survey [J]. World J Surg, 2010, 34(7): 15401547.
  24. 24. Nozaki I, Nasu J, Kubo Y, et al. Risk factors for metachronous gastric cancer in the remnant stomach after early cancer surgery [J]. World J Surg, 2010, 34(7): 15481554.
  25. 25. Arai T, Esaki Y, Inoshita N, et al. Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients [J]. Gastric Cancer, 2004, 7(3): 154159.
  26. 26. Kim DY, Joo JK, Ryu SY, et al. Clinicopathologic characteristics of gastric carcinoma in elderly patients: a comparison with young patients [J]. World J Gastroenterol, 2005, 11(1): 2226.
  27. 27. Inoshita N, Yanagisawa A, Arai T, et al. Pathological characteristics of gastric carcinomas in the very old [J]. Jpn J Cancer Res, 1998, 89(10): 10871092.
  28. 28. Ishigami S, Natsugoe S, Saihara T, et al. Clinical and pathologic features of early gastric cancer in elderly patients [J]. Hepatogastroenterology, 1997, 44(16): 11641168.
  29. 29. Fujiya T, Endoh K, Mikuni J, et al. Clinicopathological characteristics and surgical outcome of gastric carcinoma with regard to aging [J]. Jpn J Gastroenterol Surg, 1997, 30(7): 16991705.
  30. 30. Kitamura K, Yamaguchi T, Taniguchi H, et al. Clinicopathological characteristics of gastric cancer in the elderly [J]. Br J Cancer, 1996, 73(6): 798802.
  31. 31. Kunisaki C, Kobayashi S, Kido Y, et al. Clinicopathological evaluation of senile patients with gastric cancer [J]. Jpn J Clin Surg, 1996, 57(6): 18311837.
  32. 32. Sho M, Imagawa A, Hosoi T, et al. Clinical study of surgical cases of gastric cancer in patients over 80 years old [J]. Jpn J Soc Clin Surg, 1996, 57(9): 18381843.
  33. 33. AlRefaie WB, Tseng JF, Gay G, et al. The impact of ethnicity on the presentation and prognosis of patients with gastric adenocarcinoma. Results from the National Cancer Data Base [J]. Cancer, 2008, 113(3): 461469.
  34. 34. 王正林, 胡祥. 老年胃癌特點(diǎn)及手術(shù)治療進(jìn)展 [J]. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(1): 3739.
  35. 35. Siewert JR, Bttcher K, Stein HJ, et al. Relevant prognostic factors in gastric cancer: Tenyear results of the German Gastric Cancer Study [J]. Ann Surg, 1998, 228(4): 449461.
  36. 36. Yokota T, Kunii Y, Teshima S, et al. Significant prognostic factors in patients with early gastric cancer [J]. Int Surg, 2000, 85(4): 286290.
  37. 37. Chukwuemeka U, Ihemelandu RL, DeWitty, et al. Trends in clinicopathologic characteristics and prognostic predictors of survival outcome in black patients with gastric carcinoma: a single institution’s experience [J]. J Surg Res, 2009, 156(2): 325332.