中日早期胃癌临床病理及术后生存对比分析

目的　对比分析中日早期胃癌临床病理参数 ,旨在加深对早期胃癌的认识。方法　中方资料选自 1995至 1999年西安交通大学第一医院收治的早期胃癌 2 9例 ,日方资料选自 1988至 1992年日本鹿儿岛大学医学院第一外科收治的早期胃癌 6 8例。采用回顾性对比研究。结果　①早期胃癌的发病年龄日方较中方推后 10年 (P <0 .0 5 )。②肿瘤部位日方胃底贲门癌所占比例较高。③肿瘤组织学日方印戒细胞癌所占比例增加。④中方以黏膜下癌为主 ,日方黏膜内癌占较大比例 (P <0 .0 5 )。⑤手术清除淋巴结数日方明显较中方多 (P <0 .0 5 )。⑥消化道重建日方Roux en Y和空肠间置代胃比例较高。⑦术后生存率日方 3年 89.8% ,中方 80 % ,日方生存优于中方 (P <0 .0 5 )。结论　早期诊断及积极的手术治疗可以保证术后生存 ,选择适当的术式有利于提高生存质量

Comparative study of the clinicopathology and prognosis of early gastric cancer in Japan and China

Objective To make a comparative study of the clinicopathological features of early gastric cancer in Japan and China to increase the understanding and improve the diagnosis of early gastric cancer. Methods Data were collected from the First Hospital of Xi'an Jiaotong University, China, during 1995 to 1999, while data were collected from First Department of Surgery, Kagoshima University, Japan, during 1988-1992. Results The age of cancer onset was 10 years later in Japan than that in China (P< 0.05). The percentage of tumor located at the upper third of the stomach was higher in Japan, which was the same case with signet cell carcinoma. The tumor was mainly located at the submucosa in China and located at the mucosa in Japan(P< 0.05). For operation, the number of lymph node dissection was greater in Japan, and gastrointestinal reconstruction was mainly conducted by Roux-en-Y or jejunal interposition in Japan. The postoperative survival rate for 3 years in Japan and China was 89.9% and 80%, respectively (P< 0.05). Conclusion Early diagnosis and radical operation can improve the prognosis of patients with gastric cancer. Selecting the optimal operative method benefits the quality of life.