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早期胃癌 Early Gastric Cancer

대한외과학회지 1976년 18권 10호 p.37 ~ 49
盧鉉富, 金春奎, 李景植,
소속 상세정보
盧鉉富 (  ) 
延世大學校 醫科大學 外科學敎室

金春奎 (  ) 
延世大學校 醫科大學 外科學敎室
李景植 (  ) 
延世大學校 醫科大學 外科學敎室

Abstract


The term of "early gastric cancer" is strictly confined to the cancer whose depth of infil-tration is limited to the gastric mucosa or submucosa, not related to the width of infiltration or metastases of the regional lymphnodes.
The prognosis of the early gastric cancer is excellent, of which over all 5 years survival rates is over 90%, comparing to the advanced cancer of 15%, of over all 5 years survival rates.
In our country, the stomach cancer is the most common cancer of all malignancies.
However, many patients with stomach cancer are usually reluctant to visit physician because of no symptoms or vague gastrointestinal symptoms at the beginning and meanwhile cancerous lesions finally grow up to the inoperable stage.
The routine, physical check up and gastric mass survey are inevitable in order to detect patients with stomach cancer as early stage as possible.
The diagnostic tools such as U. G. I. series with double air contrast studies, fibergastroscopy with gastrocamera, gastric biopsies and exfoliative cytology through the fiberscope under direct vision, are so much improved that the diagnostic rates for early gastric cancer, are over 95% to about 100% With these combinations.
This report deals with the clinical aspects in 29 cases of early gastric cancer, which, were diagnosed by series, fibergastroscopy;and biopsies of the .gastric wall through the fibe-rscope under direct vision and then confirmed by pathology after gastric resection at Severance Hospital during about, 6 years period from 1969 to 1975.
In summary,
In this period a total of 739 patients with stomach cancer were admitted to the surgical department. 423 of them were undergone gastric resections. Among them, 29 cases of early gastric cancer were included in.
1.The incidence of early -gastric cancer was 9% of all stomach cancers and 6.9% of the resectable cases.
2. Of 29 cases of early gastric cancer, male was 19 in numbers and female was 10, of which, ex incidence was about 2: 1 and about 70% of these patients developed cancer after 40 years of age.
3. Blood group type A was, the most common and 11 cases had the past history of pepticulcer. 4. Gastrointestinal vague dyspeptic symptoms were the common complaints and the mean duration of it was over 2 years. 5. The diagnostic rates for early gastric cancer was about bout 41.4% by U.G.I. series alone, 64.0% by fibergastroscopy alone, aid 72.4% with these combinations.
The positive diagnostic rates, of gastric biopsies through the fiberscope was 80% and 96.5% of all patients was diagnosed preoperatively as malignancies of the stomach.
6. Of the 29 cases of early gastric cancers, 10 cases belong to IIc+III type, and IIc with other combination types was counted about 86.2%.
7. 13 cases had their cancers limited in the mucosa only and 16 cases had submucosal inva-sion and. only 2 cases of these had regional lymphnodes involvement (6.9%).
8. The sites of the lesions were located in the lesser curvature and posterior wall of the body and/or antrum of the stomach in most cases.
9. Regarding the sizes of the lesions, 11 cases had their lesion than 2-cm and 18 cases were over 2cm in the longest diameter. In general, the deeper the cancer invaded in, the larger the size of lesion one had
10. 23 cases, received their, surgery more than one-years ago. Among them, 20 cases were
followed up ostoperatively.
Of 7 cases over 5 years 5 are alive and one was died at 2 years after operation because of chronic pulmonary in sufficiency due to bronchial asthma and one was missed from follow up:
Of the remaining 16 cases14 are alive and 2 cases were missed from follow up.

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