Objective To explore clinical characteristics, reason of misdiagnosis, preventive strategy and treatment of Borrmann type Ⅳ gastric carcinoma.Methods A retrospective analysis of Nanchang People 's Liberation Army Hospital from January 1996 to January 2013, 18 misdiagnosis cases clinical data of pathologically confirmed Borrmann Ⅳ type gastric cancer and review of the literature.Results 18 cases of BorrmannⅣtype gastric cancer patients including 7 males and 11 fe-males, aged from 30 to 71 years;duration from 1 week to 3 months, all have undergone 1 to 2 times gastroscopy.7 cases mis-diagnosed as chronic gastritis, 6 cases of peptic ulcer, tuberculous peritonitis in 2 cases, 3 cases of ovarian cancer.18 cases performed angiography or abdominal CT examination and revealed abnormal finding of upper digestive tract, underwent endos-copy or surgery again and got the final diagnosis, among them, adenocarcinoma in 1 case, 6 cases of poorly differentiated ade-nocarcinoma, mucinous adenocarcinoma in 2 cases, signet ring cell carcinoma in 6 cases, 3 cases of undifferentiated carcino-ma.Receiving palliative surgery of gastric cancer in 9 cases, ovarian metastases palliative surgery in 2 patients, and systemic chemotherapy and intraperitoneal chemotherapy in 12 cases.The longest survival time was 23 months, 9 patients survived a period not exceeding one year.Conclusion Joint upper gastrointestinal endoscopy imaging, abdominal CT and EUS can im-prove BorrmannⅣtype gastric cancer detection rate, combined therapy with surgery may improve survival rate.%目的 分析BorrmannⅣ型胃癌的临床特点、误诊原因及防治策略.方法 回顾性分析1996年1月—2013年1月南昌解放军第94医院肿瘤科经病理学证实的BorrmannⅣ型胃癌误诊患者18例临床资料,并复习相关文献.结果 BorrmannⅣ型胃癌患者18例中男7例,女11例,年龄30~71岁;病程1周~3个月,均曾接受1~2次胃镜检查.误诊为慢性胃炎7例,消化性溃疡6例,结核性腹膜炎2例,卵巢癌3例.18例经上消化道造影或腹部CT检查和体检提示有异常,再次行胃镜检查或手术而确诊,其中中分化腺癌1例,低分化腺癌6例,黏液腺癌2例,印戒细胞癌6例,未分化癌3例.接受胃癌姑息性手术9例,行卵巢转移癌姑息性手术2例,行全身化疗和腹腔灌注化疗12例.最长生存期为23个月,9例生存期不超过1年.结论 胃镜联合上消化道造影、腹部CT和超声内镜检查可提高BorrmannⅣ型胃癌的检出率,以手术为主的综合治疗可改善患者生存期.
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