目的: 分析早期胃癌患者的病理特征,为临床诊断与治疗提供科学依据.方法: 回顾性分析200例早期胃癌患者的临床资料,对早期胃癌患者的病理特征进行总结.结果: 200例早期胃癌患者中,有162例患者伴随胃疼、胃部不适等症状,其中有18例部分患者伴随食欲不振、呕血、黑便等症状;有38例患者无症状.分析发现,该病多发于60～69岁之间,且男性患者发生率要高于女性.患者多为单发病灶,仅有3例患者为多发病灶.患者的病灶分布位置主要集中在胃窦、胃体.Ⅱ型发生率要高于Ⅰ、Ⅲ型,其中以Ⅱc型发生率最高.200例早期胃癌患者中,分化型癌的比重远高于未分化型癌.200例患者中有25例(12.5％)患者出现淋巴结转移,其中黏膜内癌淋巴结转移率显著低于黏膜下癌(P＜0.05),分化型癌淋巴结转移率显著低于未分化型癌(P＜0.05),分化型黏膜内癌淋巴结转移率显著低于分化型黏膜下癌(P＜0.05),未分化型黏膜内癌及黏膜下癌的淋巴结转移率差异无统计学意义.结论: 早期胃癌无典型临床症状,且多发于老年男性群体中,单发病灶的发生率较高,病灶集中分布于胃窦、胃体,胃癌分型以Ⅱc型发生率最高.早期胃癌淋巴结转移与病灶浸润深度、分化类型有密切的相关性.早期胃癌临床诊断存在一定的难度,内镜联合活检是最有用的诊断方法,窄带成像技术的应用能够提高早期胃癌的检出率.%Objective: To analyze the pathological features of early gastric cancer and provide scientific basis for clinical diagnosis and treatment. Methods: The clinical data of 200 patients with early gastric cancer from August 2014 to October 2017 were retrospective analyzed, and the pathological features of early gastric cancer were summarized. Results: Among 200 cases of early gastric cancer, 162 were accompanied by stomach pain, stomach discomfort and other symptoms, of which 18 cases were accompanied by anorexia, hematemesis, melena and other symptoms; 38 cases were asymptomatic. Analysis found that the incidence of the disease was between 60 to 69 years old, and was higher in males than in females. Most of the patients were single lesion, and only 3 patients had multiple lesions. The foci of the patients were mainly located in the antrum and the gastric body. The occurrence rate of type Ⅱ is higher than that of type Ⅰ and Ⅲ, among them with highest incidence type Ⅱc. In the 200 patients with early gastric cancer, the proportion of differentiated cancer is much higher than that of undifferentiated carcinoma. Twenty-five cases of 200 patients (12. 5％) patients had lymph node metastasis. the lymph node metastasis rate of intramucosal cancer was significantly lower than in submucosal carcinoma (P＜ 0. 05). The lymph node metastasis rate of differentiated carcinoma was significantly lower than that of undifferentiated carcinoma (P＜ 0. 05); the lymph node metastasis rate of differentiated mucosa cancer was significantly lower than that of differentiated submucosal carcinoma (P＜ 0. 05); There was no significant difference in lymph node metastasis rate between undifferentiated intramucosal carcinoma and submucosal carcinoma. Conclusion: There were no typical clinical symptoms in early gastric cancer, and the incidence of single lesion was higher in the elderly male population. The focus was concentrated in the antrum and gastric body. The incidence of gastric cancer type Ⅱ c was the highest. The lymph node metastasis of early gastric cancer is closely related to the depth of invasion and the type of differentiation. The clinical diagnosis of early gastric cancer is difficult, and endoscopic combined biopsy is the most useful diagnostic method. The application of narrow band imaging technology can improve the detection rate of early gastric cancer.
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