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asbryobvrz · Wysłany: Wto 14:08, 15 Mar 2011

Multiple lesions of early gastric cancer missed

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was missed. Missed diagnosis of oral cancer types of superficial depressed type (Ic type) the most common,[link widoczny dla zalogowanych], accounting for about 1 / 4. Followed by the superficial flat type (Ib type) in 9 cases have all been missed, and protruded (I type), surface (superficial) protruded (Ia type) and compound (Ia + Ic, Ic + Ia) is relatively easy missed. 2. In the stomach area prone to missed diagnosis of gastric cancer observed in this study occurred in the stomach and small bend low probability of missed diagnosis of gastric cancer, which may be the site most often unnoticed. In the stomach greater curvature, anterior wall of the stomach and the upper part of the lower part of the posterior wall of the stomach and missed diagnosis rate was higher in the examination should pay special attention to prevent misdiagnosis. Missed diagnosis of cancer found in the stomach cancer and the location and diameter size of no significant difference between the lesser curvature in the upper stomach, proximal gastric anterior wall, greater curvature of the middle stomach, the lower part of the anterior wall of the stomach, even if the foci in these parts is also a large diameter prone to misdiagnosis. 3. Easily missed histological features of lesions from the whole to 7, the Japanese medical Hui Ping Shao 19t} 5 16 6 years from the preoperative x-ray diagnosis of multiple gastric f. Fight the current excellent results of early gastric cancer, therefore, have reduced their treatment by endoscopic surgery and resection of the lesions in the mucosa, using a variety of equipment for the treatment of research trends. But the more difficult to diagnose cancer. The mechanism is not only difficult to grasp, but difficult to control risk factors. In the clinic I,[link widoczny dla zalogowanych], either by endoscopy or by x ray, for obvious lesions, and can still diagnosed with multiple cancers, however, for small gastric subclinical lesions, is basically a pathological diagnosis can be confirmed by . Determine treatment guidelines, mainly based on the preliminary diagnosis of diseases and the development of both confirmed it and select the appropriate therapy, ie the decision to multiple surgical procedures and postoperative cancer and other long-term follow-up to become a research topic. Of this paper does not cover small cancer diagnosis, that is, multiple cancer lesions in diameter limited to 6mm or more, preoperative x-ray diagnosis and x ray review diagnosis, focusing on the basis of preoperative diagnosis, of gross morphology and histological type and depth of invasion, location and tumor size. First, the objects and method objects for the past 15 years, the hospital and the hospital diagnosis and surgery of multiple cancers, lesions with a diameter of 6mm or more cases of the 156 spider. Preoperative x-ray diagnosis of the study, lesions identified by the reading of films and 116 were diagnosed spider (Deputy lesion 149), a clear case of repeat photography at diagnosis of 118 cases (Deputy lesions 151) for the study. At the same time the total number of 1603 cases of gastric cancer cases, of which the total number of 247 cases of multiple gastric cancer. All cases of gastric surgery were carried out to 200 copies from 7O biopsy, who organized the United States and mutual Toshiaki park, school tests, x-ray diagnosis of lesions of all of the cut. More than two made the definition of cancer is based on Moertel's such as the development of diagnostic criteria, namely; ① proved in the pathology of the lesions as malignant; ③ significant emblem of all the microscopic lesions were isolated from normal gastric wall; ③ the lesion is not a transfer or caused by direct leaching Shan; ④ the onset of the disease and the largest lesion-based lesions, other lesions were all vice lesions. Second, the results 1. The incidence of multiple gastric cancer surgery in the total number of 1603 cases of early gastric cancer accounted for 851 falls, accounting for 752 cases of advanced cancer. Cancer accounted for more than 247 down, the occurrence of multiple cancers was 15.4. Only 153 in the 247 back down to more cancer early cancer,[link widoczny dla zalogowanych], accounting for all cases of early gastric cancer incidence 18. O, Similarly, the incidence of advanced cancer was 12.1, more cancers were detected in 59 fell more than 3 lesions, accounting for more than 247 cases of cancer incidence of 23.9, 30.1 cancers early days, progress cancers was 14.3 (Table 1). Table 1 The incidence of multiple gastric cancer 2. Vice-cancer lesions of multiple x-ray diagnosis of preoperative x ray view, missed both cancer and cancer found in differentiated adenocarcinoma, there was no significant difference. Missed diagnosis of cancer, almost all the depth of infiltration in the mucosal layer,[link widoczny dla zalogowanych], 7 / 58 cases (12) infiltration in the submucosa. 4. Ic-type gastric cancer missed by the study of village on the gastric body of the depressed type early gastric cancer, especially the lack of eyes see, the size of gastric cancer were studied in the lOmm below the detection rate was 37. The size of the type Ic in lOmm following the discovery of gastric cancer was 3O, shows foci less than lOmm's not easy to find. The study found that Ic was missed by the histological type of gastric cancer to poorly differentiated adenocarcinoma. Ic-type early gastric cancer missed by the foci often without submucous fibrosis. In short,[link widoczny dla zalogowanych], in Japan, gastric cancer there is a growing multi-tendency, the study found one case of rare disseminated countless tiny stomach cancer. Therefore, multiple gastric cancer should lead to sufficient understanding of, and continuously improve the diagnosis of multiple correct rate of early gastric cancer, prevent misdiagnosis Liu Baoxuan Translation Day