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目的:根据WHO(2010版)消化系统胃肿瘤分类标准,探讨分析军事医学科学院附属医院胃肿瘤的病理类型及分布特点。方法:收集2010年11月至2015年3月军事医学科学院附属医院诊治的1 575例胃肿瘤,并复习其临床资料、HE及免疫组织化学切片,按WHO(2010版)分类标准进行病理诊断及分类。结果:1 575例胃肿瘤中,多数为男性患者(1 048例),约占66.54%,女性患者527例,约占33.46%。胃良性肿瘤25例(1.59%)、上皮内瘤变553例(35.11%)、胃癌893例(56.70%)、神经内分泌肿瘤24例(1.52%)、混合性腺神经内分泌癌3例(0.19%)、淋巴瘤20例(1.27%)、间叶性肿瘤47例(2.98%)、纤维上皮性肿瘤1例(腺肌瘤0.06%)、继发性肿瘤9例(0.57%)。胃癌中,管状腺癌明显居多(640例),占上皮性恶性肿瘤的71.67%,其次为混合癌(209例),占上皮性恶性肿瘤的23.40%。胃癌中分子亚型分类HER2 FISH阳性表达的有53例,阴性表达的有586例,未做检测的有254例,总体阳性率为8.29%。结论:胃部肿瘤种类多样,其中胃癌的发病率占明显优势,但其缺乏特征性的临床表现使大多数患者就诊时已处于中晚期,因此内窥镜检查对于胃癌高危人群的筛查尤为重要,以便早发现、早治疗。
OBJECTIVE: To investigate the pathological types and distribution characteristics of gastric tumors in Affiliated Hospital of Military Academy of Medical Sciences according to WHO (2010 edition) classification criteria of gastric cancer. Methods: A total of 1 575 gastric cancers diagnosed and treated in the Affiliated Hospital of Academy of Military Medical Sciences from November 2010 to March 2015 were collected. The clinical data, HE and immunohistochemical sections were reviewed and their pathological diagnosis was performed according to the WHO (2010 version) classification criteria. classification. Results: Most of the 1 575 gastric cancers were male (1048 cases), accounting for 66.54% of the total, 527 female patients, accounting for 33.46%. There were 25 (1.59%) cases of gastric benign tumor, 553 cases (35.11%) of intraepithelial neoplasia, 893 cases (56.70%) of gastric cancer, 24 cases of neuroendocrine tumors (1.52%) and 3 cases of mixed glandular neuroendocrine carcinoma (0.19% , Lymphoma in 20 cases (1.27%), mesenchymal tumor in 47 cases (2.98%), fibrous epithelial tumor in 1 case (adenomyosis of 0.06%) and secondary tumor in 9 cases (0.57%). In gastric cancer, tubular adenocarcinoma was obviously predominant (640 cases), accounting for 71.67% of epithelial malignant tumors, followed by mixed carcinoma (209 cases), accounting for 23.40% of epithelial malignant tumors. There were 53 cases of HER2 FISH positive expression in gastric cancer, 586 cases were negative, 254 cases were not detected, the overall positive rate was 8.29%. Conclusions: There are many types of gastric tumors, of which the incidence of gastric cancer accounts for obvious advantages. However, the lack of characteristic clinical manifestations has led to the majority of patients being diagnosed late. Therefore, endoscopy is particularly important for the screening of high-risk patients with gastric cancer , So early detection, early treatment.