手術中以肉眼判斷胃癌進行程度準確性的評估

A Study for the Accuracy of Gross Staging in the Patients with Gastric Cancer

黃裕勝(Yu-Sheng Huang) ； 黃宗人(Tsung-Jen Huang) ； 黃哲人(Che-Jen Huang) ； 謝建勲(Jan-Sing Hsieh) ； 簡崇和(Chung-Ho Chien) ； 林相如(Hsiang-Ju Lin)

《The Kaohsiung Journal of Medical Sciences》 4卷7期 (1988/07) Pp. 409-413

https://doi.org/10.6452/KJMS.198807.0409

摘要

Exact staging is an essential prerequisite for diagnosis and treatment in modern oncology. In this study, the accuracy of gross staging in patients with respectable gastric cancer is discussed.
One hundred and thirty-eight patients with gastric cancer were studied usin the staging system proposed by the Japanese Research Society for Gastric Cancer. Gross and histological staging was conducted in each case both operatively and postoperatively, respectively.
The following results were obtained:
1) The prevalence of exact gross staging was: 58.8% in stage i, 27.3% in stage ii, 73.1% in stage iii, and 93.1% in stage iv.
2) 2) One hundred and five patients including 10 cases in stage I, 3 in stage ii, 38 in stage iii and 54 in stage iv had exact gross staging. Exact gross staging in a patient with stage I gastric cancer was attributed to a small tumor size, an intact serosa and the absence of any metastatic focus in lymph nodes, liver and peritoneum. However, either gross cancerous invasion on the serosa or any metastatic site in the lymph nodes, liver or peritoneum was essential to exact gross staging in a patient with advanced gastric cancer.
3) Thirteen patients were over-estimated in gross staging. Ten over-estimations in serosal invasions and ten over-estimations in metastases of lymph nodes were responsible for the mistakes. A larger tumor was easily mistaken for more advanced stages of the disease and resulted in over-estimations.
4) Twenty patients were under-estimated in gross staging. Eleven under-estimations in serosal invasions and fourteen under-estima-tions in metastases of lymph nodes were responsible for the mistakes. Similarly, an erroneous judgement of a less advanced stage could be made on a smaller tumor.

並列摘要

Exact staging is an essential prerequisite for diagnosis and treatment in modern oncology. In this study, the accuracy of gross staging in patients with respectable gastric cancer is discussed.
One hundred and thirty-eight patients with gastric cancer were studied usin the staging system proposed by the Japanese Research Society for Gastric Cancer. Gross and histological staging was conducted in each case both operatively and postoperatively, respectively.
The following results were obtained:
1) The prevalence of exact gross staging was: 58.8% in stage i, 27.3% in stage ii, 73.1% in stage iii, and 93.1% in stage iv.
2) 2) One hundred and five patients including 10 cases in stage I, 3 in stage ii, 38 in stage iii and 54 in stage iv had exact gross staging. Exact gross staging in a patient with stage I gastric cancer was attributed to a small tumor size, an intact serosa and the absence of any metastatic focus in lymph nodes, liver and peritoneum. However, either gross cancerous invasion on the serosa or any metastatic site in the lymph nodes, liver or peritoneum was essential to exact gross staging in a patient with advanced gastric cancer.
3) Thirteen patients were over-estimated in gross staging. Ten over-estimations in serosal invasions and ten over-estimations in metastases of lymph nodes were responsible for the mistakes. A larger tumor was easily mistaken for more advanced stages of the disease and resulted in over-estimations.
4) Twenty patients were under-estimated in gross staging. Eleven under-estimations in serosal invasions and fourteen under-estima-tions in metastases of lymph nodes were responsible for the mistakes. Similarly, an erroneous judgement of a less advanced stage could be made on a smaller tumor.

並列關鍵字

gastric carcinoma ； gross staging ； histological staging