| Objective: Currently most scholars think gastric stump cancer, defined as a carcinoma detected more than 5 years after primary surgery for a benign disease and more than 10 years after for malignant lesions.In recent years, with the increasing incidence of GSC and understanding of deepening to GSC, more and more scholars studied gastric stump cancer. Because of gastric stump cancer lack of specificity and clinical manifestations, gastric stump cancer have often been described as having low resectability rates and a poor prognosis. We have studied gastric stump cancer clinical characteristics and gastric stump cancer endoscopic features, in order to improve the detection of early gastric stump cancer. Studying the relationship between The age for the first partial gastrectomy and gastric cancer incidence, in order to improve diagnostic significance of GSC in early. A study shows that gastric stump cancer prognosis is poorer than primary gastric cancer, and most scholars discusses the prognostic factors of gastric stump cancer. Studies show that gastric stump cancer has unique biological behaviors and poor prognosis. This study analyzed GSC in pathologic classification in retrospectively analysis method. Some scholars think gastric stump cancer incidence are more in men than women, GSC mainly happened in the anastomotic site and cardiac, From the first partial gastrectomy has reported the longer GSC happening again, the biological behaviour is relatively good, we through sex,tumor location, treatment, the Time interval between original gastrectomy and first detection of gastric stump cancer, the PTNM stages to explore prognostic factors of GSC.Methd: The collection of jilin university the first hospital in June 1995~2009 September have treated with GSC definition of 65 patients, and through the mail, telephone and outpatient follow-up, which may follow-up to the clinical data and GSC patient fifty-two. The complete material of GSC with 52 patients were retrospectively analysis method .we study the clinical characteristics, pathologic classification, the relationship between The age for the first partial gastrectomy and gastric stump cancer incidence, according to the relationship between sex, tumor location, time interval between original gastrectomy and first detection of gastric stump cancer, treatment, PTNM stages and survival analysis. SPSS 13.0. software was used for statistical analysis. The age for the first partial gastrectomy and time interval correlation analysis, log-rank test for univariate analysis. Survival curves were calculated according to the Kaplan-Meier method.Results: 1. The age for the first partial gastrectomy is a negative correlation with the time interval.2. gastric stump cancer clinical manifestations of the 52 patients: among these patients, 25 had upper abdominal pain (48.1%), 17 had abdominal distension (32.7%), 13 had nausea (25%), 7 had black stool (13.5%), 5 had eating a choked and swallowing difficulties (9.6%), 4 had hematemesis (7.7%) and 4 has dysorexia and weight loss (7.7%). endoscopic features of GSC:Of the 52 patients, 32 had GSC at Anastomotic site (61.6%), 10 at Fundus and cardiac of the stomach (19.2%), 6 at body of the stomach (11.5%), 4 at the entire remnant stomach (7.7%). Of the 52 patients, 24 had ulcer, 17 had of irregular bulged changes, 11 had mucosal rough. pathologic classification: Of the 52 patients, 29 had Poorly differetiated adenocarcinoma (55.8%), 10 had moderately differetiated adenocarcinoma (19.2%), 5 had well differetiated adenocarcinoma (9.6%), 5 had mucous cell carcinoma (9.6%), 3 had signer-ring cell carcinoma (5.8%). 3. The survival rates of the patients with gastric stump cancer were significantly influenced by treatment methods (χ2=54.576, P<0.01) and PTNM stages (χ2=31.522, P<0.01), but sex, time interval and tumor location do not affact the survival rates of the patients with gastric stump cancer.Conclusion: 1. The older for the initial gastrectomy, gastric stump cancer occurred shorter time interval, Periodic follow-up endoscopic examination after initial gastrectomy may be useful for the early detection of RGC. 2. Doctor should pay special attention to observe tiny mucomem-branous change in the department of anastomotic stoma, Gastric fundus and cardiac part, when gastrectomized patients to carry out the endoscopy follow-up. 3. It's suggested that early diagnosis, early therapy and Curative resection are the main ways to improve long-term outcomes of surgical therapy for patients with gastric stump cancer. |
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