The Analysis Of Clinical And Pathological Features On Cardiac Carcinoma

ObjectiveTo analyze the clinical,endoscopic and pathological manifestations and prognosis of patients with cardiac carcinoma,summarize the clinical,endoscopic and pathological features of cardiac carcinoma and its correlation with H.pylori,and to propose an effective method for the diagnosis of cardiac carcinoma.MethodsThe clinical data,endoscopic manifestations,pathological results and follow-up data of 207 patients with cardiac carcinoma in our hospital in the last 5 years were retrospectively analyzed.The patients were divided into the middle-aged group and the elderly group based on the age,and the lesion sites were also grouped according to four quadrants.Then the clinical and pathological differences were compared in each group.ResultsIn the 207 patients,the male-female ratio was 2.3:1,and there were 75.36%elderly patients,161 cases of heavy smokers(77.78%),and 201 cases of high-salt diet(97.10%).The high-salt diet had a statistically significant difference between middle-aged group and elderly group(P<0.05).In terms of the clinical manifestations,abdominal pain,abdominal distension and other atypical symptoms accounted for 28.99%,while difficulty in swallowing,gastrointestinal bleeding,emaciation and other obvious symptoms or signs accounted for 71.01%.Difficulty in swallowing had a statistically significant difference between middle-aged group and elderly group(P<0.05).In terms of the gross morphology,there were 110 cases of Borrmann II type,accounting for 53.14%.The carcinoma frequently occurred in the posterior wall and lesser curvature side(165 cases),accounting for 79.71%.There were 89 cases of differentiated carcinoma,accounting for 43.00%in middle-aged group and 35.75%in elderly group,showing a statistically significant difference(P<0.05).The H.pylori was positive in 177 cases(85.51%).Moreover,there were 202 cases of positive chronic inflammatory response(97.58%),154 cases of positive atrophy(74.40%),and 140 cases of positive intestinal metaplasia(67.63%).The patients with positive chronic inflammatory response,atrophy and intestinal metaplasia were dominated,and mucosal atrophy had a statistically significant difference between middle-aged group and elderly group(P<0.05).There were 38 cases of early carcinoma,and the early diagnosis rate was about 18.36%.The patients were followed up for 1?72 months with a mean of(23±3.6)months,and the follow-up rate was 98.55%.78 patients died of tumor,accounting for 37.68%.The survival rate had a statistically significant difference between early and advanced cancer(P<0.05).Conclusion1.Cardiac carcinoma occurs more frequently in males than females in the region,and the incidence is significantly increased in the elderly.Gastroscopy should be performed as soon as possible in the case of difficulty in swallowing for elderly males with smoking and high-salt diet.2.The cardiac part should be carefully observed in gastroscopy,and attention should be paid to the ulcerative lesions on the posterior wall and lesser curvature side.3.The high-risk people should be screened;in particular,the regular gastroscopy and follow-up are required for those with positive H.pylori,cardiac mucosal atrophy,intestinal metaplasia and dysplasia.