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Revista de Gastroenterología del Perú

versión impresa ISSN 1022-5129

Resumen

ESPEJO ROMERO, Hernán  y  NAVARRETE SIANCAS, Jesús. Cáncer Gástrico Temprano: estudio de 371 lesiones en 340 pacientes en el Hospital E. Rebagliati. Lima - Perú. Rev. gastroenterol. Perú [online]. 2005, vol.25, n.1, pp. 48-75. ISSN 1022-5129.

The first concrete description of the Gastric Cancer in Early Stage is attributed to the German, M. Versé in 1903, in his book "Die Histogenese der Schleimhautcarcinome", but the first to use the term, was the French, Bayle in 1833, calling it "First Stage Gastric Cancer". From 1963 to 2002, 5118 gastric cancers were histologically diagnosed, in our hospital from which 2337 (46%) were resected in 340 of the resected specimens, 371 early gastric cancers (EGC) (15.87%) were found. Distribution: For every five periods, the number and proportion of early cancers increases, from 10 (6.8%) in the first five years to 78 (21,0%) in the last one. Age: The average is: 64 years old for men and 58 for women with a global average of 61 years old. The youngest case was in a woman of 23 years old. The oldest case in men was 93 years old, and in women, 81 years old. Sex: 235 males and 105 females, with a ratio of 2,2:1. Macroscopy: ELEVATED TYPE: Type l 70 (18.9%) Ila 66 (17.8%) Ila+Ilc 26 (7.0%) lla+l 1 (0.3%) I+lla 0 (0.0) IIa+III 1 (0.3%) IIa+IIb 1 (0.3%). Global average of the elevated type: 44.6%. SUPERFICIAL TYPE: llb 17 (4.6%), DEPRESSED TYPE: llb+llc 10 (2.7%), llc 127 (34.2%), llc+l 0 (0.0%) llc+lll 43 (11.6%) lll 3 (0.8%) lll+llc 5 (1.3%) llc+lla 1 (0.3%) lla+llb 0 (0.0%). The global average of the depressed type is: 50.9%. Location: antrum 171 (46.1%) body 138 (37.3%) bottom 46 (12.3%) antrum-body 12 (3%) and body-bottom 3 (1%). Size: Maximum 90 mm, minimum 1.5 mm, average 24.9 mm; 25 (8%) diminute (microcarcinomas), 58 (21%) small. Histology: Differentiated 219 (64%) undifferentiated 121 (36%). Degree of differentiation in men 74% and in women 26%. Degree of differentiation in diminutes 92%, in small 79% and in large 69%. Depth: 204(55%) in mucous, 167(45%) in mucous / submucous. In differentiated 182(63%) in mucous, 108(37%) in mucous / submucous. Ganglion Metastasis: In the 187 located in mucous, 13 (3.8%) were positive, in the 153 located in mucous / submucous 30 (8.8%) were positive. Global percentage of positive ganglions: 12.3%. Synchronic lesions: General in synchronic lesions in 54.6% in other types of cancer 12.7%.  Intestinal Metaplasia: Present in 65%, of which 50% of them were uncompleted Symptoms and signs: Dyspepsia 82.2%, hyperoxia 32.9%, loss of weight 23.3%, non-characteristic pain 23.3%, ulcer pain 20,5%, melena 8,2%, anemia 7,7%, diarrhea and/or constipation 7,4%, vomiting 2,2%, hematemesis 1,9%.  Blood Type: O (63.2%) A (24.7%) B (11.3%) AB (0.6%). Gastric secretion: This was determined in 70 patients: In 55 with ulcer, none showed achlorhydria 0%, 20 (36%) hypochlorhydria, 20 (36%) normochlorhydria and 15 (28%) hyperacidity. In 16 in an elevated form 13 (87.5%) with achlorhydria, 1 (6.5%) with hypochlorhydria, 1 (6.5%) with normal acidity. Average in ulcerated cases DAB 3.04 ± 1.25 mEqh and DAM 12.31 ± 8.00. In elevated cases: DAB 0.89 ± 0.32 and DAM 2.20 ± 0.95 mEqh.

Palabras llave : Early Gastric Cancer; Early Gastric Cancer.

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