GASTRIC-CANCER AFTER PEPTIC-ULCER SURGERY - A HISTORIC PROSPECTIVE COHORT INVESTIGATION
GASTRIC-CANCER AFTER PEPTIC-ULCER SURGERY - A HISTORIC PROSPECTIVE COHORT INVESTIGATION
复制标题
DOI：
10.1097/00000658-198908000-00004
复制
发表时间：
1989-08-01
影响因子：
9
通讯作者：
TOFTGAARD, C
中科院分区：
文献类型：
--
作者：
TOFTGAARD, C
对1955年至1960年在丹麦西部53家医院接受消化性溃疡手术的4131例患者进行了历史前瞻性队列研究，研究了随后发生胃癌的风险。对患者的胃癌发展进行随访，直至其死亡或1982年底，并将该队列中的癌症发病率与同一时期同一地区总人群的发病率进行比较。总共诊断出46例胃癌，而预期为47例。术后15年，癌症风险低于预期。15年后的风险高于预期，25年后总患者人群的发生率高出2.1倍。在接受Billroth II胃大部切除术的男性受试者中观察到最高风险，25年后风险增加3.2倍。胃溃疡和十二指肠溃疡患者之间没有差异;对穿孔溃疡进行简单缝合的患者没有显示癌症发病率增加。症状持续时间长的患者与症状较短的患者发生率相同。这些观察结果表明，手术本身而不是溃疡病可能是癌前病变。
In a historical prospective cohort investigation of 4131 patients undergoing peptic ulcer surgery in 53 hospitals in the western part of Denmark from 1955 through 1960, the risk of subsequent gastric cancer development was studied. The patients were followed with regard to gastric cancer development until their death or the end of the year 1982 and the incidence of cancer in this cohort was compared to the incidence in the total population in the same region during the same period. A total of 46 gastric cancers were diagnosed versus 47 expected. Up to 15 years after operation the cancer risk was lower than expected. After 15 years the risk was higher than expected with a 2.1-fold higher incidence after 25 years for the total patient population. The highest risk was observed in male subjects undergoing a Billroth II subtotal gastrectomy with a 3.2 times increase in risk after 25 years. There was no difference between gastric and duodenal ulcer patients; and patients undergoing simple suture for a perforated ulcer showed no increase in cancer incidence. Patients with long-lasting symptoms had the same incidence as patients with briefer symptoms. These observations indicate that the operation per se and not the ulcer disease may be precancerous.