Early gastric cancers (EGCs) are confined to the gastric mucosa and submucosa irrespective of lymph node metastases and constitute only a minor proportion of gastric cancer in Western countries. We aimed to characterize EGCs and assess the survival of EGC in Central Norway during 2001–2016. A retrospective population-based study on 1205 patients with gastric cancer was performed. At the time, surgical resection was the standard treatment, and 88 (7.3%) EGCs were identified. Histopathological specimens were re-examined, and the eCura score and survival were evaluated. The number of gastric cancers declined (p= 0.010), but the relative proportion of EGC was unchanged during the study period. EGCs were more often of the Lauren intestinal type (p< 0.001) compared with controls. A significant proportion (9.4%, n = 5) of the patients with a low-risk eCura had lymph node metastases, whereas further exclusion of tumors with histological ulceration or SM2 invasion identified an N0 cohort. The median survival for EGC patients was 117.1 months (95% CI 99.8–134.3) and the 5-year overall survival was 75%. Twelve deaths were cancer-related, either due to postoperative complications (5.7%, n = 5) or cancer recurrence (8%, n = 7). In conclusion, EGCs constituted a minor but constant proportion of gastric cancers. eCura alone was insufficient in predicting patients with pN0 disease.
早期胃癌（EGCs）指局限于胃黏膜及黏膜下层的胃癌，无论是否存在淋巴结转移，在西方国家仅占胃癌的较小比例。本研究旨在分析2001年至2016年间挪威中部地区早期胃癌的临床病理特征及患者生存情况。通过对1205例胃癌患者进行回顾性人群研究，发现当时手术切除为标准治疗方案，共确诊88例（7.3%）早期胃癌。对组织病理学标本进行复检，评估eCura评分及生存数据。研究期间胃癌总病例数呈下降趋势（p=0.010），但早期胃癌的相对比例保持稳定。与对照组相比，早期胃癌更多为Lauren肠型（p<0.001）。在eCura低风险患者中，仍有显著比例（9.4%，n=5）存在淋巴结转移；而进一步排除组织学溃疡或SM2浸润的肿瘤后，可筛选出无淋巴结转移（N0）的病例组。早期胃癌患者中位生存期为117.1个月（95% CI 99.8–134.3），5年总生存率为75%。12例死亡与癌症相关，其中术后并发症占5.7%（n=5），癌症复发占8%（n=7）。结论：早期胃癌在胃癌中占比虽小但保持稳定，单独使用eCura评分不足以准确预测病理淋巴结阴性（pN0）患者。
Early Gastric Cancers in Central Norway 2001 to 2016—A Population-Based Study
肿瘤(癌症)患者之家