文档介绍：卫生部胃癌诊疗标准-2022版
of rural drinking water sources, protection of drinking water sourcn of the scope of protection, complete with warning signs, isolating network protection facilities
of rural drinking water sources, protection of drinking water sources in rural areas by the end of the delimitation of the scope of protection, complete with warning signs, isolating network protection facilities4
of rural drinking water sources, protection of drinking water sources in rural areas by the end of the delimitation of the scope of protection, complete with warning signs, isolating network protection facilities
晚期胃癌患者可扪及上腹部包块，发生远处转移时，根据转移部位，可出现相应的体征。出现上消化道穿孔、出血或消化道梗阻等情况时，可出现相应体征。
〔三〕辅助检查。
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〔１〕胃镜检查：确诊胃癌的必须检查手段，可确定肿瘤位置，获得组织标本以行病理检查。必要时可酌情选用色素内镜或放大内镜。
〔２〕超声胃镜检查：有助于评价胃癌浸润深度、判断胃周淋巴结转移状况，推荐用于胃癌的术前分期。对拟施行内镜下粘膜切除〔EMR〕、内镜下粘膜下层切除〔ESD〕等微创手术者必须进行此项检查。
〔３〕腹腔镜：对疑心腹膜转移或腹腔内播散者，可考虑腹腔镜检查。
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组织病理学诊断是胃癌确实诊和治疗依据。活检确诊为浸润性癌的患者进行标准化治疗。如因活检取材的限制，活检病理不能确定浸润深度，报告为癌前病变或可疑性浸润的患者，建议重复活检或结合影像学检查结果，进一步确诊后选择治疗方案。
〔１〕胃镜活检标本处理。
①标本前期处置：活检标本离体后，立即将标本展平，使粘膜的基底层面贴附在滤纸上。
of rural drinking water sources, protection of drinking water sources in rural areas by the end of the delimitation of the scope of protection, complete with warning signs, isolating network protection facilities
of rural drinking water sources, protection of drinking water sources in rural areas by the end of the delimitation of the scope of protection, complete with warning signs, isolating network protection facilities4
of rural drinking water sources, protection of drinking water sources in rural areas by the end of the delimitation of the scope of protection, complete with warning signs, isolating network protection facilities
②标本固定：置于10%-13%福尔马林缓冲液中。包埋前固定时间须大于6小时，小于48小时。
③石蜡包埋：去除滤纸，将组织垂直定向包埋。
④HE制片标准：修整蜡块，要求连续切6～8个组织面，捞取在同一张载玻片上。常规HE染色，封片。
〔2〕病理诊断标准。
①低级别上皮内肿瘤：粘膜内腺体结构及细胞学形态呈轻度异型性，与周围正常腺体比拟，腺体排列密集，腺管细胞出现假复层，无或有极少粘液，细胞核染色浓重，出现核分裂相。