目的:探讨胃癌临床演变时间段的相关因素。方法:以北京大学第三医院1974年~2002年间所有门诊胃镜“病例数”例数68500例,结合病理证实的初次排除胃癌,跟踪随访若干年后演变为胃癌共65例为研究对象,按演变时间分组对患者性别、胃癌部位、组织学类型等进行统计比较。结果:2年是消化科门诊患者由非胃癌转变为胃癌的高发时段,其中贲门癌的发病尤其值得警惕,初检组织学类型有异常者尤其是中重度异型增生者演变为胃癌的几率明显增高,有关胃癌组织学类型的变化有待于更多的研究。 Objective: To investigate the factors related to the clinical evolution of gastric cancer. Methods: A total of 68 500 cases of gastroscopy at the outpatient department of Peking University Third Hospital from 1974 to 2002 were enrolled in this study. A total of 68 500 gastric cancer cases were retrospectively analyzed. According to the evolvement time, the patients’ gender, gastric cancer location and histological type were statistically compared. Results: Two years was the high-risk period for patients with Gastroenterology from non-gastric cancer to gastric cancer. The incidence of cardia cancer should be especially vigilant. The abnormalities of primary histological types, especially those with moderate-severe dysplasia, evolved into gastric cancer significantly increased , Changes in histological types of gastric cancer need more research.