重庆地区食管腺癌和贲门腺癌胃镜检出率变化-35年回顾性分析

发布时间：2019-04-17 17:05

【摘要】：研究背景和目的自上世纪70年代始,西方发达国家食管腺癌(EAC)和贲门癌(GCC)的发病率明显增长,至90年代逐渐稳定,尤其是在美国,其发病率增加了2.5-3.0倍,这引起了国内外学者的重视。而我国却缺乏大样本多中心流行病学研究。本文将回顾第三军医大学附属第一医院1978-2012年食管腺癌及贲门腺癌的检出情况,对这两种肿瘤的流行病学特征及趋势进行探讨,这将对进一步了解中国的发病情况、引起临床医生对该病的重视有重要的意义。方法汇总第三军医大学附属第一医院1978年1月-2012年12月期间食管鳞癌(ESCC)、食管腺癌(EAC)、贲门癌(GCC)和远端胃癌(GNCC)患者的胃镜诊疗记录,对性别、年龄、诊断等相关数据进行整理,采用线性回归检验进行统计学分析,p0.05视为统计学上有差别。结果1、总体检出例数及检出率我院35年间共行胃镜检查440248例,食管鳞癌10323例(检出率为2.3%),食管腺癌350例(0.08%),贲门癌3076例(0.70%),远端胃癌5642例(1.3%)。2、性别比例各种肿瘤男女比例分别为:食管鳞癌4:1,食管腺癌:3.6:1,贲门癌:4.5:1,胃癌:2.3:1。3、疾病检出率3.1在过去35年间,食管腺癌总检出率依次为0.18%、0、0.07%、0.08%、0.08%、0.11%、0.07%(R=0.143,p=0.143)。贲门癌的总检出率依次为0.53%、0.70%、0.82%、0.81%、0.81%、0.79%、0.63%(R=0.981,p=0.001)。3.2在男性,食管腺癌检出率为0.24%、0、0.10%、0.11%、0.11%、0.16%、0.12%(R=0.032,p=0.945);贲门癌检出率为0.64%、0.90%、1.12%、1.04%、1.14%、1.30%、1.09%(R=0.796,p=0.032)。3.3在女性,食管腺癌检出率为0、0、0.02%、0.02%、0.04%、0.06%、0.03%(R=0.826,p=0.022);贲门癌检出率为0.22%、0.27%、0.35%、0.42%、0.38%、0.28%、0.22%(R=0.917,p=0.049)。4、构成比4.1食管腺癌总体构成比(食管腺癌检出率/(食管腺癌+食管鳞癌)检出率)依次为21.4%、0、1.9%、2.2%、3.4%、3.9%、3.2%(R=0.880,p=0.021)。贲门癌总体构成比(贲门癌检出率/(贲门癌+远端胃癌)检出率)依次为16.8%、25.3%、33.7%、30.7%、38.3%、36.6%、35.3%(R=0.842,p=0.018)。4.2在男性,食管腺癌构成比依次为23.1%、0、2.0%、2.5%、3.4%、3.7%、3.2%(R=0.865,P=0.026)。贲门癌构成比依次为18.0%、26.3%、37.0%、33.6%、41.7%、41.1%、37.9%(R=0.839,p=0.018)。4.3在女性,食管腺癌构成比为0、0、1.6%、1.1%、3.3%、4.7%、3.4%(R=0.902,p=0.0005)。贲门癌构成比依次为7.1%、13.5%、23.1%、22.5%、29.0%、24.3%、25.4%(R=0.833,p=0.020).5、四种肿瘤的发病随年龄增长,发病率显著上升,以》70岁为主要发病人群,50-69岁次之,《49岁发病率最低。6、食管鳞癌和远端胃癌检出率明显降低。结论:35年来食管腺癌检出率无明显改变,构成比上升。贲门癌检出率和构成比均缓慢上升,以男性更明显。食管鳞癌在经历10年急剧的上升趋势后开始下降,胃癌的检出率明显下降。四种疾病均以70岁以上人群为主要发病群体,随着年龄的增长,发病率明显上升。
[Abstract]:Background and objective since the 1970s, the incidence of esophageal adenocarcinoma (EAC) and cardiac cancer (GCC) has increased significantly in western developed countries, and gradually stabilized in the 1990s, especially in the United States, the incidence of which has increased by 2.5%. This has attracted the attention of scholars at home and abroad. However, there is a lack of multicenter epidemiological studies of large samples in China. This article will review the detection of esophageal adenocarcinoma and cardiac adenocarcinoma in the first affiliated Hospital of the third military Medical University from 1978 to 2012, and discuss the epidemiological characteristics and trends of these two kinds of tumors, which will help to further understand the incidence of esophageal adenocarcinoma and cardiac adenocarcinoma in China. It is of great significance for clinicians to attach importance to the disease. Methods from January 1978 to December 2012, the records of gastroscopic diagnosis and treatment in patients with esophageal squamous cell carcinoma, (ESCC), esophageal adenocarcinoma, (EAC), cardiac carcinoma, (GCC) and distal gastric cancer, (GNCC), were collected from January 1978 to December 2012 in the first affiliated Hospital of the third military Medical University, with regard to sex and age. Diagnosis and other related data were collated, linear regression test was used for statistical analysis, p0.05 as statistically different. Results 1. There were 440248 cases of gastroscopy, 10323 cases of esophageal squamous cell carcinoma (2.3%), 350 cases of esophageal adenocarcinoma (0.08%) and 3076 cases of cardiac carcinoma (0.70%). 5642 cases (1.3%) of distal gastric cancer were found. 2. The sex ratio of all kinds of tumors were: esophageal squamous cell carcinoma (4 渭 1), esophageal adenocarcinoma (3.6%), gastric cardia carcinoma (4.5%), gastric cancer (2.3%), esophageal adenocarcinoma (3.6%), gastric cancer (2.3%). The overall detection rate of esophageal adenocarcinoma over the past 35 years was 0.18%, 0,0.07%, 0.08%, 0.08%, 0.11%, 0.07% (R = 0.143, p = 0.143). The total detection rates of cardiac cancer were 0.53%, 0.70%, 0.82%, 0.81%, 0.81%, 0.79%, 0.63%, respectively (R = 0.981, p < 0.001). 3.2 in males, the detection rate of esophageal adenocarcinoma was 0.24%. 0,0.10%, 0.11%, 0.11%, 0.16%, 0.12% (R = 0.032, p = 0.945); The detection rate of cardiac cancer was 0.64%, 0.90%, 1.12%, 1.04%, 1.14%, 1.30%, 1.09% (R = 0.796, p = 0.032). 3.3 in women, the detection rate of esophageal adenocarcinoma was 0,0,0.02%. 0.02%, 0.04%, 0.06%, 0.03% (R = 0.826, p = 0.022); The detection rate of cardiac cancer was 0.22%, 0.27%, 0.35%, 0.42%, 0.38%, 0.28%, 0.22% (R = 0.917, p = 0.049) .4, The overall composition ratio of 4.1 esophageal adenocarcinoma was 21.4%, 0,1.9%, 2.2%, 3.4%, 3.9%, 3.2%, respectively (R = 0.880, r = 0.880, P < 0.01, P < 0.01). (P = 0.021). The overall composition ratio (the detection rate of cardiac cancer / distal gastric cancer) was 16.8%, 25.3%, 33.7%, 30.7%, 38.3%, 36.6%, 35.3% (R = 0.842), respectively. 4.2 in males, the proportion of esophageal adenocarcinoma was 23.1%, 0,2.0%, 2.5%, 3.4%, 3.7%, 3.2% (R = 0.865, P = 0.026). The proportion of gastric cardia cancer was 18.0%, 26.3%, 37.0%, 33.6%, 41.7%, 41.1%, 37.9% (R = 0.839, p = 0.018). 4.3 in women, the proportion of esophageal adenocarcinoma was 0, 0, 1.6%, and the ratio of esophageal adenocarcinoma to esophageal cancer was 18.0%, 26.3%, 33.6%, 41.7%, 41.1% and 37.9%, respectively. 1.1 percent, 3.3 percent, 4.7 percent, 3.4 percent (R = 0.902, p = 0.0005). The constituent ratios of cardiac cancer were 7.1%, 13.5%, 23.1%, 22.5%, 29.0%, 24.3%, 25.4% (R = 0.833, p = 0.020). 5. The incidence of the four tumors increased significantly with age. The incidence rate of esophageal squamous cell carcinoma and distal gastric cancer was significantly lower than that of > 70 years old (> 70 years old), followed by 50 years old (69 years old) and less than 49 years old (< 49 years old). Conclusion: the detection rate of esophageal adenocarcinoma has not changed significantly in the past 35 years, and the constituent ratio has increased. The detection rate and composition ratio of cardiac cancer increased slowly, especially in males. Esophageal squamous cell carcinoma (ESCC) began to decline after 10 years of sharp rise, and the detection rate of gastric cancer was significantly decreased. The incidence of the four diseases increased significantly with the increase of age in the population over 70 years old.
【学位授予单位】：第三军医大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735

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