体质指数与贲门腺上皮内瘤变和早期贲门癌关系分析  

The Relationship between Body Mass Index and Intraepithelial Neoplasia and Early Carcinoma of the Gastric Cardia

作　　者：陈志峰[1] 侯俊[1] 贺宇彤[1] 宋国慧 靳国良 郭翠兰 白文龙 温登瑰[1] 王士杰[1] 

机构地区：[1]河北医科大学第四医院肿瘤研究所,石家庄市050011 [2]河北省磁县肿瘤医院

出　　处：《中国肿瘤临床》2008年第13期721-724,共4页Chinese Journal of Clinical Oncology

基　　金：国家十五科技攻关项目基金;卫生部食管癌早诊早治专项基金资助(编号:2001A703B10)

摘　　要：目的:探讨北方食管癌高发区人群体质指数(BMI)与早期贲门腺癌和上皮内瘤变的关系。方法:2004年3月和2006年7月,选择磁县两个乡25个自然村40～65岁为内镜筛查队列样本,应筛查5331例,实际内镜筛查4078例。筛查率76.5%,其中男性2012例,女性2066例,性别比0.97,中位年龄47.0岁。以WHO2000年消化道肿瘤病理诊断标准,贲门腺上皮轻度不典型增生划为低级别上皮内瘤变(LIN),高级别上皮内瘤变(HIN)包括重度不典型增生、粘膜内癌。本队列共检出贲门LIN55例、HIN31例和早期浸润腺癌17例。根据中国成人BMI分类标准,<18.5体重过低、18.5～23.9正常、24.0～27.9超重、≥28.0肥胖共计4个切点,与病理诊断正常人群、贲门腺上皮内瘤变(LIN、HIN)和早期浸润癌,建立R×C列联表,分析BMI与贲门腺上皮内瘤变和贲门腺癌关联性。结果:男性在BMI正常切点,病理诊断正常、LIN、HIN和浸润癌分别占62.3%、64.1%、81.0%和83.0%;在BMI>24.0以上分别占34.5%、33.3%、19.0%和16.7%,χ2=6.675,P>0.05;女性分别为51.7%、56.3%、70.0%和40.0%;45.4%、43.8%、30.0%和60.0%,χ2=5.387,P>0.05。结论:中国北方食管癌高发区贲门LIN、HIN及早期浸润癌在BMI不同切点的变化无关联性,BMI可能不是贲门癌主要危险因素。Objective： To correlate body mass index （BMI） with the prevalence of eady stage adenocarcinoma and intraepithelial neoplasia of the gastric cardia as detected by a population-based endoscopy survey. Methods： In March 2004 through July 2006, patients aged 40 to 65 in 25 villages of two townships in Cixian County were selected for endoscopic screening. A total of 5,331 cases were recruited and 4,078 of them underwent endoscopic screening, providing a screening rate of 76.5%. The male/female ratio of these 4,078 patients was 0.97 and the average age was 47.0 years. According to 2000 WHO pathological standards for tumors of the digestive system, mild cardia epithelial dysplasia was considered low-grade neoplasia （LIN）, while severe dysplasia and intramucosal carcinoma were considered high-grade intraepithelial neoplasia （HIN）. This study included 55 cases of LIN, 67 cases of HIN and 17 cases of early carcinoma of the gastric cardia. Chinese adult BMI classification criteria were as follows： underweight （〈18.5）, normal （18.5-23.9）, overweight （24.0-27.9）, and obese （≥28.0）. The association of BMI with the pathological degree was investigated by R×C contingency table. Results： For the male patients, when the BMI was 18.5-23.9, the proportion of normal tissue, LIN, HIN and invasive cancer was 62.3%, 64.1%, 81.0% and 83.0%, respectively. When the BMI was higher than 24.0, the proportion of normal tissue, LIN, HIN and invasive cancer was 4.5%, 33.3%, 19.0% and 16.7%, respectively, with a statistical relevance （X^2=6.675,P〉0.05）. For the female patients, when the BMI was 18.5-23.9, the proportion of normal tissue, LIN, HIN and invasive cancer was 51.7%, 56.3%, 70.0% and 40.0%, respectively. When the BMI was higher than 24.0, the proportion of normal tissue, LIN, HIN and invasive cancer was 45.4%, 43.8%, 30.0% and 60.0%, respectively （X^2=5.387, P〉0.05）. Conclusion： There seems to be no correlation between BMI and the prevalence of intraepithelial neoplasia and early ca

关 键 词：体质指数 贲门腺癌 高级别内瘤变 低级别内瘤变 

分 类 号：R735.2[医药卫生—肿瘤] R589.2[医药卫生—临床医学]