胃癌前病变转归影响因素回顾性队列研究  

Influencing factors of reverse of gastric precancerous lesions:a retrospective cohort study

作　　者：周亮[1] 赵瑶[2] 朱伟[1] 沈月平[2] 

机构地区：[1]溧阳市疾病预防控制中心,江苏213300 [2]苏州大学医学部公共卫生学院流行病与卫生统计学教研室

出　　处：《中国公共卫生》2013年第8期1154-1157,共4页Chinese Journal of Public Health

基　　金：国家自然科学基金(30872176)

摘　　要：目的研究胃癌前病变的转归情况及其影响因素,为胃癌前病变或胃癌的预防提供基础资料。方法采用回顾性队列研究方法对江苏省溧阳市2004年前经病理确诊为胃癌前病变的患者进行随访,通过胃镜检查、病理诊断及问卷调查获取病理结局及相关影响因素。结果 122例胃癌前病变患者有41例转归为非胃癌前病变,转归率为33.61%;Cox回归模型分析显示,在调整年龄、性别、职业、吸烟、饮茶、饮酒等因素后,与不采取治疗措施的对象比较,采取治疗措施对象发生转归的RR值为3.24(95%CI=1.22～8.57),常规服药对象发生转归的RR值为3.92(95%CI=1.45～10.64),西药治疗对象发生转归的RR值为2.84(95%CI=1.08～7.46),中药治疗对象发生转归的为RR值为5.13(95%CI=1.22～21.74)。结论采取治疗措施和常规服药是促使胃癌前病变患者发生良性转归的重要因素。Objective To study the reverse status of gastric precancerous lesions and its influencing factors. Methods Using retrospective cohort study,the patients diagnosed as gastric precancerous lesions by pathology in 2004 in Liyang city,Jiangsu province were followed up for 5 years to get the pathological outcome by endoscopy and information on relevant factors were collected with a questionnaire survey. Results Totally 41 of 122 patients（33.61%）were reversed from precancerous lesions to non-precancerous lesions.Cox regression analysis showed that after adjustment for age,sex,occupation,smoking,drinking tea and alcohol drinking,compared to non-treatment group,the treatment group had an increased predisposition of reversing precancerous lesions（relative risk [RR]=3.24;95% confidence interval [95%CI]：1.22-8.57）.The RR of the reverse for the patients adopting regular medication was 3.92（95%CI：1.45-10.64）,the RR of reverse for the patients taking traditional Chinese medication was 5.13（95%CI：1.22-21.74）,and the RR for taking western medicine treatment was 2.84（95%CI：1.08-7.46）,compared with the unchanged group. Conclusion Taking therapy measures,regular medication may be the important factors to promote gastric precancerous lesions to reverse into the benign outcome.

关 键 词：胃癌前病变 转归 回顾性队列研究 

分 类 号：R73-31[医药卫生—肿瘤]