食管癌临床症状类型及其年龄和性别分布特征  

Classification and distribution of clinical symptoms for esophageal cancer by age and gender

作　　者：鲍启德[1] 张长江[1] 刘敏[1] 张海鹏[1] 周利霞[1] 宋昕[2] 刘军清[1] 赵学科[2] 孙李凌[1] 陈培楠[2] 崔月龙 杜丹凤[2] 张向阳[2] 王立东[2] 

机构地区：[1]安阳地区医院肿瘤科,河南安阳455000 [2]郑州大学第一附属医院河南省食管癌重点开放实验室,河南郑州450052

出　　处：《新乡医学院学报》2017年第7期570-573,578,共5页Journal of Xinxiang Medical University

基　　金：河南省重大科技专项项目(编号:161100311300)

摘　　要：目的分析食管癌常见临床症状种类及其在年龄和性别中的分布特征,确定症状出现到诊断和首次治疗时间(延迟诊断和治疗时间),为进一步阐明临床症状对食管癌早期预警和预后的影响提供重要信息。方法本组18 996例食管癌手术患者的临床信息资料均来自郑州大学第一附属医院河南省食管癌重点开放实验室50万例食管癌和贲门癌临床信息数据库,平均诊断年龄(59.32±8.68)岁。根据患者主诉进行症状分类,并根据常用医学术语进行规范,归纳症状类型和出现频率。记录每例患者主要症状距首次治疗的间隔时间,并将这一间隔时间定义为延迟诊断和治疗时间。症状出现频率统计采用百分比的方法,按照出现频率1%为界限,分为常见症状和少见症状。对4种最常见症状的性别、年龄分布的差异性采用列联表χ~2检验进行比较分析;对发病年龄、延迟诊断和治疗时间采用描述性统计方法分析比较平均数。结果 18 996例食管癌患者中,共出现292种不同症状;对这些症状进行医学术语规范和归类共归纳出44种临床症状。在归纳出的44种症状中,最常见的症状是吞咽哽噎(87.29%),其次为吞咽疼痛(5.10%)、腹部不适(3.36%)和胸骨后不适(1.48%),这4种症状占所有症状的97.23%。吞咽哽噎、吞咽疼痛、腹部不适、胸骨后不适症状的食管癌患者平均诊断年龄分别为(59.33±8.74)、(58.38±8.36)、(60.45±8.38)、(58.03±8.01)岁。男性和女性患者均以这4种症状为主,分布相似(χ~2=2.68,P=0.44)。<60岁男性患者出现吞咽疼痛和胸骨后不适的频率明显高于≥60岁男性患者(χ~2=13.37,P<0.05);<60岁女性患者出现吞咽疼痛和胸骨后不适的频率明显高于≥60岁女性患者,出现腹部不适症状频率明显低于≥60岁女性患者(χ~2=11.17,P<0.05)。腹部不适和吞咽疼痛患者的延迟诊断和治疗中位时间(30 d)明显短于吞咽哽噎和胸骨后不适患者(60Objective To characterize the common clinical symptoms of esophageal cancer and their distributions by age and gender on esophageal cancer patients,to determine the delayed time for diagnosis and treatment,and to provide important information for further elucidating the role of the clinical symptoms in early alarm and prognosis for esophageal cancer.Methods The clinical information of 18 996 esophageal cancer patients was derived from the clinical databases of 500 000 esophageal and gastric cardia carcinomas of the Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital of Zhengzhou University with an average age of（ 59. 32 ± 8. 68） years. Based on the chief complaint,the clinical symptoms were classified and standardized using medical terms. The type and frequency of symptoms were calculated based on the standardized symptoms. The time of symptom occurrence and the first diagnosis and treatment were recorded to define the interval between the main symptoms and the first treatment as the delayed diagnosis and treatment time. The frequency of symptom occurrence was measured by percentage and divided into common symptoms and rare symptoms according to frequency1%. The difference of gender and age distribution between the four kinds of common symptoms was analyzed by contingency table χ^2test. The diagnosis age,delayed diagnosis and treatment time were analyzed by descriptive statistics,and the average number was compared. Results A total of 292 different clinical symptoms were classified from the 18 996 esophageal cancer patients. After standardization by medical terms,44 kinds of symptoms were finally classified for final analysis. Statistical analysis showed that the most common symptom for esophageal cancer was dysphagia（ 87. 29%）,followed by swallowing pain（ 5. 10%）,abdominal discomfort（ 3. 36%） and retrosternal discomfort（ 1. 48%）. These four kinds of symptom accounted for97. 23% of the total 44 kinds of symptoms. The average diagnostic age at diagnosis of fou

关 键 词：食管癌 临床症状 年龄 性别 延迟诊断和治疗时间 

分 类 号：R735.1[医药卫生—肿瘤]