早期胃癌临床病理学特征及年代变化趋势分析  

Analysis of clinicopathological features and pattern changes of early gastric cancer

作　　者：于云鹏 俞静 杨林[2] 司君利[1] 姜相君[3] 咸会波 刘冠群[1] 綦素霞 Yu Yunpeng;Yu Jing;Yang Lin(Department of Emergency,the Affiliated Qingdao Municipal Hospital of Medical College of Qingdao University,Qingdao 266011,China)

机构地区：[1]青岛大学附属青岛市市立医院急诊科,266011 [2]青岛大学附属医院消化内科 [3]青岛大学附属青岛市市立医院消化内二科,266011

出　　处：《中华保健医学杂志》2018年第2期98-101,共4页Chinese Journal of Health Care and Medicine

基　　金：国家自然科学基金(81301623)

摘　　要：目的分析1 025例早期胃癌的临床病理学特征及16年来的年代变化趋势,以期为早期胃癌人群的研究提供参考。方法回顾性分析青岛大学附属青岛市市立医院2001年1月～2016年12月诊断的早期胃癌患者临床病理特征资料,采用卡方检验分析不同人口学因素、不同年代与各临床病理特征间的关系。结果 166 260例行胃镜检查患者中共检出胃癌患者4 846例,检出率为2.91%,早期胃癌患者1 025例,早期胃癌检出率为0.62%,早期胃癌占全部胃癌比例的21.2%。男性检出率明显高于女性(0.78%vs 0.44%;χ~2=78.924,P<0.001)。早期胃癌检出率的年龄分布中,<40岁、40～49岁、50～59岁、≥60岁4个年龄组的检出率分别为0.20%、0.48%、0.60%、0.92%,随着年龄的增长,早期胃癌的检出率呈明显增长趋势,差异有统计学意义(χ~2=191.635,P<0.001)。临床病理特征分布:肿瘤最大径≤2 cm者占64.20%;好发部位依次为胃窦(48.00%)、胃体(30.73%)、贲门/胃底(21.27%);肿瘤浸润至黏膜层638例(62.24%),脉管浸润44例(4.29%),神经侵犯99例(9.66%),淋巴结转移174例(16.98%),分化型611例(59.61%),有合并溃疡者467例(45.56%)。肿瘤标记物检测阳性182例(17.16%);幽门螺杆菌检测阳性127例(12.96%)。近16年来胃镜检查早期胃癌的检出率呈逐年上升趋势,年代变化趋势分析发现最大径≤2 cm的胃癌的检出例数及构成比逐年增加,尤其是2010年以后增加明显,差异有统计学意义(P<0.001);黏膜内癌的检出比例逐年上升(P=0.007),未出现淋巴结转移的早期胃癌检出例数及构成比呈逐年上升趋势(P=0.003)。结论早期胃癌检出率逐年升高,其中直径≤2 cm胃癌、黏膜内癌、未出现淋巴转移的早期胃癌检出率增高。Objective To analyze the clinicopathological features and pattern changes of 1025 cases of early gastric cancer in the past 16 years and to provide a reference for population study of early gastric cancer.Methods All relevant data from early gastric cancer patients from 2001 to 2016 were collected from the affiliated Qingdao Municipal Hospital of Medical College of Qingdao University for retrospective analysis of the clinical pathological characteristics.The Chi square test was used to analyze the relationship among different demographic factors,different ages and clinicopathological characteristics.Results In 166260 gastroscopy patients,there was detection of gastric cancer in 4846 cases(detection rate of 2.91%).Early gastric cancer was detected in 0.62%.Early gastric cancer accounted for 21.2%of all gastric cancer.The detection rate in males was higher than that in females(0.78%vs 0.44%;χ2=78.924,P<0.001).The age distribution of the early detection rate of gastric cancer in those aged<40 years,40~49 years,50~59 years old,and 60 and above was 0.20%,0.48%,0.60%,and 0.92%,respectively.With increasing age,the detection rate of early gastric cancer was significantly increased(χ2 trend=191.635,P<0.001).The clinical and pathological features of distribution were as follows:maximum tumor diameter less than 2 cm accounted for 64.20%;the good parts were in the gastric antrum(48%),(30.73%)and gastric cardia/stomach(21.27%);tumor infiltrating the mucosa was seen in 638 cases(62.24%),vascular invasion in 44 cases(4.29%),99 cases of nerve invasion(9.66%)and lymph node metastasis in 174 cases(16.98%).There were 611 cases of differentiated type(59.61%),and 467 cases with ulcer(45.56%).Tumor markers were positive in 182 cases(17.16%).Helicobacter pylori was positive in 127 cases(12.96%).In the past 16 years,the detection rate of early gastric cancer increased yearly.Analysis of the change in the trend that was less than or equal to 2 cm involved a small number of detected cases of gastric cancer,and the constituent ratio incr

关 键 词：早期胃癌 胃镜 病理特征 流行病学 

分 类 号：R735.2[医药卫生—肿瘤]