胃癌筛查指南在基层无症状人群的实施研究初探  

Study of a new gastric cancer screening scoring system in early gastric cancer screening at primary hospitals

作　　者：卢志斌 林良兜 黄俊[1] 马伟钦 孙占军 陈羽[1] LU Zhi-bin;LIN Liang-dou;HUANG Jun;MA Wei-qin;SUN Zhan-jun;CHEN Yu(Department of Gastroenterology,The Seventh Affiliated Hospital of Southern Medical University,Foshan,Guangdong 528244;Department of Gastroenterology,Puning People’s Hospital,Puning,Guangdong 515399)

机构地区：[1]南方医科大学第七附属医院消化内科,1528244 [2]普宁市人民医院消化内科,2515399

出　　处：《现代消化及介入诊疗》2021年第8期949-952,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：广东省中医药局科研项目(20211278);广东省医学科研基金(B2019207);佛山市卫生健康局医学科研课题(20220809A010002,20220809A010452)。

摘　　要：目的初步探讨胃癌筛查指南在基层无症状人群实施研究过程的应用价值和问题。方法收集2019年1月至2019年12月南方医科大学第七附属医院行健康体检的无症状人群共1429名,早期胃癌筛查采用新型胃癌筛查评分系统进行初筛,根据初筛结果分为低危组、中危组、高危组,对中高危均通过电话随访动员进行精查胃镜检查,对完成胃镜检查者比较胃癌前病变等检出率,再次对中、高危组体检者行电话回访,记录并分析回访结果。结果中、高危组的胃癌前疾病及癌前病变检出率(糜烂性胃炎、消化性溃疡、癌前病变、胃息肉)明显高于低危组(P<0.05)。我院胃镜检查率低危组8%,中危组10.17%,高危组7.14%,总胃镜检查率1.61%(23/1429),中、高危组胃镜检查率相对低危组为高(P<0.05)。电话回访结果示早癌筛查意义理解度、胃镜检查畏惧度、胃镜费用满意度、胃镜检查基层医院信任度,胃镜组与非胃镜组比较差异无统计学意义(P>0.05),而在胃功能意义理解度方面有统计学意义(P<0.05)。结论新型胃癌筛查评分系统在基层医院早期胃癌筛查中有很好的应用价值,对胃功能意义的理解可能是决定患者是否接受胃镜筛查的关键因素。Objective To explore the application value of a new early gastric cancer screening scoring system at primary hospitals.Methods 1429 teachers in the area who underwent physical examination at the Nanhai Hospital of Southern Medical University from January 2019 to December 2019 were collected.Early gastric cancer screening was conducted by a new gastric cancer screening scoring system.According to the preliminary screening results,they were divided into low-risk,medium-risk and high-risk groups.The detection rate of precancerous diseases and precancerous lesions under gastroscopy was compared,and the persons in the middle and high risk groups were followed up by telephone,and the results were recorded and analyzed.Results The detection rate of precancerous diseases and precancerous lesions(erosive gastritis,peptic ulcer,precancerous lesions,gastric polyps)in the high-risk group was significantly higher than that in the low-risk group(P<0.05).The gastroscopy rate of low-risk group was 8%,medium risk group(10.17%),high-risk group(7.14%),the total gastroscopy rate was 1.61%(23/1429),and the gastroscopy rate of medium and high-risk group was higher than that of low-risk group(P<0.05).The results of telephone follow-up showed that there was no significant difference in understanding of significance of early cancer screening,fear of gastroscopy,satisfaction degree of gastroscopy cost and trust degree of primary hospital of gastroscopy(P>0.05),but there was significant difference in understanding of gastric function between gastroscopy group and non gastroscope group(P<0.05).Conclusion The early gastric cancer screening scoring system has a good application value in the screening of gastric cancer for healthy people.The understanding of the significance of gastric function may be the key factor in determining whether patients receive gastroscopy screening.

关 键 词：胃癌 筛查 评分系统 

分 类 号：R735.2[医药卫生—肿瘤] R573[医药卫生—临床医学]