1973-2020年中国食管鳞状细胞癌TNM分期分布的变化  

Changes of TNM stages distribution of esophageal squamous cell carcinoma during 1973-2020 in China

作　　者：宋昕[1] 王盼盼[1] 钟侃 胡景峰 李欣然 王伟[1] 周福有[2] 刘志才[3] 李爱丽[3] 李吉林 王献增 李学民 王苒[1] 范宗民[1] 韩文莉 吉佳佳 雷玲玲 王立东[1] SONG Xin;WANG Panpan;ZHONG Kan;HU Jingfeng;LI Xinran;WANG Wei;ZHOU Fuyou;LIU Zhicai;LI Aili;LI Jilin;WANG Xianzeng;LI Xuemin;WANG Ran;FAN Zongmin;HAN Wenli;JI Jiajia;LEI Lingling;WANG Lidong(State Key Laboratory of Esophageal Cancer Prevention and Treatment,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Department of Thoracic Surgery,Anyang Tumor Hospital,Anyang,Henan 455000;Department of Oncology,Linzhou Tumor Hospital,Linzhou,Henan 456550;Department of Pathology,Linzhou Esophageal Cancer Hospital,Linzhou,Henan 456592;Department of Oncology,Linzhou People′s Hospital,Linzhou,Henan 456550;Department of Pathology,Cixian People′s Hospital,HanDan,Hebei 056599)

机构地区：[1]郑州大学第一附属医院省部共建食管癌防治国家重点实验室,郑州450052 [2]安阳市肿瘤医院胸外科,河南安阳455000 [3]林州市肿瘤医院肿瘤科,河南林州456550 [4]林州市食管癌医院病理科,河南林州456592 [5]林州市人民医院肿瘤科,河南林州456550 [6]磁县人民医院病理科,河北邯郸056599

出　　处：《郑州大学学报（医学版）》2022年第1期10-14,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金面上项目(81872032)。

摘　　要：目的:阐明1973-2020年中国食管鳞状细胞癌(ESCC)TNM分期分布的变化特征。方法:162814例ESCC病例来自郑州大学第一附属医院省部共建食管癌防治国家重点实验室建立的50万例食管/贲门癌患者临床信息数据库,均接受食管癌根治术治疗,TNM分期参照第6版AJCC/UICC标准。比较不同临床特征患者TNM分期的分布。采用Joinpoint回归分析总体、男性、女性早期(0+Ⅰ期)癌患者占比的变化趋势,报告年度变化百分比(APC)、全局平均年度变化百分比(AAPC)及其95%CI。结果:162814例中,早期癌占10.7%;女性早期癌比例高于男性(12.1%vs 10.0%),高发区0、Ⅰ、Ⅱ期患者比例高于低发区,城镇0、Ⅰ、Ⅲ期患者比例高于农村,男、女性中青年患者(<50岁)早期癌占比均低于年龄≥50岁的患者(P<0.05)。48 a间,总体患者和女性患者早期癌占比在2015-2020年升高最为快速,APC(95%CI)分别为27.8%(18.1%~38.2%)和28.9%(14.4%~45.1%),男性患者早期癌占比在2014-2020年升高最为快速,APC(95%CI)为22.2%(12.5%~32.7%);48 a间,总体、男性、女性患者中早期癌占比均呈升高趋势(P<0.05),AAPC(95%CI)分别为2.8%(1.3%~4.4%)、3.6%(2.3%~5.0%)、2.8%(1.2%~4.4%)。结论:我国早期ESCC占比呈明显升高趋势,但是占比仍低于中晚期。食管癌早期发现筛查技术仍是食管癌研究领域亟待解决的关键科学问题。Aim:To clarify the changes of TNM stage distribution of esophageal squamous cell carcinoma(ESCC)during 1973-2020 in China.Methods:A total of 162814 ESCC cases from 1973 to 2020 were obtained from the esophageal and gastric cardia cancer database(with a total of 500000 cases)established by Key Laboratory of Esophageal Cancer Prevention and Treatment,the First Affiliated Hospital of Zhengzhou University.The cases were all treated with radical operation,TNM stages were according to the 6th edition AJCC/UICC standard,and Stage 0 andⅠwere classified as early stage.TNM stages distribution of the cases with different clinical characters were compared.Joinpoint regression was used to analyze the trend of the proportion of early stage ESCC,annual change percentage(APC),and AAPC,and the 95%CI were reported.Results:Among the 162814 cases,early stage(0+Ⅰ)accounted for only 10.7%;the proportion of early stage cancer of females was significantly higher than that of males(12.1%vs 10.0%),the proportion of 0+Ⅰ+Ⅱstage cases in high incidence area was higher than that in low incidence area,and that in urban area was higher than in rural area(P<0.05).The proportions of early stage cancer in young male and female patients(<50 years old)were significantly lower than that in older patients(P<0.05).During the 48 years,the proportion of early stage cancer in total patients and female patients increased most rapidly from 2015 to 2020,with APC(95%CI)of 27.8%(18.1%-38.2%)and 28.9%(14.4%-45.1%),respectively;the proportion of early stage cancer in male patients increased most rapidly from 2014 to 2020,with APC(95%CI)of 22.2%(12.5%-32.7%);the proportion of early esophageal cancer in total,male and female patients showed an increasing trend(P<0.05),with AAPC(95%CI)of 2.8%(1.3%-4.4%),3.6%(2.3%-5.0%),2.8%(1.2%-4.4%),respectively.Conclusion:The proportion of early stage ESCC was significantly increased,but was still significantly lower than that of advanced ESCC.It is still a key scientific issue in the field of esophageal cancer research

关 键 词：食管鳞状细胞癌 TNM分期 高/低发区 

分 类 号：R735.1[医药卫生—肿瘤]