体检人群胃镜检查发现胃癌及胃癌前疾病结果分析  

Analysis of gastroscopic findings of gastric cancer and precancerous diseases in physical examination population

作　　者：赵倩[1] 杨振威[2] 赵艳[1] 冯云 张丹[1] 李雅睿[1] 和水祥[1] 刘亚萍[1] ZHAO Qian;YANG Zhen-wei;ZHAO Yan;FENG Yun;ZHANG Dan;LI Ya-rui;HE Shui-xian;LIU Ya-ping(Department of Gastroenterology,First Affiliated Hospital of Xian Jiaotong University,710061 Xi’an,China;Department of Gastroenterology,Xian Central Hospital,710004 Xi’an,China)

机构地区：[1]西安交通大学第一附属医院消化内科,陕西西安710061 [2]西安市中心医院消化内科,陕西西安710004

出　　处：《临床消化病杂志》2022年第1期26-30,共5页Chinese Journal of Clinical Gastroenterology

基　　金：国家自然科学基金青年项目(No:81602611)。

摘　　要：[目的]了解体检人群中胃癌及胃癌前疾病检出情况及疾病分布特点,探讨胃镜检查对体检人群的必要性。[方法]将2 839例体检者分为无症状组和有症状组,比较2组胃癌及胃癌前疾病检出率,分析年龄分布、性别构成比对检出率的影响,以及对胃息肉、慢性萎缩性胃炎病理特点、幽门螺杆菌(Hp)的影响。[结果](1)除胃息肉外,有症状组胃癌、胃溃疡、慢性萎缩性胃炎总体检出率均明显高于无症状组(P<0.01);(2)有症状组慢性萎缩性胃炎各年龄段检出率均高于无症状组(P<0.05),有症状组>60岁者中胃癌、胃息肉的检出率及60岁以下各年龄段中胃溃疡检出率明显高于无症状组(P<0.05);(3)慢性萎缩性胃炎检出率男性明显多于女性(P<0.05);(4)有症状组重度萎缩及重度肠化检出率明显高于无症状组(P<0.01);(5)有症状组胃息肉、胃溃疡、慢性萎缩性胃炎Hp感染率明显高于无症状组(P<0.01)。[结论](1)对于有上消化道相关症状的体检者来说,有必要行胃镜检查;(2)有必要针对≥45岁的体检者开展胃镜体检筛查;(3)胃镜活检病理对于判断慢性萎缩性胃炎萎缩和肠化程度及预后有重要的临床意义;(4)Hp感染与胃癌前疾病消化道症状可能有关。[Objective]To investigate the detection and distribution of gastric cancer and precancerous diseases and to explore the necessity of gastroscopy examination in physical examination population.[Methods]A total of 2 839 patients from January 2015 to December 2018 were reviewed.They were divided into asymptomatic group and symptomatic group.The detection rates of gastric cancer and precancerous diseases were compared between the two groups.Age distribution, sex ratio, pathological characteristics and Hp were also analyzed.[Results](1)Except of gastric polyp, the overall detection rate of gastric cancer, gastric ulcer and chronic atrophic gastritis in symptomatic group was significantly higher than that in asymptomatic group(P<0.01).(2)Except the asymptomatic group of gastric cancer and the symptomatic group of gastric ulcer, the detection rate of chronic atrophic gastritis in symptomatic group was higher than that in asymptomatic group of all ages(P<0.05).In gastric cancer and gastric polyp over-60 yrs and gastric ulcer under-60 yrs, the detection rates in the symptomatic group were significantly higher than those in the asymptomatic group(P<0.05).(3)The prevalence of chronic atrophic gastritis in male was higher than that in female(P<0.05).(4)The detection rate of severe atrophy and severe intestinal metaplasia in symptomatic group were significantly higher than that in asymptomatic group(P<0.01).(5)Hp infection in the symptomatic was significantly higher than in asymptomatic group for gastric polyp, gastric ulcer, chronic atrophic gastritis(P<0.01).[Conclusion](1)Gastroscopy is necessory for those subjects with upper gastrointestinal tract-related symptoms;(2)It is necessary to do gastroscopy screening for people over 45 year-old, especially for those with upper gastrointestinal tract related symptoms;(3)Gastroscopy biopsy for gastric tissue is helpful to judge the degree of atrophy and intestinal metaplasia and prognosis of chronic atrophic gastritis.(4)Hp infection may be associated with gastrointestinal symptom

关 键 词：胃癌 体检 胃镜检查 胃癌前疾病 

分 类 号：R735.2[医药卫生—肿瘤]