新型胃癌筛查评分系统在福建海岛胃癌风险人群的应用  

Application of a new gastric cancer screening scoring system to high-risk population of gastric cancer in Fujian island area

作　　者：胡嘉庆 谢峻伟 黄晓殷 邓万银[1] 郑金辉[1] 叶为民 梁玮[1] Hu Jiaqing;Xie Junwei;Huang Xiaoyin;Deng Wanyin;Zheng Jinhui;Ye Weimin;Liang Wei(Digestive Endoscopy Center,Provincial Clinical Medical College of Fujian Medical University,Fujian Provincial Hospital,Fuzhou 350001,China;Digestive Endoscopy Center,The First Hospital of Putian City,Putian 351100,China;Public Health School of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院(福建省立医院)消化内镜中心,福州350001 [2]莆田市第一医院消化内镜中心,莆田351100 [3]福建医科大学公共卫生学院,福州350001

出　　处：《中华消化内镜杂志》2023年第11期881-885,共5页Chinese Journal of Digestive Endoscopy

基　　金：福建省自然科学基金面上项目(2020J011091);福建医科大学启航基金(2022QH1299)。

摘　　要：目的探讨新型胃癌筛查评分系统在福建海岛胃癌风险人群的应用价值。方法2019年4—6月,对福建省莆田市南日岛人群进行胃癌筛查,前瞻性收集了研究对象的流行病学数据。采用新型胃癌筛查评分系统进行胃癌风险分级后,对所有受试者进行胃镜检查,随后对疑似阳性病例进行放大内镜检查和活检。后续针对阳性人群进行手术治疗(包括内镜及外科手术)。比较胃癌风险分级的各组人群中胃癌及癌前病变的检出率,采用卡方检验等统计学分析。结果共纳入研究对象1423例,检出胃癌19例(1.34%)。胃癌风险分级的低危组、中危组和高危组胃癌检出率分别为0.88%(9/1025)、1.76%(6/341)和7.02%(4/57)。对胃癌检出率进行配对比较显示,低危组和高危组差异有统计学意义(χ^(2)=12.364,P=0.003)。低危组与中危组、中危组与高危组之间差异无统计学意义(P>0.05)。所有患者共检出胃癌前病变87例(6.11%)。对胃癌前病变检出率进行配对比较显示,低危组、中危组和高危组的检出率分别为6.24%(64/1025)、5.87%(20/341)和5.26%(3/57),3组间差异无统计学意义(P>0.05)。结论在胃癌筛查过程中,新型胃癌筛查评分系统有助于对福建海岛胃癌风险人群进一步风险分层,为内镜精查提供依据。Objective To explore the application value of the new gastric cancer screening scoring system for risk populations in the island of Fujian province.Methods From April to June 2019,gastric cancer screening was performed on the population of Nanri Island,Putian City,Fujian Province,and epidemiological data of all subjects were prospectively collected.Participants underwent gastroscopy based on gastric cancer risk stratification of the new scoring system.Suspected positive cases further received magnifying endoscopy and biopsy.Additional endoscopic procedures and other surgical treatments were conducted.The detection rates of gastric cancer and precancerous lesions in each group of gastric cancer risk stratification were compared,and the Chi-square test was used for statistical analysis.Results A total of 1423 subjects were included,and 19 cases(1.34%)of gastric cancer were detected.The detection rates of gastric cancer were 0.88%(9/1025)in the low-risk group,1.76%(6/341)in the medium-risk group,and 7.02%(4/57)in the high-risk group.Paired comparison between the low-risk group and the high-risk group showed significant difference(χ^(2)=12.364,P=0.003).There was no significant difference between the low-risk group and medium-risk group,or between the medium-risk group and high-risk group(P>0.05).Among all participants,87(6.11%)cases of gastric precancerous lesions were identified.The detection rates of precancerous lesions in the low-risk,medium-risk,and high-risk groups were 6.24%(64/1025),5.87%(20/341),and 5.26%(3/57)respectively,with no significant difference among the three groups(P>0.05).Conclusion During gastric cancer screening,the novel gastric cancer screening scoring system helps to stratify gastric cancer risk for population in the islands of Fujian province,serving as a foundation for subsequent detailed endoscopy.

关 键 词：癌前状态 早期诊断 胃肿瘤 幽门螺杆菌 新型评分系统 

分 类 号：R735.2[医药卫生—肿瘤]