胃镜在无症状体检者癌前疾病及胃癌筛查中的应用价值研究  

Application value of gastroscopy in screening for precancerous disease and gastric cancer in asymptomatic health screen examinees

作　　者：鞠昕丽 张洪军 JU Xin-li;ZHANG Hong-jun(Department of Gastroenterology,Lixia District People's Hospital,Jinan 250014,China)

机构地区：[1]济南市历下区人民医院消化内科,250014

出　　处：《中国实用医药》2024年第4期82-84,共3页China Practical Medicine

摘　　要：目的研究无症状体检者癌前疾病及胃癌的患病情况,探讨胃镜检查的临床应用价值。方法回顾性分析3055例无症状体检者的胃镜下及病理检查结果,对体检者的性别、年龄、病理特性等进行分析。结果3055例体检者胃镜筛查发现慢性萎缩性胃炎313例(10.25%)、胃息肉848例(27.76%)、残胃炎14例(0.46%)、胃溃疡69例(2.26%)及胃癌13例(0.43%),其中胃早癌8例(0.26%)。共1257例受检者检出癌前疾病及胃癌,男女比例1‥1.94。男性慢性萎缩性胃炎和胃息肉占比低于女性,残胃炎、胃溃疡、胃癌占比高于女性,不同性别癌前疾病及胃癌分布情况比较差异有统计学意义(P<0.05)。不同年龄慢性萎缩性胃炎、胃息肉、残胃炎、胃溃疡及胃癌分布情况比较差异有统计学意义(P<0.05)。慢性萎缩性胃炎、残胃炎、胃癌占比随年龄增长呈上升趋势。对可疑病灶取活检,病理组织学分析。黏膜组织萎缩、肠化生均常见于慢性萎缩性胃炎、胃癌,非萎缩、肠化生黏膜组织常见于胃息肉、胃溃疡,不同胃黏膜组织萎缩、肠化生情况的慢性萎缩性胃炎、胃息肉、残胃炎、胃溃疡及胃癌分布情况比较差异有统计学意义(χ^(2)=794.231、486.775,P<0.05)。结论通过胃镜筛查,可使得癌前疾病及胃癌筛查效果显著提升,对于疾病的早期诊断、治疗有重要价值。Objective To study the prevalence of precancerous disease and gastric cancer in asymptomatic health screen examinees and explore the clinical application value of gastroscopy.Methods The endoscopic and pathological results of 3055 cases of asymptomatic health screen examinees undergoing gastroscopy examination were retrospectively analyzed,and the correlation analysis was conducted for gender,age and pathological characteristics of the health screen examinees.Results Gastroscopy screening of 3055 subjects revealed 313 cases(10.25%)of chronic atrophic gastritis,848 cases(27.76%)of gastric polyp,14 cases(0.46%)of residual gastritis,69 cases(2.26%)of gastric ulcer and 13 cases(0.43%)of gastric cancer,including 8 cases(0.26%)of early gastric cancer.Precancerous disease and gastric cancer were detected in 1257 patients,with a male to female ratio of 1‥1.94.The detection rates of chronic atrophic gastritis and gastric polyps in male were lower than those in female,while those of residual gastritis,gastric ulcer and gastric cancer were higher than those in female,and the difference was statistically significant(P<0.05).There were statistically significant differences in the distribution of precancerous diseases and gastric cancer among different genders(P<0.05).There were significant differences in the distribution of chronic atrophic gastritis,gastric polyp,residual gastritis,gastric ulcer and gastric cancer among different ages(P<0.05).The proportion of chronic atrophic gastritis,residual gastritis and gastric cancer increased with age.The suspected lesions were biopsied for histopathological analysis.Mucosal tissue atrophy and intestinal metaplasia were common in chronic atrophic gastritis and gastric cancer,while non-atrophic and intestinal metaplasia mucosal tissue are common in gastric polyps and gastric ulcers.There were statistically significant differences in the distribution of chronic atrophic gastritis,gastric polyp,residual gastritis,gastric ulcer and gastric cancer among different levels of gastric mucos

关 键 词：无症状体检 胃镜 筛查 癌前疾病 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]