基于问卷调查联合新型胃癌筛查评分系统对酒仙桥地区人群慢性萎缩性胃炎及胃癌的比较研究  

A comparative study of chronic atrophic gastritis and gastric cancer in Jiuxianqiao area based on questionnaire survey combined with new gastric cancer screening scoring system

作　　者：庞梦瑶 程艳丽 PANG Mengyao;CHENG Yanli(Department of Gastroenterology,the First Affiliated Hospital of Tsinghua University,Beijing 100016,China)

机构地区：[1]清华大学第一附属医院消化内科,北京100016

出　　处：《胃肠病学和肝病学杂志》2024年第10期1308-1312,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨问卷调查联合新型胃癌筛查评分系统在北京市酒仙桥地区人群中对慢性萎缩性胃炎及胃癌的诊断效能,重新评估胃镜检查的筛查人群,践行个体化医疗服务,避免医疗资源浪费,初步探讨胃癌预防策略。方法纳入2022年3月至2022年11月因上腹部不适在清华大学第一附属医院(包括协同单位—将台社区、东风社区及高家园社区)就诊的291例患者作为研究对象,通过问卷调查联合新型胃癌筛查评分系统(以下简称综合评分系统)与单独应用新型胃癌筛查评分系统分别开展胃癌初步筛查,结合初筛结果,将人群分为低危组、中危组和高危组,比较三组根据病理结果诊断慢性非萎缩性胃炎、慢性萎缩性胃炎和胃癌的检出率。结果共291例患者参与胃镜检查,应用综合评分系统,低危组156例(53.61%),中危组108例(37.11%),高危组27例(9.28%),在慢性萎缩性胃炎和胃癌的检出率上,高危组明显高于中危组和低危组,差异有统计学意义(P<0.05)。同时ROC分析显示,综合评分系统与单独应用新型胃癌筛查评分系统对慢性萎缩性胃炎和胃癌诊断评估的AUC分别为0.658(0.595~0.721)、0.684(0.622~0.746),敏感度分别为62.22%、63.70%,特异度分别为67.31%、63.70%,阳性预测值分别为0.622、0.652,阴性预测值分别为0.673、0.692;综合评分系统与单独应用新型胃癌筛查评分系统对胃癌诊断评估的AUC分别为0.756(0.583~0.929)、0.717(0.552~0.882),敏感度分别为50.00%、80.00%,特异度分别为92.17%、55.87%;阳性预测值分别为0.179、0.130,阴性预测值分别为0.981、0.974。结论问卷调查联合新型胃癌筛查评分系统在北京市酒仙桥地区人群中对胃癌具有良好的筛查价值,值得临床推广,可为大规模胃癌风险评估体系的建立奠定基础。Objective To explore the application value of questionnaire survey combined with new gastric cancer screening scoring system in the diagnosis of chronic atrophic gastritis and gastric cancer in Jiuxianqiao district of Beijing,Evaluate the screening population for gastroscopy,practice individualized medical services,avoid the waste of medical resources,and preliminarily explore the prevention and treatment strategy of gastric cancer.Methods A total of 291 patients with symptoms of upper abdominal discomfort admitted to the First Affiliated Hospital of Tsinghua University from Mar.2022 to Nov.2022(including the cooperative unit-Jiangtai Community,Dongfeng Community and Gaojiayuan Community)were included as analysis objects.Preliminary screening for gastric cancer was carried out through questionnaire survey combined with the new gastric cancer screening scoring system(hereinafter referred to as the comprehensive scoring system)and the single application of the new gastric cancer screening scoring system.Combined with the preliminary screening results,the population was divided into low-risk group,medium-risk group and high-risk group,and the detection rates of chronic non-atrophic gastritis,chronic atrophic gastritis and gastric cancer after gastroscopy were compared among the three groups.Results A total of 291 patients participated in gastroscopy,and the comprehensive scoring system was used.There were 156(53.61%)patients in the low-risk group,108(37.11%)patients in the medium-risk group,and 27(9.28%)patients in the high-risk group.In terms of the detection rate of chronic atrophic gastritis and gastric cancer,the high-risk group was higher than the medium-risk group and low-risk group,with significant difference among the three groups(P<0.05).Meanwhile,ROC analysis showed that the AUC of the comprehensive scoring system and the new gastric cancer screening scoring system for the diagnosis and evaluation of chronic atrophic gastritis and gastric cancer were 0.658(0.595-0.721)and 0.684(0.622-0.746),respectively,wi

关 键 词：问卷调查 新型胃癌筛查评分系统 胃镜检查 胃癌 慢性萎缩性胃炎 

分 类 号：R735.2[医药卫生—肿瘤]