發(fā)布時(shí)間：2019-04-17 17:05

【摘要】：研究背景和目的自上世紀(jì)70年代始,西方發(fā)達(dá)國(guó)家食管腺癌(EAC)和賁門(mén)癌(GCC)的發(fā)病率明顯增長(zhǎng),至90年代逐漸穩(wěn)定,尤其是在美國(guó),其發(fā)病率增加了2.5-3.0倍,這引起了國(guó)內(nèi)外學(xué)者的重視。而我國(guó)卻缺乏大樣本多中心流行病學(xué)研究。本文將回顧第三軍醫(yī)大學(xué)附屬第一醫(yī)院1978-2012年食管腺癌及賁門(mén)腺癌的檢出情況,對(duì)這兩種腫瘤的流行病學(xué)特征及趨勢(shì)進(jìn)行探討,這將對(duì)進(jìn)一步了解中國(guó)的發(fā)病情況、引起臨床醫(yī)生對(duì)該病的重視有重要的意義。方法匯總第三軍醫(yī)大學(xué)附屬第一醫(yī)院1978年1月-2012年12月期間食管鱗癌(ESCC)、食管腺癌(EAC)、賁門(mén)癌(GCC)和遠(yuǎn)端胃癌(GNCC)患者的胃鏡診療記錄,對(duì)性別、年齡、診斷等相關(guān)數(shù)據(jù)進(jìn)行整理,采用線性回歸檢驗(yàn)進(jìn)行統(tǒng)計(jì)學(xué)分析,p0.05視為統(tǒng)計(jì)學(xué)上有差別。結(jié)果1、總體檢出例數(shù)及檢出率我院35年間共行胃鏡檢查440248例,食管鱗癌10323例(檢出率為2.3%),食管腺癌350例(0.08%),賁門(mén)癌3076例(0.70%),遠(yuǎn)端胃癌5642例(1.3%)。2、性別比例各種腫瘤男女比例分別為:食管鱗癌4:1,食管腺癌:3.6:1,賁門(mén)癌:4.5:1,胃癌:2.3:1。3、疾病檢出率3.1在過(guò)去35年間,食管腺癌總檢出率依次為0.18%、0、0.07%、0.08%、0.08%、0.11%、0.07%(R=0.143,p=0.143)。賁門(mén)癌的總檢出率依次為0.53%、0.70%、0.82%、0.81%、0.81%、0.79%、0.63%(R=0.981,p=0.001)。3.2在男性,食管腺癌檢出率為0.24%、0、0.10%、0.11%、0.11%、0.16%、0.12%(R=0.032,p=0.945);賁門(mén)癌檢出率為0.64%、0.90%、1.12%、1.04%、1.14%、1.30%、1.09%(R=0.796,p=0.032)。3.3在女性,食管腺癌檢出率為0、0、0.02%、0.02%、0.04%、0.06%、0.03%(R=0.826,p=0.022);賁門(mén)癌檢出率為0.22%、0.27%、0.35%、0.42%、0.38%、0.28%、0.22%(R=0.917,p=0.049)。4、構(gòu)成比4.1食管腺癌總體構(gòu)成比(食管腺癌檢出率/(食管腺癌+食管鱗癌)檢出率)依次為21.4%、0、1.9%、2.2%、3.4%、3.9%、3.2%(R=0.880,p=0.021)。賁門(mén)癌總體構(gòu)成比(賁門(mén)癌檢出率/(賁門(mén)癌+遠(yuǎn)端胃癌)檢出率)依次為16.8%、25.3%、33.7%、30.7%、38.3%、36.6%、35.3%(R=0.842,p=0.018)。4.2在男性,食管腺癌構(gòu)成比依次為23.1%、0、2.0%、2.5%、3.4%、3.7%、3.2%(R=0.865,P=0.026)。賁門(mén)癌構(gòu)成比依次為18.0%、26.3%、37.0%、33.6%、41.7%、41.1%、37.9%(R=0.839,p=0.018)。4.3在女性,食管腺癌構(gòu)成比為0、0、1.6%、1.1%、3.3%、4.7%、3.4%(R=0.902,p=0.0005)。賁門(mén)癌構(gòu)成比依次為7.1%、13.5%、23.1%、22.5%、29.0%、24.3%、25.4%(R=0.833,p=0.020).5、四種腫瘤的發(fā)病隨年齡增長(zhǎng),發(fā)病率顯著上升,以》70歲為主要發(fā)病人群,50-69歲次之,《49歲發(fā)病率最低。6、食管鱗癌和遠(yuǎn)端胃癌檢出率明顯降低。結(jié)論:35年來(lái)食管腺癌檢出率無(wú)明顯改變,構(gòu)成比上升。賁門(mén)癌檢出率和構(gòu)成比均緩慢上升,以男性更明顯。食管鱗癌在經(jīng)歷10年急劇的上升趨勢(shì)后開(kāi)始下降,胃癌的檢出率明顯下降。四種疾病均以70歲以上人群為主要發(fā)病群體,隨著年齡的增長(zhǎng),發(fā)病率明顯上升。
[Abstract]:Background and objective since the 1970s, the incidence of esophageal adenocarcinoma (EAC) and cardiac cancer (GCC) has increased significantly in western developed countries, and gradually stabilized in the 1990s, especially in the United States, the incidence of which has increased by 2.5%. This has attracted the attention of scholars at home and abroad. However, there is a lack of multicenter epidemiological studies of large samples in China. This article will review the detection of esophageal adenocarcinoma and cardiac adenocarcinoma in the first affiliated Hospital of the third military Medical University from 1978 to 2012, and discuss the epidemiological characteristics and trends of these two kinds of tumors, which will help to further understand the incidence of esophageal adenocarcinoma and cardiac adenocarcinoma in China. It is of great significance for clinicians to attach importance to the disease. Methods from January 1978 to December 2012, the records of gastroscopic diagnosis and treatment in patients with esophageal squamous cell carcinoma, (ESCC), esophageal adenocarcinoma, (EAC), cardiac carcinoma, (GCC) and distal gastric cancer, (GNCC), were collected from January 1978 to December 2012 in the first affiliated Hospital of the third military Medical University, with regard to sex and age. Diagnosis and other related data were collated, linear regression test was used for statistical analysis, p0.05 as statistically different. Results 1. There were 440248 cases of gastroscopy, 10323 cases of esophageal squamous cell carcinoma (2.3%), 350 cases of esophageal adenocarcinoma (0.08%) and 3076 cases of cardiac carcinoma (0.70%). 5642 cases (1.3%) of distal gastric cancer were found. 2. The sex ratio of all kinds of tumors were: esophageal squamous cell carcinoma (4 渭 1), esophageal adenocarcinoma (3.6%), gastric cardia carcinoma (4.5%), gastric cancer (2.3%), esophageal adenocarcinoma (3.6%), gastric cancer (2.3%). The overall detection rate of esophageal adenocarcinoma over the past 35 years was 0.18%, 0,0.07%, 0.08%, 0.08%, 0.11%, 0.07% (R = 0.143, p = 0.143). The total detection rates of cardiac cancer were 0.53%, 0.70%, 0.82%, 0.81%, 0.81%, 0.79%, 0.63%, respectively (R = 0.981, p < 0.001). 3.2 in males, the detection rate of esophageal adenocarcinoma was 0.24%. 0,0.10%, 0.11%, 0.11%, 0.16%, 0.12% (R = 0.032, p = 0.945); The detection rate of cardiac cancer was 0.64%, 0.90%, 1.12%, 1.04%, 1.14%, 1.30%, 1.09% (R = 0.796, p = 0.032). 3.3 in women, the detection rate of esophageal adenocarcinoma was 0,0,0.02%. 0.02%, 0.04%, 0.06%, 0.03% (R = 0.826, p = 0.022); The detection rate of cardiac cancer was 0.22%, 0.27%, 0.35%, 0.42%, 0.38%, 0.28%, 0.22% (R = 0.917, p = 0.049) .4, The overall composition ratio of 4.1 esophageal adenocarcinoma was 21.4%, 0,1.9%, 2.2%, 3.4%, 3.9%, 3.2%, respectively (R = 0.880, r = 0.880, P < 0.01, P < 0.01). (P = 0.021). The overall composition ratio (the detection rate of cardiac cancer / distal gastric cancer) was 16.8%, 25.3%, 33.7%, 30.7%, 38.3%, 36.6%, 35.3% (R = 0.842), respectively. 4.2 in males, the proportion of esophageal adenocarcinoma was 23.1%, 0,2.0%, 2.5%, 3.4%, 3.7%, 3.2% (R = 0.865, P = 0.026). The proportion of gastric cardia cancer was 18.0%, 26.3%, 37.0%, 33.6%, 41.7%, 41.1%, 37.9% (R = 0.839, p = 0.018). 4.3 in women, the proportion of esophageal adenocarcinoma was 0, 0, 1.6%, and the ratio of esophageal adenocarcinoma to esophageal cancer was 18.0%, 26.3%, 33.6%, 41.7%, 41.1% and 37.9%, respectively. 1.1 percent, 3.3 percent, 4.7 percent, 3.4 percent (R = 0.902, p = 0.0005). The constituent ratios of cardiac cancer were 7.1%, 13.5%, 23.1%, 22.5%, 29.0%, 24.3%, 25.4% (R = 0.833, p = 0.020). 5. The incidence of the four tumors increased significantly with age. The incidence rate of esophageal squamous cell carcinoma and distal gastric cancer was significantly lower than that of > 70 years old (> 70 years old), followed by 50 years old (69 years old) and less than 49 years old (< 49 years old). Conclusion: the detection rate of esophageal adenocarcinoma has not changed significantly in the past 35 years, and the constituent ratio has increased. The detection rate and composition ratio of cardiac cancer increased slowly, especially in males. Esophageal squamous cell carcinoma (ESCC) began to decline after 10 years of sharp rise, and the detection rate of gastric cancer was significantly decreased. The incidence of the four diseases increased significantly with the increase of age in the population over 70 years old.
【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R735

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相關(guān)期刊論文 前1條

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本文編號(hào)：2459628