上海不同等级10个医疗机构早期胃癌的筛选结果比较

Comparison on early-stage gastric cancer screening in different levels of medical facilities in Shanghai Shanghai Early Gastric Cancer Clinical Collaboration

目的总结及比较不同等级医疗机构的早期胃癌临床筛查水平。方法回顾分析上海瑞金医院等上海市早期胃癌临床协作组所属10个医疗机构接受电子胃镜检查患者的胃癌筛查结果，比较胃癌检出率和早期胃癌的情况。结果10个医疗机构共进行胃镜检查241782例，经活检病理检查共检出胃癌4892例，检出率2．02％，不同机构中胃癌检出率最高为3．13％，最低为0．65％。4892例胃癌中，经外科手术病理检查证实早期胃癌470例，占所有检出胃癌的9．61％。早期胃癌中，55例手术病理证实伴有胃周淋巴结或其他脏器转移，早期胃癌伴转移者为11．7％。结论目前早期胃癌临床筛查水平仍较低，扩大门诊胃镜筛查早期胃癌指证，加强随访，建立多科合作、序贯检查及治疗模式以及加强基础培训、开展早期胃癌诊断新技术是提高早期胃癌诊断水平的重要途径。

Objective To compare and summarize the status of early-stage gastric cancer screening in different levels of medical facilities in Shanghai. Methods To retrospectively analyze the data from patients who underwent esophageo-gastroduodenoscopy in 10 medical facilities of Shanghai Early Gastric Cancer Clinical Collaboration. Results A total of 241 782 esophageo-gastroduodenoscopies was carried out in all 10 medical facilities, of which 4 892 cases （2. 02% ） of gastric cancer were confirmed by histopathology. The detection rate of gastric cancers in various facilities was different, from 0. 65% to 3.13%. Among patients with gastric cancers, 470 cases （9. 61% ） were confirmed as early-stage gastric cancer by post-surgical histopathology. Of all patients with early-stage gastric cancer, fifty-five cases （11.7%） were verified to have tumor metastasis by the way of either lymph node infiltration or invasion of other organs. Condusion The overall level of early-stage gastric cancer screening is still behind expectation, h is critical for us to enhance the diagnostic technique for early-stage gastric cancer, to enlarge the indication of gastric cancer screening by esophageo-gastroduodenoscopy in out-patient clinics, to establish collaboration between different medical services, to carry out serial examinations and treatments and to intensify basic skill training as well as the deployment of new diagnostic methods.