1982年至1999年食管癌、贲门癌低发区和高发区患者TNM分期比较

TNM staging for cases of esophageal and gastric cardia cancers: comparison on 5 679 cases from municipal low-risk and rural high-risk regions over a 18-year study period (1982~1999)

目的探讨1982年到1999年18a间中国北方城市食管、贲门癌城市低发区与农村高发区居民中新发食管癌与贲门癌患者的肿瘤TNM分期分布特征。方法根据北京同仁医院和河北磁县人民医院的病例资料记录,动态分析这2个医院18a间首次确诊时的食管癌和贲门癌TNM分期,并依据TNM分期,将患者分为早期(TNM0和Ⅰ期),中期(TNMⅡa和Ⅱb期)及晚期(TNMⅢ和Ⅳ期)。结果18a间农村居民患者首次确诊的4928例食管癌(3074例)和贲门癌(1854例)中,早期患者仅占5%和2%,95%以上的患者均为中、晚期。城市居民患者首次确诊的751例食管癌和贲门癌患者中,早期食管癌(14%)和早期贲门癌(10%)均略高于农村患者(P<0.05),但是城市患者中,90%的贲门癌和86%的食管癌患者仍为中、晚期。结论城市低发区和农村高发区首次就诊的食管癌和贲门癌患者仍以中、晚期为主,这是导致食管贲门癌预后差、死亡率高的主要原因。

Aim： To detect TNM staging of esophageal and gastric cardia cancers from the new patients at municipal low-risk and rural high-risk regions in northern China over a 18-year study period （1982 -1999）. Methods：Based on the data record for registered esophageal and gastric cardia cancer patients in Beijing Tongren Hospital and Cixian People＇s Hospital from 1982 to 1999,tumor TNM staging was analyzed and all the patients were further classified into early （TNM 0 and Ⅰ ）, middle （TNMⅡa and Ⅱb） and advanced Stages （TNMⅢ and Ⅳ ）. Results： In rural region, early esophageal and gastric cardia cancers accounted only 5% and 2% of the 4 928 cases diagnosed for the first time, and more than 95% of the patients were in middle and advanced stages. In municipal region, early esophageal and gastric cardia cancers accounted 14% and 10% of the 751 cases, which was higher than those in rural region （P 〈0.05）, however,90% of gastric cardia cancers and 86% of esophageal cancers were still in middle and advanced stages. Conclusion ： All the esophageal and gastric cardia cancer patients from municipal and rural regions are predominantly in middle and advanced stages at the first diagnosis, which is the chief reason for the poor prognosis and high mortality rate for the cancers.