南京大学胃癌诊治回顾性分析

Investigation on diagnosis and prognosis in patients with gastric cancer in Nanjing University

目的明确职工及家属近年来胃癌早期诊断情况、胃镜受检率,并分析未及时诊治的原因,为胃癌的早期防治提供依据。方法回顾性收集近10年来诊治的胃癌病人资料,比较早期胃癌和中晚期胃癌病人,寻找胃癌延误诊断的原因及对预后的影响。收集近2年来我校职工及家属胃癌高危人群的资料,统计胃镜受检率,并分析未行胃镜检查的原因。结果从1998年2月-2008年6月共发现胃癌病人32例,其中早期胃癌8例（25%）、中、晚期胃癌24例（75%）。24例中晚期病人中有19例（79.2%）在确诊前2个月或更早被建议过行胃镜检查,其中害怕胃镜检查（10例,41.7%）或病人对病情不够重视（5例,20.83%）是造成病人诊断延误的主要原因。从2006年1月-2008年6月期间共有84例高危病人被建议作胃镜等检查,但1个月内行胃镜检查的仅有26例（31.0%）,患者未予重视和害怕胃镜痛苦是患者未行胃镜检查的主要原因。结论胃癌早期诊断率直接影响胃癌病人预后,胃镜受检率低是目前妨碍胃癌早期诊断的主要原因。

Objective To investigate the early diagnostic ratio of gastric cancer and examination rate of gastroscopy among employees and their family members of Nanjing University so as to provide the evidence for improving gastric cancer control. Methods The data about gastric cancer in recently ten years were collected and analyzed to find why and how gastric cancer patients were delayed for the detection by comparing with the different prognoses between early gastric cancer and advanced carcinoma of stomach. The examination rate of gastroscopy was investigated in the high-risk group of gastric cancer in employees and their family members in recently two years to find the reasons of refusing the examination of gastroscopy. Results A total of 32 patients were made the definite diagnosis of gastric cancer from February, 1998 to June, 2008, and 8 patients （25%） were early gastric cancer and 24 （75%） advanced carcinoma of stomach. Nineteen patients （79.2 % ） in the advanced group had been suggested examination of gastroscopy two months or more forward before they were diagnosed definitely, but they failed to do it. Being afraid of pain （10 case,41.7% ） or failed to think highly of the examination of gastroscopy （5 case,20.83% ）was the prima reasons for patients to refuse the examination which directly lead to delay in early diagnosis. Eighty-four patients were defined as the high-risk group of gastric cancer and they were suggested to receive the examination of gastroscopy from January, 2006 to June, 2008 but there were only 26 patients （31.0 % ）received the examination of gastroscopy within a month after the suggestion. Failing to think highly of the examination or worry about pain were the prima reasons for the patients to refuse the examination. Conclusions A low-grade of examination rate of gastroscopy directly leads to delay in early diagnosis and aggravate in prognosis of gastric cancer.