贲门癌患者临床病理特点及预后变化趋势分析

Trend analysis for clinical characteristics and prognosis of adenocarcinoma of cardia

背景与目的:近年来,国外文献报道贲门癌发病率有明显上升趋势。虽然在我国尚缺乏贲门癌相关的流行病学统计资料,但是有少量地区研究显示贲门癌的收治率呈逐年上升趋势。本研究比较1984～2003年间不同时期贲门癌患者的临床病理特点及预后情况,以期了解其发病和预后变化趋势。方法:选取1984～2003年在中山大学肿瘤防治中心连续收治的589例贲门腺癌病例,回顾分析并比较相关的临床病理资料及预后情况。结果:20年间收治贲门癌患者数增加134.5%,每年平均增长率为4.6%。患者中位年龄60岁,20年间中位年龄上升5岁。55～64岁患者构成比下降,≥65岁患者构成比上升。全组男女性别构成比为2.88:1,不同时期性别构成比差异无统计学意义(P=0.160)。20年间,Ⅰ期、Ⅱ期患者的构成比差异无统计学意义(P>0.05),Ⅲ期患者比例上升,Ⅳ期患者比例下降。生存分析显示,全组贲门癌患者5年生存率为28.5%,5年生存率由1984～1993年的20.9%提升至1994～2003年的35.5%。结论:20年来,随着贲门癌发病率的增加,我院贲门癌患者的收治率不断上升;患者的发病中位年龄提高;男女性别比例无明显改变;晚期病例减少;患者预后得到改善,生存率明显提高。

Background and Objective：The incidence of adenocarcinoma of cardia is on the rise recently.This study was to compare the clinicopathologic features and prognosis of the patients with adenocarcinoma of cardia in different periods from 1984 to 2003.Methods：A total of 589 patients with pathologically confirmed adenocarcinoma of cardia hospitalized to Sun Yatsen University Cancer Center from 1984 to 2003 were divided into four 5-year groups.The clinical characteristics and prognosis were retrospectively analyzed and compared between the four groups.Results：The number of hospitalized patients increased by 134.5%,with an annual increase rate of 4.6%.The median age of patients was 60 years,with an increase of 5 years.The constituent ratio of the patients aged 55-64 years decreased,while that of the patient aged ≥65 years increased.The male-to-female ratio was 2.88：1,without significant change.The constituent ratio of Stage-Ⅰ and Stage-Ⅱpatients in the four groups did not significantly change,...更多while that of Stage-Ⅲ patients increased significantly and that of Stage-Ⅳ patients decreased significantly.The 5-year survival rate of all the patients was 28.5%.And the 5-year survival rate increased from 20.9% in the period from 1984 to 1993 to 35.5% in the period from 1994 to 2003.Conclusions：During the past 20 years,the admission ratio of the patients with adenocarcinoma of cardia in our hospital increased with the upward-trending incidence of adenocarcinoma of cardia.The median age of the patients increased.The male-to-female ratio had no significant change.The proportion of patients in late stage decreased and prognosis has improved.