2005年和2010年食管癌高/低发区慢性食管炎与食管癌流行特征对比分析

The comparison of epidemiologic features for patients with chronic esophgealtis and esophageal cancer between year 2005 and 2010 in the high-and low incidence areas of esophageal cancer

目的通过分析食管癌高/低发区2005年和2010年慢性食管炎与食管癌流行特征的变化,加深对食管癌流行趋势的了解。方法调查2005年和2010年高/低发区医院门诊胃镜检查患者共计15 342例,其中2005年6 436例(慢性食管炎患者874例,食管癌患者746例),2010年8 906例(慢性食管炎患者1 059例,食管癌患者839例),采用卡方检验分析各组间差异。结果高发区2005年和2010年食管癌检出率分别为13%(431/3 401)和9%(484/5 138),差异有统计学意义(P>0.05);低发区2005年和2010年食管癌检出率无统计学差异(10%,9%,P>0.05);慢性食管炎的检出率均为12%以上。高/底发区食管癌和慢性食管炎的男女比例为1.4∶1至2.2∶1。食管癌的高发年龄组为50～69岁组,慢性食管炎的高发年龄组为60岁以下组。结论高发区食管癌检出率5年间有下降趋势;低发区食管癌5年间检出率为9%,没有明显变化;高/低发区食管癌和慢性食管炎均为男性多于女性;高/低发区慢性食管炎的高发年龄段较食管癌的高发年龄段平均提前10a。

Objective To elucidate the effect of environmental changes on the esophageal/gastric cardia carcinogenesis through the analysis on the spectrum variation of esophagus and gastric cardia disease diagnosed by endoscopy in HIA and LIA for both EC and GCA from 2005 to 2010.Methods We investigated 15 342 outpatient patients who underwent endoscopy,8 539（2005： n=3 401;2010： n=5 138） from HIA for EC and 6 803（2005： n=3 035;2010： n=3 768） from LIA for EC.The HIA patients were enrolled from the Cixian City,Hebei Province and Linzhou City,Henan Province and LIA patients from Puyang City,Henan Province.Results There was a significant difference between detection rate of outpatient EC in 2005（431/3 401;13%） compared with 2010（484/5 138;9%）（P 0.05） in the LIA for EC.There was a significant difference between detection rate of outpatient GCA in 2005（244/3 401;7%） compared with that in year 2010（248/5 138;5%）（P 0.05） in the LIA for EC.When detection rate for GCA between HIA and LIA in the same years was compared,significant difference was found in 2005 and 2010（P 〈0.05）.Conclusion The detection rates of EC and GCA in HIA had a trend of decrease in five years.There was little change of EC and GCA detection rate（EC：9%;GCA：3%） in LIA for EC in five years.The EC detection rate in LIA was consistent with that in HIA,The GCA detection rate in LIA was lower than that in HIA.