河湟谷地胃癌临床流行病学特征分析

Analysis of characteristics of clinical epidemiology about gastric cancer in Hehuang Valley

背景与目的:青海省境内的河湟谷地是我国胃癌高发病率及高死亡率地区之一,该地区位于青藏高原东北麓,地理位置特殊,具有民族多样性。本研究旨在分析青海省境内河湟谷地胃癌临床流行病学特征及其变化趋势,为胃癌的防治工作提供帮助。方法:回顾性分析近10年间河湟谷地2 379例胃癌患者临床流行病学资料,并按照1∶2比例设立对照组,进行组内患者对照研究。结果:男性胃癌构成比(78.52%)与女性胃癌构成比(21.48%)相比,10年间差异无统计学意义(χ2=1.376,P=0.241);青年型胃癌与老年型胃癌构成比近5年组与远5年组比较,差异有统计学意义(χ2=23.629,P=0.000);胃癌民族构成比差异无统计学意义(χ2=0.757,P=0.685);胃癌城镇与农村构成比,差异无统计学意义(χ2=1.102,P=0.294);胃癌家族史者构成比近5年组与远5年组相比,差异有统计学意义(χ2=45.082,P=0.000);近5年组与远5年组胃癌患者幽门螺旋杆菌(helicobacter pyloki,HP)感染阳性者构成比差异有统计学意义(χ2=13.512,P=0.000);饮酒、进食速度快、高盐高脂辛辣食物、饮用浓茯茶及喜食过凉过烫食物与男性胃癌相关(P<0.05);高盐高脂辛辣食物及饮用浓茯茶与女性胃癌相关(P<0.05)。结论:河湟谷地胃癌高发年龄为中老年男性,发病年龄呈年轻化趋势;农村仍是胃癌的高发地区,胃癌的发生与不良饮食习惯、HP感染及家族遗传有关;改变不良饮食习惯、根除HP感染及遗传监测是今后该地区胃癌一级预防的重要内容。

Background and purpose：The morbidity and mortality of gastric cancer in Hehuang Valley are both on the high level in China. Hehuang Valley is located in the northeast of Qing-Tibetan Plateau where is in the special geographical position and a multiracial region. This study aimed to analyze the tendency and characteristics of clinical epidemiology about gastric cancer in Hehuang Valley, and to help the prevention and treatment of gastric cancer.Methods：A case-control study was performed, and the clinical data about epidemiology of 2 379 cases with gastric cancer in recent 10 years were analyzed retrospectively. Results：There were no statistical differences about the constituent ratio of gender in gastric cancer group （χ2=1.376, P=0.241）, also, there were no statistical differences about racial distribution in gastric cancer group （χ2=0.757, P=0.685）, but a signiifcant difference was shown obviously about the constituent ratio of age in gastric cancer group （χ2=23.629, P=0.000）. No statistical differences were demonstrated about the geographical distribution in gastric cancer group （χ2=1.102, P=0.294）. There was an obvious statistical differ-ence about family history in gastric cancer group in recent 10 years （χ2=45.082, P=0.000）, Also, there was a signiifcant difference between the group of recent 5 years and the group of late 5 years about HP infection （χ2=13.512, P=0.000）. Some of the dietary habits such as alcohol drinking, fast food-intake, salty, fatty or spicy food-intake, strong tea （also called boiled tea） drinking and very hot or cool food-intake were related to the occurrence of gastric cancer in males （P＆lt;0.05）. Nevertheless, the dietary habits of salty, fatty or spicy food-intake and strong tea drinking were associated to the occurrence of gastric cancer in females （P＆lt;0.05）. Conclusion： The prevalence of gastric cancer tends to be younger even if the medium-elderly men are still the main group with predilection ages of occurrence of gastric cancer in Hehuang Valley. Rural areas are still the regions with high morbidity of gastric cancer in Hehuang Valley, and some bad dietary habits, HP infection and hereditary factors are associated with the occurrence of gastric cancer, so measures of dietary habits changes, HP eradication and hereditary surveillance must be taken as the main contents for primary prevention of gastric cancer in Hehuang Valley in the future.