北京西南地区近12年上消化道肿瘤的临床特点变化分析

Clinical characteristics of upper gastrointestinal malignant tumor patients of southwest in Beijing in recent 12 years

目的总结北京西南地区近12年上消化道肿瘤的发病特点,分析其变化趋势,以便更好开展对上消化道肿瘤的筛查工作。方法将2001年-2012年首都医科大学宣武医院消化内镜中心胃镜检出的1 126例上消化道肿瘤患者分为4个阶段（2001年-2003年、2004年-2006年、2007年-2009年、2010年-2012年）进行统计,分析比较4种上消化道肿瘤（食管癌、胃癌、贲门癌、十二指肠癌）各组间发病年龄、性别构成、内镜下表现、病理类型等方面的差异。将前6年与后6年进行比较,分析各种肿瘤临床特点随年份发展的变化趋势。结果上消化道肿瘤检出数后6年较前6年呈上升趋势,食管癌呈下降趋势、胃癌呈上升趋势,40~49岁年龄段的胃癌在4个阶段中比较,差异有统计学意义（P〈0.05）,且后6年发病人数较前6年呈下降趋势;食管癌的男性发病率后6年较前6年呈上升趋势,而女性发病率呈下降趋势;胃癌的性别变化则与之相反;胸中段、胸下段食管癌的发病率在4个阶段比较,差异有统计学意义（P〈0.05）,胸中段的发病率后6年较前6年呈上升趋势,而胸下段的发病率后6年较前6年呈下降趋势;胃底癌的发病率后6年较前6年呈上升趋势;胃癌的黏液细胞癌的发病率在4个阶段中相比,差异有统计学意义（P〈0.05）,且后6年的发病率较前6年呈下降趋势。结论近12年北京西南地区上消化道肿瘤的发病特点有了一些新的变化,掌握这些临床特点,更好地完成消化道肿瘤的＂早发现、早诊断、早治疗＂。

Objective To summarize the clinical characteristics of upper gastrointestinal malignant tumor patients oi southwest in Beijing in recent 12 years and analyze the change trend, so as to better screen upper gastrointestinal malig- nant tumor. Methods A total of 1 126 cases of upper gastrointestinal malignant tumor treated in Xuanwu Hospital from 2001 to 2012 were studied from 4 phases （2001 -2003 years, 2004-2006 years, 2007 -2009 years and 2010 ~ 2012 years）. The relative ratios about onset age, gender, endoscopic manifestations and pathological type of upper gastroin- testinal malignant tumor were analyzed. Results The number of upper gastrointestinal cancer detection of the next six years had an upward trend compared with the previous six years. Esophageal cancer was declining and gastric cancer had a rising trend. Gastric 40 -49 years old group had a statistically significant difference in the four stages of comparison and it was declining. The male incidence of esophageal cancer had upward trend in next 6 years compared with the pre- vious six-year, while the incidence of women decreased. Sex change was the opposite of gastric cancer. The carcinoma of the middle thoracic esophagus was rising and lower thoracic of esophageal carcinoma was declining. Incidence of the gastric cancer in the bottom of the stomach had a upward trend. Mucinous gastric carcinoma incidence in the next six years had a downward trend compared with the previous six years. Conclusion The incidence of upper gastrointestinal cancer of southwest in Beiiing has some new changes in recent 12 years. If we can master these clinical features, we could do better for ＂early discovery, early diagnosis and early treatment＂ of the digestive tract tumors.