上海、洛阳两地胃癌发生部位分析

Gastroscopic Analysis of Gastric Carcinoma in Luoyang and Shanghai

目的 比较上海、洛阳两地胃癌的发生部位、年龄分布有何异同。方法 选择上海市新华医院和洛阳市第一人民医院 1998年到 1999年门诊胃镜检查病人为统计对象。胃镜影像和病理细胞学结合诊断胃癌 ,按胃癌发生部位分为 :贲门胃底部癌、胃体部癌、幽门窦部癌。同时用HE银染法检查胃癌病人的幽门螺杆菌感染情况。结果 洛阳市第一人民医院在选择时间段内 ,检出胃癌 115例 ,贲门癌 47例 ,胃体部癌 43例 ,胃窦部癌 19例 ,其它 6例 ;上海新华医院查出胃癌 91例 ,贲门癌 18例 ,胃体部癌 3 4例 ,胃窦部癌3 3例 ,其它 6例。两地胃癌发生部位比较 ,有显著差异 ,P <0 0 5。随年龄增长贲门胃底部癌所占比例从 15 %上升到 3 6 7% ,而胃窦部癌所占比例从 5 5 %下降到 2 5 %左右。两地胃癌病人HP感染情况相似 ,胃窦 -胃体部癌HP阳性率明显高于贲门部癌。结论 胃癌的发生部位有显著的地区特点、年龄特点、时期特点。上海市胃窦部癌较贲门部多见 ,洛阳地区贲门部癌较胃窦部多见 ;随年龄增长 ,贲门部癌比例增高 ,胃窦部癌比例减少 ;在过去 2 0年到 3 0年之间 ,贲门部癌呈上升趋势 ,胃窦部癌呈下降趋势。HP感染与胃窦 -胃体部癌关系密切相关。

Objective To investigate the endoscopic characteristics of gastric carcinoma,assess its position and age distribution difference between Luoyang and Shanghai. Methods Patients examined by gastroscopy from the Xinhua Hospital in Shanghai and the First People's Hospital in Luoyang were added up from 1998 to 1999 years. Combining imaging with pathological diagnosed gastric carcinoma. According to the postiton of gastric carcinoma, the patients were classsified into three groups: cardiac carcinoma?corpus carcinoma and antrum carcinoma. Helicobacter pylori status was evaluated by histologic straining method in every patient. Results There were 115 gastric carcinomas in the First People's Hospital of Luoyang, including 47 cardiac carcinomas, 43 corpus carcinomas,19 antrum carcinomas, 6 others. There were 91 gastric carcinomas in Xinhua Hospital of Shanghai,including 18 cardiac carcinomas?34 corpus carcinomas and 33 autrum carcinomas, 6 others. Statistics showed that a significent difference in position of gastric carcinoma between Luoyang and Shanghai, P <0.05. With age growing, cardiac carcinoma occupying rate increased from 15% to 35%,antrum carcinoma decreased from 55% to 25%. Hp positive rates were similar in Luoyang and Shanghai,antrum-corpus carcinoma patients had a much higher Hp positive rate than cardiac carcinoma patients. Conclusions Occurence position of gastric carcinoma has singnificent difference in region? age and time. In Shanghai, neoplasms predispose to stomach antrum portion. In Luoyang, cardia is predominance. With age growing, cardiac carcinoma is more frequent than antrum portion. During the past 2～3 decades, the incidence rate of cardiac carcinoma increased, and that of antrum carcinoma decreased. HP infection was associated with increased risks of antrum-corpus carcinoma. Therefore, carcinoma in different parts of the stomach suggests a difference in etiological factors.