地区差异对胃癌疾病特征的影响

Effect of regional difference on characteristics of gastric cancer

目的:对比分析胃癌在天津市南开区及甘肃省陇南市两地区的疾病特征差异性,并探讨可能的影响因素.方法:收集两地区胃癌患者的临床资料,包括发病率、年龄、性别、家族史、癌前状态、幽门螺杆菌(Helicobacter pylori,H.pylori)感染、胃镜及病理特点、治疗等,回顾性分析两地区胃癌的不同疾病特征.结果:天津市南开区与甘肃省陇南市胃癌发病率分别为4.60%及5.77%,H.pylori检测率分别为74.16%及55.60%,伴随H.pylori感染率分别为50.70%及57.95%,发病年龄分别为63.09岁±9.46岁及54.46岁±8.87岁,其中高发年龄分别为60-69岁及50-59岁,差异具有统计学意义(P<0.05).两地区早期胃癌诊断率分别为0.72%及0.58%,男女发病比分别为1.23∶1及1.25∶1,差异无统计学意义(P>0.05).甘肃省陇南市胃癌患者多数存在肿瘤家族史及萎缩性胃炎等癌前状态.两地区胃癌发生部位均以胃窦及低分化腺癌为主,但患者采取治疗及预后不同.结论:胃癌的发病率及疾病特征存在地区差异性,天津市南开区胃癌的发病率及H.pylori感染率低,患者随诊依从性好,多数采取手术及化疗积极手段,预后较好;甘肃省陇南市胃癌的发病年龄轻,有明显的家族聚集性,多数患者存在癌前状态.胃癌疾病特征地区差异性可能与环境、饮食、H.pylori感染、患者依从性等因素密切相关.

AIM： To analyze the difference in the characteristics of gastric cancer between patients from Nankai District, Tianjin and those from Longnan City of Gansu Province, and to explore the possible influencing factors. METHODS： Clinical data for gastric cancer patients from the two regions were collected, including incidence, age, gender, family history, precancerous condition, Helicobacter pylori （H. pylori） infection, gastroscopy, pathology, treatment and so on. A retrospective study was then performed to analyze the difference in disease characteristics. RESULTS： The incidence of gastric cancer （4.60% vs 5.77%）, H. pylori detection rate （74.16% vs 55.60%）, rate of H. pylori infection （50.70% vs 57.95%）, onset age （63.09 years ＋ 9.46 years vs 54.46 years ＋ 8.87 years）, and peak age of onset （60-69 years vs 50-59 years） differed significantly between patients from Nankai District of Tianjin and those from Longnan City of Gansu Province （P 〈 0.05）, while the diagnosis rate of early gastric cancer （0.72% vs 0.58%） and the male to female ratio （1.23 ： 1 vs 1.25 ： 1） showed no significant difference between the two regions （P 〉 0.05）. Most of the patients from Longnan City had family histories of cancer, atrophic gastritis and other precancerous conditions. The most common location of gastric cancer was gastric antrum, and the main pathological type was low differentiation adenocarcinoma in both regions, but their treatment and prognosis were different. CONCLUSION： Regional differences were found in the incidence and characteristics of gastric cancer. Compared to Longnan region, the incidence of gastric cancer and H. pylori infection rate were lower in Nankai district, with a better prognosis due to good patient compliance and active treatment. For patients from Longnan city, the onset age of gastric cancer was younger, the occurrence of gastric cancer had a clear tendency of family history of cancer and most of the patients had precancerous diseases. The differences in the characteristics of gastric cancer may be closely related to factors such as environment, diet, H. pylori infection and patient compliance.