慢性胃溃疡癌变的临床特点及潜在预测因子分析

Clinical Characteristics of Carcinogenesis of Chronic Gastric Ulcer and Relative Potential Predictive Factors

目的探讨慢性胃溃疡癌变的临床特点及潜在预测因子分析。方法选取确诊为慢性胃溃疡患者251例,其中包括癌变溃疡病例99例,非癌变的慢性胃溃疡152例;分析比较两组一般资料及溃疡特点,应用多因素Logistics回归模型分析慢性胃溃疡癌变的潜在预测因子。结果溃疡癌变组患者有早餐习惯者,偏好腌制和熏制食品者比例以及有胃病和恶性肿瘤家族史者均较高。溃疡癌变组中女性三餐规律者和偏好腌制食品者比例较高,而男性中有早餐习惯,有恶性肿瘤家族史者比例偏高。癌变组典型溃疡比例低,病初典型继而不典型以及不典型比例,发生于胃小弯处、直径在2~3 cm的且多发的比例则偏高;此外溃疡侵袭粘膜层以及侵袭深度较浅的比例在非癌变组较高。癌变组中男性患者更多倾向于罹患典型溃疡,女性更多倾向于罹患不典型溃疡以及病初典型继而不典型的溃疡,溃疡分布分散;男性溃疡边缘整齐和边缘隆起的比例,深入浆膜的比例较高,直径集中在2~3 cm,溃疡深度达到肌层的构成比例较低。回归分析提示病程>5年和溃疡直径在2~3 cm;饮食习惯上偏好腌制、熏制食品是潜在危险因素;溃疡单发以及饮食上偏好大葱和蒜类食品则会减低癌变风险。结论慢性胃溃疡发生癌变的临床特征存在明显性别差异,病程、溃疡大小以及饮食习惯对慢性胃溃疡癌变有一定预测作用。

Objective To investigate the clinical characteristics and potential predictive factors of carcinogenesis of chronic gastric ulcer. Methods 251 patients with chronic gastric ulcer were selected,including 99 cases of cancerous ulcer and 152 cases of non-cancerous chronic gastric ulcer. The chi-square test and t-test were used to analyze the relationship between the 2 groups and the general information of men and women. And the multivariate logistic regression model was used to analyze the po- tential prognostic factors of chronic gastric ulcer. The data were analyzed by SPSS17.0 statistical software package. Results Ul- cerative cancer patients with breakfast habits, preference for marinated and smoked food and the proportion of patients with stom- ach and malignant tumors family history were higher. Ulcer cancer group of women in the 3 meals the law and the preferred ratio of marinated food, while men have breakfast habits, a high proportion of family history of malignant tumors. The proportion of typi- cal ulcer in the cancerous group was typical and the atypical and atypical ratio occurs at the small curvature of the stomach, and the proportion was 2 - 3 cm in diameter and the proportion of multiple lesions was high. In addition, the ulcer invades the mucous membrane and the shallow depth The proportion was higher in the non-cancerous group. Male patients in the cancerous group were more likely to develop typical ulcers, and women were more likely to develop atypical ulcers and were atypical and atypical ulcers. The ulcers were scattered and the proportions of the ulcers were neat and the edges were raised. The proportion was higher,the di- ameter was concentrated in 2 - 3 cm, the ulcer depth to the muscle layer composition ratio was low. Regression analysis suggested that the course of disease 〉 5 years and ulcer diameter of 2 - 3 cm; eating habits preferred pickled, smoked food was a potential risk factor;ulcer single and diet preferences onions and garlic food will reduce the risk of cancer. Conclusion The clinical characteristics of chronic gastric ulcer have obvious gender difference. The course of disease, ulcer size and diet habit are associated with the onset of carcinogenesis of chronic gastric ulcer.