2018—2019年安徽省农村居民胃癌筛查检出情况及相关影响因素分析

Result and Related Influencing Factors of Gastric Cancer Screening for Rural Residents in Anhui Province,2018—2019

[目的]分析安徽省农村居民上消化道癌(胃癌)筛查人群的相关行为、病史及病理检查结果情况。[方法]分析2018年7月1日至2019年6月30日,安徽省10个县区开展农村居民上消化道癌筛查的40~69岁居民的全部胃癌筛查记录。[结果]共完成29386人次筛查。胃部病理活检9989份(33.99%,9989/29386),活检共发现各种类型的胃部异常9904例,占活检对象的99.15%(9904/9989),共发现各种类型的胃部癌变197例,癌前病变683例,炎症8023例。多因素回归分析结果显示,胃部组织损害方面,50~59岁年龄组检出胃部癌前病变和胃腺癌的概率最低(OR=0.10,0.38);男性检出损害的风险更高(OR=1.65,2.18);家庭年均收入与胃腺癌呈负相关(OR=0.64)。癌前病变与饮酒、豆制品、烫热食品的摄入频率及胃/十二指肠溃疡呈正相关(OR=1.28~2.10),与吸烟、饮茶、霉变食品摄入频率、胃肠炎呈负相关(OR=0.18~0.79)。胃腺癌与水果、腌晒食品摄入频率呈正相关(OR=2.01,1.61)。[结论]上消化道癌内镜筛查结合病理诊断,可降低上消化道癌的漏诊,应继续探究胃癌相关的影响因素,以进一步完善癌症筛查和防治工作。

[Purpose]To analyze the results and influencing factors of gastrointestinal cancer screening among rural residents in Anhui Province.[Methods]The data of rural residents aged 40~69 years who participated in upper gastrointestinal cancer screening in Anhui Province during July2018 to June 2019 were analyzed.[Results]A total of 29386 people participated in the screening.There were 9989(33.99%)gastric biopsies and pathological examinations performed,and 197 cases of gastric cancer,683 cases of precancerous lesions and 8023 cases of inflammation were detected.Multivariate regression analysis showed that gastric precancerous lesions and gastric adenocarcinoma tissue damage was the lowest in the 50~59 age group(OR=0.10 and 0.38);men were more likely to have the damage(OR=1.65 and 2.18).The annual family income was negatively correlated with gastric adenocarcinoma(OR=0.64).Precancerous lesions were positively correlated with the intake frequency of alcohol,soy products,hot foods and gastric/duodenal ulcers(OR=1.28 to 2.10);negatively correlated the frequency of smoking,tea drinking,moldy food intake and gastroenteritis(OR=0.18 to 0.79).Gastric adenocarcinoma was positively correlated with fruits and pickled foods intake frequency(OR=2.01 and 1.61).[Conclusion]Endoscopy combined with pathological diagnosis can reduce the missed diagnosis of upper gastrointestinal cancer.It is necessary to further study on the influencing factors related to gastric cancer for improving cancer screening and prevention.