中国早期胃癌筛查流程专家共识意见在广东地区的应用

Application of China consensus on the protocol of early gastric cancer screening in Guangdong province

目的:探讨"中国早期胃癌筛查流程专家共识意见"在广东地区胃癌风险人群中的应用价值。方法:纳入2018年3月—2019年3月在广东地区进行早期胃癌筛查的居民,采用量化的新型胃癌筛查评分系统进行胃癌初筛,根据初筛结果将患者分为高危组、中危组和低危组,比较各组精查胃镜下早期胃癌、癌前疾病、癌前病变的检出率,统计学分析采用卡方检验。结果:完成精查胃镜检查共545例,其中高危组32例,中危组184例,低危组329例。精查胃镜结果显示,早期胃癌检出率方面,高危组(12.5%)>中危组(1.1%)>低危组(0),差异有统计学意义(χ^2=41.85,P<0.01);癌前疾病检出率方面,高危组(60.9%)>中危组(52.4%)>低危组(34.3%),差异有统计学意义(χ^2=18.00,P<0.01);癌前病变检出率分别为17.9%、8.8%及8.8%,差异无统计学意义(χ^2=2.58,P=0.28)。内镜病变检出阳性率组间比较,高危组(71.9%)>中危组(57.1%)>低危组(40.1%),差异有统计学意义(χ^2=21.54,P<0.01)。结论:"中国早期胃癌筛查流程专家共识意见"在广东地区胃癌风险人群的早期胃癌及癌前疾病筛查中具有较好的应用价值。

Objective To assess the application value of China consensus on the protocol of early gastric cancer screening in Guangdong province.Methods A new quantitative scoring system was used in Cantonese residents who underwent early gastric cancer screening from March 2018 to March 2019.According to the scores of initial screening,patients were divided into high-risk,medium-risk and low-risk groups.The detection rates of early gastric cancer,precancerous diseases and precancerous lesions under gastroscopy in each group were compared.Chi-square test was performed for statistical analysis.Results A total of 545 individuals were selected for gastroscopy,in which 32 cases were classified into high-risk group,184 into medium-risk group and 329 into low-risk group.The results of gastroscopy examination showed that high-risk group had the highest detection rate of early gastric cancer(12.5%),followed by medium-risk group(1.1%)and low-risk group(0)(χ^2=41.85,P<0.01);the detection rates of precancerous diseases exhibited a similar pattern:high-risk group(60.9%)>medium-risk group(52.4%)>low-risk group(34.3%)(χ^2=18.00,P<0.01).The detection rates of precancerous lesions were 17.9%,8.8%and 8.8%,respectively,with no significant difference(χ^2=2.58,P=0.28).In terms of the positive rate of endoscopy,high-risk group(71.9%)showed the highest positive rate,followed by medium-risk group(57.1%)and low-risk group(40.1%)(χ^2=21.54,P<0.01).Conclusion China consensus on the protocol of early gastric cancer screeing is of application value for the screening of early gastric cancer and precancerous lesions in the populations at risk of gastric cancer in Guangdong province.