陕西汉中地区胃癌危险因素及基于胃功能指标胃癌风险预测模型的建立

Investigation of risk factors for gastric cancer in Hanzhong area and establishment of a gastric cancer risk prediction model based on gastric function index

目的调查汉中地区胃癌危险因素并基于胃功能指标建立胃癌风险预测模型。方法采用问卷调查的方式对2018年1月至2019年1月期间汉中市中心医院消化内科收治入住的227例胃癌和非胃癌患者进行调查,收集研究对象的饮食、生活习惯、家族史、既往史等胃癌危险因素;随后对研究对象进行血清学检验(包括血清PGⅠ和Ⅱ、G-17),实施胃镜检查并对样本进行病理检测,多因素logistic回归分析各因素的高危性,ROC曲线评估血清胃功能用于胃癌筛查的效能。结果两组患者在年龄(χ^2=0.054,P=0.816)、性别(χ^2=3.823,P=0.051)及BMI(χ^2=5.569,P=0.135)上的分布差异无统计学意义,提示两组间临床资料具有可比性。多因素logistic回归分析结果显示,仅熏制食品摄入(P=0.031,95%CI:1.150~17.545)和高血脂(P=0.039,95%CI:0.216~0.960)是胃癌癌前病变的高危因素,其余因素未见显著高危性(P>0.05)。ROC曲线结果显示,联合PGⅠ、PGⅡ及G-17的诊断效能要显著高于单独PGⅠ、PGⅡ及G-17的诊断效能(P<0.05)。结论汉中地区胃癌危险因素主要包括熏制食品的摄入和高血脂,临床治疗时可建议患者注意饮食;基于胃功能指标PGⅠ、PGⅡ及G-17对于胃癌癌前病变的诊断具有较好的预测,联合诊断效能更佳,为临床胃癌的早期诊断提供理论依据。

Objective To investigate the risk factors of gastric cancer in Hanzhong area and establish a gastric cancer risk prediction model based on gastric function indexes.Methods A questionnaire survey was conducted on 227 patients with gastric and non-gastric cancer admitted to the Department of Gastroenterology of Hanzhong Central Hospital from January 2018 to January 2019.The diet,lifestyle habits,family history,and past history of the subjects were collected.Serological tests(including serum PGⅠ,Ⅱ,and G-17),gastroscopy and pathological examination of the samples were carried out.Multi-factor Logistic regression analysis was performed to analyze the high risk factors.The efficacy of serum gastric function for gastric cancer screening was assessed through ROC curve.Results There were no significant differences in the distribution of age(χ^2=0.054,P=0.816),gender(χ^2=3.823,P=0.051)and BMI(χ^2=5.569,P=0.135)between the gastric cancer and non-gastric cancer groups,suggesting that the clinical data between the two groups was comparable.Multivariate logistic regression analysis showed that smoked food intake(P=0.031,95%CI:1.150~17.545)and hyperlipidemia(P=0.039,95%CI:0.216~0.960)were high risk factors for gastric precancerous lesions,other factors did not show significant high risk(P>0.05).The results of ROC curve showed that the diagnostic efficacy of combined PG I,PG II,and G-17 was significantly higher than that of PG I,PGⅡ,or G-17 alone(P<0.05).Conclusion The risk factors of gastric cancer in Hanzhong area mainly included the intake of smoked food and hyperlipidemia.Patients can be advised to pay attention to diet during clinical treatment.Based on gastric function indexes PG,PGⅡand G-17,the diagnosis of gastric precancerous lesions had a good prediction.The combined diagnosis is more effective,which provided a theoretical basis for the early diagnosis of clinical gastric cancer.