京都胃炎分类在基层医院胃癌筛查中的应用

Application of Kyoto Classification of Gastritis to gastric cancer screening in a primary hospital

背景胃癌是我国常见的消化系统恶性肿瘤,其预后与诊治时机密切相关,我国早期胃癌的发现率小于10%,远远低于日本(70%)和韩国(50%).规范胃镜诊断标准,探索适合我国国情的胃癌筛查方案迫在眉睫.目的探讨京都胃炎分类标准在基层医院消化内科就诊患者的临床应用价值.方法采用京都胃炎分类标准对2019-09/2020-11间因消化系统症状在深圳市蛇口人民医院就诊,依据《中国早期胃癌筛查流程专家共识意见(草案2017年,上海)》确定纳入研究对象,并依据京都胃炎分类评分将纳入患者分为3组,即低分组(小于2分)、中分组(≥2分,<4分)、高分组(≥4分),对3组患者的胃癌检出情况进行分析.结果共1383例患者纳入本研究,低分组共918例;中分组共290例;高分组175例.3组患者间的胃癌、早期胃癌检出率两两对比,差异具有统计学意义(P<0.05).结论采用京都胃炎分类评分,可提高基层医院就诊人群中早期胃癌、胃癌的检出率.

BACKGROUND Gastric cancer is a common malignant digestive system tumor in China,and its prognosis is closely related to the early diagnosis and treatment.The rate of early gastric cancer is less than 10%in China,which is far less than those in Japan(70%)and Korea(50%).Standardization of gastroscopic diagnosis and finding gastric cancer screening program suitable for China are of great significance.AIM To explore the clinical value of Kyoto Classification of Gastritis in gastric cancer screening in primary hospitals.METHODS The Kyoto Classification of Gastritisg was used to retrospectively analyze the data of patients who visited Shekou People’s Hospital of Shenzhen for digestive symptoms from September 2019 to November 2020 and met the new system for gastric cancer screening requirements.All patients were divided into three groups according to the grading results of the Kyoto Classification of Gastritis:Low-score group(<2 points),medium-score group(≥2 points but<4 points),and high-score group(≥4 points).A comparative analysis was performed on the detection of gastric cancer among the three groups.RESULTS A total of 1383 patients were included in this study,including 918(66.4%)in the low-score group,290(20.9%)in the medium-score group,and 175(12.7%)in the highscore group.The total detection rate of gastric cancer was 3.54%(49/1383).There were significant differences in the detection rates of gastric cancer between any two of the three groups(P<0.05).CONCLUSION The Kyoto Classification of Gastritis can significantly improve the detection rate of early gastric cancer and gastric cancer.