2011-2020年恩施地区胃癌流行情况及与幽门螺杆菌菌株感染的相关性分析

Prevalence of gastric cancer and its correlation with Helicobacter pylori infection in Enshi Tujia and Miao Autonomous Prefecture in 2011-2020

目的根据2011—2020年恩施州土家族苗族自治州胃癌发病与死亡流行情况,以及与幽门螺杆菌(Helicobacter pylori,Hp)菌株感染的相关性,分析此十年间胃癌流行趋势,为恩施州土家族苗族自治州胃癌防治工作提供理论依据。方法参照全国统一的审核与评价标准,在恩施州土家族苗族自治州选择出15个符合要求的肿瘤登记处,汇总所有胃癌发病、死亡人口数据,并按照性别、年龄分层统计其发病率、死亡率。比较恩施自治州下辖恩施市、利川市及建始、巴东、宣恩、咸丰、来凤、鹤峰6个县发病标化率及Hp阳性率。采用Spearman相关性分析恩施州土家族苗族自治州各区胃癌区发病标化率与Hp阳性率的相关性分析。结果男性与女性病标化率均呈上升趋势。男性和女性胃癌发病化标率平均上升速度分别为4.07%和4.15%,不同性别发病标化率变化趋势差异均无统计学意义(P>0.05);男性与女性死亡粗粮与死亡标化率均呈下降趋势。男性和女性胃癌死亡化标率平均下降速度分别为-3.91%和-4.12%,不同性别死亡标化率变化趋势差异均无统计学意义(P>0.05)。2016—2020年50~80年龄段发病率明显高于2011—2015年(P<0.05);且2016—2020年在60~80年龄段死亡率明显低于2011—2015年(P<0.05);两个时间段不同年龄组发病率与死亡率变化趋势一致。恩施州土家族苗族自治州各区胃癌区发病标化率与Hp阳性率呈正相关(r=0.473,P<0.05)。结论2011—2020年恩施州土家族苗族自治州胃癌发病与死亡率均处于较高水平,其发病率呈上升趋势,死亡率呈下降趋势。胃癌高发区人口Hp阳性率明显高于低发区,且Hp新感染率也高于低发区。

Objective Based on the incidence and mortality of gastric cancer and the correlation with Helicobacter pylori(Hp)infection in Enshi Tujia and Miao Autonomous Prefecture from 2011 to 2020,the prevalence trend of gastric cancer in this decade was analyzed,providing theoretical basis for the prevention and treatment of gastric cancer in Enshi Tujia and Miao Autonomous Prefecture.Methods According to the unified national examination and evaluation standards,15 tumor registries meeting the requirements were selected in Enshi Tujia and Miao Autonomous Prefecture.The incidence and death data of gastric cancer were collected,and the incidence and death rates were analyzed by gender and age.The normalized incidence rate and Hp positive rate of enshi city,Lichuan city and six counties including Jianshi,Badong,Xuan′en,Xianfeng,Laifeng and Hefeng were compared.Spearman correlation analysis was used to analyze the correlation between standard incidence rate and Hp positive rate of gastric cancer in each district of Tujia and Miao Autonomous Prefecture of Enshi Prefecture.Results Both male and female had an upward trend.The average rate of standard incidence of gastric cancer in male and female was 4.07%and 4.15%,respectively,and there was no significant difference in the trend of standard incidence rate in different genders(P>0.05).The gross death rates and standardized death were decreased in both male and female.The average decreasing rate of standardized death rate of gastric cancer in males and females was-3.91%and-4.12%,respectively,and there was no significant difference in the trend of standardized death rate in different genders(P>0.05).Overall,the incidence rate in age group 50-80 from 2016 to 2020 was significantly higher than that from 2011 to 2015(P<0.05).The mortality rate in the 60-80 age group from 2016 to 2020 was significantly lower than that from 2011 to 2015(P<0.05).The trend of morbidity and mortality in different age groups was consistent in the two periods.There was a positive correlation between the incidence standard rate of gastric cancer and Hp positive rate(r=0.473,P<0.05).Conclusion From 2011 to 2020,the incidence and mortality of gastric cancer in Enshi Tujia and Miao Autonomous Prefecture were both at a high level,with an upward trend and a downward trend.The positive rate of Hp and the new infection rate of Hp in the high incidence area of gastric cancer were higher than those in the low incidence area.