2008—2021年辽宁省庄河市胃癌内镜筛查诊治效果及变化趋势分析

The Effect and Changing Trend of Endoscopic Screening for Gastric Cancer in Zhuanghe City of Liaoning Province from 2008 to 2021

[目的]分析2008—2021年辽宁省庄河市胃癌筛查人群内镜筛查及治疗效果的变化趋势。[方法]以2008—2021年期间辽宁省庄河市胃癌筛查及早诊早治项目的受检人群为研究对象,计算胃镜活检率、阳性病例检出率和早诊率等。采用线性回归模型计算平均年度变化百分比(average annual percentage change,AAPC)和95%置信区间(confidence interval,CI)来评估其统计显著性。生存分析采用Kaplan-Meier方法,并使用Log-rank检验比较不同组别的生存曲线差异。[结果] 2008—2021年,庄河市接受胃癌筛查的受检者累计24 269人。其中,17 370人接受了胃镜检查及胃黏膜活检,活检率为71.57%,阳性病例检出率为0.66%,早诊率为84.38%,治疗率95.00%。上述指标的年代变化趋势均无统计学差异(P均>0.05)。随访至2023年12月31日,阳性病例5年生存率为90.74%,其中早期(93.92%)显著高于进展期(74.12%)(P=0.013)。[结论]高质量的筛诊治技术是胃癌大规模人群筛查早诊早治取得显著成效的重要基础和保障。需切实做好基层医院内镜医生的规范技术培训。

[Purpose] To analyze the endoscopic screening and treatment effect for gastric cancerin Zhuanghe City of Liaoning Province from 2008 to 2021. [Methods] Individuals who underwentgastric cancer screening and early diagnosis and treatment in Zhuanghe City from 2008 to 2021were included in the study. The rate of endoscopic biopsy, detection rate of positive cases, andearly diagnosis rate were calculated. A linear regression model was used to calculate the averageannual percentage change (AAPC) and 95% confidence interval. Survival analysis was conductedusing the Kaplan-Meier method, and the Log-rank test was used to compare survival curve betweengroups. [Results] From 2008 to 2021, a total of 24 269 individuals in Zhuanghe underwentgastric cancer screening, 17 370 of whom received endoscopic examinations and gastric mucosalbiopsies. The biopsy rate was 71.57%, the detection rate of positive cases was 0.66% , the earlydiagnosis rate was 84.38%, and the treatment rate was 95.00%. There was no statistically significantdifference in the AAPC trends for the above indicators from 2008 to 2021(all P>0.05). Followupwas conducted until December 31, 2023. The 5-year survival rate for positive cases was90.74%, with early-stage cases (93.92%) significantly higher than advanced-stage cases (74.12%)(P=0.013). [Conclusion] High-quality screening and diagnostic technology is essential for the successfulimplementation of large-scale population screening and early diagnosis and treatment ofgastric cancer. It is crucial to ensure standardized technical training for endoscopists in primary hospitals.