CAJ | 학술논문

目的探讨河北省食管癌和胃癌高发区居民胃癌发生部位的变化.方法回顾性分析1993-2006年河北省食管癌高发区磁县和胃癌高发区赞争县伞部首诊为胃癌的4334例患者的临床资料,比较不同地区、不同年份、不M性别和不同年龄患者贲门、胃体和胃窦部位胃癌的构成比,分析当地胃癌发生部位的变化及趋势.结果两地伞部旨诊胃癌患者巾,贲门癌占68.0%,明显高于胃体痛(24.2%)和胃窦癌(7.9%;X2=124.396,P＜0.0001).1993-2006年间,贲门痛在胃癌中所占的比例呈逐渐增高的趋势.磁县患者中,贲门癌所占的比例为71.2%,明显高于赞皇县(51.2%;X2=109.648,P＜0.0001).磁县贲门癌比例逐渐增多的同时,胃体癌比例呈逐渐减少的趋势;而赞争县胃癌构成比的变化主要体现在胃窦癌逐渐减少.性别对胃癌发生部位的变化无明显影响;但不同部位胃癌患者的年龄构成比存在着差异(X2=58.380,P＜0.0001),其中＜50岁组胃体癌所占的比例在所有年龄组中最高,为34.2%,而贲门癌在61～70岁组中所占的比例最高,为71.6%.结论贲门是河北省胃癌高发区磁县和食管癌高发区赞皇县居民胃癌发生的主要部位.在流行病学因素不变的条件下,磁县胃癌患者中,贲门痛的构成比将继续上升,胃体癌的构成比将继续下降;而赞皇县患者中,胃窦癌的构成比将继续下降.
목적 탐토하북성식관암화위암고발구거민위암발생부위적변화.방법 회고성분석1993-2006년하북성식관암고발구자현화위암고발구찬쟁현산부수진위위암적4334례환자적림상자료,비교불동지구、불동년빈、불M성별화불동년령환자분문、위체화위두부위위암적구성비,분석당지위암발생부위적변화급추세.결과 량지산부지진위암환자건,분문암점68.0%,명현고우위체통(24.2%)화위두암(7.9%;X2=124.396,P＜0.0001).1993-2006년간,분문통재위암중소점적비례정축점증고적추세.자현환자중,분문암소점적비례위71.2%,명현고우찬황현(51.2%;X2=109.648,P＜0.0001).자현분문암비례축점증다적동시,위체암비례정축점감소적추세;이찬쟁현위암구성비적변화주요체현재위두암축점감소.성별대위암발생부위적변화무명현영향;단불동부위위암환자적년령구성비존재착차이(X2=58.380,P＜0.0001),기중＜50세조위체암소점적비례재소유년령조중최고,위34.2%,이분문암재61～70세조중소점적비례최고,위71.6%.결론 분문시하북성위암고발구자현화식관암고발구찬황현거민위암발생적주요부위.재류행병학인소불변적조건하,자현위암환자중,분문통적구성비장계속상승,위체암적구성비장계속하강;이찬황현환자중,위두암적구성비장계속하강.
Objective To analyze the changing trends of frequency and localization of gastric cancers arising from the gastric cardia,corpus and antrum during the past 14 years in population of the high incidence area of esophageal and gastric carcinoma in Hebei province.China.Methods The clinicopathological data of 4334 cases of gastric carcinomas among the local residents of Cixian and Zanhuang counties,initially diagnosed in our department from 1993 to 2006.were retrospectively analyzed.The proportion of gastric carcinomas arising from the gastric cardia,corpus and antrum in different years and in patients with different sex and ages were analyzed and compared,and the changing trends of the frequency of gastric carcinoma arising from difie.rent sites of the stomach were statistically analyzed.Results Among all the 4334 gastric carcinomas,gastric cardia carcinoma accounted for 68.o%.significantly higher than that of corpus(24.2%)and antrum(7.9%;X2=124.396,P＜0.0001).An increasing tendency in the proportion of gastric cardia carcinoma from 1993 to 2006 was seen.The percentage of cardiac carcinoma in the high incidence area of esophageal carcinoma(Cixian county)was higher than that in the high incidence area of gastric cancer(Zanhuang county)(71.2%vs.51.2%;X2=109.648,P＜0.0001).The increase in the incidence of cardiac carcinoma in Cixian county was mainly due to the increase of cardiac carcinoma from 1993 to 2006.while the contributing factor for the increase in the proportion of cardiac carcinomas was resulted from the decrease of incidence of antrum carcinoma in Zanhuang county during the same period.The occurring site of gastric carcinoma Was related with age of paitents(X2:58.380,P＜0.0001).The percentage of carcinoma of the gastric body was highest in ＜50 year age group,while that in the gastric cardia was highest in 61-70 year age group (71.6%).Conclusion The major occurring site of gastric carcinoma is the gastric cardia among the local residents in population of the high incidence areas of esophageal and gastric carcinomas during the past 14 years in Hebei province,China.The increasing trend of cardiac carcinoma and decreasing trend of corpus carcinoma in Cixian county and antrum carcinoma in Zanhuang county will be maintained in the coming years if the epidemiological conditions will not be changed.