西安地区12年间胃镜检出上消化道癌症分析

目的探讨西安地区内镜检出并经病理证实的上消化道癌症的临床流行病学特点。方法选择1991年1月至2002年12月于西安市三所大型医院进行胃镜检查并经病理确诊的上消化道癌症患者,对其临床、病理、内镜及流行病学特征进行分析。结果12年来上消化道癌症总检出率为8.13%,其中食管癌检出率3.42%,贲门癌检出率1.44%,非贲门部胃癌检出率3.26%,十二指肠癌检出率0.01%。12年来食管癌和胃癌的检出率虽有一些波动,但呈明显下降趋势(P=0.000),贲门癌呈现出较为平缓的上升趋势(P=0.000)。贲门癌的男女性别比为6.29∶1,远较胃癌和食管癌为高(2.92∶1和3.09∶1,P=0.000)。食管鳞癌和腺癌构成无明显变化(P=0.562),食管腺癌没有明显的升高趋势(P=0.557)。结论西安地区食管癌居上消化道癌症之首;12年来胃癌、食管癌的检出率明显下降,贲门癌的检出率呈明显升高趋势;贲门癌为不同于食管癌和胃癌的独立疾病。

A clinical epidemiological analysis of the carcinoma of upper digestive tract diagnosed by endoscopy in 12 years in Xi'an

Objective To investigate the clinical epidemiological characteristic of the cancer in upper digestive tract detected by endoscopy and pathologically diagnosed in Xi'an.Methods Patients with cancer of upper digestive tract,detected by endoscopy and pathologically diagnosed from 1991.1 to 2002.12 were selected.The main clinical data,epidemiologyical,endoscopic manifestation and the pathological characteristics were studied.Results The overall diagnosis rate of upper digestive tract cancer was 8.13% in 12 years.Of all the patients who underwent endoscopy,cancer of esophagus,cardia,stomach and duodenum was 3.42%,1.44%,3.26% and(0.01%),respectively.Although the incidences of esophageal cancer and gastric cancer fluctuated,they showed remarkable decreasing tendency(P=0.000).Meanwhile,the incidence of cardiac adenocarcinoma increased slightly(P=0.000).The male/female ratio of cardiac cancer is 6.29∶1,which is much higher than that of esophageal cancer and gastric cancer(P=0.000).The ratio of squamous cell cancer and adenocarcinoma in esophagus didn't chang in 12 years((P=0.562)),and the adenocarcinoma of esophagus did not show any remarkable tendency (P=0.557).Conclusion Esophageal cancer is the most frequent cancer of upper digestive tract in Xi'an.The detection rate of esophageal cancer and gastric cancer has decreased respectively,and cardiac cancer has increased.Cardiac cancer is different from either esophageal or gastric cancer.