目的: 使用新型胃癌筛查评分系统评估内蒙古西部地区人群中胃癌发病现况。方法: 收集2019年6月至2021年1月就诊于包头医学院第二附属医院门诊及体检中心患者的基本数据,对符合纳入标准的11 008例患者进行血液生化检测,依据新型胃癌筛查评分系统进行评分分组,分为低、中、高危组3组,各组患者均行胃镜检查,评估入组患者胃癌发病率。结果: 11 008例胃癌风险人群中,低、中、高危组胃癌检出率分别为0.67 %、1.46 %、9.13 %,高危组的胃癌检出率高于中危组及低危组,差异具有统计学意义(P＜0.05);低、中、高危组早期胃癌检出率分别为0.61 %、1.19 %、7.21 %,高危组的早期胃癌检出率高于中危组及低危组,差异具有统计学意义(P＜0.05)。不同风险等级的人群在性别、年龄、幽门螺杆菌感染分布上,差异具有统计学意义(P＜0.05)。结论: 内蒙古西部地区人群的胃癌患病风险处于较高水平,新型胃癌筛查评分系统适用于内蒙古西部胃癌高危人群筛查。
Objective: To evaluate the incidence of gastric cancer in western Inner Mongolia with a new gastric cancer screening scoring system. Methods: Specimens of 11 008 patients were collected from the outpatient service of the Second affiliated Hospital of Baotou Medical College during June 2019 to January 2021. Health information of selected patients were obtained from the physical examination center of the hospital. Blood biochemistry test was done with the gastric cancer screening scoring system. All subjects were classified into the low-risk group, intermediate-risk group and high-risk group, and gastroscopy was performed to assess the incidence of gastric cancer. Results: Among the 11 008 subjects with risk of gastric cancer, the detection rates of gastric cancer in the low-risk group, intermediate-risk group and high-risk group were 0.67 %、1.46 % and 9.13 % respectively. The detection rate of gastric cancer in the high-risk group was higher than that in the low-risk group and intermediate-risk group, and the difference was statistically significant (P＜0.05). The detection rates of early gastric cancer in the low-risk group, intermediate-risk group and high-risk group were 0.61 %, 1.19 % and 7.21 % respectively. The detection rate of early gastric cancer in the high-risk group was higher than that in the low-risk group and intermediate-risk group, and the difference was statistically significant(P＜0.05). There were statistically significant differences in age, gender, and helicobacter pylori infection rate among people under different risk levels (P＜0.05). Conclusion: The western Inner Mongolia is a high risk region for gastric cancer. The new gastric cancer scoring system is feasible to detect individuals with high risk of gastric cancer.
[1] 曹毛毛, 李贺, 孙殿钦, 等. 2000-2019年中国胃癌流行病学趋势分析[J]. 中华消化外科杂志, 2021, 20(1): 102-109.
[2] Fan XH, Qin XX, Zhang Y, et al. Screening for gastric cancer in China: Advances, challenges and visions[J]. Chin J Cancer Res, 2021, 33(2): 168-180.
[3] Luo MC, Li LF. Clinical utility of miniprobe endoscopic ultrasonography for prediction of invasion depth of early gastric cancer: A meta-analysis of diagnostic test from PRISMA guideline[J]. Medicine, 2019, 98(6): e14430.
[4] Zhang WX, Li ZZ, Akram MS, et al. Gastric cancer screening methods: a comparative study of two scoring methods[J]. Cancer Manag Res, 2021, 13: 5785-5791.
[5] 杨卫生, 吴峰, 周岑, 等. 新型胃癌筛查评分系统在胃癌和癌前病变筛查中的价值[J]. 江西医药, 2020, 55(6): 641-644.
[6] 国家消化系疾病临床医学研究中心, 中华医学会消化内镜学分会, 中华医学会健康管理学分会, 等. 中国早期胃癌筛查流程专家共识意见(草案2017年, 上海)[J]. 中华消化内镜杂志, 2018, 35(2): 77-83.
[7] 倪栋琼, 吕宾, 包海标, 等. 不同血清学危险分层方法在人群早期胃癌筛查中的比较研究[J]. 中华内科杂志, 2019, (4): 294-300.
[8] 卢志斌, 林良兜, 黄俊, 等. 胃癌筛查指南在基层无症状人群的实施研究初探[J]. 现代消化及介入诊疗, 2021, 26(8): 949-952.
[9] 罗慧, 朱利明, 江小林. 新型胃癌筛查评分系统在体检人群中的应用价值分析[J]. 中国医学创新, 2021, 18(6): 172-176.
[10] 陈志娟, 唐玉虎, 刁卓, 等. 新型胃癌筛查评分系统在早期胃癌机会性筛查中的指导作用[J]. 贵州医药, 2020, 44(12): 1876-1877.
[11] 朱婧菡, 马春涛, 冯璜, 等. 新型胃癌筛查评分系统在社区早期胃癌筛查中的初步应用[J]. 胃肠病学, 2020, 25(7): 395-399.
[12] 潘杰, 朱丽明, 林介军, 等. 新型胃癌筛查评分系统在医院就诊人群中的应用[J]. 中华消化内镜杂志, 2019, (7): 487-490.
[13] Sumiyama K. Past and current trends in endoscopic diagnosis for early stage gastric cancer in Japan[J]. Gastric Cancer, 2017, 20(Suppl 1): 20-27.
[14] Katai H, Ishikawa T, Akazawa K, et al. Five-year survival analysis of surgically resected gastric cancer cases in Japan: a retrospective analysis of more than 100,000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001-2007)[J]. Gastric Cancer, 2018, 21(1): 144-154.
[15] Liu XM, Ma XY, Liu F, et al. Gastric cancer screening methods: a comparative study of the Chinese new gastric cancer screening score and Kyoto classification of gastritis[J]. Gastroenterol Res Pract, 2022, 2022: 7639968.
[16] 谢玲, 尚莹莹, 吴云林, 等. 上海市嘉定区胃癌确诊的影响因素研究[J]. 胃肠病学和肝病学杂志, 2019, 28(1): 24-28.
[17] 李丹, 周莹, 王联君, 等. 2007-2019年北京市东城区居民恶性肿瘤死亡流行趋势分析[J]. 中国肿瘤, 2021, 30(12): 911-918.
[18] 刘明法, 柳艳萍, 刘军秋, 等. 2008-2019年天津市滨海新区恶性肿瘤死亡特征及变化趋势分析[J]. 中国慢性病预防与控制, 2021, 29(7): 548-551.
[19] 高福利, 钱建清, 徐晓丹, 等. 新型胃癌评分系统在早期胃癌筛查中的应用[J]. 中国实用医刊, 2020, 47(16): 6-9.
[20] 方柯红, 房玥晖, 连怡遥, 等. 我国成年居民胃癌归因于钠摄入过量的发病和死亡负担研究[J]. 中华疾病控制杂志, 2022, 26(1): 1-6.
