Kong Seong-Ho, Park Do Joong, Lee Hyuk-Joon, Jung Hyun Chae, Lee Kuhn Uk, Choe Kuk Jin, Yang Han-Kwang
Department of Surgery, Seoul National University College of Medicine, Chongno-gu, Seoul, Korea.
Jpn J Clin Oncol. 2004 Jan;34(1):1-7. doi: 10.1093/jjco/hyh009.
The aim of this study was to analyze the characteristics of patients diagnosed with gastric adenocarcinoma without the presence of symptoms and to evaluate the usefulness of screening programs for gastric cancer in Korea.
We retrospectively analyzed the characteristics of 1277 gastric adenocarcinoma patients at Seoul National University Hospital (SNUH) (665 in 1996; 612 in 2001) by dividing them into two groups according to the presence or absence of symptoms (symptomatic group vs asymptomatic group).
The proportion of asymptomatic patients increased from 1996 (4.7%) to 2001 (17.2%) (P < 0.001). Gastroscopy was the most commonly used screening tool (77.4% in 1996, 95.2% in 2001). The proportion of early gastric cancer (EGC) in the asymptomatic group was higher than in the symptomatic group (74.2% vs 25.9% in 1996, 78.1% vs 35.7% in 2001) (P < 0.001). The curative operation rate was significantly higher in the asymptomatic group. The asymptomatic group had a higher 5-year survival rate (87.7%) than the symptomatic group (51.6%) (P < 0.01). Complementary data from a screening program at the SNUH showed that 19 gastric cancer cases (0.76%) were detected out of 2501 endoscopic examinations; of these, 78.9% (15/19) were early gastric cancer cases, which is in agreement with our results.
Patients with asymptomatic gastric adenocarcinoma had fewer advanced lesions, a greater chance for curative operation and a higher survival rate than symptomatic patients. An increase in the number of asymptomatic patients contributed to the increase in overall EGC from 1996 to 2001. These results seemed to support the usefulness of gastroscopy as a screening test for gastric cancer in Korea, where the incidence of gastric cancer is high.
本研究旨在分析无症状性胃腺癌患者的特征，并评估韩国胃癌筛查项目的有效性。
我们回顾性分析了首尔国立大学医院（SNUH）1277例胃腺癌患者的特征（1996年665例；2001年612例），根据有无症状将他们分为两组（有症状组与无症状组）。
无症状患者的比例从1996年的4.7%增至2001年的17.2%（P<0.001）。胃镜检查是最常用的筛查工具（1996年为77.4%，2001年为95.2%）。无症状组早期胃癌（EGC）的比例高于有症状组（1996年为74.2%对25.9%，2001年为78.1%对35.7%）（P<0.001）。无症状组的根治性手术率显著更高。无症状组的5年生存率（87.7%）高于有症状组（51.6%）（P<0.01）。SNUH筛查项目的补充数据显示，在2501例内镜检查中检测出19例胃癌病例（0.76%）；其中，78.9%（15/19）为早期胃癌病例，这与我们的结果一致。
与有症状的患者相比，无症状性胃腺癌患者的进展期病变较少，根治性手术的机会更大，生存率更高。无症状患者数量的增加导致了1996年至2001年总体早期胃癌的增加。这些结果似乎支持了胃镜检查作为韩国胃癌筛查试验的有效性，韩国胃癌发病率较高。
