Gholipour C, Shalchi R A, Abbasi M
Department of General Surgery, Sinaea Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Dis Esophagus. 2008;21(4):322-7. doi: 10.1111/j.1442-2050.2007.00776.x.
Esophageal cancer (EC) accounts for a considerable proportion of carcinomas of the upper gastrointestinal tract in the population of the Caspian littoral. The global histologic pattern of the disease has changed recently. The intent of this study was to determine the incidence of EC over the past decade in Eastern Azerbaijan--a north-western province of Iran--on the western side of the Caspian littoral and to assess the alteration of the histological pattern of the disease. In a retrospective study, all 1792 documented EC cases of all registered cancer, surgery, pathology, and radiotherapy centers of the province over a period of 9 years (from March 1994 to March 2003) were enrolled in the study. Data concerning demographic characteristics, EC risk factors, and histological findings were recorded. The incidence and the relative incidence of the pathological subtypes of EC in the population of the province were determined. The change in incidence rates and the interaction between main risk factors and tumor histology of the patients were assessed over the study years. The average incidence of EC in the over 30-year-old population of the province was 16.2 (12.7 for squamous cell carcinoma [SCC] and 1.9 for adenocarcinoma [AC]) cases per 100 000 person-years. Incidence of SCC, as well as AC, peaked at ages older than 65. Compared to women, men had higher incidences of AC and lower incidences of SCC; the average incidence rate of EC was equal in men and women. AC and SCC accounted for 12.8% and 86.9% of cases, respectively. Upper, middle and lower thirds of the esophagus were the location of tumors in 9.8%, 32.9% and 57.3% of cases, respectively. During the study period, incidence rates of EC and SCC tended to decrease. The incidence rate of EC from 1995 to 1998 was almost 30% higher than that of the period from 1999 to 2002. Incidence rate of EC on the western side of the Caspian littoral is moderately high, but much lower than that of the eastern Caspian littoral as it was three decades ago. The incidence of EC was lower in the second half than the first half of the study period. Unlike the global pattern of EC, the incidence of EC as well as SCC in women is as high as or higher than in men, which is identical to the pattern in the eastern Caspian littoral.
食管癌（EC）在里海沿岸地区人群的上消化道癌中占相当大的比例。该疾病的全球组织学模式最近发生了变化。本研究的目的是确定过去十年中伊朗西北部东阿塞拜疆省（位于里海沿岸西侧）的食管癌发病率，并评估该疾病组织学模式的变化。在一项回顾性研究中，纳入了该省所有注册的癌症、手术、病理和放疗中心在9年期间（从1994年3月至2003年3月）记录的所有1792例食管癌病例。记录了有关人口统计学特征、食管癌危险因素和组织学检查结果的数据。确定了该省人群中食管癌病理亚型的发病率和相对发病率。评估了研究期间发病率的变化以及主要危险因素与患者肿瘤组织学之间的相互作用。该省30岁以上人群中食管癌的平均发病率为每10万人年16.2例（鳞状细胞癌[SCC]为12.7例，腺癌[AC]为1.9例）。SCC以及AC的发病率在65岁以上年龄段达到峰值。与女性相比，男性AC发病率较高，SCC发病率较低；食管癌的平均发病率在男性和女性中相等。AC和SCC分别占病例的12.8%和86.9%。食管上、中、下三段分别是9.8%、32.9%和57.3%病例的肿瘤发生部位。在研究期间，食管癌和SCC的发病率呈下降趋势。1995年至1998年期间食管癌的发病率比1999年至2002年期间高出近30%。里海沿岸西侧的食管癌发病率中等偏高，但远低于三十年前里海沿岸东侧的发病率。研究期后半段的食管癌发病率低于前半段。与全球食管癌模式不同，女性食管癌以及SCC的发病率与男性相同或高于男性，这与里海沿岸东侧的模式一致。
