Levi F, La Vecchia C, Franceschi S, Te V C
Registre vaudois des tumeurs, Institut universitaire de médecine sociale et préventive, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Br J Cancer. 1991 Apr;63(4):567-72. doi: 10.1038/bjc.1991.132.
Detailed data and statistics per each morphological site of various digestive neoplasms were obtained for the period 1976-87 from the Vaud Cancer Registry datafile, a population-based cancer registration scheme covering about 530,000 inhabitants from the French-speaking part of Switzerland. Tabulations presented include absolute number of cases (1,041 oral and pharyngeal, 545 oesophageal, 1,131 gastric, 83 small intestine, 1,980 colon, 1,267 rectal, 357 liver, 328 gallbladder and 725 pancreatic cancers), percent distributions, age-standardised rates, sex ratios and 5-year survival. The report has essentially a descriptive value, and should be viewed as a contribution towards quantification, in a well surveilled population of the West-central part of Europe, of the proportional distribution of digestive neoplasms by morphological type, and corresponding incidence and survival rates. Among the points deserving specific attention, there are the elevated frequency of upper digestive tract cancers, the very high male-to-female ratios for squamous cell carcinomas, adenocarcinomas of the oesophagus and hepatocellular carcinomas of the liver, the female excesses in infiltrating carcinoids of the colon, transitional and squamous cell carcinomas of the rectum and adenocarcinomas of the gallbladder, and the crossover in male-to-female ratio in squamous cell carcinoma along the digestive tract (i.e. from 6.0 at the level of the mouth/pharynx to 0.5 in the rectum). As concerns survival, rates were higher for lymphomas and sarcomas than for carcinomas in oral cavity and stomach, similar for carcinoids and carcinomas in the small bowel (about 35% at 5 years), as well as for colon (34%) and rectal (37%) cancers. Some of the findings, such as the higher survival of carcinomas arising from polyps in the colon and rectum, or the higher proportion of cholangiocellular and combined cholangio- and hepatocellular carcinomas in females than in males find plausible prognostic or aetiologic correlates, but others, such as the large proportions of squamous and transitional cell cancers of the rectum in females are more difficult to explain. These and several other indications emerging from careful examination of the data herein presented underline the interest of morphological analyses of digestive tract cancers.
1976 - 1987年期间，从沃州癌症登记数据库获取了各类消化器官肿瘤各形态学部位的详细数据和统计信息。该数据库是一个基于人群的癌症登记系统，覆盖瑞士法语区约53万居民。所呈现的表格包括病例绝对数（口腔和咽癌1041例、食管癌545例、胃癌1131例、小肠癌83例、结肠癌1980例、直肠癌1267例、肝癌357例、胆囊癌328例、胰腺癌725例）、百分比分布、年龄标准化率、性别比和5年生存率。本报告本质上具有描述性价值，应被视为对欧洲中西部一个监测良好的人群中消化器官肿瘤按形态学类型的比例分布以及相应发病率和生存率进行量化的一份贡献。在值得特别关注的要点中，有上消化道癌症的高发病率、食管鳞状细胞癌、腺癌以及肝细胞癌极高的男女比例、女性在结肠浸润性类癌、直肠移行细胞癌和鳞状细胞癌以及胆囊腺癌中的高发率，以及沿消化道的鳞状细胞癌男女比例的交叉情况（即从口腔/咽部水平的6.0降至直肠的0.5）。关于生存率，淋巴瘤和肉瘤的生存率高于口腔癌和胃癌中的癌，小肠类癌和癌的生存率相似（5年约为35%），结肠癌（34%）和直肠癌（37%）也是如此。一些研究结果，如结肠和直肠息肉引发的癌生存率较高，或女性胆管细胞癌以及胆管和肝细胞联合癌的比例高于男性，都能找到合理的预后或病因学关联，但其他一些结果，如女性直肠鳞状和移行细胞癌的高比例则更难解释。仔细研究本文所呈现的数据后出现的这些及其他一些迹象突显了消化道癌症形态学分析的重要性。
