中、日两国综合医院胃癌患者病理行为及预后的比较

Comparison in pathological behaviours & prognosis of gastric cancers from general hospitals between China & Japan.

机构信息

Department of Biochemistry & Molecular Biology, College of Basic Medicine, China Medical University, Shenyang, China.

出版信息

Indian J Med Res. 2010 Sep;132:295-302.

PMID:20847376

Abstract

BACKGROUND & OBJECTIVES: Gastric cancer is the fourth most common cancer and the second leading cause of cancer-related deaths after lung carcinoma. The aim of this study was to understand the difference in clinicopathological behaviours and prognosis of gastric cancer in patients from China and Japan.

METHODS

Paraffin-fixed tissue samples of gastric cancer were collected retrospectively from two hospitals between 1993 to 2006 in Japan (n=2063) and during 1980-2003 in China (n=2496) respectively, and staging was done by TNM system and typing by Japanese Endoscopy Society criteria or Borrmann's classification. The histological architecture of the tumours was expressed according to Lauren's classification.

RESULTS

Compared to Japan, the occurrence of gastric cancer was more common in younger Chinese population and prone to invasion and metastasis in muscularis propia, lymphatic, lymph node, liver, peritoneal parts, and exhibited large tumour size and high TNM staging in both the sexes and in different age groups (P<0.05). Intestinal and mixed types of carcinomas were more frequently observed in Japanese patients compared to Chinese and the difference was significant (P<0.05). It was observed that the commonly reported types in early gastric cancers (EGC) in Japanese patients were IIc, IIa+IIc or IIa while those of Chinese patients were IIc, III or IIb. In the case of advanced gastric cancers (AGC), type II and III were most common in both the countries. The cumulative survival rate of Chinese patients was significantly (P<0.05) higher compared to Japanese in different stratified groups via depth of invasion, TNM staging or Lauren's classification.

INTERPRETATION & CONCLUSION: Gastric cancers in Chinese patients had more aggressive pathological characteristics and poorer prognosis than those from Japan. To reduce incidence and to improve treatment facilities, it is necessary to have a systematic screening system.

摘要

背景与目的

胃癌是第四大常见癌症，也是仅次于肺癌的第二大癌症相关死亡原因。本研究旨在了解中国和日本患者胃癌的临床病理行为和预后差异。

方法

分别回顾性收集了日本两家医院 1993 年至 2006 年（n=2063）和中国 1980 年至 2003 年（n=2496）的胃癌石蜡固定组织样本，并通过 TNM 系统进行分期，根据日本内镜学会标准或 Borrmann 分类进行分型。肿瘤的组织学结构根据 Lauren 分类进行表达。

结果

与日本相比，中国年轻人群中胃癌的发生率更高，且更易侵犯和转移至肌层、淋巴、淋巴结、肝、腹膜等部位，且两性和不同年龄组的肿瘤均较大，TNM 分期较高（P<0.05）。与中国患者相比，日本患者更常出现肠型和混合型癌，差异有统计学意义（P<0.05）。观察到日本患者早期胃癌（EGC）中常见的类型为 IIc、IIa+IIc 或 IIa，而中国患者为 IIc、III 或 IIb。在晚期胃癌（AGC）中，两国最常见的类型均为 II 和 III。不同浸润深度、TNM 分期或 Lauren 分类的分层组中，中国患者的累积生存率明显（P<0.05）高于日本患者。