Department of Hepato-Gastroenterology, Brest University Hospital of Finistère, Brest, France.
Eur J Gastroenterol Hepatol. 2010 Dec;22(12):1412-9. doi: 10.1097/MEG.0b013e3283408865.
The aim of this study was to evaluate trends in incidence and prognosis of gastric and cardia carcinomas in the area of Finistère (France) between 1984 and 2003.
The Digestive Tumor Registry of Finistère recorded all new cases of gastric and cardia carcinomas from January 1, 1984 to December 31, 2003. Raw incidence data were standardized using the direct method based on the reference world population. The data and survival rates were studied in univariate and multivariate analyses.
Between 1984-1988 and 1999-2003 the standardized incidence of distal gastric carcinomas decreased (10.74 ± 0.39-5.68 ± 0.27/year/100 000 inhabitants, P < 0.001). There was no significant increase in the incidence of cardia carcinomas (0.83 ± 0.11-1.25 ± 0.14/year/100 000 inhabitants). The frequency of macroscopically infiltrating tumors doubled (P < 0.001) and linitis plastica increased from 9 to 16.2% (P < 0.001). Overall survival rates increased only for patients with metastatic carcinomas of both locations (P < 0.001) and with advanced tumors of distal stomach (P < 0.001) receiving therapy.
This study showed a significant decrease over time in the incidence of distal gastric carcinomas but no significant increase in the incidence of cardia carcinomas. Despite improvement in the management of patients, prognosis remains dismal, probably because of an increased incidence of poor prognosis of histological and anatomical types.
本研究旨在评估法国菲尼斯泰尔省（Finistère）地区 1984 年至 2003 年期间胃和贲门癌的发病率和预后趋势。
菲尼斯泰尔省消化肿瘤登记处记录了 1984 年 1 月 1 日至 2003 年 12 月 31 日期间所有新发的胃和贲门癌病例。原始发病率数据采用基于世界参考人口的直接法进行标准化。在单变量和多变量分析中研究数据和生存率。
1984-1988 年至 1999-2003 年，远端胃癌的标准化发病率下降（10.74 ± 0.39-5.68 ± 0.27/年/10 万居民，P < 0.001）。贲门癌的发病率无显著增加（0.83 ± 0.11-1.25 ± 0.14/年/10 万居民）。肉眼浸润性肿瘤的频率增加了一倍（P < 0.001），并且弥漫型胃癌从 9%增加到 16.2%（P < 0.001）。仅在两种部位转移癌（P < 0.001）和晚期远端胃癌（P < 0.001）接受治疗的患者中，总体生存率才有所提高。
本研究表明，远端胃癌的发病率随时间显著下降，但贲门癌的发病率无显著增加。尽管患者管理得到改善，但预后仍然不佳，可能是由于组织学和解剖学类型预后不良的发生率增加所致。
