胃癌趋势：日本 35 年的外科手术经验。
Trend in gastric cancer: 35 years of surgical experience in Japan.
机构信息
Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan.
出版信息
World J Gastroenterol. 2011 Aug 7;17(29):3390-7. doi: 10.3748/wjg.v17.i29.3390.
AIM
To investigate the trend in gastric cancer surgery in the context of rapid therapeutic advancement in Japan and East Asia.
METHODS
A retrospective analysis was performed on 4163 patients who underwent gastric resection for gastric cancer with histological confirmation between 1971 and 2007 at the surgical unit in Kitasato University Hospital, to determine the trend in gastric cancer requiring surgery.
RESULTS
Gastric cancer requiring surgical resection increased in our hospital, but the incidence adjusted for population was constant during the observed period. Interestingly, the ratio of diffuse type/intestinal type gastric cancer was unexpectedly unchanged, and that of advanced/early gastric cancer (EGC) was, however, markedly reduced, while the actual incidence of potentially curative advanced gastric cancer tended to decrease. The incidence of EGC requiring surgery tended to increase as a whole, which is consistent with increased prevalence of endoscopic surveillance. As a result, overall survival and mortality of gastric cancer requiring gastric resection has recently markedly improved.
CONCLUSION
In Japan, planned interventions may improve surgical gastric cancer mortality, but an unexpected trend of persistent existence of intestinal type cancer suggests the need for more robust medical intervention.
目的
探讨在日本和东亚地区快速治疗进展的背景下胃癌手术的趋势。
方法
对 1971 年至 2007 年间在北里大学医院外科进行组织学确认的 4163 例接受胃癌胃切除术的患者进行回顾性分析，以确定需要手术的胃癌趋势。
结果
我院需要手术治疗的胃癌患者有所增加，但在观察期间，按人口调整的发病率保持不变。有趣的是，弥漫型/肠型胃癌的比例出人意料地没有变化，而晚期/早期胃癌（EGC）的比例明显下降，而潜在可治愈的晚期胃癌的实际发病率则呈下降趋势。需要手术治疗的 EGC 的发生率总体呈上升趋势，这与内镜监测的普及有关。结果，最近需要进行胃切除术的胃癌的总生存率和死亡率明显提高。
结论
在日本，有计划的干预措施可能会改善胃癌手术死亡率，但肠型癌症持续存在的意外趋势表明需要更有力的医疗干预。
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