胃癌的早期检测
Early detection of gastric cancer.
作者信息
Hallissey M T, Allum W H, Jewkes A J, Ellis D J, Fielding J W
机构信息
Department of Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham.
出版信息
BMJ. 1990 Sep 15;301(6751):513-5. doi: 10.1136/bmj.301.6751.513.
OBJECTIVE
To see whether investigation of dyspeptic patients aged over 40 after their first consultation with the general practitioner would increase the proportions with early and operable gastric cancers.
DESIGN
Prospective study of gastric cancer in dyspeptic patients aged over 40 from a defined population.
SETTING
10 General practices (six in central Birmingham, four in Sandwell); the Queen Elizabeth Hospital, Birmingham; and Sandwell District General Hospital.
PATIENTS
2659 Patients aged 40 or over referred with dyspepsia.
MAIN OUTCOME MEASURE
Increase in early and operable gastric cancers detected in middle aged patients with dyspepsia.
RESULTS
Disease was identified in 1992 patients (75%). Fifty seven were found to have gastric cancer, 36 being treated by potentially curative resection, including 15 with early cancer.
CONCLUSIONS
The investigation of dyspeptic patients over 40 at first attendance can increase the proportion of early gastric cancers detected to 26% and the proportion of operable cases to 63%. Such a policy has the potential to reduce mortality from gastric cancer in the population.
目的
观察对40岁以上消化不良患者在首次就诊于全科医生后进行检查，是否会增加早期可手术胃癌患者的比例。
设计
对特定人群中40岁以上消化不良患者的胃癌前瞻性研究。
地点
10家全科诊所（伯明翰市中心6家，桑德韦尔4家）；伯明翰市伊丽莎白女王医院；以及桑德韦尔区综合医院。
患者
2659例40岁及以上因消化不良前来就诊的患者。
主要观察指标
中年消化不良患者中早期可手术胃癌的检出率增加情况。
结果
1992例患者（75%）被确诊患有疾病。57例被发现患有胃癌，36例接受了可能治愈性切除治疗，其中15例为早期癌症。
结论
对40岁以上首次就诊的消化不良患者进行检查，可将早期胃癌的检出率提高到26%，可手术病例的比例提高到63%。这样的政策有可能降低人群中胃癌的死亡率。
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