Peng Jian-Jun, Xiao Ping, Xu Jian-Bo, Song Wu, Liao Bing, He Yu-Long
Jian-Jun Peng, Jian-Bo Xu, Wu Song, Yu-Long He, Department of Gastrointestinal Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 51080, Guangdong Province, China.
World J Gastroenterol. 2014 Apr 21;20(15):4401-6. doi: 10.3748/wjg.v20.i15.4401.
To investigate the clinicopathological features of gastric carcinoma in southern China and disease trends changes over the last 18 years.
We designed a retrospective study in the Department of Gastrointestinal Surgery, the first affiliated hospital, Sun Yat-sen University. A total of 2100 adult patients with definitely diagnosed, histologically proven gastric carcinomas treated with radical gastrectomy from 1994 to 2013 were examined retrospectively. In all cases patient age, gender, tumor location, Borrmann type, histopathological type and grade, and pTNM stage were identified and recorded. The information was obtained from hospital records. The data were analyzed with Stata12.0 software.
In this study, the mean age of patients was 57 years with a range from 19-89 years. A higher incidence was found in patients over 60 years of age. In the study population, 67.38% of patients were male and 32.62% were female. Women had a higher disease incidence than men in patients less than 40 years of age (P < 0.001). No obvious change of patient age and gender was observed in the last 18 years. The rates of disease by location were the following: antrum (44.57%), followed by fundus/ body (24.95%) and cardia/gastroesophageal junction (23.00%). The mean tumor diameter was 5.57 cm, and advanced gross type Borrmann III was most common. Most patients were at advanced stages when first diagnosed, and patients with early stage disease were relatively rare. More early stage patients were detected in recent years, especially after 2000 (P < 0.001). Gastric carcinoma has different features in young and old patients. The young patients had the following features: more frequently female, tumors in the antrum, larger tumor size, poorly differentiated carcinoma, high rate of metastasis to other sites and advanced stages (P < 0.05).
In southern China, gastric carcinoma was more frequent in old men and young women. Young and old patients should be treated differently for having different features.
探讨中国南方胃癌的临床病理特征以及过去18年疾病趋势的变化。
我们在中山大学附属第一医院胃肠外科开展了一项回顾性研究。对1994年至2013年期间共2100例经根治性胃切除术治疗、确诊且组织学证实为胃癌的成年患者进行回顾性检查。在所有病例中，确定并记录患者的年龄、性别、肿瘤位置、Borrmann分型、组织病理学类型和分级以及pTNM分期。这些信息来自医院记录。数据采用Stata12.0软件进行分析。
本研究中，患者的平均年龄为57岁，范围为19至89岁。60岁以上患者发病率较高。在研究人群中，67.38%为男性，32.62%为女性。40岁以下患者中女性发病率高于男性（P<0.001）。在过去18年中，患者年龄和性别无明显变化。按部位划分的疾病发生率如下：胃窦（44.57%），其次是胃底/胃体（24.95%）和贲门/胃食管交界处（23.00%）。肿瘤平均直径为5.57 cm，大体类型以进展期Borrmann III型最为常见。大多数患者初诊时处于进展期，早期疾病患者相对较少。近年来检测到更多早期患者，尤其是2000年后（P<0.001）。老年和年轻患者的胃癌具有不同特征。年轻患者具有以下特征：女性更常见、肿瘤位于胃窦、肿瘤体积较大、低分化癌、其他部位转移率高以及分期较晚（P<0.05）。
在中国南方，老年男性和年轻女性胃癌发病率较高。老年和年轻患者因特征不同应区别对待。
