Bautista Marita C, Jiang Sheng-Fang, Armstrong Mary Anne, Kakar Sanjay, Postlethwaite Debbie, Li Dan
Department of Gastroenterology (#248), Kaiser Permanente Northern California, 710 Lawrence Expressway, Santa Clara, CA, 95051, USA.
Dig Dis Sci. 2015 Apr;60(4):984-95. doi: 10.1007/s10620-014-3409-7. Epub 2014 Oct 30.
Racial and ethnic differences in gastric cancer are not well understood. This study sought to compare the clinicopathological features and survival of noncardia gastric adenocarcinoma (NCGA) patients with different racial/ethnic backgrounds in Kaiser Permanente Northern California (KPNC), a large integrated health care system.
This was a retrospective cohort study of 1,366 patients with newly diagnosed NCGA between 2000 and 2010. The subjects were categorized into four racial/ethnic groups: non-Hispanic Whites, Blacks, Asians, and Hispanics. Clinicopathological information and survival data were obtained from the KPNC electronic databases and compared among the four racial/ethnic groups.
The incidence of NCGA declined in Blacks and Whites, but remained stable in Asians and Hispanics. Whites had a lower incidence of NCGA compared with non-Whites. Asians and Hispanics were diagnosed at a younger age compared with Whites (mean age at diagnosis: 66, 63, and 72 years, respectively; P < 0.0001). Diffuse/mixed histological type (Lauren classification) was more prevalent in Asians and Hispanics than in Whites and Blacks (46 and 45 vs. 36 and 29 %, respectively, P = 0.001). History of Helicobacter pylori testing was associated with better survival. Asians had the highest survival rates at 1, 2, and 5 years, while Whites had the lowest (P < 0.0001).
Significant racial/ethnic differences exist in patients with noncardia gastric cancer. Asians and Hispanics were younger at diagnosis and had more diffuse/mixed histological type. Asians had the highest survival, while Whites had the lowest. Such differences may be related to biological, environmental, and treatment-related factors.
胃癌的种族和民族差异尚未得到充分了解。本研究旨在比较北加利福尼亚永久医疗集团（KPNC，一个大型综合医疗系统）中不同种族/民族背景的非贲门胃腺癌（NCGA）患者的临床病理特征和生存率。
这是一项对2000年至2010年间1366例新诊断的NCGA患者的回顾性队列研究。研究对象被分为四个种族/民族组：非西班牙裔白人、黑人、亚洲人和西班牙裔。临床病理信息和生存数据从KPNC电子数据库中获取，并在四个种族/民族组之间进行比较。
NCGA的发病率在黑人和白人中有所下降，但在亚洲人和西班牙裔中保持稳定。与非白人相比，白人的NCGA发病率较低。与白人相比，亚洲人和西班牙裔被诊断时年龄更小（诊断时的平均年龄分别为66岁、63岁和72岁；P < 0.0001）。弥漫性/混合型组织学类型（劳伦分类）在亚洲人和西班牙裔中比在白人和黑人中更普遍（分别为46%和45%，而白人和黑人分别为36%和29%，P = 0.001）。幽门螺杆菌检测史与更好的生存率相关。亚洲人在1年、2年和5年时的生存率最高，而白人最低（P < 0.0001）。
非贲门胃癌患者存在显著的种族/民族差异。亚洲人和西班牙裔诊断时年龄更小，且有更多的弥漫性/混合型组织学类型。亚洲人的生存率最高，而白人最低。这些差异可能与生物学、环境和治疗相关因素有关。
