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法国口腔癌特征:早期检测的描述性流行病学。

Oral cancer characteristics in France: Descriptive epidemiology for early detection.

机构信息

General Cancer Registry of Lille and its area, GCS-C2RC, 59037 Lille, France.

University Hospital of Caen, U1086 Inserm UCBN "Cancers & preventions", 14000 Caen, France.

出版信息

J Stomatol Oral Maxillofac Surg. 2017 Apr;118(2):84-89. doi: 10.1016/j.jormas.2017.02.003. Epub 2017 Feb 24.

Abstract

Despite the frequency and lethality of oral cancers in France, there are no detailed general population data regarding the characteristics of these patients to fuel the public health authorities' reflections about early detection policies. Thus, the objective of this study was to determine, in the general population, the characteristics of both patients and tumours at the time of the diagnosis. A high-resolution, population-based study using 13 French registries was conducted on 1089 tumours diagnosed in 2010. Men accounted for 75% of cases. The most frequent sites were tonsil (28.4%) and oral tongue (21.1%). The median age varied from 56.7 years for floor of mouth to 66.4 years for gum. The lesions were mainly diagnosed on pain and those diagnosed after routine clinical examination were scarce (2.6%). There were 65.5% stage III and IV at diagnosis. Oral tongue, floor of mouth and palate presented tumours less than 2cm only in 34 to 40% of cases. Advanced stage was associated with the presence of comorbidities, and tonsil or base of tongue topography. Stage was not associated with Département, deprivation index or gender. This study provided a picture of the characteristics of oral cancer patients and their tumours and showed that diagnoses are often made late, even for those tumours most easily accessible to direct visual and tactile examination. Nevertheless, it remains to define the target population of an early detection and to evaluate the benefit of such detection on the mortality rate.

摘要

尽管法国口腔癌的发病率和死亡率都很高,但针对该人群的特征,目前尚无详细的一般人群数据来为公共卫生当局的早期检测政策提供参考。因此,本研究的目的是在普通人群中确定诊断时患者和肿瘤的特征。该研究采用了法国 13 个登记处的高分辨率、基于人群的方法,对 2010 年诊断的 1089 例肿瘤进行了研究。男性占 75%。最常见的部位是扁桃体(28.4%)和口腔舌(21.1%)。中位年龄从口底的 56.7 岁到牙龈的 66.4 岁不等。病变主要因疼痛而诊断,通过常规临床检查诊断的病例很少(2.6%)。诊断时 65.5%为 III 期和 IV 期。口舌、口底和腭部的肿瘤小于 2cm 的仅占 34%至 40%。晚期与合并症和扁桃体或舌根的位置有关。分期与 Departement、剥夺指数或性别无关。本研究提供了口腔癌患者及其肿瘤特征的描述,并表明诊断往往较晚,即使对于那些最容易通过直接视觉和触觉检查发现的肿瘤也是如此。然而,仍需确定早期检测的目标人群,并评估这种检测对死亡率的影响。

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