ASST of Cremona, Viale Concordia 1, 26100, Cremona, CR, Italy.
ASST of Crema, Largo Ugo Dossena 2, 26013, Crema, CR, Italy.
BMC Cancer. 2019 Mar 8;19(1):212. doi: 10.1186/s12885-019-5366-1.
The gastric cancer incidence rate differs widely across geographical areas. In Italy, in the province of Cremona the incidence is high, compared to the national situation. For this reason a specialized population-based registry was set up.
The collection encompasses all gastric cancers diagnosed in the three districts of the province since January 1, 2010. The main data sources were the pathological and Hospital Discharge Records and patient clinical charts. Only diagnoses of primary gastric cancer were considered. For each case the following variables were registered: personal data, medical history and symptoms at diagnosis; imaging assessments performed, details on surgery and other treatments received; genetic background and biomolecular characteristics; social and environmental factors.
As of November 2017, 1087 cases were collected; of which 876, diagnosed up to December 2015, were analyzed. Male/female ratio was 1.4. The European Age-standardized Incidence Rate was 41.4 for males and 28.3 for females as compared to a national average of 33.3 and 17.0 respectively. Median age at diagnosis was 73 for male and 78 for female. Helicobacter Pylori infection was present in fewer than 20% of cases. HER-2 gene was amplified in about 25% of cases. Primary tumour location was the gastro-esophageal junction or cardia in 17.5% in males and 8.3% in females. The majority of cases (58.3%) were diagnosed at an advanced stage and overall only 41.2% underwent surgery. Median overall survival was 14.8 months for men and 18.5 for women. Age standardized 5-year relative survival was 31.4% for men and 40.5% for females. Neoadjuvant treatment was performed in fewer than 10% of patients who underwent surgery, and the rate of postoperative therapy adherence was low.
This study shows a high gastric cancer incidence in the province of Cremona, with a geographical spread across different districts. Moreover, a high percentage of gastric cancers were detected at an advanced stage of disease and a low rate of 5-year relative survival was registered. Based on these findings, effective preventive interventional health strategies and screening procedures need to be implemented to reduce the impact of this pathology in this geographical area.
胃癌的发病率在不同地区差异很大。在意大利，克雷莫纳省的发病率高于全国平均水平。出于这个原因，建立了一个专门的基于人群的登记处。
该研究涵盖了自 2010 年 1 月 1 日以来在该省三个地区诊断出的所有胃癌病例。主要的数据来源是病理和住院记录以及患者临床图表。只考虑原发性胃癌的诊断。对于每个病例，登记了以下变量：个人数据、病史和诊断时的症状；进行的影像学评估、手术细节和其他治疗；遗传背景和生物分子特征；社会和环境因素。
截至 2017 年 11 月，共收集了 1087 例病例；其中，截至 2015 年 12 月诊断的 876 例进行了分析。男女比例为 1.4。男性欧洲年龄标准化发病率为 41.4，女性为 28.3，而全国平均水平分别为 33.3 和 17.0。男性诊断时的中位年龄为 73 岁，女性为 78 岁。不到 20%的病例存在幽门螺杆菌感染。约 25%的病例存在 HER-2 基因扩增。男性原发性肿瘤位于胃食管交界处或贲门的比例为 17.5%，女性为 8.3%。大多数病例（58.3%）在晚期诊断，总体而言只有 41.2%的病例接受了手术。男性中位总生存期为 14.8 个月，女性为 18.5 个月。标准化 5 年相对生存率为男性 31.4%，女性 40.5%。接受手术的患者中不到 10%接受了新辅助治疗，术后治疗的依从性较低。
这项研究表明，克雷莫纳省的胃癌发病率很高，在不同地区都有分布。此外，发现大量胃癌在疾病晚期被检出，且 5 年相对生存率较低。基于这些发现，需要实施有效的预防性干预卫生策略和筛查程序，以减少该地区这种疾病的影响。
