漏诊胃癌的特征及后果：一项多中心队列研究。

Characteristics and consequences of missed gastric cancer: A multicentric cohort study.

作者信息

Hernanz Nerea, Rodríguez de Santiago Enrique, Marcos Prieto Héctor Miguel, Jorge Turrión Miguel Ángel, Barreiro Alonso Eva, Rodríguez Escaja Carlos, Jiménez Jurado Andrea, Sierra María, Pérez Valle Isabel, Volpato Nadja, García Prada María, Nuñez-Gómez Laura, Ríos-León Raquel, Castaño García Andrés, García de Paredes Ana García, Aicart Marta, Caminoa Alejandra, Peñas Parcía Beatriz, Vázquez-Sequeiros Enrique, Albillos Agustín

机构信息

Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, University of Alcala, Spain.

Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, University of Alcala, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS),Spain.

出版信息

Dig Liver Dis. 2019 Jun;51(6):894-900. doi: 10.1016/j.dld.2019.02.006. Epub 2019 Feb 26.

DOI:10.1016/j.dld.2019.02.006

PMID:30898522

Abstract

BACKGROUND

Missed gastric cancer (MGC) is poorly documented in Mediterranean populations.

AIMS

(1) To assess the rate, predictors and survival of MGC. (2) To compare MGC and non-MGC tumors.

METHODS

This is a retrospective-cohort study conducted at four centers. MGC was defined as cancer detected within three years after negative esophagogastroduodenoscopy. Gastric adenocarcinomas diagnosed between 2008-2015 were included. Patients with no follow-up were excluded.

RESULTS

During the study period 123,395 esophagogastroduodenoscopies were performed, with 1374 gastric cancers being diagnosed (1.1%). A total of 1289 gastric cancers were finally included. The overall rate of MGC was 4.7% (61/1289, 3.7-6%). A negative esophagogastroduodenoscopy in MGC patients was independently associated with PPI therapy (p < 0.001), previous Billroth II anastomosis (p = 0.002), and lack of alarm symptoms (p < 0.001). The most frequent location for MGC was the gastric body(52.4%). MGCs were smaller than non-MGCs (31 vs 41 mm, p = 0.047), more often flat or depressed (p = 0.003) and less likely to be encountered as advanced disease. Overall 2-year survival was similar between MGC (34.1%) and Non-MGC (35.3 %) (p = 0.59).

CONCLUSION

MGC accounted for nearly five percent of newly-diagnosed gastric adenocarcinomas. Overall survival was poor and not different between MGC and non-MGC.

摘要

背景

在地中海人群中，漏诊胃癌（MGC）的记录很少。

目的

（1）评估MGC的发生率、预测因素和生存率。（2）比较MGC和非MGC肿瘤。

方法

这是一项在四个中心进行的回顾性队列研究。MGC被定义为在食管胃十二指肠镜检查阴性后三年内检测到的癌症。纳入2008年至2015年间诊断的胃腺癌患者。排除无随访的患者。

结果

在研究期间，共进行了123395次食管胃十二指肠镜检查，诊断出1374例胃癌（1.1%）。最终纳入1289例胃癌患者。MGC的总体发生率为4.7%（61/1289，3.7-6%）。MGC患者食管胃十二指肠镜检查阴性与PPI治疗（p<0.001）、既往毕Ⅱ式吻合术（p=0.002）和无报警症状（p<0.001）独立相关。MGC最常见的部位是胃体（52.4%）。MGC比非MGC小（31对41mm，p=0.047），更常为扁平或凹陷型（p=0.003），进展期疾病的发生率较低。MGC组和非MGC组的总体2年生存率相似（34.1%对35.3%，p=0.59）。