巴基斯坦人群食管癌的临床、流行病学和诊断特征。

Clinical, epidemiological, and diagnostic characteristics of esophageal carcinoma in a Pakistani population.

机构信息

From the Department of Internal Medicine, Dow University of Health Sciences, Ojha Campus, Karachi, Sindh, Pakistan.

From the Department of General Surgery, Liaquat National Hospital and Medical College, Karachi, Sindh, Pakistan.

出版信息

Ann Saudi Med. 2021 Mar-Apr;41(2):91-100. doi: 10.5144/0256-4947.2021.91. Epub 2021 Apr 1.

DOI:10.5144/0256-4947.2021.91

PMID:33818145

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8020643/

Abstract

BACKGROUND

Esophageal cancer ranks eighth among the most prevalent cancers globally and is the sixth leading cause of mortality from malignancy worldwide; it is the 7th most prevalent malignancy in males and the 6th most prevalent malignancy in females. In Pakistan, the incidence is 4.1 per 100 000 with the province of Baluchistan having the greatest incidence.

OBJECTIVE

Report trends and characteristics of esophageal cancer in Pakistan over the past 10 years.

DESIGN

Cross-sectional, retrospective review of medical records.

SETTING

Tertiary care hospital.

PATIENTS AND METHODS

The study included all patients admitted with a diagnosis of esophageal carcinoma with a mass lesion or luminal narrowing. The records were for the period from January 2011 to September 2020.

MAIN OUTCOME MEASURES

Gender, histopathological types/differentiation along with clinical/laboratory findings.

SAMPLE SIZE

1009 with a mean (standard deviation) age of 49.3 (14.2) and a median (interquartile range of 50 (22) years (443 males and 566 females with age of 51.0 [20] years and 47.9 [23.8] years, respectively). The male-to-female ratio was 1:1.2.

RESULTS

Most patients (82.7%) had squamous cell carcinomas with a male-to-female ratio of 1:2; the remainder had adenocarcinomas with a male-to-female ratio of 4:1 (<.001). Dysphagia, weight loss, and vomiting were the most prevalent symptoms. More adenocarcinoma masses were located distally compared with squamous cell carcinomas (=.030), lesions were most likely to be ulcerated (=.910). Luminal narrowing was slightly more frequent in squamous cell carcinoma (=.215), thickening was more prominently circumferential in the adenocarcinomas. In squamous cell carcinoma, the most common variant was moderately differentiated while moderate to poorly differentiated variants were more common in adenocarcinoma. In the survival analysis, squamous cell carcinoma (=.014 vs adenocarcinoma), particularly the well-differentiated type (=.018 vs other variants), projected a better prognosis.

CONCLUSION

Our study reports the most recent trends of esophageal carcinoma in this region.

LIMITATIONS

Lack of metastatic workup, TNM staging, and mode of treatment, along with the overlapping pattern of histological variants.

CONFLICT OF INTEREST

None.

摘要

背景

食管癌是全球最常见的癌症之一，位列第八，也是全球第六大恶性肿瘤致死病因；在巴基斯坦，其发病率为每 10 万人中有 4.1 人，俾路支省的发病率最高。

目的

报告过去 10 年巴基斯坦食管癌的趋势和特征。

设计

回顾性横断面研究，分析病历。

地点

三级护理医院。

患者和方法

本研究纳入所有经诊断患有食管癌并存在肿块或管腔狭窄的患者。研究时间段为 2011 年 1 月至 2020 年 9 月。

主要观察指标

性别、组织病理学类型/分化及临床/实验室检查结果。

样本量

1009 例，平均（标准差）年龄为 49.3（14.2）岁，中位数（50 岁的四分位间距）为 50（22）岁（443 例男性和 566 例女性，年龄分别为 51.0[20]岁和 47.9[23.8]岁），男女比例为 1:1.2。

结果

大多数患者（82.7%）患有鳞状细胞癌，男女比例为 1:2；其余患者患有腺癌，男女比例为 4:1（<.001）。最常见的症状是吞咽困难、体重减轻和呕吐。与鳞状细胞癌相比，更多的腺癌肿块位于远端（=.030），病变更可能为溃疡性（=.910）。管腔狭窄在鳞状细胞癌中更为常见（=.215），而腺癌的增厚更呈环形。在鳞状细胞癌中，最常见的变体是中度分化，而中度至低分化变体在腺癌中更为常见。在生存分析中，与腺癌相比，鳞状细胞癌（=.014 比腺癌），特别是分化良好的类型（=.018 比其他变体），预后更好。