Xing Yujin, Hosaka Hiroko, Moki Fumitaka, Tomaru Shota, Itoi Yuki, Sato Keigo, Hashimoto Yu, Tanaka Hirohito, Kuribayashi Shiko, Takeuchi Yoji, Nagai Kazue, Uraoka Toshio
Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, 3-39-15 Syowa-machi, Maebashi 371-8511, Gunma, Japan.
Gunma Health Foundation, Gunma Prefectural Cancer Registry, 16-1 Horinoshita-machi, Maebashi 371-0005, Gunma, Japan.
J Clin Med. 2024 Apr 25;13(9):2524. doi: 10.3390/jcm13092524.
: Gastric cancer (GC) epidemiology and outcomes vary by gender. : We reviewed 18,436 GC patients from 2008 to 2018 and looked for gender differences in clinical characteristics and survival. : The gender proportion was 71% male and 29% female. Males had a significantly ( < 0.001) higher proportion of differentiated GC (66.3%) and a lower proportion of undifferentiated GC (26.3%). Diagnosis through medical check-ups was more common in males (30.0% vs. 26.4%, < 0.001). Clinical staging revealed 54.6% of males and 52.9% of females had localized disease without lymph node metastasis (LNM), while distant metastasis occurred in 17.4% of males and 16.9% of females ( < 0.001). Kaplan-Meier survival curves indicated females had a significantly higher overall survival ( = 0.0018). The survival advantage for females was evident in the early stages, with a significant difference in localized disease without LNM ( < 0.001) and localized disease with LNM ( = 0.0026, log-rank test) but not in the advanced stages. Multivariate Cox regression analysis showed a significantly reduced mortality risk in females ( < 0.001). : Significant gender differences exist with regard to pathological type, presentation, clinical stage, and overall survival. These findings suggest gender-specific strategies for screening, diagnosis, and treatment.
胃癌（GC）的流行病学和预后因性别而异。我们回顾了2008年至2018年的18436例胃癌患者，探讨了临床特征和生存方面的性别差异。性别比例为男性71%，女性29%。男性中高分化胃癌的比例显著更高（<0.001），为66.3%，低分化胃癌的比例更低，为26.3%。通过体检诊断在男性中更为常见（30.0%对26.4%，<0.001）。临床分期显示，54.6%的男性和52.9%的女性患有无淋巴结转移（LNM）的局限性疾病，而远处转移在17.4%的男性和16.9%的女性中出现（<0.001）。Kaplan-Meier生存曲线表明女性的总生存率显著更高（=0.0018）。女性的生存优势在早期阶段很明显，在无LNM的局限性疾病（<0.001）和有LNM的局限性疾病（=0.0026，对数秩检验）中有显著差异，但在晚期阶段没有。多因素Cox回归分析显示女性的死亡风险显著降低（<0.001）。在病理类型、表现、临床分期和总生存方面存在显著的性别差异。这些发现提示了针对性别差异的筛查、诊断和治疗策略。
