2002-2012年上海市杨浦区原发性胃癌发病及生存情况分析

目的：阐明上海市杨浦区2002～2012年期间胃癌发病和生存情况。方法系统整理上海市肿瘤登记和管理系统中的杨浦区户籍人群胃癌病例和手术治疗信息，应用年平均变化百分比（APC）模型分析胃癌患者发病的时间趋势，应用Kaplan-Meier方法进行生存率的计算，组间生存采用Log-rank检验进行分析。结果2002～2012年报道胃癌新发病例4853例，其中男3150例。男性粗发病率为50.60/10万；女性为29.55/10万。标化发病率男性为20.52/10万，显著高于女性的13.91/10万（U＝136.14，P＜0.01）。在此期间胃癌发病水平未显著变化（APC＝0.06）。男性40岁、女性45岁之后发病率明显上升。因胃癌死亡4093例，其中男性死亡2645例。男性年均粗死亡率为43.36/10万；女性为24.90/10万。标化死亡率男性为18.46/10万，显著高于女性的11.18/10万（U＝116.72，P＜0.01）。男性50岁、女性55岁之后胃癌死亡率明显上升。整体中位生存时间为1.375年。接受手术者中位生存时间是5.126年，非手术组为0.690年。胃癌患者1～5年生存率分别为56.2%、43.8%、37.6%、33.8%和30.9%。手术治疗组1～5年生存率分别为78.01%、65.26%、58.29%、54.09%和50.29%，显著高于非手术组42.74%、30.45%、24.73%、21.29%和18.96%（P＜0.001）。结论上海市杨浦区男性胃癌发病率和死亡率均高于女性，手术治疗可显著延长胃癌患者的生存期。

The incidence and survival analysis of gastric cancer among permanent residents in Yangpu district of Shanghai from 2002 to 2012

Objective To clarify the incidence and survival of gastric cancer patients among permanent residents in Yangpu District of Shanghai from 2002 to 2012. Methods The data of gastric cancer in permanent residents of Yangpu district were collected from the database of the registration and management system in Shanghai city. Temporal trend in the incidence of gastric cancer was analyzed by using annual percent change （APC） model. Kaplan-Meier analysis with log-rank test was employed to estimate the survival. Results A total of 4853 cases of gastric cancer were diagnosed from 2002 to 2012. Of those, 3150 were males. The crude incidences were 50.60/105 in males and 29.55/105 in females. The standardized incidence was 20.52/105 in males, significantly higher than 13.91/105 in females （U=136.14, P〈0.01）. The incidence in both genders did not significantly change in this period （APC=0.06）. The incidences in males older than 40 years and in females older than 45 years kept increasing significantly. A total of 4093 cases died of gastric cancer in this period. Of those, 2645 were males. Annual crude mortalities were 43.36/105 in males and 24.90/105 in females. The standardized mortality was 18.46/105 in males, significantly higher than 11.18/105 in females （U=116.72, P〈0.01）. The mortality in males older than 50 years and in females older than 55 years kept increasing. The median survival time was 1.375 years in total, 5.126 years in those who received surgery, and 0.690 years in those without surgery. The 1- to 5-year survival rates in all cases were 56.2%, 43.8%, 37.6%, 33.8%, and 30.9%, respectively. The rates in those who received surgery were 78.01%, 65.26%, 58.29%, 54.09%, and 50.29%, which were significantly higher than those without surgery （42.74%, 30.45%, 24.73%, 21.29%, and 18.96%） （P〈0.001 for each comparison）. Conclusion The incidence and mortality of gastric cancer is significantly higher in males than in females. Surgical treatment significantly prolongs overall survival of the patients with gastric cancer.