1979—2008年山东聊城一间医院胃癌手术患者临床病理特征的变化

目的 探讨一间医院30年来胃癌手术患者临床病理特征的变化趋势.方法 分析山东省聊城市人民医院1979-2008年间收治的2715例胃癌手术患者（研究组）的临床资料,并与1974-1978年间收治的168例患者（对照组）临床资料进行比较.结果 研究组患者男女性别比为3.393,高于对照组的 1.897（χ2 ＝12.193,P＜0.01）.研究组患者的中位年龄为59岁,高于对照组的54岁（z＝-6.294,P＜0.01）.研究组与对照组肿瘤部位比较：胃底贲门癌构成比为45.7%比13.0%（χ2＝56.596,P＜0.01）,胃体癌构成比为9.4%比13.8%（χ2＝2.026,P＝0.155）、胃窦癌构成比为44.9%比73.2%（χ2＝ 53.980,P＜0.01）.研究组中,2004-2008年间组低分化腺癌构成比为62.1%,较1994-1998年间组的51.7%升高（χ2＝12.267,P＜0.01）,而管状腺癌构成比降低（23.9%比31.8%,χ2＝8.781,P＜0.01）.时间序列分析表明,年龄亦呈升高趋势（均方根误差＝1.275,可决系数＝0.702）;胃底贲门癌构成比呈升高趋势（均方根误差＝0.066,可决系数＝0.768）,胃窦癌构成比呈下降趋势（均方根误差＝0.055,可决系数＝0.798）.结论 近30年来,胃癌手术患者男女性别比升高、年龄增大;胃底贲门癌构成比升高,而胃窦癌构成比下降;近15年来,低分化腺癌构成比升高,而管状腺癌构成比下降.

Changing trends in the clinicopathological characteristics of patients with gastric carcinoma undergoing surgery between 1979 and 2008 in Liaocheng Shandong province

Objective To evaluate the changing trends in clinicopathological characteristics of patients with gastric carcinoma undergoing surgery between 1979 and 2008. Methods Two thousand seven hundred and fifteen patients with gastric cancer who received operation in Liaocheng People′s hospital between 1979 and 2008 were analyzed retrospectively, and were compared to 168 patients between 1974 and 1978. Categorical data were evaluated with Chi-squared or Fisher′s exact test. Quantitative data were analyzed with nonparametric test. Time series analysis was used to evaluate the changing trend of data. Results The male to female ratio during 1979-2008 was 3.393, which was higher than that (1.897) during 1974-1978 (χ2＝12.193,P＜0.01). The median age (59 years) during 1979-2008 was higher than that(53.5 years) during 1974-1978(z＝-6.294 P＜0.01). Comparing the tumor distribution of gastric cancer during 1979-2008 with that during 1974-1978, proportion of gastric cardia and fundus cancer was higher(45.7% vs. 13.0%, χ2＝56.596,P＜0.01), while the proportion of gastric antrum cancer was lower(44.9% vs. 73.2%,χ2＝53.980,P＜0.01). There was no significant difference in gastric body cancer(13.8% vs. 9.4%,χ2＝2.026,P＝0.155). Compared to 1994-1998, there were more poorly differentiated adenocarcinomas during 2004-2008(62.1% vs. 51.7%, χ2＝12.267,P＜0.01), and there were less tubular adenocarcinomas during 2004-2008(23.9% vs. 31.8%, χ2＝8.78,P＜0.01). Time series analysis showed the patient age during 1979 to 2008 increased(Root mean square error＝1.275, R-square＝0.702), gastric cardia and fundus cancer was increasing and antrum cancer was decreasing (Root mean square error＝0.055, R-square＝0.798). Conclusions In the past 30 years from 1979 to 2008, the male to female ratio and the median age of surgical patients with gastric cancer increased with time. The gastric cardia and fundus cancer increased over time, however antrum cancer decreased with time. In the past 15 years from 1994 to 2008, the proportion of poorly differentiated adenocarcinoma increased, and that of tubular adenocarcinoma declined.