从中国胃肠肿瘤外科联盟相关数据分析我国早期胃癌诊治现状和发展趋势

胃癌是我国最常见的恶性肿瘤之一,但我国早期胃癌病人比例仍较低。2014—2017年中国胃肠肿瘤外科联盟数据在一定程度上可反映我国早期胃癌的发病趋势和诊疗现状。该数据共收集全国95家中心的134111例胃癌病例,针对时间趋势的分析基于至少提交3年数据的中心数据进行分析。在所有病例中,早期胃癌所占比例为19.7%。早期胃癌病人比例分布最高的地区包括浙江、北京、江苏、天津、上海等,而比例最低的地区包括青海、海南、内蒙古、云南、广西等。2014—2017年,早期胃癌的比例从19.7%增加至20.9%,内镜治疗、腹腔镜手术、开腹手术所占比例分别为24.3%、37.7%和38.0%,其中内镜治疗、腹腔镜手术比例有所增加,而开腹手术比例则有所减小。在接受手术切除的病人中,T1a期病人淋巴结转移比例达5.9%,T1b期病人淋巴结转移比例达19.6%。总体来看,我国早期胃癌病人比例近年来略有增加,但与日韩等国相比仍有较大上升空间。早期胃癌的微创治疗逐渐成为主流治疗方式。

Current treatment status and trends of early gastric cancer in China: analyzed based on the data of China Gastrointestinal Cancer Surgery Union

Current treatment status and trends of early gastric cancer in China: analyzed based on the data of China Gastrointestinal Cancer Surgery Union　　MIAO Ru-lin, LI Zi-yu，JI Jia-fu.Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100142, China
Corresponding authors: JI Jia-fu,E-mail: jijiafu@hsc.pku.edu.cn
Abstract　Gastric cancer is one of the most common cancers in China. The proportion of early gastric cancer (EGC) is still relatively low in China. The data of China Gastrointestinal Cancer Surgery Union from 2014 to 2017 can reflect the current status and trends of diagnose and treatment of EGC in China. The union collected data of 134,111 cases of gastric cancer in 95 centers in China. The trend analysis was performed with data from centers with at least 3 years data collected. Within all the patients, the proportion of EGC was 19.7%. The proportions of EGC were higher in Zhejiang, Beijing, Jiangsu, Tianjin, and Shanghai, and were lower in Qinghai, Hainan, Inner Mongolia, Yunnan, and Guangxi. The proportion of EGC increased from 19.7% in 2014 to 20.9% in 2017. In terms of treatment, the proportions of endoscopic treatment, laparoscopic surgery, and open surgery were 24.3%, 37.7%, and 38.0%. From 2014 to 2017, the proportions of endoscopic treatment and laparoscopic surgery increased while the proportion of open surgery decreased. Among patients received surgery, 5.9% of pT1a patients and 19.6% of pT1b patients were with lymph node metastasis. In conclusion, the proportion of EGC increased slightly in China but was still lower than that of Japan and South Korea. Minimally invasive treatment gradually become the main treatment method of EGC.