摘要
[目的]分析鹤壁市农村上消化道癌早诊早治患者的生存状况,以及不同治疗方法下的差异。[方法]选取2011年7月至2017年6月经初筛确诊的食管重度异型增生/原位癌、贲门/胃高级别上皮内瘤变及以上患者263例,采用Kaplan-Meier法分析1、3、5、7年生存率;Fisher精确概率法比较手术、内镜治疗、放/化疗,以及未治疗情形下不同病理类型患者的生存状况。[结果]癌前病变、早期癌、浸润癌、多原发病例平均5年生存率分别为97.76%、82.86%、71.43%和53.30%。早期病例治疗方法中,手术、内镜治疗、放/化疗分别占29.79%、23.94%和5.85%。比较5年生存状况,癌前病变、浸润癌患者不同治疗方法下差异无统计学意义(P>0.05);早期癌、多原发患者不同治疗方法下差异有统计学意义(P<0.05);以治疗方法两两比较,手术组、内镜组差异无统计学意义(P>0.05),且两者均优于放/化疗组,差异有统计学意义(P<0.001)。[结论]科学筛查策略和精准治疗方案高效匹配是提高患者5年生存率和生存质量的有效手段。加强基层医师内镜下治疗技能培训和提升,减少治疗过度或治疗不及,在当前显得尤为重要。
[Purpose]To analyze the survival status of patients with early diagnosis and treatment of upper gastrointestinal cancer in rural areas of Hebi City,and the discrepancy under different treatments.[Methods]Total 263 patients,who were pre-screened and diagnosed as severe dysplasia or preinvasive carcinoma of esophagus,high-grade cardiac or gastric intraepithelial neoplasia,or more serious lesions from July 2011 to June 2017 in rural areas of Hebi City,were enrolled in the study.Kaplan-Meier method was adopted to analyze the 1-,3-,5-and 7-year survival rate.Fisher’s exact test was used to compare the survival status of patients of different pathological types,who received surgery,endoscopic therapy,radiotherapy/chemotherapy or no any treatment.[Results]The average 5-year survival rates of patients with precancerous lesions,early carcinoma,invasive carcinoma and multiple primary lesions were 97.76%,82.86%,71.43%and 53.30%,respectively.Among the treatments for patients with early lesion,surgery,endoscopic therapy,radiotherapy/chemotherapy accounted for 29.79%,23.94%and 5.85%,respectively.There was no significant difference in survival among patients with precancerous lesions and invasive carcinoma under different treatments(P>0.05);while there was significant difference between patients with early carcinoma and multiple primary lesions(P<0.05).There was no significant difference in survival between patients receiving operation and endoscopic treatment(P>0.05),and their survival was better than that of patients receiving radiotherapy/chemotherapy(P<0.001).[Conclusion]The combination of screening strategy and appropriate therapeutic regimen can effectively improve the survival and living quality of patients with upper gastrointestinal cancer.
作者
胡凤琴
任红勤
HU Feng-qin;REN Hong-qin(Hebi People’s Hospital,Hebi 458030,China)
出处
《中国肿瘤》
CAS
CSCD
北大核心
2020年第2期114-118,共5页
China Cancer
基金
国家重点研发计划“重大慢性非传染性疾病防控研究”消化道恶性肿瘤(食管癌、胃癌、大肠癌)高危人群识别及高危人群预防研究(2016YFC1302800)
国家重点研发计划“精准医学研究”食管癌专病队列研究(2016YFC0901400).
关键词
上消化道癌
早诊早治
早期癌
5年生存率
河南
upper gastrointestinal cancer
early diagnosis and treatment
early carcinoma
5-year survival rate
Henan
作者简介
通信作者:胡凤琴,E-mail:lee377@outlook.com
