| 胡凤琴,任红勤.2011—2017年河南省鹤壁市农村上消化道癌[J].中国肿瘤,2020,29(2):114-118. |
| 2011—2017年河南省鹤壁市农村上消化道癌 |
| Survival Analysis on Upper Gastrointestinal Cancer with Early Diagnosis and Treatment under Different Interventions in Rural Areas of Hebi City from 2011 to 2017 |
| 中文关键词 修订日期：2019-08-29 |
| DOI：10.11735/j.issn.1004-0242.2020.02.A006 |
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| 中文关键词: 上消化道癌 早诊早治 早期癌 5年生存率 河南 |
| 英文关键词:upper gastrointestinal cancer early diagnosis and treatment early carcinoma 5?鄄year survival rate Henan |
| 基金项目: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） |
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| 中文摘要: |
| 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。 |
| 英文摘要: |
| Abstract：［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. |
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