| 林艳苹,龙庭凤,周永春.2005—2014年云南省肿瘤医院结直肠癌临床流行病学特征变化趋势分析[J].中国肿瘤,2020,29(7):497-502. |
| 2005—2014年云南省肿瘤医院结直肠癌临床流行病学特征变化趋势分析 |
| Trend Analysis of Clinical Epidemiological Characteristics of Colorectal Cancer in Yunnan Cancer Hospital from 2005 to 2014 |
| 中文关键词 修订日期：2019-09-08 |
| DOI：10.11735/j.issn.1004-0242.2020.07.A004 |
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| 中文关键词: 结直肠恶性肿瘤 临床流行病学 云南 |
| 英文关键词:colorectal cancer clinical epidemiology Yunnan |
| 基金项目:国家重大公共卫生服务项目城市癌症早诊早治项目 |
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| 中文摘要: |
| 摘 要：［目的］ 探讨云南省2005—2014年结直肠癌临床特征及其变化趋势，为该地区结直肠癌防治提供理论依据。［方法］ 采用回顾性调查研究方法，通过简单随机抽样抽取云南省肿瘤医院2005—2014年间结直肠癌住院患者，应用统一、规范的调查问卷提取患者的社会人口学及临床病理特征，并进行数据统计分析。［结果］ 共纳入1000例结直肠癌患者，平均年龄（56.6±12.6）岁，男、女比例为1.42∶1.0。患者性别、年龄构成比随年份的变化趋势差异无统计学意义（P＞0.05）。最常见的发病部位是直肠，占57.1%，其次为升结肠（13.6%）和乙状结肠（13.0%）；晚期（Ⅲ/Ⅳ期）患者占47.8%；腺癌为最主要的病理类型，占80.4%。2010—2014年患者的吸烟史、肿瘤发病部位、肿瘤标志物CEA和CA199较2005—2009年差异有统计学意义（P＜0.05）。2005—2014年趋势分析显示，体质指数（BMI）为24.0~27.9kg/m2及BMI≥28.0kg/m2的患者占比增加（P＜0.001）。正在饮酒患者从31%下降至24%，无饮酒史患者从69%上升至76%（P=0.021）。Ⅰ/Ⅱ期患者从49%上升至60%，Ⅲ/Ⅳ期患者从51%下降至40%，但差异无统计学意义（P=0.068）。患者吸烟史、肿瘤部位、CEA、CA199检验结果阳性率随年份的变化趋势差异均无统计学意义（P＞0.05）。结直肠癌患者MRI检查应用从0.4%上升到37.0％（P＜0.001），肠镜检查使用率从82.0%增加到98.0%（P＜0.001），超声、CT检查应用率随年份的变化趋势差异均无统计学意义（P＞0.05）。在所有治疗方案中，手术联合化疗是最常用的治疗方法，各治疗方案随年份的变化趋势差异均无统计学意义（P＞0.05）。［结论］ 近10年来，云南省结直肠癌患者性别、年龄构成无明显变化。直肠、升结肠和乙状结肠为主要发病部位。病理类型主要为腺癌。肥胖患者占比逐渐上升，饮酒患者占比逐渐减少。早期患者比例有所增加。MRI、结肠镜诊断使用率逐年上升，但主要治疗方式无明显变化。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the clinical features and trends of colorectal cancer in Yunnan from 2005 to 2014，and to provide theoretical basis for prevention and treatment of colorectal cancer in this district. ［Methods］ A retrospective survey method was used and the hospitalized patients with colorectal cancer from 2005 to 2014 were selected by simple random sampling. The sociodemographic and clinical pathological features of the patients were extracted by using a unified and standardized questionnaire，and the data were statistically analyzed. ［Results］ A total of 1000 patients with colorectal cancer were included，with an average age of 56.6±12.6 years old and the ratio of male to female was 1.42∶1.0. From 2005 to 2014，there was no statistically significant difference in the trend of gender and age composition ratios of patients with the year changing(P>0.05). The most common site of cancer was rectal，accounting for 57.1%，followed by ascending colon(13.6%) and sigmoid colon(13.0%)；advanced patients(Ⅲ/Ⅳ) accounted for 47.8%. Adenocarcinoma was the most common pathological type，accounting for 80.4%. In the past 5 years(2010-2014)，the smoking history，tumor location，and tumor markers CEA and CA199 of patients were significantly different from those during 2005—2009(P<0.05). The 2005—2014 trend analysis showed increase in the proportion of patients with body mass index(BMI) of 24.0~27.9kg/m2 and BMI≥28.0kg/m2(P<0.001) The number of patients who were current drinkers decreased from 31% to 24%，and the number of patients without alcohol consumption increased from 69% to 76%(P=0.021). Patients in stage Ⅰ/Ⅱ increased from 49% to 60%，and patients in stage Ⅲ/Ⅳ decreased from 51% to 40%，but there was no statistical difference(P=0.068). There was no significant difference in the trend of smoking history，tumor location，CEA，CA199 test positive rate change with the year changing(P>0.05). The application of MRI in patients with colorectal cancer increased from 0.4% to 37.0%(P<0.001)，the rate of colonoscopy usage increased from 82.0% to 98.0%(P<0.001)，and the application rate of ultrasound and CT examination varied with the year changing. There was no statistical significance in the trend of application rate of ultrasound and CT examination over the years(P>0.05). Surgery combined with chemotherapy were the most common treatments of all. There was no significant difference in the trend of each treatment with the year changing(P>0.05). ［Conclusion］ There was no significant change in gender and age composition of colorectal cancer patients in Yunnan province in the past 10 years. The rectum，ascending colon and sigmoid colon were the main sites of cancers. The most common pathological type was adenocarcinoma. The proportion of obese patients gradually increased，while the proportion of drinking patients gradually decreased. The proportion of early stage patients has increased. The utilization rate of MRI and colonoscopy has increased year by year，but the main treatment methods did not change significantly. |
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