| 李佳悦,孙可欣,朱 倩,等.全球不同国家胃癌亚型的分布特征及其负担变化趋势分析[J].中国肿瘤,2026,35(2):81-87. |
| 全球不同国家胃癌亚型的分布特征及其负担变化趋势分析 |
| Distribution Characteristics and Temporal Trends in the Incidence of Gastric Cancer Subtypes Across Different Countries Worldwide |
| 投稿时间：2025-10-13 |
| DOI：10.11735/j.issn.1004-0242.2026.02.A001 |
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| 中文关键词: 胃贲门癌 胃非贲门癌 时间趋势 亚型差异 性别差异 |
| 英文关键词:gastric cardia cancer gastric non-cardia cancer temporal trends subtype differences sex differences |
| 基金项目:国家自然科学基金（82273704）；首都卫生发展科研专项（2024-2G-40213）；中央高水平医院临床科研业务费（2025-LYZX-R-A03）；北京市科技新星计划（202504841003） |
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| 中文摘要: |
| 摘 要：［目的］ 分析全球不同国家胃癌亚型发病负担的时间变化趋势，量化其亚型和性别差异的变化规律，为各国制定胃癌的针对性防控措施提供科学依据。［方法］ 选取《五大洲癌症发病率》（Cancer Incidence in Five Continents，CI5） Ⅷ~Ⅻ卷（1993—2017年）中具有高质量分型数据的24个国家进行胃癌亚型发病负担的趋势分析，以Segi世界标准人口为参照，计算胃癌亚型的年龄标准化发病率（age-standardized incidence rate，ASIR）以及ASIR的亚型比值，并采用Joinpoint回归模型估计其年度变化百分比（annual percentage change，APC）。CI5 Ⅻ卷（2013—2017年）是截至目前全球基于肿瘤登记处真实上报数据的最新高质量数据集，单独筛选出该卷具有分型数据的48个国家进行胃癌亚型发病率性别差异的现况分析。［结果］ 1993—2017年，胃贲门癌（gastric cardia cancer，GCC）的ASIR在7个国家中显著下降，其中中国（APC=-6.22%，95%CI：-9.53%~-3.53%）降幅最明显，而在丹麦（APC=1.84%，95%CI：1.13%~2.61%）等4个国家中明显上升；胃非贲门癌（gastric non-cardia cancer，GNCC）的ASIR在23个国家中显著下降，其中奥地利降幅最明显（APC=-4.91%，95%CI：-7.13%~-3.06%）。亚型差异分析显示GCC的ASIR在全球范围内始终低于GNCC，但两者ASIR的差异在16个国家中显著缩小，而中国人群GCC与GNCC的ASIR比值从0.15显著下降至0.06。性别差异分析显示男性GCC和GNCC的ASIR均显著高于女性，且GCC的性别差异比GNCC更显著。［结论］ GNCC的ASIR在多数国家呈下降趋势，而GCC的ASIR在部分欧美国家显著上升。GCC和GNCC的发病负担差异逐渐缩小，性别差异在多数国家中长期保持相对稳定状态，且均以男性为主导。 |
| 英文摘要: |
| Abstract： ［Purpose］ To analyze the temporal trends in the incidence burden of gastric cancer (GC) subtypes across different countries worldwide. ［Methods］ We analyzed temporal trends in the burden of GC subtypes using high-quality subtype data from 24 countries included in Cancer Incidence in Five Continents (CI5) Volumes Ⅷ~Ⅻ (1993—2017). Age-standardized incidence rate (ASIR) for gastric cardia cancer (GCC) and gastric non-cardia cancer (GNCC)， as well as subtype-specific ASIR ratios， were calculated using world standard population. Annual percentage changes (APC) were estimated using Joinpoint regression analysis. Data from 48 countries with high-quality subtype information in CI5 Volume Ⅻ were used for a cross-sectional analysis of sex differences. ［Results］ From 1993 to 2017， ASIR for GCC decreased significantly in 7 countries， with the most pronounced decrease observed in China (APC=-6.22%， 95%CI： -9.53%~-3.53%). In contrast， ASIR for GCC increased significantly in 4 countries， notably in Denmark (APC=1.84%， 95% CI： 1.13%~2.61%). ASIR for GNCC decreased significantly in 23 countries， with the steepest decline in Austria (APC=-4.91%， 95%CI： -7.13%~-3.06%). Subtype-specific analysis revealed that GCC ASIR remained consistently lower than GNCC ASIR globally. However， the difference in ASIR between the two subtypes narrowed significantly in 16 countries. In China， the GCC-to-GNCC ASIR ratio decreased significantly from 0.15 to 0.06. Sex-specific analysis showed that ASIR for both GCC and GNCC were consistently higher in male than in female across all countries， with more pronounced sex disparities observed for GCC. ［Conclusion］ The ASIR of GNCC showed a declining trend in most countries， while the ASIR of GCC increased significantly in some European and American countries. The disparity in incidence burden between GCC and GNCC has gradually narrowed over time. Sex differences in the incidence of both subtypes remained relatively stable and predominantly male-dominated in most countries during the study period. |
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