| Objective: To explore the epidemiological characteristics of GC and to investigate the detection of GC,precancerous state and precancerous lesions by gastroscopy at the same time in northwest Sichuan(Mianyang,Deyang and Guangyuan)in recent 5 years,so as to understand the incidence trend of GC and the diagnosis level of GC,precancerous state and precancerous lesion under gastroscopy in the region.Methods: Part one: We collected clinical data of patients with GC diagnosed pathologically from January 2015 to December 2019.The date from Sichuan Mianyang 404 hospital,The Third Hospital of Mianyang,Mianyang Hospital of Traditional Chinese Medicine,Anzhou Area Hospital of Traditional Chinese Medicine,Pingwu County People’s Hospital,Santai County People’s Hospital,Zitong County People’s Hospital,Deyang Zhongjiang County People’s Hospital,The First People Hospital of Guangyuan and The Third People Hospital of Guangyuan.We divided the data into two groups: group A(January 2015 to June 2017)and group B(July 2017 to December 2019).The basis is based on the admission time.The number of patients,gender,pathological type,pathological site and other related data were analyzed.Part two: The data of gastroscope room and pathology department from January2015 to December 2019 were collected in Mianyang Hospital of Traditional Chinese Medicine,Sichuan Mianyang 404 hospital,Zitong County People’s Hospital,Deyang Zhongjiang County People’s Hospital,The First People Hospital of Guangyuan and The Third People Hospital of Guangyuan.Patients with precancerous state(GA and IM),precancerous lesions(LGIN and HGIN)and GC diagnosed by pathological biopsy were screened.We divided the data into two groups: group A(January 2015 to June 2017)and group B(July 2017 to December 2019).The basis is based on the admission time.The number of gastroscopy,gender,age,detection rate and other relevant data were analyzed.Results:1.A total of 4083 GC patients were included.From 2015 to 2019,there were 830,701,811,838 and 903 patients respectively.The male to female ratio was 3.33:1.1.1 There was a statistical difference that the proportion of the elderly group showed a rising trend,while that of the young group and the middle-aged group showed a decreasing trend(P<0.05).The GC patients of group A and B and the whole GC patients were mainly elderly patients.1.2 The pathological changes of GC are mainly located in the cardia,followed by gastric antrum and gastric body.Pathological types consisted of three parts: The first was a rare adenosquamous carcinoma;The second was adenocarcinoma,which was the majority;The last part was a small amount of squamous cell carcinoma.1.3 The mean age of patients with GC was(65.55 ± 11.18)years old.Men were older than women.There was a statistical difference between the two.Female onset age and male onset age in group B were higher than those in group A(P <0.05).1.4 Patients with GC aged 60-69 were the main incidence population,and patients younger than 40 were the least.2.A total of 218766 gastroscopic examinations were performed in recent5 years.From 2015 to 2019,the number of gastroscopy was 34583,38333,40712,48020 and 57118 respectively.2.1 A total of 9563 patients with GA were detected,and the detection rate was 4.37%.From 2015 to 2019,the detection rate was on the rise,the difference had statistical significance(P<0.001).The detection rate of group B was higher than that of group A(P<0.001).The male to female ratio was 1.68:1.The ratio in group A was higher than that in group B(P<0.05).Mean age of onset in patients with GA was(56.92±11.82)years old.The average age of onset was lower in women than in men(P<0.05).The mean age of onset in group B was higher than that in group A(P<0.05).By age group,The overall patients with GA and the patients with GA in groups A and B were that young patients had the lowest proportion,followed by elderly patients,and middle-aged patients had the largest proportion.The proportion of middle-aged and elderly people was increasing,while that of young people was decreasing(P<0.05).The lesions of GA were mainly located in gastric antrum,gastric horn and gastric body.2.2 A total of 9642 patients with IM were detected,and the detection rate was 4.41%.From 2015 to 2019,the detection rate was on the rise,the difference had statistical significance(P<0.05).The detection rate of group B was higher than that of group A(P<0.001).The male to female ratio was 1.53:1.This ratio in group B was lower than that in group A(P<0.05).Average age of onset in patients with IM was(56.92±11.82)years old.The mean age of men was older than that of women(P<0.001).The average age of group A was less than that of group B(P<0.05).By age group,Composition ratio of each age group in the overall patients with IM and the patients with IM in groups A and B were that young patients had the lowest proportion,followed by elderly patients,and middle-aged patients had the largest proportion.The proportion of middle-aged and elderly groups was on the rise,while that of young groups was on the decline(P<0.001).The lesions of IM were mainly located in gastric antrum,gastric horn and gastric body.2.3 A total of 9642 patients with LGIN were detected,and the detection rate was 0.57%.The male to female ratio was 2.40:1 and the mean age of onset in patients with LGIN was(56.56 ± 11.99)years old.The difference in detection rate,male to female ratio,composition ratio of each age group and average age between group A and group B was no statistical difference(P>0.05).There was no significant difference in average age of onset between males and females(P>0.05).Composition ratio of each age group in the overall patients with LGIN and the patients with LGIN in groups A and B were that young patients had the lowest proportion,followed by elderly patients and middle-aged patients had the largest proportion.The lesions of LGIN mainly distributed in gastric antrum,gastric Angle and gastric body.2.4 A total of 389 patients with HGIN were detected,and the detection rate was 0.18%.The detection rate of group B was higher than that of group A(P<0.05).Mean age of onset in patients with HGIN was(64.54±10.83)years old and the male to female ratio was 3.23:1.The difference in average age,constituent ratio of each age group and male to female ratio between group A and group B was no statistical difference(P>0.05).The average age of men was higher than that of women(P<0.05).The overall patients with HGIN and the patients with HGIN in groups A and B were mainly elderly patients,followed by middle-aged patients,the proportion of young patients was the lowest.The lesions of HGIN were mainly located in gastric antrum,gastric horn,gastric body and cardia.2.5 A total of 1446 patients with GC were detected,and the detection rate was 0.66%.There was no statistical difference in the detection rate between group A and group B(P> 0.05).Conclusion:1.Analysis of epidemiological characteristics of gastric cancer in northwest SichuanIn this region,gastric cancer lesions are mainly located in the cardia,followed by gastric antrum and gastric body.The main pathological type was adenocarcinoma(97.73%),followed by squamous carcinoma(2.00%)and adenosquamous carcinoma(0.27%).More men than women were diagnosed with stomach cancer,with a male to female ratio of 3.33 to 1.The majority of GC patients were aged 60 or older,and(60-69)years old group was the most,followed by(70-79)years old,and patients(< 40)years old were the least.The onset age of GC was on the rise and the average age was younger in female than in man.2.Analysis of characteristics of gastric cancer,precancerous state and precancerous lesions detected by gastroscopic biopsy in northwest Sichuan1)In this region,the detection rates of gastric mucosal atrophy and intestinal metaplasia under gastroscopy were 5.2% and 4.41%,respectively,showing an upward trend.The detection rate of low grade intraepithelial neoplasia,high grade intraepithelial neoplasia and gastric cancer under gastroscopy were 0.57%,0.18% and 0.66%,respectively.The detection rate of high grade intraepithelial neoplasia showed a slight upward trend.Precancerous state and precancerous lesions mainly involved gastric antrum,gastric horn and gastric body.2)In this region,the proportion of female patients was lower than that of male patients in precancerous state and precancerous lesions.The male to female ratio was on the rise in patients with precancerous state.The onset age of patients with precancerous state and precancerous lesions showed an aging trend.The majority of patients with high grade intraepithelial neoplasia were at least 60 years old.The onset age of patients with precancerous state and low grade intraepithelial neoplasia was mostly between 40 and 60 years old.The mean age of onset in patients with precancerous state and high grade intraepithelial neoplasia was older than that of female patients. |
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