Prevalence and Clinicopathologic Characteristics of Gastric Cardia Cancer in South Korea
Prevalence and Clinicopathologic Characteristics of Gastric Cardia Cancer in South Korea
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DOI：
10.1111/j.1523-5378.2012.00958.x
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发表时间：
2012-10-01
期刊：
影响因子：
4.4
通讯作者：
Jung, Hyun Chae
中科院分区：
文献类型：
--
作者：
Kim, Ji Yeon;Lee, Hye Seung;Jung, Hyun Chae
背景与目的：西方报道表明贲门癌（GCC）的患病率不断增加，并指出贲门癌和非贲门癌（GNCC）之间存在一些差异。然而，在亚洲进行的研究却很少。本研究的目的是估计韩国 GCC 的患病率并评估 GCC 和 GNCC 之间临床病理特征的差异。方法：本研究为单中心病例对照研究。 2003 年至 2011 年间，共有 829 名胃癌患者和 270 名对照者入组。比较了三组（GCC、GNCC 和对照）的基线特征、幽门螺杆菌 (H. pylori) 感染状况和组织学特征。结果：60例（7.2%）胃癌位于贲门部。多变量分析显示，与对照组相比，男性比值比（OR，5.72；95% CI，1.7219.07；p = .005）和吸烟（OR，5.38；95% CI，1.3920.90；p = .015）是GCC的危险因素，但幽门螺杆菌感染率不显着。对于 GNCC，吸烟（OR，3.87；95% CI，1.818.29；p < .001）、既往饮酒（OR，2.82；95% CI，1.286.20；p = .010）、肠化生（OR，3.22；95% CI，2.005.17；p < .001) 和幽门螺杆菌感染 (OR, 3.06; 95% CI, 1.904.93; p < .001) 是 GNCC 的危险因素。 GNCC 中的胃食管反流病症状 (21.2%) 高于对照组 (13.5%) (p = .008)。然而，就 GCC 而言，GCC (12.7%) 和对照组之间相似 (p = .872)。根据多变量分析，幽门螺杆菌根除史（OR，0.34；95% CI，0.190.61；p < .001）与 GNCC 的保护作用相关。 GCC 比 GNCC 具有更高的浸润深度 (p = .038) 和更频繁的远处转移 (p = .012)。结论：在这项基于转诊中心的研究中，韩国 GCC 的患病率为 7.2%。 GCC和GNCC的危险因素和临床病理特征不同，支持GCC和GNCC发展的病理生理学不同。
Background and Aim: Western reports have suggested that the prevalence of gastric cardia cancer (GCC) has been increasing, and indicated some differences between GCC and gastric noncardia cancer (GNCC). However, few studies have been conducted in Asia. The aims of this study were to estimate the prevalence of GCC and to evaluate differences of clinicopathologic characteristics between GCC and GNCC in South Korea. Methods: This study was single-center casecontrol study. A total of 829 patients with gastric cancer and 270 controls were enrolled between 2003 and 2011. Baseline characteristics, Helicobacter pylori (H. pylori) infection status, and histologic characteristics were compared among three groups (GCC, GNCC, and control). Results: Sixty cases (7.2%) of gastric cancer were located in cardia. Multivariate analysis showed that male odds ratio (OR, 5.72; 95% CI, 1.7219.07; p = .005) and cigarette smoking (OR, 5.38; 95% CI, 1.3920.90; p = .015) were risk factors of GCC in comparison with control group, but H. pylori infection rate was not significant. In the case of GNCC, cigarette smoking (OR, 3.87; 95% CI, 1.818.29; p < .001), past alcohol intake (OR, 2.82; 95% CI, 1.286.20; p = .010), intestinal metaplasia (OR, 3.22; 95% CI, 2.005.17; p < .001), and H. pylori infection (OR, 3.06; 95% CI, 1.904.93; p < .001) were risk factors of GNCC. Gastroesophageal reflux disease symptoms were higher in the GNCC (21.2%) than control group (13.5%) (p = .008). However, in the case of GCC, they were similar between the GCC (12.7%) and control group (p = .872). According to multivariate analysis, history of H. pylori eradication (OR, 0.34; 95% CI, 0.190.61; p < .001) was associated with a protective effect on GNCC. GCC showed higher depth of invasion (p = .038) and frequent distant metastasis (p = .012) than GNCC. Conclusion: In this referral center based study, the prevalence of GCC was 7.2% in South Korea. Risk factors and clinicopathologic characteristics for GCC and GNCC were different, supporting that the pathophysiology is different in the development of GCC and GNCC.