Effect of repeated endoscopic screening on the incidence and treatment of gastric cancer in health screenees
Effect of repeated endoscopic screening on the incidence and treatment of gastric cancer in health screenees
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DOI：
10.1097/meg.0b013e328318ed42
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发表时间：
2009-08-01
影响因子：
2.1
通讯作者：
Kim, Young-Woo
中科院分区：
文献类型：
--
作者：
Nam, Su Youn;Choi, Il Ju;Kim, Young-Woo
目的 早期胃癌（EGC）可通过微创内镜切除术治疗，且预后良好。本研究的目的是探讨重复食管胃十二指肠镜（EGD）筛查是否是检测可通过内镜切除术治疗的EGC的有效方法。方法对于韩国国家癌症中心筛查计划中诊断为胃癌的患者，根据诊断前2年内是否（重复筛查组）或未（不频繁筛查组）接受EGD筛查，分析胃癌的发病率、临床病理特征和治疗方式。 18414名接受EGD的患者中，81名（0.44%）被发现患有胃癌。重复筛查组胃癌发病率低于不频繁筛查组（多重调整比值比=0.45，95%置信区间：0.26-0.77，P=0.004）。重复筛查组 EGC 比例为 96%（26 例中 25 例），不频繁筛查组 EGC 比例为 71%（48 例中 34 例）（P=0.01）。前者的肿瘤平均尺寸（SD）较小[1.9（1.2）vs. 3.0（1.6）cm，P=0.01]，粘膜内癌比例较高[81%（26例中的21例）vs. 50%（48例中的24例），P=0.02]。重复筛查组内镜切除的频率更高[54%（26人中的14人）vs. 23%（48人中的11人），P=0.007]。结论 2年内重复内镜筛查降低了胃癌的发生率，内镜切除术可应用于更多2年内接受EGD筛查的患者。 Eur J Gastroenterol Hepatol 21:855-860 (C) 2009 Wolters Kluwer Health 垂直条 Lippincott Williams & Wilkins。
Objectives Early gastric cancer (EGC) can be treated by minimally invasive endoscopic resection and has an excellent prognosis. The aim of this study was to investigate whether repeated esophagogastroduodenoscopy (EGD) screening is an effective method for detecting EGC that can be treated by endoscopic resection.Methods For patients diagnosed with gastric cancer in the Korean National Cancer Center screening program, we analyzed the incidence of gastric cancer, clinicopathological characteristics, and treatment modality according to whether they had (repeated screening group) or not (infrequent screening group) undergone EGD screening within 2 years before diagnosis.Results Of the 18414 patients who underwent EGD, 81 (0.44%) were found to have gastric cancer. Incidence of gastric cancer in repeated screening group was lower than that of infrequent screening group (multiple adjusted odds ratio=0.45, 95% confidence interval: 0.26-0.77, P=0.004). The proportion of EGCs was 96% (25 of 26) n the repeated screening group and 71% (34 of 48) in the infrequent screening group (P=0.01). Mean (SD) tumor size was smaller [1.9 (1.2) vs. 3.0 (1.6) cm, P=0.01] and the proportion of intramucosal cancer was higher [81% (21 of 26) vs. 50% (24 of 48), P=0.02] in the former than in the latter. Endoscopic resection was performed more frequently in the repeated screening group [54% (14 of 26) vs. 23% (11 of 48), P=0.007].Conclusion Repeated endoscopic screening within 2 years decreased the incidence of gastric cancer and endoscopic resection could be applied to more patients who underwent EGD screening within 2 years. Eur J Gastroenterol Hepatol 21:855-860 (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.