上消化道癌诊断和发病的影响因素分析

Analysis of factors affecting diagnosis and morbidity of upper gastrointestinal cancer

摘要:

目的 分析上消化道癌诊断和发病的影响因素。方法 收集2020年1月－2022年1月该院行上消化道内镜检查的患者17 830例，结合问卷调查和病理学检查，分析上消化道癌诊断和发病的影响因素。结果 发现食管癌、贲门癌和胃癌分别为88、33和119例。其中，早期食管癌57例，早期贲门癌27例，早期胃癌91例。分为观察组和对照组，观察组（n = 240）为上消化道癌阳性患者，对照组（n = 17 590）为上消化道癌阴性患者。单因素分析结果提示：两组患者在文化程度、饮酒、腌制食品、萎缩性胃炎、低级别上皮内瘤变、无痛胃镜、标准胃镜彩图和焦虑方面比较，差异均有统计学意义（P < 0.05）。多因素非条件Logistic回归分析和倾向评分匹配表明：饮酒、萎缩性胃炎、腌制食物、上皮内瘤变和焦虑，是影响上消化道癌诊断和发病的危险因素。结论 饮酒、萎缩性胃炎、腌制食物、上皮内瘤变和焦虑，是影响上消化道癌诊断和发病的危险因素，进行健康教育，调整饮食结构和生活方式，提升早癌筛查意识，可控制上消化道癌诊断和发病的危险因素。

Abstract:

Objective To analyze the factors affecting diagnosis and morbidity of upper gastrointestinal cancer.Methods Clinical data of 17 830 patients who were performed with upper gastrointestinal endoscopy between January 2020 and January 2022 was collected. Combined with questionnaire and pathological examination, the diagnosis and morbidity of upper gastrointestinal cancer was analyzed.Results There were 88, 33 and 119 cases of carcinoma of esophagus, cardia and stomach respectively. Among them, 57, 27 and 91 cases of early carcinoma of esophagus, cardia and stomach were found. They were divided into the observation group (240 cases) and control group (17 590 cases). Univariate analysis showed significant differences between the two groups in education, drinking, pickled food, atrophic gastritis, intraepithelial neoplasia, painless gastroscopy, standard gastroscopy, and anxiety. Multivariate unconditional Logistic regression analysis and propensity score matching showed that drinking, atrophic gastritis, pickled food, intraepithelial neoplasia and anxiety were risk factors influencing the diagnosis and morbidity of upper gastrointestinal cancer.Conclusion Drinking, atrophic gastritis, pickled food, intraepithelial neoplasia and anxiety are risk factors influencing the diagnosis and morbidity of upper gastrointestinal cancer. Adjust the diet and life style, enhance the awareness of early cancer screening, can control the risk factors influencing the diagnosis and morbidity of upper gastrointestinal cancer.