Analysis of clinicopathological features and pattern changes of early gastric cancer

doi:10.3969/.issn.1674-3245.2018.02.003

Abstract：Objective To analyze the clinicopathological features and pattern changes of 1025 cases of early gastric cancer in the past 16 years and to provide a reference for population study of early gastric cancer. Methods All relevant data from early gastric cancer patients from 2001 to 2016 were collected from the affiliated Qingdao Municipal Hospital of Medical College of Qingdao University for retrospective analysis of the clinical pathological characteristics. The Chi square test was used to analyze the relationship among different demographic factors,different ages and clinicopathological characteristics. Results In 166260 gastroscopy patients,there was detection of gastric cancer in 4846 cases(detection rate of 2.91%). Early gastric cancer was detected in 0.62%. Early gastric cancer accounted for 21.2% of all gastric cancer.The detection rate in males was higher than that in females(0.78% vs 0.44%;χ2=78.924,P < 0.001). The age distribution of the early detection rate of gastric cancer in those aged < 40 years,40 ~ 49 years,50 ~ 59 years old,and 60 and above was 0.20%,0.48%,0.60%,and 0.92%,respectively. With increasing age,the detection rate of early gastric cancer was significantly increased(χ2trend =191.635,P < 0.001). The clinical and pathological features of distribution were as follows: maximum tumor diameter less than 2 cm accounted for 64.20%; the good parts were in the gastric antrum(48%),(30.73%)and gastric cardia/stomach(21.27%);tumor infiltrating the mucosa was seen in 638 cases(62.24%),vascular invasion in 44 cases(4.29%),99 cases of nerve invasion(9.66%)and lymph node metastasis in 174 cases(16.98%).There were 611 cases of differentiated type(59.61%),and 467 cases with ulcer(45.56%). Tumor markers were positive in 182 cases(17.16%). Helicobacter pylori was positive in 127 cases(12.96%). In the past 16 years,the detection rate of early gastric cancer increased yearly. Analysis of the change in the trend that was less than or equal to 2 cm involved a small number of detected cases of gastric cancer,and the constituent ratio increased yearly,and especially after 10s,it increased significantly(P<0.001).The detection rate of mucosal cancer increased yearly(P=0.007). No lymph node metastasis was detected in early gastric cancer,and the number of detected cases and constituent ratio increased yearly(P=0.003). Conclusion The early gastric cancer detection rate increased yearly,especially for tumors less than 2 cm in diameter,gastric intramucosal carcinoma,and for cancer without lymph node metastasis.