温登瑰, 单保恩, 张立玮, 邹文娣, 魏丽珍, 王士杰. 按食管贲门癌的原发部位对其中家族性癌比例的比较研究[J]. 中国肿瘤临床, 2012, 39(10): 687-691. DOI: 10.3969/j.issn.1000-8179.2012.10.016
引用本文: 温登瑰, 单保恩, 张立玮, 邹文娣, 魏丽珍, 王士杰. 按食管贲门癌的原发部位对其中家族性癌比例的比较研究[J]. 中国肿瘤临床, 2012, 39(10): 687-691. DOI: 10.3969/j.issn.1000-8179.2012.10.016
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Deng-gui WEN, Bao-en DAN, Li-wei ZHANG, Wen-di ZOU, Li-zhen WEI, Shi-jie WANG. Comparative Study on the Proportion of Familial Cancer in Esophageal and Gastric Cardia Carcinomas by the Site of Primary Cancer in a High-risk Region[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(10): 687-691. DOI: 10.3969/j.issn.1000-8179.2012.10.016
Citation: Deng-gui WEN, Bao-en DAN, Li-wei ZHANG, Wen-di ZOU, Li-zhen WEI, Shi-jie WANG. Comparative Study on the Proportion of Familial Cancer in Esophageal and Gastric Cardia Carcinomas by the Site of Primary Cancer in a High-risk Region[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(10): 687-691. DOI: 10.3969/j.issn.1000-8179.2012.10.016
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按食管贲门癌的原发部位对其中家族性癌比例的比较研究

Comparative Study on the Proportion of Familial Cancer in Esophageal and Gastric Cardia Carcinomas by the Site of Primary Cancer in a High-risk Region

    摘要
  • 摘要:
      目的  按食管贲门癌的原发部位对其中家族性癌所占的比例进行比较。
      方法  回顾性分析了7 267例手术病例的家族史、发病年龄、多原发癌发生率及性别比从食管上、中、下段的鳞癌到贲门腺癌的变化。
      结果  多原发食管贲门癌患者中家族史阳性的比例最高, 男女分别为42.1%和59.3%;单原发食管贲门癌患者中从食管上、中、下段的鳞癌再到贲门腺癌, 家族史阳性的比例逐渐下降, 男性分别为38.5%、26.3%、26.5%、11.2%(P < 0.001), 女性分别为25.0%、22.3%、23.9%、9.8%(P < 0.001);从食管上、中、下段的鳞癌再到贲门腺癌, 发病年龄逐渐推迟, 男性分别为49、52、55、56岁(P=0.002), 女性分别为50、53、55、56岁(P=0.004);上述部位别肿瘤的男女性别比逐渐增加, 分别为2.2、2.1、2.2和6.2比1(P < 0.001);另外上述部位别肿瘤中多原发癌的比例逐渐下降, 男性分别为21.2%、2.3%、2.2%、1.4%(P=0.02), 女性分别为14.3%、2.4%、3.4%、3.0%(P=0.04)。
      结论  从食管上、中、下段的鳞癌再到贲门腺癌, 家族性癌所占的比例逐渐减小, 本研究对进一步研究遗传易感性的分子基础及临床实践有提示意义。

     

    Abstract:
      Objective  This study aims to compare the proportion of familial carcinomas in esophageal and gastric cardia carcinomas by the site of the primary cancer in a high-risk region.
      Methods  Data from 7 267 consecutive esophageal and gastric cardia carcinoma patients who underwent surgery between 1970 and 1994 in the Department of Thoracic Surgery of The Fourth Hospital of the Hebei Medical University were collected to analyze changes in median age at diagnosis, family history, sex ratio, and the prevalence of multiple primary cancers(MPC), including squamous cell carcinoma(SCC) of the upper, middle, and lower third of the esophagus, and adenocarcinoma of the gastric cardia(gastrocardiac adenocarcinoma, GCA).
      Results  Patients with a positive family history ranked first in MPC cases, with 42.1%for males and 59.3%for females.The proportion of patients with a positive family history who had single primary cancers of the upper, middle, and lower third of the esophagus, and GCA was cut down to 38.5%.26.3%, 26.55%, and 11.2%in males(P = 0.000). and 25.0%, 22.3%, 23.9%, and 9.8%in females, respectively(P = 0.000).Moreover, the median age of onset for patients with cancers in the above mentioned sites was 49, 52, 55, and 56 years old in males, and 50, 53.55.and 56 years old in females(both P = 0.000), with a significant increase in the age of onset in both male and female patients(male: P = 0.002.female: P = 0.004).The sex ratio between the males and females increased site-specifically by 2.2.2.1, 2.2, and 6.2:1(P = 0.000).Based on the comparison of the ratio of MPCs among the cases in relation to SCC of the upper, middle, and lower third of the esophagus and GCA.the percentage also decreased to 21.2%, 2.3%, 2.2%, and 1.4%in males and 14.3%.2.4%, 3.4%, and 3.0%in females(male: P = 0.02.female: P = 0.04).
      Conclusion  These observations suggest that the proportion of familial cancers gradually decreased in patients with SCC of the upper, middle, and lower third of the esophagus and GCA in the high-risk region of Hebei province.This result has clinical significance and needs further molecular investigation.

     

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