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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

34

期数:

2017年7

页码:

570-573

栏目:

临床研究

出版日期:

2017-07-05

文章信息/Info

Title:

Classification and distribution of clinical symptoms for esophageal cancer by age and gender

作者:

鲍启德¹; 张长江¹; 刘　敏¹; 张海鹏¹; 周利霞¹; 宋　昕²; 刘军清¹; 赵学科²; 孙李凌¹; 陈培楠²; 崔月龙¹; 杜丹凤2; 张向阳2; 王立东2

（1.安阳地区医院肿瘤科，河南　安阳　455000；2.郑州大学第一附属医院　河南省食管癌重点开放实验室，河南　郑州　450052）

Author(s):

BAO Qi-de¹; ZHANG Chang-jiang¹; LIU Min¹; ZHANG Hai-peng¹; ZHOU Li-xia¹; SONG Xin²; LIU Jun-qing¹; ZHAO Xue-ke²; SUN Li-ling¹; CHEN Pei-nan²; CUI Yue-long¹; DU Dan-feng²; ZHANG Xiang-yang²; WANG Li-dong²

（1.Department of Oncology，Anyang District Hospital of Henan Province，Anyang 455000，Henan Province，China；2.Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，Henan Province，China）

关键词:

食管癌; 临床症状; 年龄; 性别; 延迟诊断和治疗时间

Keywords:

esophageal cancer; clinical symptom; age; gender; delayed diagnosis and treatment time

分类号:

R735.1

DOI:

10.7683/xxyxyxb.2017.07.004

文献标志码:

A

摘要:

目的　分析食管癌常见临床症状种类及其在年龄和性别中的分布特征，确定症状出现到诊断和首次治疗时间（延迟诊断和治疗时间），为进一步阐明临床症状对食管癌早期预警和预后的影响提供重要信息。方法　本组18 996例食管癌手术患者的临床信息资料均来自郑州大学第一附属医院河南省食管癌重点开放实验室50万例食管癌和贲门癌临床信息数据库，平均诊断年龄（59.32±8.68）岁。根据患者主诉进行症状分类，并根据常用医学术语进行规范，归纳症状类型和出现频率。记录每例患者主要症状距首次治疗的间隔时间，并将这一间隔时间定义为延迟诊断和治疗时间。症状出现频率统计采用百分比的方法，按照出现频率1%为界限，分为常见症状和少见症状。对4种最常见症状的性别、年龄分布的差异性采用列联表χ²检验进行比较分析；对发病年龄、延迟诊断和治疗时间采用描述性统计方法分析比较平均数。结果　18 996例食管癌患者中，共出现292种不同症状；对这些症状进行医学术语规范和归类共归纳出44种临床症状。在归纳出的44种症状中，最常见的症状是吞咽哽噎（87.29%），其次为吞咽疼痛（5.10%）、腹部不适（3.36%）和胸骨后不适（1.48%），这4种症状占所有症状的97.23%。吞咽哽噎、吞咽疼痛、腹部不适、胸骨后不适症状的食管癌患者平均诊断年龄分别为（59.33±8.74）、（58.38±8.36）、（60.45±8.38）、（58.03±8.01）岁。男性和女性患者均以这4种症状为主，分布相似（χ²=2.68，P=0.44）。<60岁男性患者出现吞咽疼痛和胸骨后不适的频率明显高于≥60岁男性患者（χ²=13.37，P<0.05）；<60岁女性患者出现吞咽疼痛和胸骨后不适的频率明显高于≥60岁女性患者，出现腹部不适症状频率明显低于≥60岁女性患者（χ²=11.17，P<0.05）。腹部不适和吞咽疼痛患者的延迟诊断和治疗中位时间（30 d）明显短于吞咽哽噎和胸骨后不适患者（60 d）。结论　吞咽哽噎、吞咽疼痛、腹部不适、胸骨后不适是食管癌的代表性症状，男性和女性分布相似；年轻患者胸骨后不适症状频率较高，而老年人腹部不适症状明显。腹部不适和吞咽疼痛的患者延迟诊断和治疗的时间明显低于吞咽哽噎和胸骨后不适的患者，为进一步阐明临床症状对食管癌早期预警和预后的影响提供了基础。

Abstract:

Objective　To characterize the common clinical symptoms of esophageal cancer and their distributions by age and gender on esophageal cancer patients，to determine the delayed time for diagnosis and treatment，and to provide important information for further elucidating the role of the clinical symptoms in early alarm and prognosis for esophageal cancer.Methods　The clinical information of 18 996 esophageal cancer patients was derived from the clinical databases of 500 000 esophageal and gastric cardia carcinomas of the Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital of Zhengzhou University with an average age of （59.32±8.68）years.Based on the chief complaint，the clinical symptoms were classified and standardized using medical terms.The type and frequency of symptoms were calculated based on the standardized symptoms.The time of symptom occurrence and the first diagnosis and treatment were recorded to define the interval between the main symptoms and the first treatment as the delayed diagnosis and treatment time.The frequency of symptom occurrence was measured by percentage and divided into common symptoms and rare symptoms according to frequency 1%.The difference of gender and age distribution between the four kinds of common symptoms was analyzed by contingency table χ² test.The diagnosis age，delayed diagnosis and treatment time were analyzed by descriptive statistics，and the average number was compared.Results　A total of 292 different clinical symptoms were classified from the 18 996 esophageal cancer patients.After standardization by medical terms，44 kinds of symptoms were finally classified for final analysis.Statistical analysis showed that the most common symptom for esophageal cancer was dysphagia （87.29%），followed by swallowing pain （5.10%），abdominal discomfort （3.36%） and retrosternal discomfort （1.48%）.These four kinds of symptom accounted for 97.23% of the total 44 kinds of symptoms.The average diagnostic age at diagnosis of four symptoms：dysphagia，swallowing pain，abdominal discomfort，retrosternal discomfort symptoms in patients with esophageal cancer was （59.33±8.74），（58.38±8.36），（60.45±8.38），（58.03±8.01） years old respectively.The distribution by gender showed that the distribution for common four kinds of symptoms was very similar in male and females （χ²=2.68，P=0.44）.The distribution by age showed that the frequency of dysphagia and retrosternal discomfort in young male patients （<60 years） was apparently higher than that in old patients （≥60 years） （χ²=13.37，P<0.05）.The similar results were observed in female patients；Interestingly，the frequency of abdominal discomfort in old female patients （≥60 years） was higher than that in young patients （χ²=11.17,P<0.05）.The median time for delayed diagnosis and treatment in those patients with abdominal discomfort and swallowing pain was apparently shorter than that in patients with dysphagia and retrosternal discomfort （median time：30 vs 60 days）.Conclusion　Dysphagia，swallowing pain，abdominal discomfort and retrosternal discomfort were typical symptoms of esophageal cancer；the distribution in male and female is similar.Retrosternal discomfort in young patients was apparently higher，abdominal discomfort in old patients was obvious.The delayed diagnosis and treatment time was significantly short in the patients with abdominal discomfort and swallowing pain than that in the patients with dysphagia and retrosternal discomfort.These findings shed light on further analysis for the role of clinical symptom in early alarm and prognosis for esophageal cancer.

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更新日期/Last Update: 2022-03-30