| Objective:Gastric cancer is one of the most common malignant tumor[1,2].. According to the different site, gastric cancer could be classified as:cardia cancer, gastric fundus cancer, gastric corpus cancer, gastric antrum cancer and mixed type cancer. The traditional idea thinks that the gastric antrum cancer is the most common site of gastric cancer[3,4]. But recent studies show that the type and site of gastric cancer were changing in recent decades of the population of Europe and the United States[5], the composition of gastric cardia cancer in gastric cancer seems to have an increasing trend[6,7,8].For a long time, clinicians believe that distal gastric cancer is closely related to Hp infection (either intestinal type or diffuse type), and Hp infection does not cause the increasing incidence of gastric cardia cancer[9]. At present, most research find Hp infection is more closely related to intestinal type gastric cancer. And there is no research report about the relationship between Hp infection and Borrmann typing.Therefore, understanding the factors associated with the causes and pathological features of gastric cancer in different sites, could improve people's understanding of gastric cancer in different sites. It also can provide evidences for the follow-up study of gastric cancer.Methods:This study selects 704 cases of gastric cancer patients underwent surgical resection and confirmed by pathology in Zhongda Hospital from January 2005 to December 2015. And compares the clinical and pathological characteristics of gastric cancer patients between different sex and age groups in order to reflect the clinical and pathological characteristics of patients with different gender and age. According to the different site.gastric cancer could be classified as: cardia cancer, gastric fundus cancer, gastric corpus cancer, gastric antrum cancer and mixed type cancer. We analysis and discuss the relationship between gastric cancer from different anatomical sites and sex, age, family history (gastric cancer, esophageal cancer), smoking, drinking, Hp infection, body mass index (BMI), Lauren type, Borrmann type, histological type, degree of differentiation, TNM staging, size, distant metastasis. Using SPSS 19 statistical software package for data descriptive analysis, correlation test by chi-square test, the level of significance for a: 0.05.Results:According to clinical data, we find:1. The ratio of male to female is about 2.1:1, and the incidence of male in different parts is more than that in female.(P=0.002< 0.05).2.In several different parts of gastric cancer, gastric cardia cancer patients accounted for 30.5% of the total. The incidence of cardiac cancer of less than 50 year old age group (40.7%) is higher than up 50 year old age group (37.3%). And in recent 11 years, the composition of gastric cardia cancer in gastric cancer seems to have an increasing trend.3.Smoking (P=0.002< 0.05), drinking (P=0.01< 0.05) will increase the incidence of gastric cancer, they are also the main factors of gastric cardia cancer.A.Hp infection can increase the risk of gastric cancer, but does not increase the risk of gastric cardia cancer (P=0.000< 0.05). There was no significant difference between Hp infection and Lauren typing (P=0.06> 0.05). In Hp positive group, the proportion of Borrmann type ? was highest,52%, followed by Borrmann type ? (39.2%), Hp infection was closely related to Borrmann type ? gastric cancer (P=0.001<0.05).5. The incidence of gastric cancer family history was about 1.85%, and the proportion of gastric antrum cancer with family history was significantly higher than other parts (P=0.03<0.05).6. In low BMI group, gastric antrum cancer incidence rate (40%) was the highest; in BMI normal group, gastric cardia cancer incidence rate was the highest (29.1%), and than the gastric corpus cancer (27.1%), gastric antrum cancer (26.5%); in high BMI groups, cardia cancer incidence rate was the highest(45%). The incidence of gastric cardia cancer was higher in obese patients (P=0.01< 0.05).7. The diameter of cardia cance and gastric fundus cancer are less than gastric corpus cancer and gastric antrum cancer (P=0.02< 0.05).8. Low differentiated adenocarcinoma accounts for the highest proportion in gastric corpus cancer and mixed type cancer; and the mid differentiated adenocarcinoma accounts for the highest proportion in cardia cancer and gastric antrum cancer(P=0.01< 0.05).9. TNM stage:stage ? and ? accounts for the vast proportion in cardia and gastric fundus cancer, but stage IV occurred rate was significantly lower than that of other parts, stage ? incidence was significantly higher in mixed type cancer than that in other sites; the stage ? occurred rate in gastric corpus cancer and gastric antrum cancer was significantly higher than that of other sites (P =0.02< 0.05).Gastric cancer with lymph node metastasis was about 67.3%, the transfer rate of mixed type was the highest(84.1%) (P=0.01< 0.05).Conclusion:1. in the past 11 years, the composition of cardiac cancer is rising and then constant, cardiac cancer is common in male patients under 50 years of age.2. Helicobacter pylori (Hp) infection is associated with the incidence of gastric antrum cancer, obesity, smoking and alcohol consumption are related to the incidence of gastric cardia cancer.3. There was no significant difference between Hp infection and Lauren typing, but Hp infection was close with Borrmann type ? gastric cancer.4. The length diameter of cardia gastric cancer tumor is generally shorter than other parts, and the TNM staging often earlier.5. Under 50 years old group of familial gastric cancer incidence rate is higher than that of the up 50 years old, and the proportion of gastric antrum cancer with family history was significantly higher than other parts. |
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