目的 探索不同亚型早期食管胃结合部腺癌(AEG)和癌前病变发病的危险因素.方法 选择2018年1月至2023年1月期间于晋城市人民医院接受胃镜检查并经病理确诊的128例早期AEG和癌前病变患者作为研究组,同期128名健康体检者作为对照组,根据Siewert分型将早期AEG和癌前病变患者分为Ⅱ型和Ⅲ型两个亚型,分析不同亚型早期AEG和癌前病变发病的独立危险因素.结果 早期AEG和癌前病变患者发病的平均年龄为65.68岁,男女性别比例为 5.1∶1.萎缩/肠化(OR=8.89,95%CI 4.85~16.29)和肿瘤家族史(OR=5.07,95%CI 1.70~15.15)是早期AEG和癌前病变发病的独立危险因素(P<0.05);萎缩/肠化和肿瘤家族史是Ⅱ型和Ⅲ型早期AEG和癌前病变发病共同的独立危险因素(P<0.05).结论 老年男性、存在萎缩/肠化以及肿瘤家族史的个体更容易患早期AEG和癌前病变;Ⅱ型和Ⅲ型早期AEG和癌前病变患者的发病危险因素无差异;早期AEG患者与癌前病变患者发病危险因素无差异.
Objective To explore the risk factors for the occurrence of different subtypes of early-stage adenocarci-noma of the esophagogastric junction(AEG)and precancerous lesions.Methods A total of 128 patients diagnosed with early-stage AEG and precancerous lesions,confirmed through gastroscopy and pathology,between January 2018 and January 2023 at Jincheng City People's Hospital were selected as the study group.A control group of 128 healthy indi-viduals who underwent physical examinations during the same period was included.The early-stage AEG and precancer-ous lesion patients were classified into two subtypes,namely type Ⅱ and type Ⅲ,according to the Siewert classification.Independent risk factors for the occurrence of different subtypes of early-stage AEG and precancerous lesions were ana-lyzed.Results The average age of patients with early-stage AEG and precancerous lesions was 65.68 years,with a male-to-female ratio of 5.1:1.Atrophy/intestinal metaplasia(OR=8.89,95%CI 4.85~16.29)and family history of tumors(OR=5.07,95%CI 1.70~15.15)were identified as independent risk factors for the occurrence of early-stage AEG and precancerous lesions(P<0.05).Atrophy/intestinal metaplasia and family history of tumors were identified as common independent risk factors for the occurrence of type Ⅱ and type Ⅲ early-stage AEG and precancerous lesions(P<0.0 5).Conclusion Elderly males with atrophy/intestinal metaplasia and a family history of tumors are more sus-ceptible to early-stage AEG and precancerous lesions.There is no difference in the risk factors for the occurrence of typeⅡ and type Ⅲ early-stage AEG and precancerous lesions.Additionally,there is no difference in the risk factors for the occurrence of early-stage AEG and precancerous lesions.