To analyze the clinical, endoscopic, and histological features of gastric cancer in Tibet.

A total of 367 cases of gastric cancer diagnosed by endoscopy at Fukang Hospital Affiliated to Xizang University from October 2018 to September 2020 were included retrospectively. Sex, age, nationality, occupation, Helicobacter pylori (H. pylori) infection status, tumor distribution, endoscopic classification, and histological classification were analyzed.

The total detection rate of gastric cancer was 3.4%, and the detection rate of early gastric cancer was 0.06%. The total detection rates of gastric cancer among men and women were 3.6% and 2.8%, respectively (P＜0.05). There were 59.4% middle-aged people, 36.2% elderly people, and 4.4% young people, and the detection rates of gastric cancer in the three age groups were 0.5%, 4.8%, and 4.7%, respectively (P＜0.05). There was no significant difference in the detection rate among different nationalities and occupations (P＞0.05). The positive rate of H. pylori infection in patients with gastric cancer (81.4%) was higher than that in patients without (66.3%; P＜0.05). The antral pylorus was the most commonly affected site in both genders, followed by the gastric body, cardia, gastric fundus, gastric angle, and whole stomach in males, and the gastric angle, gastric body, cardiac fundus, and whole stomach in females (P＜0.05). The proportion of patients with involvement of the cardia and gastric fundus was higher in males than in females, while the proportion of patients with involvement of the gastric angle was higher in females than in males (P＜0.05). More than half of cases were classified as having Borrmann type Ⅲ, which was followed by type Ⅳ, type Ⅰ, and type Ⅱ. There was no significant difference between in Borrmann type distribution between males and females (P＞0.05). Histologically, papillary adenocarcinoma, tubular adenocarcinoma, mucinous adenocarcinoma, and adenocarcinoma accounted for 96.1% of all cases, Signet ring cell carcinoma accounted for 3.3%, and adenosquamous carcinoma and undifferentiated carcinoma accounted for 0.3% each. The vast majority of patients had poorly differentiated tumors.

Gastric cancer in Tibet usually occurs in the antral pylorus, is endoscopically mainly infiltrating and ulcerative types, and has poor differentiation, advanced clinical stage, and low detection rate. The prevention and treatment measures of gastric cancer in Tibet should be further strengthened.