食管及贲门癌前病变自然史内镜筛查分析

目的：了解食管和贲门癌前病变进展较快者的滞留时间，为寻找合适的筛查间隔提供线索。方法：在涉县对40～69岁人群开展重复的内镜筛查。结果：8例重度不典型增生者中从首栓为正常间隔13个月检出1例．从首捡为基底细胞增生间隔7个月检出1例，从首检为轻度不典型增生分别间隔3～10．5个月检出4例。从首检为中度不典型增生分别间隔12．5、43．4个月检出2例；8例原位癌或黏膜内癌中由首检为基底细胞增生分别间隔18和51．7个月检出2例，由首栓为轻度不典型增生间隔48个月检出1例，由首检为中度不典型增生分别间隔4、13个月检出2例，由首检为重度不典型增生分别间隔3．5-17．5个月检出3例：4例浸润性癌中由轻度不典型增生间隔13个月栓出1例，由中度不典型增生间隔50个月检出1例，由重度不典型增生间隔14和19个月栓出2例。结论：首检过后对基底细胞增生和轻度不典型增生应间隔一年复查一次，对中度不典型增生应半年内复查一次。以防止其中进展较快者发展为癌。

Analysis of Endoscopic Screening for the Natural History of Precancerous Lesions in Esophagus and Cardia

Objective:To investigate the developmental period of atypical hyperplasia in patients with a rapid progression of precancerous esophageal and cardiac lesions in order to provide clues for establishing a suitable screening interval. Methods:Periodic endoscopic screening was performed for the population aged 40 to 69 years old in Shexian county. Results:In 8 cases of severe atypical hyperplasia (SAH), one case had a normal result at the initial test (IT) with a 13-month interval (i.e. the time between examinations), one case had basal cell hyperplasia (BCH) at the IT with a 7-month interval, 4 cases had slight atypical hyperplasia (SAH) at the IT with a 3 to 10.5-month interval and 2 cases had moderate atypical hyperplasia (MAH) at the IT with a 12.5 to 43.4-month interval. In 8 cases of cancer in situ or intramucosal carcinoma, 2 cases had BCH at the IT with an 18 to 51.7-month interval, 1 case had SAH at the IT with a 48-month interval, 2 cases had MAH at the IT with a 4 to 13-month interval and 3 cases had SAH at the IT with a 3.5 to 17.5-month interval. In 4 cases of invasive carcinoma, 1 case had SAH at the IT with a 13-month interval, 1 case had MAH at the IT with a 50-month interval and 2 cases had SAH at the IT with a 14 to 19-month interval. Conclusion:After the initial tests, the interval between reexaminations should be once a year for BCH and SAH and once every 6 months for MAH in order to prevent rapid development to more advanced stages.