河南贲门癌高、低发区人群贲门粘膜组织活检结果分析

目的：通过贲门癌高、低发区1975例无症状居民普查，进一步了解贲门上皮病变的特征及其与性别、年龄的关系，加深对贲门癌变多阶段演进的形态学变化特征的了解。方法：对食管癌高发区1006无症状居民，低发区208无症状居民进行纷纷内镜检查、粘膜活检和组织病理检查。结果：高发区1006例活检标本中，共发现9例早期贲门腺癌患者（GCA，0．9％），33例间变患者（DYS，3．3％），102例慢性萎缩性贲门炎患者（CAG，10．1％）和269例慢性浅表性贲门炎患者（CSG，26．7％），以及593例正常贲门上皮（NOR，58．9％）。9例早期GCA均发生在男性，间变患者男性明显高于女性；低发区：208例普查对象中，未发现早期GCA，但发现2例DYS（1．0％），7例CAG（3．4％），118例CSG（56．7％）和81例正常贲门上皮（38．9％）。男性CAG较女性常见，2例DYS中，男女各1例。结论：贲门癌高发区居民GCA、DYS、CAG的发现率明显高于低发区，进一步证实贲门癌的地域性分布特征，提示DYS和CAG是贲门癌重要的癌前病变。

Analysis on prevalence of gastric cardia precancerous lesions and early gastric cardia adenocarcinoma from the symptom-free subjects at high and low-incidence area in Henan

Aim: To characterize the prevalence of gastric cardia lesions, to correlate these lesions with sex and age through mass survey on 1 975 symptom free subjects from the high and low incidence area and to expand the knowledge on morphological changes in multistage carcinogenesis of gastric cardia adenocarcinoma (GCA). Methods: Endoscopy, mucosal biopsy and histopathology were applied.Results: In high incidence area, of the 1006 biopsy samples examined, 9 cases were identified as early GCA (0.9%),33 cases,as dysplaisa(DYS,3.3%),102 cases,as chronic atrophic gastritis(CAG,10.1%), 269 cases,as chronic superficial gastritis(CSG, 26.7%), and 593 cases,as normal(NOR, 58.9%). The detection rates of DYS were higher in males than in females;In low incidence area, of the 208 biopsy samples examined, no early GCA was identified. But 2 cases were identified as DYS(1.0%),one in male, the other in female.seven cases were identified as CAG(3.4%), 118 cases as CSG(56.7%)and 81 cases as normal(38.9%).Conclusion:The results confirm the dramatic geographic distribution of GCA, and suggest that DYS and CAG may be the severe precancerous lesions of GCA.