食管癌高发区高危人群食管癌筛查研究

目的通过内镜筛查了解食管癌高发区高危人群食管各级病变及食管癌的患病情况,为病因学研究提供科学依据。方法从2006～2011年在食管癌高发区四川省盐亭县,采取整群随机抽样的方法选择97个自然村作为筛查对象,对40～69岁的高危人群采取内镜下碘染色及指示性活检进技术行筛查,并经病理学诊断确诊。结果轻、中、重度食管增生的检出率分别为5.33%(803/15 065)、1.28%(193/15 065)、0.68%(102/15 065),原位癌、黏膜内癌、浸润性癌的检出率分别为0.15%(22/15 065)、0.06%(9/15 065)、0.29%(43/15 065);食管增生男性检出率高于女性;65岁之前轻、中、重度食管增生及浸润性癌的检出率随着年龄的增长而增加;时间分布上,轻、中、重度食管增生的检出率在不同年份之间差异具有统计学意义(P<0.01)。结论依托国家食管癌筛查项目,在食管癌高发区对高危人群进行癌症综合知识宣传,提高防癌意识,是保证早诊早治工作可持续发展的关键。

Screening of High-Risk Group with Esophageal Cancer in High Incidence Area

Objective To study the prevalence of esophageal and various lesions of esophagus in high risk areas with screening,in order to provide scientific evidence for etiological study.Methods Take random cluster sampling method to select 97 natural villages as a screening object in high risk areas from 2006 to 2011,endoscope iodine staining and index biopsy screening method was used for 40-69 old high risk people,and the diagnosis was confirmed by the pathology.Results Mild esophageal hyperplasia,moderate esophageal hyperplasia,severe esophageal hyperplasia detection rate respectively was 5.33%(803/15 065),1.28%(193/15 065),and 0.68%(102/15 065);carcinoma in situ,intramucosal carcinoma,invasive cancer detection rate was 0.15%(22/15 065),0.06%(9/15 065),and 0.29%(43/15 065).Male esophageal hyperplasia of the detection rate was higher than the female.Before the age of 65,mild esophageal hyperplasia,moderate esophageal hyperplasia,severe esophageal hyperplasia and invasive cancer detection rates increased with age.Time distribution of mild esophageal hyperplasia,moderate esophageal hyperplasia,severe esophageal hyperplasia detection rate in different years had statistical difference(P<0.001).Conclusion Relying on esophageal cancer screening program,raising cancer awareness,comprehensive cancer propaganda of high-risk groups in high incidence area were the key to make early diagnosis and early treatment work to sustainable development.