食管癌高低发区人群食管粘膜组织病理学研究

目的探讨食管癌高、低发区人群食管粘膜上皮组织学改变，为癌前病变防治提供依据。方法高（林州市）、低发区（范县、清丰县）分别取无症状居民食管活检２２９人和１８７人，均分为４组，２５岁～３４岁、３５岁～４４岁、４５岁～５４岁及≥５５岁，常规石蜡ＨＥ制片，按标准诊断归类。结果高、低发区食管上皮萎缩、棘层肥厚、炎细胞浸润相应年龄组比较无显著差异，基底细胞增生高发区３５岁～４４岁、４５岁～５４岁组显著大于低发区相应组（Ｐ＝０．０３１２，Ｐ＝０．０２７３），非典型增生４５岁～５４岁、≥５５岁组高发区显著大于低发区相应组（Ｐ＝０．０１９６，Ｐ＝０．０２６３）。高、低发区总体人群比较除棘层肥厚、炎细胞浸润无差异外，余各病变间均有极显著差异（Ｐ＜０．０１）。结论食管上皮萎缩、基底细胞增生应作为较狭义的癌前病变对待，食管上皮棘层肥厚、炎细胞浸润似与食管癌变无关。

Histopathological study of esophageal mucosa of human group in high and low risk area of esophageal carcinoma

Objective To research the histological changes of esophageal mucosa and provide foundation for the prevention and cure of precancerous lesions in high and low risk populations for esopheal cancer.Method There were 229 and 187 esophageal biopsies available from asymptomatic residents in high and low risk areas (LinZhou city and Fanxian,Qingfeng).These subjects were classified into 25～34,35～44,45～54and over 55 years groups respectively,in routine paraffin and HE section,according to criteria and statistical analysis.Results No difference was found between corresponding age groups for epithelial atrophy,acanthosis and esophagitis in high and low risk areas.The incidence of basal cell hyperplasia of 35～44 and 45～54year groups in high risk area was higher than that of corresponding age groups in low risk area(P=0.0312,P=0.0273).The incidence of dysplasia of 45～54and ≥55 year groups in high risk area was higher than that of corresponding age groups in low risk area( P=0.0196,P=0.0263).A significant difference was observed between the two overall populations for all of the esophageal lesions except acanthosis and esophagitis(P<0.01～0.005).Conclutions Esophageal epithelial atrophy and basal cell hyperplasia should be considered a precancerous lesions of comparatively narrow sense.Acanthosis and esophagitis have seemingly nothing to do with esophageal carcinogenesis.