隐血珠筛检上消化道癌和癌前病变结果报告

目的 :用隐血珠筛检食管癌、胃癌及癌前疾病 ,作为进一步研究的数据源。方法 :用隐血珠对盐城市志愿接受检查的健康人群进行筛选 ,阳性者以胃镜和病理检查结果作为诊断金标准。结果 :3450 0人接受隐血珠筛查 ,阳性 72 35人 ,共发现上消化道癌 2 2 1例 ,其中食管癌 111例 ,胃癌 (含贲门癌 ) 110例。根据隐血珠反应程度的不同 ,在 ( )～ ( )的癌检出度分别为 1 11%、5 0 8%和 6 3% ,35岁以上人群癌检出率 6 4 1/ 10万 ,4 0岁以上年龄组的癌检出率较 39岁以下组呈跳跃性上升 (χ2 =4 72 ,P <0 0 0 5) ,且随年龄的增长 ,癌的检出率增高 ,差异非常显著。癌前病变中 ,食管黏膜鳞状上皮中、重度不典型增生的检出率略低于胃腺上皮中、重度不典型增生 (P >0 0 5)。结论 :在上消化道肿瘤高发地区以“隐血珠初筛→胃镜精查→病理确诊”的三级检查法是筛检早期癌及癌前病变的有效办法。     

隐血珠筛查上消化道癌发病及生存情况调查

目的：C地隐血珠筛查人群发病及癌患者生存的情况调查。进一步探讨在上消化道癌高发区实施早期筛查的重要性。方法：空腹时吞入隐血珠,3至5分钟拉出,观察珠内试纸的变化,黄色为阴性（－）,浅蓝色为（＋）,蓝色为（＋＋）,深蓝色为（＋＋＋）,5年、10年后通过三级防癌网络对隐血珠初筛人群发病及生存情况进行了全员随访。结果：筛查31927人,阳性组3347人做胃镜,经病理确诊癌患者125人,癌检出率3．73％;阴性组645人做胃镜,确诊癌患者9人,癌检出率1．4％,两组早期癌患者共78人,占62．4％,经5年及10年后两次全员随访资料统计,隐血珠初筛阳上组癌发病率均明显高于阴性组,癌患者5年生存率为67．2％,10年生丰为55．2％,性别、年别,年龄、隐血珠反应也是影响初筛人群上消化道癌检出率的因素,结论：在上消化道癌高发区用隐血珠进行早期筛查效果显著。     

应用隐血珠法筛查盐城市上消化道恶性肿瘤结果报告

１９９９年１０月~２０００年１０月,我们应用秦德兴教授发明的隐血珠技术[１],在盐城市５３ ２００例健康人群中,筛选出胃液隐血阳性者１０ ８９３例,经胃镜结合病理确诊为上消化道癌者３８０例。现将结果分析报告如下:     

上消化道早期癌的诊断及手术疗效观察：附143例分析

作者报道1986年4月至1992年3月在上消化道癌高发区扬中县应用隐血珠初筛、胃镜普查和门诊胃镜检查共发现上消化道早期癌143例,占同期切除病例总数的15.4％(143/926)。其中早期食管癌49例,早期胃癌94例。早期胃癌的部位分布中贲门癌57例,占早期胃癌的60.6％。术后随访1、3、5年生存率分别为98.3％、97.5％、和95.2％。作者认为:上消化道早期癌病变发展较慢,病人往往有足够的时间在早期阶段被发现,在上消化道癌高发区对高危人群用隐血珠初筛胃镜普查的方法值得推广。     

新疆哈萨克族胃癌早期防治适宜技术的研究与应用

[目的]探索一套适宜新疆哈萨克族胃癌筛查和早诊早治适宜技术模式并示范应用.[方法]针对新疆哈萨克族胃癌高发的问题,通过建立哈萨克族胃癌四级医疗合作网络,培训基层医务人员,利用胃癌早期三级筛查方法,以人群为基础开展新疆哈萨克族胃癌的筛查和早期诊断、早期治疗工作.[结果]完成新疆哈萨克族大便潜血试验6012人,受检率为52.28％,隐血珠试验5329人,受检率为46.34％;完成哈萨克族胃镜检查2196例;确诊胃高级别上皮内瘤变3例,早期胃癌2例,中晚期胃癌10例,胃低级别上皮内瘤变13例,哈萨克族胃癌早诊率为33.33％.食管高级别上皮内瘤变2例,早期食管癌2例,中晚期食管癌9例,食管低级别上皮内瘤变11例,食管癌早诊率为30.77％;并对新疆哈萨克族3例胃高级别上皮内瘤变、2例早期胃癌、2例食管高级别上皮内瘤变和2例早期食管癌进行了内镜下黏膜剥离术(ESD)及术后随访.[结论]大便潜血和隐血珠试验作为新疆哈萨克族胃癌初筛的方法并不明显优于胃镜的直接检查;在少数民族高发区,将动员目标人群筛查与人群有症状者主动筛查相结合,对40岁以上人群每3年直接进行胃镜筛查,提高早癌检出率.     

秦氏隐血珠在上消化道癌初筛普查中实用价值的调查研究——附31972例初筛人群5、10年随访资料分析

目的：通过对隐血珠初筛人群及癌患5年、10年随访,进一步证实隐血珠对上消化道癌初筛普查的实用价值。方法：空腹时吞入隐血珠,3-5分钟拉出,观察珠内试纸的变化,黄色为阴性（-）,浅蓝色为（ ）,蓝色为（ ）,深蓝色为（ ）,5年、10年后对隐血珠初筛人群及癌患通过三级防癌网络进行全员随访。结果：初筛普查31927人,阳性组3347人做胃镜,经病理确诊为癌患125人,癌检出率3.74%,阴性组645人做胃镜,确诊癌患9人,癌检出率1.4%,两组中早期癌患共78人,占62.4%,性别、年龄、隐血珠反应均是影响癌检出率的因素。经5年及10年两次全员随访资料统计,隐血珠初筛阳性组癌发生率均明显高于阴性组,癌患5年生存率67.2%,10年生存率为55.2%,性别、年龄、隐血珠反应也是影响上消化道癌发病率因素。结论：秦氏隐血珠在上消化道癌初筛普查中有肯定的实用价值。值得推广。     

2006—2015年四川省盐亭县上消化道癌发病与内镜筛查结果对比分析

摘 要：［目的］ 对比分析我国食管癌高发区四川省盐亭县2006—2015年间,上消化道癌发病情况及高危人群上消化道癌内镜检出情况,为下一步明确人群防治工作的重点提供理论依据。［方法］ 将盐亭县40～69岁设为内镜筛查目标人群,对其采用内镜下碘染色及指示性活检进行筛查,统计分析目标人群早期食管癌、贲门癌、远端胃癌及相应癌前病变的检出情况;依托肿瘤登记数据,分析2006—2015年间盐亭县远端胃癌、贲门癌及食管癌发病情况。［结果］ 2006—2015年盐亭县肿瘤登记结果显示,十年期间,盐亭县40～69岁人群中胃癌发病率最高,约为食管癌的1.13倍（445.13/10万vs 393.4/10万）,其中远端胃癌发病率约占总胃癌发病率的3/4;内镜筛查42 340人,盐亭县40～69岁人群早期食管癌及癌前病变检出率显著高于早期胃部病变检出率（0.66% vs 0.28%）,其中远端胃部早期癌及癌前病变检出率略高于贲门部（0.15% vs 0.13%）;对6048例贲门黏膜无异常者进行高发位点的常规性活检,发现13例早期贲门癌癌变患者,检出率为0.21%,高于指示活检的0.12%。［结论］ 盐亭县胃癌发病率高于食管癌,远端胃癌是盐亭县胃癌主要类型,且发病率高,检出率低,下一步工作重心应放在提高早期胃癌及癌前病变的筛查及诊断水平上。     

胃隐血珠加胃镜检查在上消化道体检中应用

[目的]评价健康体检中应用胃隐血珠加胃镜检查法对上消化道癌及癌前病变的意义.[方法]用秦氏胃隐血珠对上消化道系统进行初筛16782人,对阳性及强阳性者再进行胃镜检查,明确诊断.[结果]1561例胃镜检查中566例咬取活检,病理诊断癌68例,其中食管癌26例,胃癌42例.早期癌16例,占23,5%.慢性胃炎伴重度肠化生16例,伴重度异型增生5例;食管重度异型增生4例.[结论]应用秦氏胃隐血珠加胃镜检查法,对健康体检人群进行上消化道肿瘤检查,是一种简便易行的方法,可以提高早期癌及癌前病变的检出率.     

食管癌高发区贲门癌、胃癌流行强度分析及其对内镜筛查的启示

 目的 分析涉县等食管癌高发区贲门癌、胃癌的流行强度，明确其防治任务，探讨具体控制途径。方法 对比分析涉县、林县、磁县全人群肿瘤登记的食管癌、贲门癌、胃癌发病率与死亡率以及内镜筛查6233例40-69岁人群三种癌及癌前病变的检出率。结果 太行山南麓食管癌高发区食管癌、贲门癌和胃癌发病率或死亡率的合计占到全身恶性肿瘤的70％～80％。涉县2000-2004年贲门癌发病率男女性分别为69．9／10万和41．5／10万，死亡率男女性分别为54．3／10万和33．2／10万。高发区运用内镜碘染色指导活检技术筛查，食管鳞状上皮癌前病变及早期癌的检出率高，但贲门和胃腺上皮癌前病变及早期癌的检出率相对较低。结论 太行山南部食管癌高发区存在贲门癌和胃癌共同高发的现象，要想通过旱诊早治从整体上降低该地区上消化道癌的死亡率，必须加强内镜对贲门和胃腺上皮癌前病变及早期癌检出的研究。     

早诊液初筛上消化道癌

目的 探讨在隐血珠筛查基础上,用一种更简便的口服早诊液(稀盐酸酒精)初筛法筛查上消化道癌并检验其筛查效果.方法 自1979年至今,27年中,在不同地区多次重复验证其效果.结果 2002年5月在河北、河南、山东、山西部分地区35岁以上人群中推广试用早诊液初筛.共筛查31 073人,阳性反应5695人,阳性率19.87%.其中5310人自愿接受胃镜精查,检出癌150人,检出率2.82%,可疑癌101人(1.90%),癌前病变204人(3.84%).阴性反应组自愿接受胃镜检查者中检出癌23人,漏筛率0.1%;癌前病变272人(1.19%).1979年在林县对用早诊液初筛普查后12年的阳性组和阴性组追踪随访,上消化道癌发病率分别为19.8%和3.61%,阳性组癌发病率比阴性组高5.5倍.结论 口服15 ml早诊液,激发上消化道黏膜病变症状提前数年出现,现场观察证明,它有初筛、浓缩高危人群的价值,方法简便,重复性好,尤其在上消化道癌高发人群地区,值得进一步研究、推广.     

内窥镜联合隐血珠初筛胃部肿瘤效能研究

目的探讨内窥镜联合隐血珠在健康体检人群中对胃部肿瘤及其他胃部初期病变的初筛效能。方法对新疆医科大学附属肿瘤医院20 000例体检者采取隐血珠、内窥镜复查和病理学确诊三级法进行上消化道病变初筛。结果其中胃隐血珠阳性及强阳性患者1 562例,567例进行咬取活检,幽门螺杆菌阳性979例,慢性浅表性胃炎912例,糜烂性胃炎28例,胃溃疡41例,萎缩性胃炎32例。病理诊断确诊恶性肿瘤患者70例,其中初期癌症患者17例。慢性胃炎伴重度肠化生17例,伴重度异型增生6例,食管重度异型增生5例。结论秦氏隐血珠联合内窥镜检查对无症状人群提供了一种高效便捷、检出率高、效能良好的筛查手段,可以进一步在临床普及。     

2000例隐血珠初筛强阳性受检者的胃镜检查

Mass screening for upper G-I tract cancer was performed by Qin's occult blood bead detector from Nov. 1986 to Apr. 1987 in Yangzhong county, Jiansu province. Of the examined subjects, 2,000 were positive for occult blood. There were 887 males and 1,113 females. The ages ranged from 23 to 75 years, 58.2% were over 40 years. Gastroscopic examinations were performed for all the positive subjects. Sixty-four patients with G-I tract cancers were discovered by gastroscopy with detection rate of 3.2%. Of these 64 patients, 19 had cancer of esophagus, 27 cancer of gastric cardia and 19 gastric cancer in which one patient had double primary cancers with 65 foci. In this series, there were 65.6% early cancers. It may be concluded that the occult blood test in cancer screening had definite value in early detection of the upper G-I tract cancer. The authors suggest that annual test with this bead detector be done for the adult male.     

Screening for upper digestive tract cancer with an occult blood bead detector. Investigation of a normal north China population

Screening of the general population for cancer of the upper digestive tract using an occult blood bead detector supplemented by fibergastroscopy was able to detect 126 cancers of the esophagus, gastric cardia, and stomach. This screening was carried out in two of the high-risk areas, Yangzhong and Wun counties, located in central eastern and north China. The occult blood bead detector, swallowed and retained in the stomach for 3 minutes, was able to sort out the suspected persons by its coloration from sky blue (+) to dark blue ( ) on removal. The subsequent fibergastroscopy could make a definite diagnosis by biopsy specimen. A preliminary trial performed on patients with established cancers was 100% (18 of 18) positive for stomach cancer and 81% (13 of 16) positive for esophageal cancer. A public survey of the high-risk areas, screening 38,073 normal persons ranging in age from 35 to 70 years, showed positive results in 9204 (24.2%) persons. Subsequent fibergastroscopy carried out in 4023 occult blood bead detector positive persons showed 126 cancers (41 of the esophagus, 46 of the gastric cardia, and 39 of the stomach). Factors influencing the cancer detection rate were sex, age, and degree of positivity of the occult blood bead detector test. Seventy per cent (89 of 126) of the cancers discovered were in an early stage. The occult blood bead detector costs the primary screened person only 30 cents and may be practical for the large-scale screening of cancer of the upper digestive tract in developing areas.     

Relationship between anal occult blood and hepatobiliary pancreatic carcinoma screening.

Cotton swab anal smear instead of stool occult blood test can not only be used as a mass screening method for colorectal cancer, but is an auxiliary way to screen hepatobiliary pancreatic carcinoma. Two hundred and twenty-three cases of hepatobiliary pancreatic carcinoma patients received anal occult blood test, of which 121 were positive (54.3%). The screening test was performed in 14,645 healthy people aged 40-60 years; 511 persons (3.4%) were positive for anal blood. Among these, six cases of digestive tract cancer were found (one oesophageal carcinoma, one gastric cardia carcinoma, two gastric carcinomas, two liver carcinomas). This suggests that when anal occult blood is positive, the patient should be scanned by ultrasonic means to rule out hepatobiliary pancreatic tumour.     

以隐血检测法初筛普查上消化道肿瘤七年总结

我院采用隐血珠作为普查上消化道肿瘤的初步筛选方法，从1986年至1993年，在全国各地20余个地区，作隐血检测242296人，其中17915人接受了胃镜检查，病理证实为肿瘤的共638人，平均癌检出率为3．56％。得出的结论是采用隐血检测法普查上消化道肿瘤，特异性虽不是很高，但可以发现大显的早期癌，同时提供上消化道粘膜潜在的疾病信息。     

应用隐血珠初筛普查食管癌,胃癌效果的观察

Hemoccult test bead is able to tell whether there is occult blood in the stomach juice or not. Screening test was carried out in the high incidence area for detecting the upper G-I tract cancer. The bead, swallowed and retained in the stomach for 3 minutes, was able to sort out the suspected individuals by its coloration: yellow (-), light blue (+), blue (++) and dark green ( ). 26261 normal subjects were screened in the high incidence area. The ages ranged from 35 to 70. 6353 (24.2%) of them showed positive results. Subsequent fiber-gastroscopy was performed for definite diagnosis in 2888 persons with positive results. 98 cancers were confirmed by pathology (26 in esophagus, 34 in gastric cardia, and 38 in stomach) with a detection rate of 3.4%. 73.5% of the cancer so discovered were in early stage. Factors influencing the cancer detection rate are sex, age and degree of positivity.     

隐血珠检测上消化道出血病变的价值

目的 评介隐血珠在检测上消化道出血性病变中的意义,为该法用于筛检胃癌及食管癌提供客观的数据资料。方法 对一组因有上消化道症状来医院就诊而需做胃镜检查的患者,在行胃镜检查前先做隐血珠检测,以胃镜和（或）病理学检查结果为金标准,对隐血珠检测的结果用敏感性,特异性,似然比及Ｙｏｕｄｅｎ指数（正确指数）等指标进行评价。结果 ５２１７例患者中,隐血珠阳性者２４０３例（４６．１％）,共发现上消化道恶性肿瘤２０     

Occult blood detector for the upper G-I tract. I. A preliminary application in cancer screening

The traditional chemical detection of small amount of blood in the stool can not tell whether the original bleeding site is in the upper or lower part of the G-I tract. The occult blood detector, designed by the authors, having a diameter of 8 mm, can easy be swallowed into the stomach with 30 to 50 ml of water. After remaining for 3 minutes in the stomach, it is pulled out by the patient himself and its coloration read to reveal the degree of bleeding. It can be used either by the medical personnel or the patient himself, at home, for the purpose of detecting minute bleeding in the upper G-I tract and for cancer screening in the high risk population. This detector gave a positive rate of 95% in patients with malignancies in the upper gastrointestinal tract. It is highly acceptable for its lack of discomfort during application. In cancer screening, it gave a positive rate of 5% to 10% in 10000 high risk persons. Those positive in this test showed a high incidence of gastric or esophageal cancers as proved by gastroscopy. This detector is being manufactured and sold by the Baiyunshan Pharmaceutical Factory, Guangzhou, Guangdong Province. Other papers concerning this topic are to be published.     

上海市社区居民大肠癌筛查便隐血检测效果分析

背景与目的：上海市为符合条件的居民提供免费的大肠癌筛查服务,通过对上海市居民大肠癌筛查中两次便隐血检测和后续诊断检查结果的分析,评价筛查中两次便隐血检测的效果,为基于人群的疾病筛查项目提供科学依据。方法：筛查的目标人群为50~74岁的上海居民,使用两次免疫法便隐血检测和危险度评估为初筛,初筛阳性者进行肠镜检查。结果：筛查期间,共有809 528人完成了两次便隐血检测,便隐血检测阳性者共有104 953人,其中第一次阳性的人数为47 421人,阳性率为5.9%,第二次阳性的人数为36 462人,阳性率为4.5%,两次阳性的人数为21 070人,阳性率为2.6%。便隐血检测阳性的筛查对象中,有49 339人接受了肠镜检查,肠镜检查顺应性为47.0%。两次阳性的筛查对象的肠镜参与率明显高于单次阳性的筛查对象（P<0.001）。在所有筛查出的大肠癌和癌前期病变中,仅进行一次便隐血检测可以诊断出大肠癌1 200例,占79.5%;发现癌前期病变3 777例,占68.1%。进行第二次便隐血检测可以多诊断出大肠癌310例,占20.5%;发现癌前期病变1 767例,占31.9%。结论：相比于单次便隐血检测, 进行两次便隐血检测的初筛可以更有效地检测出阳性对象,两次便隐血检测可提高后续肠镜检查的参与率,所检出的大肠癌和癌前期病变数量也均有所提高且增量成本较低。因此建议在以人群为基础的大肠癌筛查中采用两次或更多次数的便隐血检测,以提高筛查效率。     

隐血珠对上消化道疾病诊断价值初步研究

 目的　探讨隐血珠对上消化道疾病诊断价值。方法　对自然人群中24712例志愿者行隐血珠检测,对检测结果为“+++”及“++者作纤维胃镜进一步检查确诊,并进行统计分析。结果　对隐血珠检测阳性者志愿作胃镜检查2568例,发现上消化道各种炎性病变2015例,占75.80%,上消化道癌108例,占4.06%,消化性溃疡、平滑肌瘤、憩室、息肉等病变占3.76%。结论　秦氏隐血珠在上消化道肿瘤高发区高危人群中作为普查初筛手段确有重要实用价值;对临床判断有无上消化道炎性病变亦有重要参考价值,故值得进一步推广应用。