食管癌高低发区人群食管粘膜病理组织学研究

探讨食管瘤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、低发区（林州市和范县、清丰县）分别取无症状居民食管活检229人和187人，均分为25岁～、35岁～、45岁～及55岁以上四组，常规石蜡HE制片，按标准诊断归类。统计学处理。结果高、低发区食管上皮萎缩、棘层肥厚、炎细胞湿润相应年龄组比较无显著差异，基底细胞增生高发区35岁～、45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～、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＜0．01～0．005）。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 population at high and low risk for esophageal cancer

Objective To research the histological changes of esophageal mucosa and providefoundation for the prevention and cure of precancerous lesions in high and low risk population foresophageal cancer. Method There were 229 and 187 esophageal biopsies available from asymptomaticresidents in high and low risk areas (Lin Zhou City, Fanxian County and Qingfeng county). These subjects were classified as 25-, 35-,45-and over 55 years groups respectively, routine Pavaffin HE section, classification according to criteria and statistical analysis. ResuIts No evident difference wasfound between corresponding age groups for epithelial atrophy, acanthosis and esophagitis in high andlow risk areas. The incidence of basal cell hyperp1asia of 35- and 45-year groups in high risk area washigher than that of corresponding age groups in low risk area (P= 0. 0312, P= 0. 0273). The incidenceof dysplasia of 45-and 55-year groups in high risk area was higher than that of corresponding agegroups in low risk area (P= 0. 0196, P= 0. 0263). A significant difference was observed between thetwo overall populations for all of the esophageal lesions except acanthosis and esophagitis(P<0.01-0.005). ConcIuslou Esophageal epithelial atrophy and basal cell hyperplasia should be considered a precancerous lesion of comparatively narrow sense. Acanthosis and esophagitis have seemingly nothing todo with esophageal carcinogenesis.