淮安市沿淮河食管癌高发区食管癌和癌前病变 流行特征分析

摘要:目的　了解淮安市淮河流域食管癌高发区居民食管癌和癌前病变状况，为食管癌的二级预防提供依据。方法　在淮河流域食管癌早诊早治项目县洪泽、金湖2地，对高危人群进行碘染色内镜筛查，并取活检组织进行病理诊断。病理活检结果按性别、年龄等进行描述性分析，各级食管病变的检出率比较采用χ2检验。结果　食管炎症检出率10.93%，轻度异型增生检出率4.17%，中度异型增生检出率0.77%，重度异型增生/原位癌检出率1.11%，早期癌检出率0.05%，食管癌检出率0.38%。除早期癌外，各级食管病变男性检出率均高于女性，差异均有统计学意义（P＜0.05）。各级食管病变主要分布于55岁～到65岁～年龄组，检出率均有随年龄增加而升高的趋势。2项目县食管炎症、轻、中、重度异型增生和异型增生不能分类的检出率差异有统计学意义（P＜0.05）。食管早期癌、食管癌检出率差异无统计学意义（P＞0.05）。结论　我市沿淮河地区40～69岁人群中存在大量无症状的食管癌和癌前病变患者，性别和年龄与检出率密切相关，应继续加强食管癌防治宣传及早诊早治工作。

Analysis of epidemic characteristics of esophageal cancer and precancerous lesions among residents in the high-incidence area along the Huaihe River in Huaian

Abstract: Objective This work was to observe the status of esophageal cancer and precancerous lesions among residents in the high-incidence area of Huaihe River in Huaian, and to provide evidence for the corresponding secondary prevention. Methods Iodine-staining endoscope and indicated biopsy screening were used for high-risk people in Hongze and Jinhu Counties, where the project of early diagnosis and treatment of esophageal cancer was conducted. Pathologic biopsy results were analyzed by gender and age. The detection rate of each type of esophageal lesion was compared with test. Results Esophageal inflammation detection rate was 10.93%, mild esophageal heterosexual hyperplasia detection rate was 4.17%, moderate esophageal heterosexual hyperplasia detection rate was 0.77%, severe esophageal heterosexual hyperplasia detection rate was 1.11%, early esophageal cancer detection rate was 0.04%, and esophageal cancer detection rate was 0.38%. Detection rate of each type of esophageal lesions was higher in males than in females, and all with statistical significance, except that of early esophageal cancer (P<0.05). Each type of esophageal lesions was mainly distributed to the age group of 55 and above, and the detection rate increased with age. Statistical differences in the detection rates of esophageal inflammation, mild, moderate and severe heterosexual hyperplasia were observed between Hongze and Jinhu (P<0.05), but not in that of early esophageal neoplasms and esophageal cancer (P>0.05). Conclusion A large number of asymptomatic patients with esophageal precancerous lesions and cancer were found in the high-incidence area of Huaihe River aged 40 to 69. Sex and age are closely correlated to the detection rate. Educationon esophageal cancer prevention and control, early diagnosis and treatment should be strengthened.