1600万人群上消化道癌隐血珠筛查报告

目的评价上消化道癌隐血珠筛查结果。方法隐血珠经历研制,临床患者试验;现场验证;全国范围推广应用三个阶段,历时28年,在全国20多个省市,300多个县,30~70岁人群中筛查1600多万人次,胃镜精查近100万人次,检出食管癌和胃癌7766例,2/3是早中期病例。结果最早接受普查的江苏省扬中市医院,隐血珠筛查检出的上消化道早期癌手术治疗103例,5年生存率93.3%,筛查10年后随访,隐血珠阳性组人群食管癌和胃癌发病率仍然比阴性组高出1.08倍,差异有显著性。结论胃液隐血长期不消失,是上消化道癌高危人群,或已是早期癌。经过大量随诊研究,不少当年胃液隐血阳性,胃镜报告为慢性炎症或正常者,观察1~5年后屡有转为早期癌或重度不典型增生者。30~70岁高发区居民,或有胃部疾患者,定期1~2年吞一次隐血珠筛查上消化道疾病不失为良策。

Screening of esophageal and gastric cancer by occult blood test bead in 16 million normal population of China

Objective To evaluate the results of screening esophageal and gastric cancer by occult blood test bead.Methods Occult blood test bead has passed through three phases,including research and testing in clinical patients,on-scene verification and extending throughout the country.During 28 years,16 million people at the age of 30-70 years in 300 counties of more than 20 provinces were tested by occult blood bead and afterward one million people received gastroscopy examination.Results Esophageal or stomach cancer was detected 7766 people and two third of them were in early or middle stages.Yangzhong Hospital in Jiangsu province,the first hospital carrying out this screening method,detected 103 patients with early-stage cancer.All of them received surgical treatment and the 5-year survival rate was 93.3%.After 10 year follow-up,people with positive occult blood had 1.08 times higher incidence of esophagus and stomach carcinomas compared with negative ones.The fact that after 10 years the incidence of upper alimentary carcinoma between positive and negative occult blood people still had significant difference may indicate that occult blood exists in gastric juice is a signal of preneoplastic lesions,or suggest that there is high risk of occurring upper alimentary tract carcinomas.During follow-up,some people with positive occult blood but diagnosed by gastroscopy as chronic inflammatory diseases or even normal remained occult blood positive for several years and later gastroscopy detected early-stage cancer.Conclusion The results proved that occult blood test for gastric juice is scientific for screening early-stage upper alimentary benign and malignant diseases.People at the age of 3070 years,living in high risk area receiving occult blood test every 1 to 2 years is a good method for early detection of upper alimentary diseases.