食管癌高发区队列内镜筛查随访分析

目的:分析食管癌高发区大人群内镜加碘染色筛查敏感性和漏诊率。方法:根据2002年5月河北省磁县40～65岁2013例内镜队列筛查样本,通过以2006年1月～3月随访所证实发生的食管鳞癌、贲门腺癌和胃癌病例为数据计算敏感性和漏诊率。结果:在内镜筛查后的6个月～36个月中,随访证实新发生食管鳞癌2例,贲门腺癌4例,胃窦腺癌1例,其他癌6例,死因不详1例。失访11例,随访率99.4%。经计算内镜筛查食管鳞癌灵敏度97.1%,漏诊率2.9%;贲门腺癌分别为80.0%和20.0%。结论:食管癌高发区内镜加碘染色筛查,贲门癌的灵敏度低于食管癌。

Follow-up Analysis of a Cohort Undergoing Endoscopic Screening in High Risk Area of Esophageal Cancer

Objective: To estimate the sensitivity and the rate of incorrect diagnosis of endoscopic screening using iodine staining in the high risk area of esophageal cancer. Methods: In May 2002, there were 2013 cases between 40 and 65 years old who were examined endoscopically in the Hebei province. From January to March of 2006, follow-up confirmed occurrences of esophageal squamous cancer, adenocarcinoma of gastric cardia and stomach gland cancer. These data were used to determine sensitivity and rate of incorrect diagnosis. Results: Follow-up lasted 6 to 36 months, and it confirmed the presence of esophageal squamous carcinoma in 2 cases, adenocarcinoma of gastric cardia in 4 cases, gastric antrum adenoma in 1 case. The cause of death was unclear in 1 case. Eleven cases were lost to follow-up, providing an overall follow-up rate of 99.4%. Sensitivity of endoscopic screening with iodine staining for detection of esophageal squamous carcinoma was 97.1%, and the rate of missed diagnosis 2.9%. Sensitivity of the method for detecting adenocarcinoma of gastric cardia was 80%, and the rate of missed diagnosis was 20%. Conclusions: The sensitivity of endoscopic screening with iodine staining in detecting adenocarcinoma or gastric cardia was lower than that for detection of esophageal squamous carcinoma.