| 曹小琴,郭兰伟,刘曙正.非高发区食管癌筛查人群食管病理分布[J].中国肿瘤,2019,28(10):731-737. |
| 非高发区食管癌筛查人群食管病理分布 |
| Pathological Distribution in Esophageal Cancer Screening Population in Non-High Incidence Areas |
| 投稿时间：2019-09-12 |
| DOI：10.11735/j.issn.1004-0242.2019.10.A003 |
|
 |
| 中文关键词: 食管癌 筛查 早诊早治 内镜筛查 病理分期 河南 |
| 英文关键词:esophageal cancer screening early diagnosis and treatment endoscopic screening pathological staging Henan |
| 基金项目:科技部国家重点研发计划（2018YFC1313100） |
|
| 摘要点击次数: 1861 |
| 全文下载次数: 364 |
| 中文摘要: |
| 摘 要：［目的］探讨非高发区食管癌筛查人群的食管病理分布，评价食管癌筛查检出效果。［方法］采用整群抽样的方法，以食管癌发病率不高于河南省平均发病水平的3个县/市为研究现场，对当地40～69岁居民进行风险问卷评估，对高危人群开展以食管碘染色及指示性活检为技术的食管内镜检查，并对内镜下异常的病变进行病理活检确诊。诊断结果以病理结果为标准。描述不同性别及年龄组人群食管病理分布。［结果］ 参加食管癌内镜筛查人数23 733人，进行活检人数13 679人，活检率57.64%。食管疾病发病率由高到低依次为食管炎性疾病、鳞状上皮轻度异型增生、鳞状上皮中度异型增生、鳞状上皮重度异型增生、食管早期癌、浸润癌。食管各类病变发病率随年龄增长而增加，且在男性人群中发病率均高于女性。内镜活检病理人群中，各类食管异常病理占比39.92%，癌前病变及食管癌占比7.28%，早期癌及以上病变占0.69%。内镜筛查人群中，各类食管异常病理占23.00%，癌前病变及食管癌占4.19%，早期癌及以上病变占0.39%。［结论］ 内镜下碘染色技术用于非高发区人群食管癌筛查，阳性检出率明显低于高发区食管癌筛查检出率。非高发区人群的食管癌筛查策略需要进一步改进。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the pathological distribution of esophagus in screening population，and to evaluate the effects of iodine staining endoscopic screening for esophageal cancer in non-high prevalence regions in China.［Methods］ Participants aged 40~69 years were selected from three counties which had less or equal incidence of esophageal cancer than the average incidence in Henan province，by using cluster sampling method.High-risk individuals who were assessed by an established risk estimation tool were further recommended to get access to endoscopic iodine staining，and suspicious lesions were targeted for biopsy for further pathological diagnosis. Endoscopic diagnosis was based on pathological findings. Esophageal pathological diagnoses were sorted by genders and age groups.［Results］ 23 733 participants were recruited in the endoscopic screening project for esophageal cancer，and 13 679 of them were examined through biopsy，with a biopsy rate of 57.64%. The incidence of esophageal diseases was getting lower with sequence of esophagitis，mild dysplasia，moderate dysplasia，severe dysplasia，early esophageal cancer and invasive cancer. For each disease mentioned above，a higher prevalence could be observed in males than females，and in older ages. According to endoscopic biopsy findings，the prevalence of any abnormal esophageal pathology was 39.92%，with the prevalence of precancerous lesions or esophageal cancer of 7.28%，and early cancer and above of 0.69%. Among the population screened by endoscopy，the prevalence of any abnormal esophageal pathology was 23.00%，as it was 4.19% for precancerous lesions or esophageal cancer，and 0.39% for early cancer and above，respectively.［Conclusion］ The detection rate of endoscopic iodine staining for esophageal cancer screening in non-high prevalence regions is significantly lower than that in high prevalence regions. The screening strategies for esophageal cancer in non-high prevalence regions need to be further optimized and improved. |
|
在线阅读
查看全文 查看/发表评论 下载PDF阅读器 |