食管癌高发区重度不典型增生人群γ-谷氨酰转肽酶的随访观察  

Follow-up on the γ-Glutamyl Transpeptidase in Subjects with Severe Dysplasia in High Incidence Area of Esophageal Cancer

作　　者：李健[1] 赵治国[1] 白经修[1] 刘韵源[2] 

机构地区：[1]郑州大学第二附属医院消化内科,郑州市450003 [2]中国医学科学院肿瘤研究所

出　　处：《中国肿瘤临床》2004年第16期905-907,共3页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金(编号:39770832);河南省科委自然科学基金资助(编号:20004023500)

摘　　要：目的探讨γ-谷氨酰转肽酶(γ-GT)在食管癌防治中的应用价值,寻找降低食管癌高发区食管癌发病率和死亡率的有效方法。方法分析食管癌高发区中重度不典型增生患者451例3年随访的病理学、细胞学和γ-GT反应的结果。结果随访1年后,γ-GT阳性231例患者中17例(7.4%)癌变,γ-GT阴性95例患者中无癌变。随访3年的215例中,γ-GT阳性伴重度不典型增生Ⅰ级和Ⅱ级患者的癌变率分别为5.7%和14.3%。,γ-GT阴性患者或40岁以下伴γ-GT阳性的患者未发生癌变。结论γ-GT可作为食管癌高发区食管上皮不典型增生癌变风险的分类指标,仅对γ-GT阳性伴重度不典型增生患者进行干预,可明显提高食管癌防治中的效价比。Objective: To investigate the value of γ-glutamyl transpeptidase (γ-GT) in prevention of esophageal cancer, and search for the effective method reducing incidence and mortality of esophageal cancer in high incidence area. Methods: The 451 cases of subjects with severe dysplasia were followed up 3 years with endoscopic examination, the pathology, cytology and reaction of γ-GT. Results: After 1 year follow-up, there were 17 cases with cancer in 231 cases with γ-GT positive and without cancer in 95 cases with γ-GT negative. In 215 cases with 3 years follow-up, the subject with negative γ-GT reaction or positive γ-GT reaction below 40 years old didn't detect esophageal cancer. The cancerous incidence of the subject with both severe dysplasia Ⅰand Ⅱ and positive γ-GT reaction was 5.7% and 14.3% respectively. Conclusions: These findings suggested that γ-GT should be a cancerous risky classification marker of esophageal epithelial dysplasia. The subjects with severe dysplasia should be classified according to γ-GT reaction in prevention of esophageal cancer. As long as positive γ-GT reaction combination with severe dysplasia is adopted in the prevention of esophageal cancer, the population of prevention of esophageal cancer was more definitely, and the ratio between the expense and benefit for strategy of prevent and treatment in esophageal cancer should be increased.

关 键 词：食管癌 预防 Γ-谷氨酰转肽酶 

分 类 号：R735.1[医药卫生—肿瘤]