山西长治林州移民与河南林州居民食管、贲门和胃窦内镜病理结果比较  

Histopathological comparison of the lesions at esophagus, gastric cardia and antrum on the subjects from Linzhou, Henan and the Linzhou migrated subjects from Changzhi,Shanxi

作　　者：王立东[1] 刘宾[2] 冯常炜[3] 张延瑞[4] 张彦霞[1] 李苹娟[1] 常扶保 李吉林 高福生[2] 冯笑山[1] 高珊珊[1] 何欣[1] 范宗民[1] 狄霞[2] 吴会芳[1] 焦新英 常志伟[1] 王俊宽[1] 刘小莉[1] 邵珊[1] 吕晓东[1] 王苒[1] 孙哲[1] 周建伟[1] 江亚南[1] 杜芳[1] 郭涛[1] 李琮宇[1] 刘卫娜[1] 秦豫培[1] 王能超[1] 李韶华[1] 周丽[1] 温巍[1] 张广平[1] 郐大余[2] 樊宇靖[2] 杜娴娟[1] 

机构地区：[1]河南省食管癌重点开放实验室郑州大学医学实验中心癌症研究室郑州大学第一附属医院内科,郑州450052 [2]首都医科大学同仁医院消化内科,北京100730 [3]郑州大学第二附属医院消化内科,郑州450014 [4]河南省人民医院消化内科,郑州450003 [5]林州市中心医院胸外科,林州456550 [6]林州市姚村食管癌医院病理科,林州456592

出　　处：《郑州大学学报（医学版）》2006年第1期5-9,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家杰出青年科学基金资助项目30025016;河南省高校创新人才工程基金资助项目1999125;河南省医学科技攻关基金资助项目20058;河南省食管癌重点开放实验室基金资助项目20050227;郑州大学211工程基金资助项目

摘　　要：目的:比较分析河南食管癌高发区林州居民和山西长治的林州移民食管、贲门和胃窦内镜病理结果,进一步了解遗传和环境因素对食管和贲门癌变的影响。方法:从移居到山西长治100a的林州移民村中选择1个自然村并在河南林州选择1个与移民迁居前相近的自然村作为调查现场,随机对该2个自然村中30岁以上的居民进行食管/胃内镜检查和黏膜活检组织病理学检查。结果:①食管:移民村食管中段基底细胞过度增生(BCH)检出率高于林州居民(38%vs28%,P<0.05);②贲门:移民村慢性浅表性贲门炎(CSG)、不典型增生(DYS)和肠上皮化生(IM)的检出率均高于林州居民(P<0.05),但两地区慢性萎缩性贲门炎(CAG)和贲门腺癌(GCA)的检出率相似(P>0.05);③胃窦:移民村胃窦部DYS和IM检出率均高于林州居民(P<0.05),但2地区胃窦部CSG、CAG和GCA检出率均相似(P>0.05)。结论:林州居民移民到山西长治100a后,自然人群食管癌和贲门癌检出率、食管重度癌前病变检出率仍与林州原住地居民相似,而移民贲门和胃窦部重度癌前病变检出率均高于林州居民。环境和时间变化均未明显影响食管和贲门癌前病变和癌的发生率,提示遗传因素在其发生中可能起重要作用。Aim- To determine the impact of genetic and environment factors on esophageal and gastric cardia carcino- genesis by comparing the alternations of esophageal and gastric cardia precancerous lesions from the symptom-free subjects at Linzhou, Henau, the high incidence area for esophageal cancer and the subjects migrated to Changzhi, Shanxi from Linzhou since 1905. Methods： Two natural villages were selected for the study fields, one was migrated villages in Changzhi, Shanxi, the other in Linzhou, Henan. All the subjects with 〉 30 years old in these two villages were invited to attend the mass survey with epidemiological questionnaire, endoscopic, biopsy and histopathological examinations. Results： In esophagus, the detection rate of basal cell hyperplasia （BCH） at the middle segment was apparently higher in the migrated subjects than in Linzhou subjects （ 38% vs 28% , P 〈 0. 05 ）. In gastric cardia： the prevalence of chronic superficial carditis （ CSG）, DYS, and intestinal metaplasia （ IM ） in the migrated subjects were higher than that in Linzhou subjects （ P 〈 0. 05 ）, however, the prevalence of chronic atrophic carditis （CAG） and gastric cardia adenocarcinoma （GCA） was similar between the migrated subjects and Linzhou subjects （ P 〉 0. 05 ） . In gastric antrum, the prevalence of DYS and IM in migrated subjects was higher than that in Linzhou subjects （P 〈 0. 05 ）. but, the prevalence of CSG, CAG, and GCA was very similar between the migrated and Linzhou subjects （ P 〉 0. 05 ） . Conclusion ： After 100 years, the prevalence of SCC and GCA in the migrated subjects is similar with Linzhou subjects, the prevalence of esophageal precancerous lesions in the migrated and Linzhou subjects is also similar, but the prevalence of severe precancerous lesions at gastric cardia and antrum in the migrated subjects is higher than in Linzhou subjects. The present results demonstrate that the environment and time do not show apparent effect on prevalence of esophageal and

关 键 词：食管 贲门 癌前病变 移民流行病学 

分 类 号：R735.1[医药卫生—肿瘤]