食管癌的化学预防  

Chemoprevention of Esophageal Cancer

作　　者：林培中[1] 陈志峰[2] 侯浚[2] 刘恬格[2] 王继信[1] 丁镇伟[1] 郭黎平[1] 李绍森 孟凡书 杜成林 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所,北京100021 [2]河北省肿瘤研究所 [3]河北省磁县肿瘤防治所 [4]河南省安阳人民医院

出　　处：《中国医学科学院学报》1998年第6期413-418,共6页Acta Academiae Medicinae Sinicae

基　　金：国家"八五"科技攻关课题! ( 85-91 4 -0 1 -0 2 )

摘　　要：目的 　为在扩大的人群中验证和推广河南林县河顺乡“七五”攻关成果 ,自1 992年在食管癌高发区河北省磁县 9个乡 ,进行食管癌前病变的药物阻断治疗研究。方法　 通过 40～ 6 5岁人群的食管细胞学普查 ,检出食管重增 3990例 ,轻增 5 34 6例 ,随机分为治疗组和对照组。重增和轻增治疗组分别服用中药增生平片和核黄素钙片 ,对照组均服用安慰剂。服药 3年后食管细胞学复查。结果　 重增治疗组癌变相对危险度( RR) =0 .5 0 ,95 % CI=0 .33～ 0 .75 ,抑癌率 49.9% ;同时根据细胞学五级六类分级标准计算整体疗效 ,以对照组为标准组 ,其 Ridit=0 .5 8,95 % CI=0 .5 6～ 0 .6 0。轻增组的结果分别为 Ridit=0 .5 9,95 % CI=0 .5 7～ 0 .6 1 ;RR=0 .80 ,95 % CI=0 .5 2～ 1 .2 2 ,抑癌率 2 0 .4%。结论　 本次结果与河南省林县大人群的阻断结果一致 ,表明增生平阻断食管癌前病变、预防食管癌的效果是肯定的。整体疗效显示 ,轻增人群服用核黄素钙片也有一定的潜在效果。Objective Our goal was to test and pursue the achievement achieved in Heshun town- ship of Linxian county,Henan province.Since1 992 ,we have been conducting block therapy for precancerous lesions of the esophagus in9townships of Ci county,Hebei province,a high risk area of esophageal cancer.Methods By means of a cytological survey,3990 and 5 34 6 cases of severe and mild dysplasia of esophageal epithelium were selected.These cases are divided randomly into the treated group and the control group.In the treated group,the Chinese herbal medicine Zeng Sheng Ping were given to the patients with severe dysplasia, and tablets of riboflavin Calcium were given to the patients with mild dysplasia.Placebo were given to the control group.After administration of drugs for3years,the esophageal cytological reexamination was repeated in July 1 996 . Results In the severe dysplasia treatedgroup,RR=0 .5 0 ,95 % CI=0 .33～ 0 .75 ,inhibitory rate of canceration 49.9% ;using the method of cytological five grade- six kinds as the mark of standard to calculate the general grade effects,and using the control group as the standard group,the treated group Ridit= 0 .5 8,95 % CI=0 .5 6～ 0 .6 0 ;in the mild dysplasia treated group,RR=0 .80 ,95 % CI=0 .5 2 ～ 1 .2 2 ,inhibitory rate2 0 .4% ;Ridit=0 .5 9,95 % CI=0 .5 7～ 0 .6 1 .Conclusions These herbal blocking results indicated that the effects of the Chinese herbal medicine Zeng Sheng Ping on esophageal precancerous lesions were worthy of being highly considered.

关 键 词：食管癌 化学预防 增生平 核黄素 

分 类 号：R735.101[医药卫生—肿瘤]