食管癌前病变的药物阻断性治疗——抗癌乙片、维胺酯和核黄素三年和五年的阻断效果  

Medicamentous Inhibitory Therapy of Precancerous Lesions of the Esophagus——3 and 5 Year Inhibitory Effect of Antitum or B , Retinamide and Riboflavin

作　　者：林培中[1] 张金生[1] 戎振鹏 韩锐[3] 徐世平[3] 高润泉 丁镇伟[1] 王继信[1] 冯华进 曹士国 郭万生 

机构地区：[1]中国医学科学院肿瘤研究所 [2]中国医学科学院基础医学研究所 [3]中国医学科学院药物研究所 [4]林县河顺乡惠明寺医院

出　　处：《中国医学科学院学报》1990年第4期235-245,共11页Acta Academiae Medicinae Sinicae

基　　金：国家"七五"攻关课题

摘　　要：自1983年起,在食管癌高发区河南林县河顺乡和安阳县磊口乡,进行食管癌前病变的阻断性治疗研究。通过食管细胞学普查,检出食管上皮重增患者2531人,随机分为三组,分别服用抗癌乙片、维胺酯和安慰剂。检出轻增3393人,随机分为两组,分别服用核黄素和安慰剂。三年和五年内患者的服药率在90％以上。服药三年和五年后,进行了食管细胞学复查。结果证明,抗癌乙片和维胺酯在三至五年内,使重增的癌变率下降了50％左右。食管癌前病变的药物阻断性治疗是一条有希望的食管癌预防途径。9633 subjects aged 40 to 65 were sampled from high- risk areas for esophageal cancer and examined by esophageal exfoliative cytology . 2531 and 3393 cases of markedly and mildly dysplastic patients were screened out respectively .Those with marked dysplasia were randomized into 3 groups and given respective medications : antitumor B (Chinese herbs), 4-ethoxycarbophenylretinamide (retinamide)and placebo .The subjects with mild dysplasia were randomly divided into 2 groups for riboflavin and placebo treatment .After medication for 3 or 5 years the subjects were reexamined by esophageal exfoliative cytology . The incidence of esophageal cancer in the antitumor B group after taking medication for 3 and 5 years was reduced by 52 .2% and 47.3% respectively as compared with the placebo group. These differences were statistically significant (X2= 8.9115 , P <0.01 ;X2= 10.9573 ,P <0.01). The incidence of esophageal cancer in the retinamide group after 3 years of medication was reduced by 37. 3% as compared with control, while the incidence among patients treated for 5 years dropped by 43.2 % relative to control. This difference was statistically significant (X2 =9. 2836 , P <0. 01). The incidence of esophageal cancer in the riboflavin group was reduced by 22 .2% and 34.8% respectively .The above results indicate that secondary prevention of esophageal cancer is possible and that inhibitory therapy of precancer-ous lesions of the esophagus is effective in preventing espphageal cancer. This method needs further trial and study in high risk areas of esophageal cancer .The reliability of the experimental results is critically discussed .

关 键 词：抗癌乙片 食管癌 维胺酯 

分 类 号：R735.105[医药卫生—肿瘤]