食管癌高发区居民食管癌及癌前病变状况分析  

Prevalence analysis of esophageal carcinoma and precancerous condition in esophageal cancer high risk area

作　　者：王霄[1] 王安荣[1] 樊晋川[1] 蒲世军[2] 何鑫[2] 包郁[1] 王影[1] 曹磊[2] 李胜[2] 唐潇[2] 

机构地区：[1]四川省肿瘤医院,四川成都610041 [2]阆中市人民医院,四川阆中637400

出　　处：《东南大学学报（医学版）》2013年第1期56-59,共4页Journal of Southeast University(Medical Science Edition)

基　　金：中央财政转移支付食管癌早诊早治项目(2006BAI02A15);"十一五"国家科技支撑计划项目(2006BAI02A15)

摘　　要：目的:了解食管癌高发区人群食管癌及癌前病变的分布情况,为早诊早治工作提供依据。方法:在四川省阆中市食管癌高发区,采取整群随机抽样的方法选择部分自然村作为筛查对象,对高危人群采取内镜下碘染色及指示性活检进行筛查,并经病理学诊断确诊。结果:食管炎症检出率为8.40%,食管轻度异型增生检出率为7.65%,食管中度增生检出率为2.45%,食管重度异型增生/原位癌检出率为1.75%,食管癌检出率为0.45%。按性别分布分析发现,食管炎症男、女检出率分别为11.07%(99/894)和6.24%(69/1 106),两组差异有统计学意义(χ2=15.021,P<0.001);食管癌男、女检出率分别为0.89%(8/894)和0.09%(1/1 106),两组差异有统计学意义(χ2=7.142,P=0.008)。按年龄组分析,食管炎症在55岁～组检出率最高为11.07%(56/506),轻度食管增生在60岁～组检出率最高为10.90%(46/422),中度食管增生在65岁～组检出率最高为3.39%(8/236)。各级食管病变在地理分布上差异均无统计学意义(P>0.05)。结论:在食管癌高发区人群中存在着相当数量的癌前病变患者,对该部分高危人群进行食管癌内镜筛查并进行癌症综合知识宣传,是做好食管癌二级预防工作的关键。Objective： To study the prevalence of esophageal and precancerous lesions in high risk areas in order to provide evidence for early diagnosis and treatment. Methods： Take random cluster sampling method to select a portion of natural villages as a screening object in high risk areas, endoscope iodine staining and indicated biopsy screening method were used for high risk people, and the pathology confirmed the diagnosis. Results： Esophageal inflammation detection rate was 8.40%, mild esophageal heterosexual hyperplasia detection rate was 7.65%, moderate esophageal heterosexual hyperplasia detection rate was 2.45%, severe esophageal heterosexual hvperolasia detection rate was 1.75%,esophageal cancer detection rate was 0. 45 %. From the gender distribution,esophageal inflammation of male, female detection rates were 11.07% （99/894） and 6. 24% （69/1 106） significant difference between two groups （X2 = 15.021, P 〈 0. 001 ） ; male, female esophageal cancer , with a detection rates were 0. 89% （8/894） and 0. 09% （1/1 106）, with a significant difference between two groups（X2 = 7. 142, P =0. 008 ）. Analysis by age group, esophageal inflammation at the age of 55-group had the highest detection rate [11.07% （56/506）], mild esophageal hyperplasia at the age of 60-group had the highest detection rate [10. 90% （46/422）], moderate esophageal hyperplasia at the age of 65- group had the highest detection rate [3.39% （8/236）]. Various types of esophageal lesions in the geographical distribution had no significant difference （P 〉 0. 05 ）. Conclusion： In the high risk area of esophageal cancer in populations with many premalignant lesions in patients, on the part of esophageal cancer by endoscopic screening and comprehensive cancer knowledge prooaganda, is the kev in esonhageal cancer primary prevention.

关 键 词：食管癌 癌前病变 普查 早诊早治 

分 类 号：R735.1[医药卫生—肿瘤]