2005-2009年中国食管癌高发区河南省林州市、山东省肥城市食管癌及其癌前病变人群分布研究  

Distribution of esophageal squamous cell cancer and precursor lesions in high-risk areas, Linzhou in Henan province and Feicheng in Shandong province of China, 2005-2009

作　　者：王孟[1] 郝长青[2] 赵德利[5] 李变云 王进武[4] 雷复华 周瑞雪 马山蕊 马箐[1] 李琰琰[1] 冯昊[1] 李新庆[1] 魏文强[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院流行病学教研室,100021 [2] 河南省林州市肿瘤医院腔镜室 [3] 山东省肥城市人民医院肿瘤防治中心 [4] 河南省林州市肿瘤医院流行病室 [5] 河南省林州市肿瘤医院病理室 [6] 山东省肥城市人民医院病理科 [7] 山东省肥城市人民医院消化科

出　　处：《中华预防医学杂志》2015年第8期677-682,共6页Chinese Journal of Preventive Medicine

基　　金：国家高技术研究发展计划（2012AA02A503）;国家自然科学基金（81241091）

摘　　要：目的：了解我国食管癌高发区食管癌及其癌前病变人群分布特征，为制定高发区食管癌及其癌前病变检出率参考值范围提供依据。方法利用食管癌高发区建立的自然人群队列，回顾性整理2005—2009年中国食管癌高发区河南省林州市和山东省肥城市40~69岁参加内镜下碘染色筛查人群病理诊断数据，共15709名，排除筛查前患有重要器官疾患者11例及病理诊断不明确者35例，进入分析的目标人群共15663名。计算内镜筛查依从性，比较食管癌及其癌前病变性别、地区、年龄分布差异，采用95%CI值分析食管癌及各级别癌前病变检出率范围。结果内镜筛查依从性为49.36%（15709/31826），女性（54.05%，8447/15628）依从性高于男性（44.83%，7262/16198）（χ2=88.14，P＆lt;0.001）。食管病变检出率为21.88%（3427/15663）。男性食管基底细胞增生、低级别上皮内瘤变、高级别上皮内瘤变、食管癌检出率分别为4.17%（302/7246）、17.22%（1248/7246）、1.67%（121/7246）、0.83%（60/7246），均高于女性[分别为3.45%（290/8417）、14.82%（1247/8417）、1.41%（119/8417）、0.48%（40/8417）]，且除高级别上皮内瘤变外，差异均有统计学意义（P值分别为0.018、＆lt;0.001、0.960、0.006）。食管癌及各级癌前病变检出率均随年龄增加而增加（P值均＆lt;0.001），其中40~44岁调查对象食管基底细胞增生、低级别上皮内瘤变、高级别上皮内瘤变、食管癌检出率分别为2.69%（94/3500）、8.11%（284/3500）、0.40%（14/3500）和0.14%（5/3500）；65~69岁调查对象分别为5.46%（46/843）、23.25%（196/843）、3.68%（31/843）和2.14%（18/843）。林州市食管基底细胞增生、低级别上皮内瘤变、高级别上皮内瘤变、食管癌检出率分别为4.90%（504/10287）、17.37%（1787/10287）、1.79%（184/10287）、0.60%（62/10287），除食管癌外，均高于肥城市[分别为1.64%（88/5376）�Objective To understand the distribution of esophageal squamous cell cancer and precursor lesions in high-risk areas of China, and to provide evidence for determining the reference ranges of detection rates in high-risk areas. Methods Endoscopy with Lugol＆#39;s iodine staining was performed on 15 709 local residents aged 40 to 69 years old in Linzhou of Henan province and Feicheng of Shandong province from 2005-2009. 35 cases without accurate pathology diagnosis and 11 cases with vital disease before screening were excluded.15 663 subjects were enrolled in this study. Compliance was calculated by the percentage of the people who had endoscopic screening among the target population. Chi-square test and trend chi-square test were used to compare the distribution differences in age, gender and areas of esophageal squamous cell cancer and precancer.95%CI of the detection rates was then employed to represent the reference ranges of esophageal squamous cell cancer and precursor lesions. Results The compliance rate of screening endoscopy of this study was 49.36%（15 709/31 826） of all, and female＆#39;s compliance （54.05%,8 447/15 628） was much higher than that of male（44.83%,7 262/16 198）（χ2=88.14, P＆lt;0.001）. The detection rates of basal cell hyperplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and esophageal squamous cell cancer of males were 4.17%（302/7 246）,17.22%（1 248/7 246）,1.67%（121/7 246）,0.83%（60/7 246）,and were higher than that of females（3.45%（290/8 417）,14.82%（1 247/8 417）,1.41%（119/8 417）,0.48%（40/8 417）, respectively）. Except for high-grade intraepithelial neoplasia, the detection rates of male were higher than that of female （P values were 0.018,＆lt;0.001,0.960,0.006） . The detection rates of all grades of precursor lesions increased with age rising（all P values ＆lt;0.001）, among which the detection rates of the mentioned four lesions for 40-44 years old were 2.69%（94/3 500）,8.11%（284/3 500）,0

关 键 词：食管肿瘤 癌前状态 患病率 

分 类 号：R735.1[医药卫生—肿瘤]