河南省农村胃癌筛查效果分析  

Analysis of the efficacy of gastric cancer screening in rural population in Henan Province

作　　者：张萌[1] 李鑫[2] 张韶凯[1] 陈琼[1] 刘曙正[1] 郭兰伟[1] 陆建邦[1] 孙喜斌[1] 

机构地区：[1]河南省肿瘤医院郑州大学附属肿瘤医院肿瘤流行病研究所,郑州450008 [2]河南工程学院安全工程学院,郑州450000

出　　处：《中华肿瘤杂志》2016年第1期73-77,共5页Chinese Journal of Oncology

基　　金：中央财政转移支付项目（2006BA102A15）

摘　　要：目的分析河南省农村上消化道癌高发地区人群采用内窥镜进行胃癌筛查的效果。方法在河南省农村12个上消化道癌高发市、县中，以行政村为单位选取40～69岁年龄组居民为筛查目标人群，进行内窥镜检查和病理学诊断。对初筛中检出的2856例胃重度萎缩性胃炎、重度肠上皮化生和低级别上皮内肿瘤人群进行随访。对筛查结果数据进行汇总统计，分析癌前各状态、高级别上皮内肿瘤和各期癌变的检出率及早期病例的构成比，比较初次筛查与随访筛查的检出率和早诊率。结果对88263例目标人群进行首次筛查，检出低级别上皮内肿瘤及以上病变4004例，病变检出率为4．54％。其中，低级别上皮内肿瘤3256例（3．69％），高级别上皮内肿瘤366例（0．41％），早期癌199例（0．22％），中晚期癌183例（0．21％）。高级别上皮内肿瘤及早期癌共565例，早诊率为75．53％。随访筛查1894例，随访率为66．32％；确诊早期病例45例，检出率2．38％，早诊率为100％。初筛阳性人群的随访筛查检出率和早诊率均高于首次筛查结果，差异有统计学意义（均P〈0．01）。结论在农村上消化道恶性肿瘤高发地区开展胃癌内镜筛查效果显著，加强随访筛查可提高筛查效果。Objective To analyze the efficacy of endoscopic screening for gastric cancer in rural population in high risk areas of upper gastrointestinal cancer in Henan province. Methods Subjects aged 40-69 years in the high risk areas were selected to participate in the endoscopic screening based on the cluster sampling, and screening-positive subjects were sampled for pathological examination. The data of screening were summarized and the detection rates of severe chronic atrophic gastritis, severe intestinal metaplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia, early and middle-late cancer were calculated, and the constituent ratio of early cancer cases was calculated. The detection rates and early diagnosis rates for the first round screening and follow-up screening were compared. Results In the 5 years, a total of 88 263 subjects were endoscopically examined in the first round screening and 4 004 subjects were diagnosed with low grade intraepithelial neoplasia or above （the detection rate was 4.54% ）, in which 3 256 cases were with low grade intraepithelial neoplasia （the detection rate of 3.69%）, 366 cases with high grade intraepithelial neoplasia （the rate of 0.41%）, 199 cases with early cancer （the rate of 0.22%） and 183 cases with middle-late cancer （the rate of 0.21%）. The number of cases of high grade intraepithelial neoplasia and early cancer was 565 and the early diagnosis rate was 75.53%. 1 894 subjects with severe chronic atrophic gastritis, severe intestinal metaplasia and low grade intraepithelial were followed up with a compliance of 66.32%. A total of 45 cases of early cancer were diagnosed, with a detection rate of 2.38% and early diagnosis rate of 100%. The detection rate and early diagnosis rate in the follow-up screening were both statistically significantly higher than that in the first round screening （P〈0.01 for both）. Conclusion The efficacy of endoscopic screening for gastric cancer is significant in high risk areas of upper gastrointesti

关 键 词：胃肿瘤 自然腔道内镜手术 多相筛查 检出率 早诊率 

分 类 号：R735.2[医药卫生—肿瘤]