河南食管癌高、低发区人群食管粘膜组织活检结果分析  

Analysis on prevalence of esophageal precancerous lesions and early esophageal cancer from the symptom-free subjects at high and low-incidence area in Henan

作　　者：张延瑞[1] 刘宾[2] 范宗民[1] 冯常炜[3] 白永敏[1] 岳文彬[1] 宋子博[1] 齐义军[1] 刘刚[1] 郭花芹[1] 庄则豪[1] 郭瑞锋[1] 安继业[1] 秦艳茹[1] 孙超[1] 陈虹[1] 李燕杰[1] 李吉学[1] 王启鸣[1] 贺新伟[1] 益新娜[1] 谢冬玲[1] 李吉林 高珊珊[1] 焦新英[1] 王立东[1] 

机构地区：[1]郑州大学医学院癌症研究室 [2]首都医科大学同仁医院消化内科,北京100730 [3]郑州大学第二附属医院消化内科,郑州450003 [4]河南省林州市姚村食管癌医院,林州456592

出　　处：《郑州大学学报（医学版）》2002年第6期771-774,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家杰出青年科学基金 3 0 0 2 5 0 16;河南省高校创新人才工程基金;河南省医药卫生创新人才工程基金资助项目

摘　　要：目的 :对食管癌高、低发区无症状居民食管粘膜组织活检结果进行分析。方法 :随机在高发区抽取 30岁以上无症状居民 16 84例和低发区 30岁以上无症状居民 2 94例 ,进行食管纤维内镜检查 ,粘膜活检和组织病理检查。结果 :高发区 16 32例调查对象中 ,共发现 17例早期食管癌患者 (SCC ,1.1% ) ,91例间变患者 (DYS ,5 .6 % ) ,80 7例基底细胞过度增生患者 (BCH ,4 9.4 % ) ,Barrett’s食管 12例 (0 .7% )。低发区 2 70例活检调查对象中 ,共发现BCH 94例 (34.8% ) ,DYS 3例 (1.1% ) ,Barrett’s食管 3例 (1.1% ) ,未发现早期SCC患者。结论 :无症状人群普查是发现早期食管癌患者及各级癌前病变患者最有效的手段。与 15a前该地区人群普查结果相比 ,食管癌和癌前病变检出率无明显差异 ,提示食管癌仍然是该地区人群最严重、最常见的恶性肿瘤。Aim: To further characterize the prevalence of different precancerous lesions and to correlate these observation with sex and age through mass survey at high and low incidence area in Henan.Methods: Endoscopy(Olympus GIF XQ30), mucosal biopsy and histopathology were applied to 1 684 symptom free subjects in high incidence area and 294 in low incidentce area.Results: In high incidence area, of the 1 632 symptom free subjects examined, there were 17 cases identified as early esophageal cancer (SCC, 1.1%), 91 cases as dysplaisa(DYS, 5.6%), 807 cases as basal cell hyperplasia (BCH, 49.4%), 12 cases as Barrett's esophagus(0.7%). In low incidence area, of the 270 cases symptom free subjects examined, there was no SCC patient identified, but there were 94 cases as BCH (34.8 %), 3 as DYS(1.1%) and 3 as Barrett's esophagus (1.1%).Conclusion: Mass survey was one of the most powerful strategies to detect early SCC and different precancerous lesions. To compare with mass survey results 15 years ago, the prevalence of early SCC and precancerous lesions does not change, suggesting that esophageal cancer remains the most common and severe tumor in this population.

关 键 词：河南 食管癌 低发区 高发区 人群 食管粘膜组织 活检 

分 类 号：R735.1[医药卫生—肿瘤]