河南贲门癌高、低发区人群贲门粘膜组织活检结果分析  

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

作　　者：张延瑞[1] 高珊珊[1] 刘宾[2] 冯常炜[3] 王天佑[2] 谢新纪[2] 王虹[2] 白永敏[1] 岳文彬[1] 范宗民[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] 陈虹[1] 秦艳茹[1] 孙超[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 焦新英 郭梅[5] 王立东[1] 

机构地区：[1]郑州大学医学院癌症研究室,郑州450052 [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]林州市姚村食管癌医院,林州456592 [5]安阳市肿瘤医院病理科,安阳455000

出　　处：《郑州大学学报（医学版）》2002年第6期782-785,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 :通过贲门癌高、低发区 1975例无症状居民普查 ,进一步了解贲门上皮病变的特征及其与性别、年龄的关系 ,加深对贲门癌变多阶段演进的形态学变化特征的了解。方法 :对食管癌高发区 10 0 6无症状居民 ,低发区 2 0 8无症状居民进行纤维内镜检查、粘膜活检和组织病理检查。结果 :高发区 10 0 6例活检标本中 ,共发现 9例早期贲门腺癌患者 (GCA ,0 .9% ) ,33例间变患者 (DYS ,3.3% ) ,10 2例慢性萎缩性贲门炎患者 (CAG ,10 .1% )和2 6 9例慢性浅表性贲门炎患者 (CSG ,2 6 .7% ) ,以及 5 93例正常贲门上皮 (NOR ,5 8.9% )。 9例早期GCA均发生在男性 ,间变患者男性明显高于女性 ;低发区 :2 0 8例普查对象中 ,未发现早期GCA ,但发现 2例DYS(1.0 % ) ,7例CAG(3.4 % ) ,118例CSG(5 6 .7% )和 81例正常贲门上皮 (38.9% )。男性CAG较女性常见 ,2例DYS中 ,男女各 1例。结论 :贲门癌高发区居民GCA、DYS、CAG的发现率明显高于低发区 ,进一步证实贲门癌的地域性分布特征 。Aim: To characterize the prevalence of gastric cardia lesions, to correlate these lesions with sex and age through mass survey on 1 975 symptom free subjects from the high and low incidence area and to expand the knowledge on morphological changes in multistage carcinogenesis of gastric cardia adenocarcinoma (GCA). Methods: Endoscopy, mucosal biopsy and histopathology were applied.Results: In high incidence area, of the 1006 biopsy samples examined, 9 cases were identified as early GCA (0.9%),33 cases,as dysplaisa(DYS,3.3%),102 cases,as chronic atrophic gastritis(CAG,10.1%), 269 cases,as chronic superficial gastritis(CSG, 26.7%), and 593 cases,as normal(NOR, 58.9%). The detection rates of DYS were higher in males than in females;In low incidence area, of the 208 biopsy samples examined, no early GCA was identified. But 2 cases were identified as DYS(1.0%),one in male, the other in female.seven cases were identified as CAG(3.4%), 118 cases as CSG(56.7%)and 81 cases as normal(38.9%).Conclusion:The results confirm the dramatic geographic distribution of GCA, and suggest that DYS and CAG may be the severe precancerous lesions of GCA.

关 键 词：河南 贲门癌 低发区 高发区 人群 贲门粘膜组织 活检 结果分析 

分 类 号：R735.2[医药卫生—肿瘤]