辽宁省上消化道癌机会性筛查结果分析  

Analysis of opportunistic screening for upper gastrointestinal cancer in Liaoning Province

作　　者：佟爽[1] 阎佳宁 尚德高[1] 秦怡[1] 孙笠翔[2] 于连政[1] TONG Shuang;YAN Jia-ning;SHANG De-gao;QIN Yi;SUN Li-Xiang;YU Lian-zheng(Liaoning Provincial Center for Disease Control and Prevention,Shenyang 110005,China)

机构地区：[1]辽宁省疾病预防控制中心慢性非传染性疾病预防控制所,辽宁沈阳110005 [2]辽宁省疾病预防控制中心艾滋病与性传播疾病预防控制所,辽宁沈阳110005

出　　处：《中华肿瘤防治杂志》2022年第8期544-548,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家重点研发计划(2018YFC1311600);中国消化道癌医师共同成长计划(GTCZ-2020-LN-21-0002);辽宁省科学技术计划(2019-ZD-1086)。

摘　　要：目的评估辽宁省开展上消化道癌机会性筛查的效果,为探索上消化道癌筛查模式提供参考依据。方法选取2019-07-01-2020-12-31辽宁省7个地市医院消化科就诊的患者为研究对象,按照国家下发的机会性筛查标准流程,根据高危人群评估标准,对高危人群进行筛查。将筛查结果按照病变类型及严重程度进行分类,采用χ^(2)检验比较不同筛查方式(无痛胃镜、染色、活检)在上消化道病变检出率的差异,分析影响上消化道癌筛查检出情况的因素。结果28682人完成机会性筛查,共检出上消化道异常改变28513人,检出率为99.41%。上消化道癌相关病变(高级别上皮内瘤变+黏膜内癌+中晚期癌)920人,检出率为3.21%,早期上消化道癌病变(高级别上皮内瘤变+黏膜内癌)247人,早诊率为26.85%(247/920)。上消化道癌(黏膜内癌+中晚期癌)681人,检出率为2.37%。是否采用无痛筛查方式在上消化道异常病变、早期病变及中晚期癌检出率中差异无统计学意义,均P>0.05。总体活检率为23.54%,是否采用活检的筛查方式在上消化道异常病变、早期病变及中晚期癌检出率中差异有统计学意义,均P<0.05。是否采用染色的筛查方法在上消化道异常病变、早期病变及中晚期癌检出率中差异无统计学意义,均P>0.05。但物理染色与化学染色相结合的筛查方法在早期上消化道癌病变中检出率最高(3.15%),其次是化学染色(2.33%),物理染色最低(0.83%),且差异有统计学意义,χ^(2)=36.256,P<0.001。结论活检和化学染色等技术方法是国家推行机会性筛查的主要侧重点,本研究结果证实严格依据国家推行方案,对于提高上消化道癌检出率具有重要意义,但目前开展项目医院依从性仍有待于提高,应在今后的推广过程中进一步强化。Objective To evaluate the effect of opportunistic screening for upper gastrointestinal cancer in Liaoning Province, and provide a reference for exploring the screening mode of upper gastrointestinal cancer.Methods The patients who admitted in the gastroenterology department of 7 prefecture-level hospitals from 2019-07-01-2020-12-31 in Liaoning Province were selected as the research objects.According to the standard process of opportunistic screening issued by the state and the evaluation criteria of high-risk groups, screened the high-risk groups.The screening results were classified according to the type and severity of the lesions, and the χ^(2) test was used to compare the differences in the detection rate of upper gastrointestinal lesions among different screening methods(painless gastroscopy, staining, biopsy),and to analyze the influence of screening tests on upper gastrointestinal cancer.Results A total of 28 682 people completed the opportunistic screening, and 28 513 people with abnormal changes in the upper gastrointestinal tract were detected, with a detection rate of 99.41%.There were 920 patients with upper gastrointestinal cancer-related lesions(high grade intraepithelial neoplasia+intramucosal cancer+advanced cancer),with a detection rate of 3.21%,and 247 patients with early upper gastrointestinal cancer lesions(high grade intraepithelial neoplasia+intramucosal cancer),with an early diagnosis rate was 26.85%(247/920).There were 681 patients with upper gastrointestinal cancer(intramucosal cancer+advanced cancer),with a detection rate of 2.37%.There was no significant difference in the detection rate of abnormal lesions of the upper gastrointestinal tract, early lesions and intermediate and advanced cancers between patients with or without painless screening,all P>0.05.The overall biopsy rate was 23.54%,and there were statistically significant differences in the detection rate of abnormal upper gastrointestinal lesions,early lesions and advanced cancers with or without biopsy,all P<0.05.There was no

关 键 词：癌症 上消化道 机会性筛查 检出率 活检 胃镜 

分 类 号：R735[医药卫生—肿瘤]