新型食管细胞采集器在蒙古族与汉族食管癌高危人群中的应用研究——蒙古族与汉族细胞学检查结果危险因素分析  

Esophageal Cancer Screening and High-Risk Factor Investigation in High-Risk Populations of Mongolian and Han Ethnicities

作　　者：阿拉旦乌拉 常志恒 党彤[3] 王颖莉 汤泊夫 刘璐[3] ALADAN Wula;CHANG Zhi-heng;DANG Tong;WANG Ying-li;TANG Bo-fu;LIU Lu(Inner Mongolia University of Science and Technology,Baotou Medical College 014040;First Hospital of Hohhot,Digestive Department 010020;Second Affiliated Hospital of Inner Mongolia University of Science and Technology,Baotou Medical College,Digestive Department 014031;Baotou Center for Disease Control and Prevention,Public Health Department 0140300)

机构地区：[1]内蒙古科技大学包头医学院,014040 [2]呼和浩特市第一医院消化内科,010020 [3]内蒙古科技大学包头医学院第二附属医院消化内科,014031 [4]包头市疾病预防控制中心公共卫生科,0140300

出　　处：《现代消化及介入诊疗》2024年第2期135-140,145,共7页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：呼和浩特市卫生健康领域科技项目(呼卫健青年2023001)。

摘　　要：目的验证新型食管细胞采集器-食管脱落细胞学检查对食管癌的筛查效能,调查分析蒙古族与汉族细胞学检查结果及高危因素。方法(1)选取就诊于包头医学院第二附属医院的1196例食管癌高危人群,采集食管细胞,完善内镜检查及食管的黏膜活检,以上消化道内镜活检组织病理学为金标准,验证细胞学检查的诊断效能;(2)选取包头地区参与食管癌筛查的9256例汉族人群及572例蒙古族人群作为研究对象,以问卷调查形式收集受试者一般资料,饮食习惯、生活习惯等信息,通过新型食管细胞采集器采集食管细胞,采用Logistic回归分析汉族与蒙古族细胞学阳性的危险因素。结果(1)新型食管细胞采集器-食管脱落细胞学检查具有较好的食管癌筛查能力,灵敏度(92.86%)、特异度(99.58%)、PPV(72.22)、NPV(99.92%)、PLR(221.10)、NLR(0.07)、约登指数(0.92)、ROC曲线下面积为0.961(0.923~1.0),截断值取2.50时,灵敏度为92.90%,特异度为88.20%;(2)蒙古族人群细胞学阳性率2.27%高于汉族人群的1.12%(P<0.05);饮酒者占比、热烫饮食习惯人群占比、食用腌制食品人群占比均高于汉族人群(P<0.05);经Logistics回归分析得出汉族人群的危险因素为,性别(OR=0.381,95%CI:0.256~0.568)、年龄(OR=1.091,95%CI:1.067~1.116)、饮酒(OR=1.693,95%CI:1.150~2.492)、吸烟(OR=2.127,95%CI:1.439~3.143);蒙古族人群的危险因素为性别(OR=0.174,95%CI:0.047~0.638)、年龄(OR=1.124,95%CI:1.052~1.200)、饮酒(OR=3.945,95%CI:1.074~14.489)。结论①新型食管细胞采集器-食管脱落细胞学检查对食管癌有较好的筛查效能;②蒙古族人群中性别、年龄、饮酒、热烫饮食习惯是导致细胞学诊断阳性的主要风险因素,汉族人群中性别、年龄、饮酒、吸烟是导致细胞学诊断阳性的主要风险因素。Objective To assess the screening efficacy of a novel esophageal cell collector and esophageal exfoliated cell cytology examination for esophageal cancer and investigate risk factors associated with cytological examination results in the Han and Mongolian ethnic groups.Methods①A total of 1196 high-risk individuals with esophageal cancer were selected for treatment at the Second Affiliated Hospital of Baotou Medical College.Esophageal cells were collected,and endoscopic examination and mucosal biopsy of the esophagus were performed.The pathological examination of the digestive tract endoscopic biopsy tissue was used as the gold standard to verify the diagnostic efficacy of cytological examination.①In this study,9256 Han and 572 Mongolian individuals who participated in esophageal cancer screening in the Baotou area were selected as the research subjects.General information,dietary habits,lifestyle habits,and other information of the subjects were collected through a questionnaire survey.Esophageal cells were collected using a new type of esophageal cell collector,and logistic regression analysis was used to identify the risk factors for positive cytology in Han and Mongolian populations.Results①The novel esophageal cell collector and esophageal exfoliated cell cytology examination demonstrated excellent screening capabilities for esophageal cancer,with sensitivity(92.86%),specificity(99.58%),positive predictive value(PPV)of 72.22%,negative predictive value(NPV)of 99.92%,positive likelihood ratio(PLR)of 221.10,negative likelihood ratio(NLR)of 0.07,Youden index of 0.92,and an area under the ROC curve of 0.961(0.923-1.0).The optimal cutoff value was 2.50,yielding a sensitivity of 92.90%and specificity of 88.20%.②The cytological positivity rate among the Mongolian population(2.27%)was higher than that among the Han population(1.12%).The proportion of alcohol drinkers,those with a preference for hot and spicy foods,and those consuming pickled foods was higher in the Mongolian population than in the Han populati

关 键 词：食管癌筛查 新型食管细胞采集器-食管脱落细胞学检查 蒙古族 汉族 危险因素 

分 类 号：R571[医药卫生—消化系统]