Yang Huihua, Berner Aasmund, Mei Qiang, Giercksky Karl-Erik, Warloe Trond, Yang Guanrui, Cui Jianguo, Suo Zhenhe, Zhang Sanshen, Nesland Jahn M
Department of Pathology, Anyang Tumour Hospital, Department of Oncopathology, Henan Institute of Medical Sciences, Henan Medical University, Anyang, Henan, China.
Acta Cytol. 2002 May-Jun;46(3):445-52. doi: 10.1159/000326859.
Anyang County, China, is one of the areas with the highest incidence of esophageal cancer in the world. Esophageal cancer has a poor prognosis because most tumors are unresectable at the time of diagnosis. We launched a screening study for early esophageal carcinoma in western Anyang County in 1997. The scope was to identify patients with in situ and early invasive carcinoma, applying esophageal balloon cytology and treating with photodynamic therapy (PDT).
The study cohort consisted of all inhabitants over 35 years of age in 10 communes. Screening was performed by balloon cytology. Grade 2 dysplasia and more advanced lesions were examined with endoscopy, including biopsy and brush cytology, followed by PDT for early cancer.
In total, 20,049 persons participated in the screening program, and 1,018 were diagnosed with a grade 2 dysplasia or higher, including 164 invasive cancers and 169 near-cancers. Ninety-four percent of atypical lesions were of squamous cell type. Seventy-two percent of cases showing severe dysplasia and cancer were located to the middle esophageal segment. The prevalence of dysplasia and cancer increased significantly with age. The balloon cytology results were confirmed by brush cytology and histology.
Balloon cytology is a reliable method for esophageal cancer screening. Positive cytology must be verified by endoscopy and biopsy.
中国安阳县是世界上食管癌发病率最高的地区之一。由于大多数肿瘤在诊断时无法切除，食管癌的预后较差。1997年，我们在安阳县西部开展了一项早期食管癌筛查研究。其范围是识别原位癌和早期浸润癌患者，采用食管气囊细胞学检查并进行光动力疗法（PDT）治疗。
研究队列包括10个公社中所有35岁以上的居民。通过气囊细胞学进行筛查。对2级发育异常及更高级别的病变进行内镜检查，包括活检和刷检细胞学检查，然后对早期癌症进行光动力疗法治疗。
共有20049人参与了筛查项目，1018人被诊断为2级或更高级别的发育异常，其中包括164例浸润癌和169例癌前病变。94%的非典型病变为鳞状细胞类型。72%表现为重度发育异常和癌症的病例位于食管中段。发育异常和癌症的患病率随年龄显著增加。气囊细胞学检查结果经刷检细胞学和组织学证实。
气囊细胞学是一种可靠的食管癌筛查方法。阳性细胞学结果必须通过内镜检查和活检进行验证。
