Lin P, Zhang J, Rong Z, Han R, Xu S, Gao R, Ding Z, Wang J, Feng H, Cao S
Institute of Oncology, CAMS, Beijing.
Proc Chin Acad Med Sci Peking Union Med Coll. 1990;5(3):121-9.
Since 1983, we have been conducting inhibitory therapy for precancerous lesions of the esophagus in two regions of Henan Province considered high-risk areas of esophageal carcinoma. Our goal was to effect a 50% reduction in the canceration rate of marked esophageal dysplasia. By means of a cytological survey, 2531 cases of marked esophageal dysplasia and 3393 cases of mild esophageal dysplasia were selected. The former were randomly divided into 3 groups for antitumor-B (ATB, a mixture of Chinese herbs), retinamide (4-ethoxycarbophenylretinamide) and placebo treatment respectively, and the latter into 2 groups treated with riboflavin and placebo respectively. Treatment was continued for 3 or 5 years (administration rate greater than 90% in all groups) and esophageal cytology reexamined (reexamination rates were 94.1% and 92.5% respectively). Our results were as follows: 1) ATB 3- and 5-year subjects saw the canceration rate of marked esophageal dysplasia drop by 52.2% and 47.3% respectively as compared to control (P less than 0.01). 2) Retinamide lowered the canceration rate by 37.3% after a 3-year treatment period, with this reduction reaching 43.2% after an additional 2 years of treatment with increased dosages (P less than 0.05, P less than 0.01). 3) In the riboflavin group, the canceration rate of mild esophageal dysplasia was reduced by 22.2% and 34.8% after 3 and 5 years of treatment respectively, but these differences were not statistically significant. The above results verify the efficacy of medicamentous inhibitory therapy for esophageal precancerous lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
自1983年以来,我们一直在河南省两个被视为食管癌高发区的地区对食管的癌前病变进行抑制性治疗。我们的目标是使显著食管发育异常的癌变率降低50%。通过细胞学调查,选取了2531例显著食管发育异常病例和3393例轻度食管发育异常病例。前者被随机分为3组,分别接受抗癌乙(ATB,一种中草药混合物)、维甲酸(4-乙氧羰基苯基维甲酸)和安慰剂治疗,后者分为2组,分别接受核黄素和安慰剂治疗。治疗持续3年或5年(所有组的给药率均大于90%),并对食管细胞学进行复查(复查率分别为94.1%和92.5%)。我们的结果如下:1)与对照组相比,接受ATB治疗3年和5年的显著食管发育异常患者的癌变率分别下降了52.2%和47.3%(P<0.01)。2)维甲酸在治疗3年后使癌变率降低了37.3%,在额外增加剂量治疗2年后,这一降低率达到43.2%(P<0.05,P<0.01)。3)在核黄素组中,轻度食管发育异常患者在治疗3年和5年后的癌变率分别降低了22.2%和34.8%,但这些差异无统计学意义。上述结果证实了药物抑制疗法对食管癌前病变的疗效。(摘要截选至250字)