Zhang Meng, Li Xin, Zhang Shaokai, Chen Qiong, Liu Shuzheng, Guo Lanwei, Lu Jianbang, Sun Xibin
Henan Cancer Hospital & Institute, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
Department o f Safety Engineering, Henan University of Engineering, Zhengzhou 451191, China.
Zhonghua Zhong Liu Za Zhi. 2016 Jan;38(1):73-7. doi: 10.3760/cma.j.issn.0253-3766.2016.01.014.
To analyze the efficacy of endoscopic screening for gastric cancer in rural population in high risk areas of upper gastrointestinal cancer in Henan province.
Subjects aged 40-69 years in the high risk areas were selected to participate in the endoscopic screening based on the cluster sampling, and screening-positive subjects were sampled for pathological examination. The data of screening were summarized and the detection rates of severe chronic atrophic gastritis, severe intestinal metaplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia, early and middle-late cancer were calculated, and the constituent ratio of early cancer cases was calculated. The detection rates and early diagnosis rates for the first round screening and follow-up screening were compared.
In the 5 years, a total of 88 263 subjects were endoscopically examined in the first round screening and 4 004 subjects were diagnosed with low grade intraepithelial neoplasia or above (the detection rate was 4.54%), in which 3 256 cases were with low grade intraepithelial neoplasia (the detection rate of 3.69%), 366 cases with high grade intraepithelial neoplasia (the rate of 0.41%), 199 cases with early cancer (the rate of 0.22%) and 183 cases with middle-late cancer (the rate of 0.21%). The number of cases of high grade intraepithelial neoplasia and early cancer was 565 and the early diagnosis rate was 75.53%. 1 894 subjects with severe chronic atrophic gastritis, severe intestinal metaplasia and low grade intraepithelial were followed up with a compliance of 66.32%. A total of 45 cases of early cancer were diagnosed, with a detection rate of 2.38% and early diagnosis rate of 100%. The detection rate and early diagnosis rate in the follow-up screening were both statistically significantly higher than that in the first round screening (P<0.01 for both).
The efficacy of endoscopic screening for gastric cancer is significant in high risk areas of upper gastrointestinal cancer, and improving the quality of follow-up screening will achieve a better performance of the screening.
分析河南省上消化道癌高发区农村人群胃癌内镜筛查的效果。
采用整群抽样方法，选取高发区40 - 69岁人群进行内镜筛查，对筛查阳性者进行病理检查。汇总筛查数据，计算重度慢性萎缩性胃炎、重度肠化生、低级别上皮内瘤变、高级别上皮内瘤变、早期及中晚期癌的检出率，并计算早期癌病例的构成比。比较首轮筛查与随访筛查的检出率和早期诊断率。
5年间，首轮筛查共88263例接受内镜检查，4004例诊断为低级别上皮内瘤变及以上（检出率为4.54%），其中低级别上皮内瘤变3256例（检出率3.69%），高级别上皮内瘤变366例（检出率0.41%），早期癌199例（检出率0.22%），中晚期癌183例（检出率0.21%）。高级别上皮内瘤变和早期癌病例数共565例，早期诊断率为75.53%。对1894例重度慢性萎缩性胃炎、重度肠化生及低级别上皮内瘤变者进行随访，随访依从率为66.32%。共诊断出45例早期癌，检出率为2.38%，早期诊断率为100%。随访筛查的检出率和早期诊断率均显著高于首轮筛查（均P<0.01）。
上消化道癌高发区胃癌内镜筛查效果显著，提高随访筛查质量将使筛查取得更好效果。
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