Wang X, Li B, Bao Y, Wang Y, Wang A R, Qiao L
Cancer Prevention and Control Office, Sichuan Cancer Hospital & Sichuan Cancer Center, Chengdu 610041, China.
Department of Endoscopy, Sichuan Cancer Hospital & Sichuan Cancer Ccenter, Chengdu 610041, China.
Zhonghua Zhong Liu Za Zhi. 2017 Jan 23;39(1):67-71. doi: 10.3760/cma.j.issn.0253-3766.2017.01.013.
To analyze the efficacy of endoscopic screening for esophageal cancer in high risk population from high risk areas in order to provide scientific basis for evaluation of the results of early diagnosis and treatment of esophageal cancer. Ten high incidence cities and counties of esophageal cancer in Sichuan province were included in this study. Subjects aged 40-69 years were selected to participate in the endoscopic screening based on the cluster sampling, and the screening-positive subjects were further confirmed by pathological examination. A total of 105 561 subjects were screened during 2006-2014 in 10 cities and counties in Sichuan Province. The detection rate of precancerous lesions was 5.53% (5 841/105 561), and the positive detection rate was 1.13% (1 193/105 561). The overall detection rates of low-grade hyperplasia, moderate hyperplasia, high-grade hyperplasia/carcinoma in situ, early esophageal cancer and invasive carcinoma were 3.87% (4 089/105 561), 1.66% (1 752/105 561), 0.77% (816/105 561), 0.08% (84/105 561) and 0.28% (293/105 561), respectively. The detection rates of all lesions in males were significantly higher than those in females (<0.05), and were gradually increased with age (<0.05). At these ten cities and counties in Sichuan Province with high incidence of esophageal cancer, the endoscopic screening has good effect. There are considerable numbers of patients aged 40-69 with precancerous lesions from the high risk areas. Improving the follow-up work of the population with precancerous lesions will achieve better results of early diagnosis and early treatment.
分析食管癌高发区高危人群内镜筛查的效果，为评估食管癌早期诊断与治疗效果提供科学依据。本研究纳入四川省食管癌高发的10个市、县。采用整群抽样的方法选取年龄在40 - 69岁的受试者参与内镜筛查，筛查阳性者进一步行病理检查确诊。2006 - 2014年期间，四川省10个市、县共筛查105 561例受试者。癌前病变检出率为5.53%（5 841/105 561），阳性检出率为1.13%（1 193/105 561）。低级别上皮内瘤变、中级别上皮内瘤变、高级别上皮内瘤变/原位癌、早期食管癌及浸润癌的总体检出率分别为3.87%（4 089/105 561）、1.66%（1 752/105 561）、0.77%（816/105 561）、0.08%（84/105 561）和0.28%（293/105 561）。所有病变的男性检出率均显著高于女性（P<0.05），且随年龄增长逐渐升高（P<0.05）。在四川省食管癌高发的这10个市、县，内镜筛查效果良好。有相当数量来自高危地区的40 - 69岁人群存在癌前病变。加强对癌前病变人群的随访工作，将取得更好的早期诊断和早期治疗效果。
