Lin P Z, Zhang J S, Cao S G, Rong Z P, Gao R Q, Han R, Shu S P
Cancer Institute, Chinese Academy of Medical Sciences, Beijing.
Zhonghua Zhong Liu Za Zhi. 1988 May;10(3):161-6.
In 1983, intervention of precancerous lesion of esophagus was undertaken in the high risk area of esophageal cancer, Heshun Village, Linxian County. It had been expected that cancerous degeneration rate of esophageal dysplasia should be reduced by 50% so as the prevention of esophageal cancer could become possible. 6758 subjects of the general population aging from 40 to 65 were examined by esophageal exfoliative cytology, 1729 had marked dysplasia and 2411 had mild dysplasia of esophageal epithelium. Those with marked dysplasia were randomized into 3 groups to take their respective medication: antitumor B (Chinese herbs); retinamide (4-Ethoxycarbophenylretinamide) and placebo. The subjects with mild dysplasia were divided randomly into 2 groups for treatment by riboflavin and placebo. 95% of the subjects had taken 90% or more of the total medication for 3 years, at the end of which they were reexamined by esophageal exfoliative cytology. The reexamination rate was 94.1%. The incidence of esophageal cancer in the antitumor B group (3.9%) was reduced by 53% as compared with that of the placebo group (8.3%). This difference had statistical significant (means 2 = 7.672, P less than 0.05). The incidence of esophageal cancer in retinamide and riboflavin groups were reduced by 33.7% and 19% as compared with those of the control groups. The regression rate of dysplasia in the treatment groups were increased than that of the control groups. The above results showed that our hypothesis about the secondary prevention of esophageal cancer is correct. The intervention of precancerous lesion of the esophagus is effective in the prevention of esophageal cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
1983年,在食管癌高发区林县合顺村开展了食管癌前病变干预研究。预期食管发育异常的癌变率应降低50%,从而使食管癌的预防成为可能。对6758名40至65岁的普通人群进行了食管脱落细胞学检查,其中1729人有重度发育异常,2411人有轻度食管上皮发育异常。将重度发育异常者随机分为3组,分别服用抗肿瘤B(中药)、维甲酸(4-乙氧羰基苯基维甲酸)和安慰剂。轻度发育异常者随机分为2组,分别用核黄素和安慰剂治疗。95%的受试者3年服用了90%以上的总药量,3年后再次进行食管脱落细胞学检查,复查率为94.1%。抗肿瘤B组食管癌发病率(3.9%)比安慰剂组(8.3%)降低了53%。这种差异具有统计学意义(均值2 = 7.672,P<0.05)。维甲酸组和核黄素组食管癌发病率比对照组分别降低了33.7%和19%。治疗组发育异常的消退率高于对照组。上述结果表明,我们关于食管癌二级预防的假设是正确的。食管癌前病变干预对预防食管癌是有效的。(摘要截短至250字)