Feng X, Hua Z L, Qian D F, Zhou Q, Shi A W, Wei W W, Zhou J Y
Yangzhong Cancer Institute of Jiangsu Province, Yangzhong 212200, China.
School of Medicine and Politics, Nanjing Medical University, Nanjing 211166, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Jun 10;41(6):908-912. doi: 10.3760/cma.j.cn112338-20190606-00407.
To understand the incidence of esophageal cancer in population at high risk in Yangzhong of Jiangsu province. Cluster random sampling method was conducted to select several natural villages from the high risk area of esophageal cancer in Yangzhong during 2011-2017. Local residents aged 40-69 years were selected as the target population and a total of 14 687 persons were diagnosed esophageal cancer by endoscopy and pathology. Precancerous lesions were detected in 341 persons, with the detection rate as 2.32 (341/14 687). Among them, there were 234 (1.59) cases with mild and 107 (0.73) cases with moderate esophageal hyperplasia. There were 77 positive cases with esophageal hyperplasia and the detection rate was 0.52. Among these positive cases, 41 showed severe esophageal hyperplasia/carcinoma in situ (0.28), with another 19 as early esophageal cancer (0.13) and 17 with invasive carcinoma (0.12). The overall early detection rate of positivity through active screening was 77.92 (60/77), with trends of upwarding and then downwarding. The detection rate of esophageal lesions in men was higher than that in women (<0.05), but without significant gender specific differences seen in the detection rates of early esophageal cancer or invasive carcinoma (>0.05). The detection rates of all lesions other than invasive carcinoma, gradually increased with age (<0.05). The detection rate of invasive carcinoma reached the highest (0.39, 10/2 547) in the age group of 60-years and slightly decreased in the age group of 65-years old. Considerable numbers of patients with cancer and precancerous lesions in groups at high-risk can be found through the screening program for esophageal cancer, suggesting that the screening program is of great significance in improving the survival rate and quality of life. Attention should be paid to men, with elderly groups in particular, at high-risk in order to increase the detection rate of early cases.
为了解江苏省扬中市高危人群食管癌的发病情况。采用整群随机抽样方法，于2011 - 2017年从扬中市食管癌高发区选取若干自然村落。选取40 - 69岁的当地居民作为目标人群，经内镜及病理检查，共确诊食管癌患者14687例。检出癌前病变341例，检出率为2.32（341/14687）。其中，轻度食管上皮增生234例（1.59），中度食管上皮增生107例（0.73）。食管上皮增生阳性77例，检出率为0.52。在这些阳性病例中，重度食管上皮增生/原位癌41例（0.28），早期食管癌19例（0.13），浸润癌17例（0.12）。主动筛查的总体阳性早检率为77.92（60/77），呈先上升后下降趋势。男性食管病变检出率高于女性（<0.05），但早期食管癌及浸润癌的检出率在性别上无显著差异（>0.05）。除浸润癌外，其他病变的检出率均随年龄增长而逐渐升高（<0.05）。浸润癌检出率在60岁年龄组最高（0.39，10/2547），在65岁年龄组略有下降。通过食管癌筛查项目可发现大量高危人群中的癌症及癌前病变患者，提示该筛查项目对提高生存率和生活质量具有重要意义。应关注高危人群中的男性，尤其是老年人群，以提高早期病例的检出率。
