Yamanashi Koseiren Health Care Center, Yamanashi, Japan.
Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
United European Gastroenterol J. 2022 Oct;10(8):868-873. doi: 10.1002/ueg2.12284. Epub 2022 Aug 17.
Esophageal squamous cell carcinoma (ESCC) has a poor prognosis; therefore, early detection is essential. In Japan, more than 90% of esophageal cancers are ESCC. Endoscopy is effective to detect ESCC in the early stage, but there is a limited number of reports examining its efficacy and effectiveness.
This study aimed to evaluate the efficacy of screening endoscopy for detecting ESCC.
This retrospective study analyzed the prevalence of ESCC, annual transition of prevalence, and the stage of each ESCC among 128,520 medical check-up patients who underwent esophagogastroduodenoscopy from April 2015 to March 2020 at Yamanashi Koseiren Health Care Center. Furthermore, a case-control study utilized the multivariate logistic regression analysis was performed to assess the risk factor of ESCC.
Among a total of 128,520 subjects, 42 ESCC patients were detected, with 95.2% being diagnosed at early stages. Annual prevalence in males was 0.015% (2/13,122) in 2015, 0.044% (6/13,562) in 2016, 0.044% (6/13,676) in 2017, 0.074% (10/13,488) in 2018%, and 0.11% (16/14,386) in 2019. ESCC prevalence has been increasing each year. A significant increase was observed between 2015 and 2018 (p = 0.039). ESCC prevalence was 0.102% (25/24,272) when focusing on males aged over 50 years with a history of smoking and drinking. Regarding the case-control study, the multivariate logistic regression analysis revealed smoking (p = 0.044), mean corpuscular volume (MCV) (p = 0.0018), and severe gastric atrophy (p = 0.048) as positively correlated with ESCC.
In conclusion, ESCC has been increasing in our center from 2015 to 2019, and the prevalence has been approaching that of gastric cancer in 2019 in male subjects. ESCC can be detected efficiently by targeting males with high MCV who have a history of drinking and smoking.
食管鳞状细胞癌（ESCC）预后较差，因此早期发现至关重要。在日本，超过 90%的食管癌为 ESCC。内镜检查可有效检测早期 ESCC，但有关其疗效和有效性的报道较少。
本研究旨在评估筛查性内镜检查对 ESCC 的检测效果。
本回顾性研究分析了 2015 年 4 月至 2020 年 3 月在山梨县保健中心接受食管胃十二指肠镜检查的 128520 例体检患者中 ESCC 的流行率、年度变化率以及各 ESCC 分期。此外，采用多变量 logistic 回归分析进行病例对照研究，以评估 ESCC 的危险因素。
在总共 128520 名受试者中，发现 42 例 ESCC 患者，其中 95.2%为早期诊断。2015 年男性的年患病率为 0.015%（2/13122），2016 年为 0.044%（6/13562），2017 年为 0.044%（6/13676），2018 年为 0.074%（10/13488），2019 年为 0.11%（16/14386）。ESCC 的患病率每年都在增加。2015 年至 2018 年期间观察到显著增加（p=0.039）。当关注有吸烟和饮酒史的 50 岁以上男性时，ESCC 的患病率为 0.102%（25/24272）。关于病例对照研究，多变量 logistic 回归分析显示吸烟（p=0.044）、平均红细胞体积（MCV）（p=0.0018）和严重胃萎缩（p=0.048）与 ESCC 呈正相关。
总之，自 2015 年以来，我们中心的 ESCC 病例一直在增加，并且在 2019 年男性患者中，ESCC 的患病率已接近胃癌。通过针对有饮酒和吸烟史的高 MCV 男性，可以有效地检测到 ESCC。
