CAJ | 학술논문

目的：探讨食管癌高发区农村居民食管癌和贲门癌及其各级癌前病变的患病情况。方法2006—2012年在食管癌高发区山东省肥城市部分乡镇采用整群随机抽样的方法，选取部分自然村40～69岁农村居民作为筛查对象，对其采用内镜下碘染色及指示性活检进行筛查，并行病理诊断。结果2006—2012年肥城市共完成24759人次筛查，食管、贲门阳性病例检出率分别为1．37％和0．42％，早诊率分别为84．71％和65．05％，治疗率分别为92．65％和92．23％；男性食管、贲门各级病变的检出率高于女性（ P＜0．05），且食管、贲门各级病变的检出率均随着受检者年龄的增长而增加。时间趋势分析显示，肥城市食管、贲门各级病变的检出率无明显增加或减少趋势，食管病变的检出率高于贲门病变。结论肥城市人群中存在相当数量的癌前病变患者，男性和老年人是食管癌（贲门癌）防治的重点人群。内镜碘染色可有效地提高食管癌（贲门癌）及其癌前病变的检出率，筛查中贲门脊根部必须重点观察，以提高人群贲门早期病变的检出率。
목적：탐토식관암고발구농촌거민식관암화분문암급기각급암전병변적환병정황。방법2006—2012년재식관암고발구산동성비성시부분향진채용정군수궤추양적방법，선취부분자연촌40～69세농촌거민작위사사대상，대기채용내경하전염색급지시성활검진행사사，병행병리진단。결과2006—2012년비성시공완성24759인차사사，식관、분문양성병례검출솔분별위1．37％화0．42％，조진솔분별위84．71％화65．05％，치료솔분별위92．65％화92．23％；남성식관、분문각급병변적검출솔고우녀성（ P＜0．05），차식관、분문각급병변적검출솔균수착수검자년령적증장이증가。시간추세분석현시，비성시식관、분문각급병변적검출솔무명현증가혹감소추세，식관병변적검출솔고우분문병변。결론비성시인군중존재상당수량적암전병변환자，남성화노년인시식관암（분문암）방치적중점인군。내경전염색가유효지제고식관암（분문암）급기암전병변적검출솔，사사중분문척근부필수중점관찰，이제고인군분문조기병변적검출솔。
Objective To investigate the prevalence of esophageal and gastric cardia cancer and various precancerous lesions in high?risk rural areas. Methods Random cluster sampling method was used to select people aged 40?69 years of some natural villages as screening objects in Feicheng, Shangdong province, from 2006 to 2012. The screening program was conducted by endoscopy with iodine staining and indicative biopsy followed by pathological examination. Results A total of 24 759 subjects were screened during 2006?2012 years. The positive detection rates of esophagus and gastric cardia cancers were 1.37% and 0.42% , respectively, the early diagnosis rates were 84. 71% and 65. 05%, and the treatment rates were 92.65% and 92.23%, respectively. The detection rates of all lesions in males were significantly higher than those in females (P<0.05), and were gradually increased with age(P<0.05). The time trend analysis showed that detection rates of all lesions in the two sites showed no significant changes during this period, and the detection rates of esophageal lesions were higher than those of gastric cardia. Conclusions There are considerable numbers of patients with precancerous lesions in the general population from the high risk areas. Men and the elderly are the key populations calling for cancer control programs.Endoscopy using iodine staining is an effective method to increase the detection rate of precancerous lesions and cancers. The root of mucosal fold in gastric cardia must be carefully observed so as to increase the detection rate of early gastric cardia lesions.