CAJ | 학술논문

目的评价河南省食管癌筛查效果.方法 2009—2013年在河南省上消化道癌12个高发市、县中,以行政村为单位,选取40~69岁年龄组居民为筛查目标人群,共88 263名,进行内窥镜检查和病理学诊断.对食管癌前病变患者进行定期随访,轻度异型增生每3年随访1次,中度异型增生每年随访1次,重度异型增生/原位癌应进行临床治疗,拒绝治疗者每年至少随访1次.计算食管轻、中、重度增生以及原位癌、各期癌变的检出率,比较初次筛查与随访筛查的检出率和早诊率.结果在首次筛查中,检出轻度异型增生及以上病变8 434例,病变检出率为9.56%.其中轻、中度异型增生7 224例,检出率为8.18%,重度异型增生及原位癌789例(0.89%),早期癌239例(0.27%),中、晚期癌182例(0.21%).重度异型增生/原位癌和早期癌病变1 028例,早诊率为84.96%(1 028/1 210).2012—2013年应随访筛查4 230例轻度和中度异型增生病例,实际随访筛查2 853例,随访率为67.45%,确诊早期病变94例,检出率为3.29%,早诊率为100%.随访筛查的食管病变检出率和早诊率均高于首次筛查的结果指标(P<0.001).结论在河南上消化道癌症高发地区开展食管癌内镜筛查效果明显,加强随访筛查可提高筛查效果.
목적 평개하남성식관암사사효과.방법 2009—2013년재하남성상소화도암12개고발시、현중,이행정촌위단위,선취40~69세년령조거민위사사목표인군,공88 263명,진행내규경검사화병이학진단.대식관암전병변환자진행정기수방,경도이형증생매3년수방1차,중도이형증생매년수방1차,중도이형증생/원위암응진행림상치료,거절치료자매년지소수방1차.계산식관경、중、중도증생이급원위암、각기암변적검출솔,비교초차사사여수방사사적검출솔화조진솔.결과 재수차사사중,검출경도이형증생급이상병변8 434례,병변검출솔위9.56%.기중경、중도이형증생7 224례,검출솔위8.18%,중도이형증생급원위암789례(0.89%),조기암239례(0.27%),중、만기암182례(0.21%).중도이형증생/원위암화조기암병변1 028례,조진솔위84.96%(1 028/1 210).2012—2013년응수방사사4 230례경도화중도이형증생병례,실제수방사사2 853례,수방솔위67.45%,학진조기병변94례,검출솔위3.29%,조진솔위100%.수방사사적식관병변검출솔화조진솔균고우수차사사적결과지표(P<0.001).결론 재하남상소화도암증고발지구개전식관암내경사사효과명현,가강수방사사가제고사사효과.
Objective To evaluate effect of screening of esophageal cancer at rural areas in Henan province. Methods At rural areas with high incidence of upper gastrointestinal carcinoma in Henan province total of 88 263 persons with 40 to 69 years old were set to the target population of the screening by the 12 cities and countries and endoscope and pathology diagnosis were performed during 2009-2013. For patients with precancerous lesions, follow-up visits were conducted and defined as follows:once in three years for patients with mild dysplasia, once per year for moderate hyperplasia patients, the patients with severe intraepithelial neoplasia/carcinoma in situ should be treat, at least once per year for those one who didn't under treatment. The result data of screening were summarized and detection rates of esophagus hyperplasia, carcinoma in situ, early and middle-late cancer were calculated, as well as the early diagnosis rate. The result between first round and follow-up screening was compared. Results Target population were examined in first round screening. There were 8 434 persons with above mild dysplasia and the detection rate was 9.56%, among them there were 7 224 (8.18%) cases with light-middle hyperplasia, 789 (0.89%) cases with serious dysplasia or cancer in situ, 239 (0.27%) cases with early cancer and 182 (0.21%) cases with middle-late cancer. The sum of serious dysplasia or cancer in situ and early cancer was 1 028 and the early detection rate was 84.96%(1 028/1 210). From 2012 to 2013,the follow-up screening for persons with light-middle hyperplasia which should be followed 4 230 cases, there were 2 853 people to take in screening and compliance was 67.45%. Total of 94 cases were diagnosed with cancer in situ or early cancer. The detection rate and the early detection rate were 3.29%and 100%, respectively. The rates of detection and early detection in phase of follow-up screening were statistically significantly higher than that in first round screening respectively (P<0.001). Conclusion At rural areas of high incidence upper gastrointestinal carcinoma in Henan province,the screening with endoscope had good effect and strengthening the follow-up screening could increase the effect.