目的 :探讨河南食管癌高发区无症状居民食管贲门交界部齿状线变化特征及其与食管贲门癌变的关系 ,进一步验证作者的假设 :即齿状线上移可能是该地区人群食管贲门交界部腺癌发生的重要早期改变之一。方法 :对河南食管癌高发区林州市和获嘉县 12 17例无症状居民 (≥ 30岁 )进行纤维内镜普查 ,粘膜活检和组织病理学检查。记录纤维内镜下齿状线的改变 (上移 ,不规则 ,不清晰 )并与组织病理学结果进行比较分析。活检组织均经体积分数为 85 %酒精固定 ,常规组织学石蜡包埋和HE染色。结果 :齿状线上移 (≥ 3cm) ,不规则和不清晰的检出率分别为 12 % ,10 %和 1%。男性各年龄组齿状线上移和不规则的检出率均明显高于相同年龄组女性患者 (P <0 .0 5 ) ,并随年龄增长 ,均呈现逐渐下降的趋势。女性 4 0～ 4 9岁年龄组齿状线不规则检出率明显高于其他年龄组(P <0 .0 5 )。齿状线不清晰检出率明显低于齿状线上移和不规则的检出率。齿状线上移患者食管下段发生基底细胞过度增生和间变的频率明显高于无齿状线上移的人群 ,而中段食管基底细胞过度增生无明显改变 ,但齿状线上移患者间变发生率明显升高 (P <0 .0 5 )。齿状线上移患者贲门慢性浅表性胃炎 ,慢性萎缩性胃炎伴肠上皮化生的发生率较无齿状线上移为高。结论 :河南 Objective: To investigate the changes of the dentate line at the junction of the esophagus and cardia in asymptomatic residents with high incidence of esophageal cancer in Henan Province and its relationship with the carcinogenesis of esophagus and cardia, and to further verify the author’s hypothesis that the uplift of the dentate line may be the esophagus and cardia junction One of the major early changes in the development of adenocarcinoma. Methods: 12 17 asymptomatic residents (≥ 30 years old) in Linzhou City and Xijia County, a high risk area of ​​esophageal cancer in Henan Province, were examined by fiber endoscopy, mucosal biopsy and histopathology. Changes in the endoscopic changes of the endoscopic fiber (upward, irregular, unclear) were recorded and compared with histopathological findings. Biopsy tissues were fixed by volume fraction of 85% alcohol, routine histological paraffin-embedded and HE staining. Results: The shift of dentate line (≥ 3cm), irregularity and unclear detection rate were 12%, 10% and 1% respectively. The detection rate of dentate line shift and irregular in each age group was significantly higher than that of female patients of the same age group (P <0.05), and showed a gradual downward trend with age. The irregular detection rate of dentate line in 40 ~ 40 years old women was significantly higher than that in other age groups (P0.05). The dentate line is not clear detection rate was significantly lower than the dentate line shift and irregular detection rate. The frequency of basal cell hyperplasia and metaplasia was significantly higher in patients with esophageal uplift than in those without uplift, while there was no significant change in the middle hyperplasia of esophageal basal cells. However, The incidence was significantly higher (P <0.05). The incidence of chronic superficial gastritis and chronic atrophic gastritis associated with intestinal metaplasia in patients with cardia on the shift on the dentate line was higher than that on the dentate line. Conclusion: Henan