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目的初步探索粪隐血试验(FOBT)在高原地区社区人群胃癌筛查中的可行性及应用价值。方法选择拉萨市堆龙德庆县乃琼镇社区作为调查研究现场,以35岁以上人群作为调查对象,通过问卷调查,FOBT结合胃镜序贯筛检方案进行胃癌筛查。结果共完成FOBT 1 281例,阳性36例,阳性率为2.8%。FOBT阳性人群进一步行电子胃镜检查,检出高原地区常见上消化道疾病7种,分别为糜烂性胃炎14例(38.9%),慢性浅表性胃炎7例(19.4%),消化性溃疡5例(13.9%),十二指肠球炎4例(11.1%),慢性萎缩性胃炎3例(8.3%),胆汁反流性胃炎2例(5.6%),高山食管胃黏膜像1例(2.8%)。FOBT阳性人群胃镜筛查未能检出癌前病变胃黏膜中、重度不典型增生(高级别上皮内瘤变),也未能检出早期及中、晚期胃癌。结论 FOBT在高原地区社区人群常见上消化道疾病筛查中具有一定意义,但对于胃癌初筛其价值需进一步深入探讨。
Objective To explore the feasibility and application value of FOBT in the screening of gastric cancer in community in plateau area. Methods The community of Naoqiong Town, Dandong County, Lhasa City, was selected as the site of investigation and study. Patients over 35 years of age were selected as the survey subjects. Through the questionnaire survey and FOBT combined with gastroscopy sequential screening program, gastric cancer screening was conducted. Results A total of 281 281 FOBT cases were completed, with a positive rate of 2.8%. FOBT positive population further electronic gastroscopy, detected in the plateau common upper digestive tract disease 7, respectively, 14 cases of erosive gastritis (38.9%), chronic superficial gastritis in 7 cases (19.4%), peptic ulcer in 5 cases (13.9%), 4 cases of duodenal inflammation (11.1%), 3 cases of chronic atrophic gastritis (8.3%), 2 cases of bile reflux gastritis (5.6% %). FOBT positive population gastroscopy failed to detect precancerous lesions in gastric mucosa, severe dysplasia (high grade intraepithelial neoplasia), failed to detect early and middle and late gastric cancer. Conclusions FOBT is of great significance in the screening of common upper gastrointestinal diseases in community population in plateau area. However, the value of FOBT screening in gastric cancer should be further explored.