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目的通过内镜筛查了解食管癌高发区高危人群食管各级病变及食管癌的患病情况,为病因学研究提供科学依据。方法从2006～2011年在食管癌高发区四川省盐亭县,采取整群随机抽样的方法选择97个自然村作为筛查对象,对40～69岁的高危人群采取内镜下碘染色及指示性活检进技术行筛查,并经病理学诊断确诊。结果轻、中、重度食管增生的检出率分别为5.33%(803/15 065)、1.28%(193/15 065)、0.68%(102/15 065),原位癌、黏膜内癌、浸润性癌的检出率分别为0.15%(22/15 065)、0.06%(9/15 065)、0.29%(43/15 065);食管增生男性检出率高于女性;65岁之前轻、中、重度食管增生及浸润性癌的检出率随着年龄的增长而增加;时间分布上,轻、中、重度食管增生的检出率在不同年份之间差异具有统计学意义(P<0.01)。结论依托国家食管癌筛查项目,在食管癌高发区对高危人群进行癌症综合知识宣传,提高防癌意识,是保证早诊早治工作可持续发展的关键。
Objective To investigate the prevalence of esophageal lesions and esophageal cancer in high-risk esophageal cancer-endemic areas by endoscopic screening and provide scientific basis for the study of etiology. Methods A total of 97 natural villages were selected as the screening objects in a randomized cluster sampling from 2006 to 2011 in Yanting, a high incidence area of esophageal cancer in Sichuan Province. Endoscopic iodine staining and indicator Biopsy into the technology line screening, and confirmed by pathological diagnosis. Results The detection rates of mild, moderate and severe esophageal hyperplasia were 5.33% (803/15 065), 1.28% (193/15 065), 0.68% (102/15 065), carcinoma in situ, The detection rate of cancer was 0.15% (22/15 065), 0.06% (9/15 065) and 0.29% (43/15 065) respectively. The detection rate of esophageal cancer was higher than that of the female, The detection rate of moderate and severe esophageal hyperplasia and invasive carcinoma increased with the increase of age. On the time distribution, the detection rate of mild, moderate and severe esophageal hyperplasia was statistically significant in different years (P <0.01) ). Conclusions Relying on the National Esophageal Cancer Screening Program, it is the key to ensure the sustainable development of early diagnosis and early diagnosis in the high risk area of esophageal cancer to publicize cancer comprehensive knowledge and raise awareness of cancer prevention.