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本文提出一种以流行病学病史询问、吞球测定胃液 pH 潜血与血清耐热试验、铜蓝蛋白检查结合的胃癌初筛方法,对可疑病例再用国产胃镜检查活检确诊。用本法在大连钢厂与新金县安波公社进行两次普查试点,在2,018人中发现了一批胃病患者,其中在胃癌高发区安波公社的1,001人中,查出7例胃癌;包括晚期3例、中期2例、早期2例,占受检人群的3.5‰。初步认为本胃癌普查法,具有安全、简单、低廉和有效的优点,在初筛方法组合中,流行病学病史询问和吞球测定胃液 pH 潜血地位重要,结合血清耐热试验与铜蓝蛋白异常进行分析,可能对广大基层发现可疑胃癌病人有一定意义。在这两次普查试点中,我们摸索了一些排除吞球检测胃液pH 与潜血的假阳性或假阴性因素,但是仍有农民陈述病史含糊(如神经衰弱),胃液潜血反应不稳定及血生化结果特异性不强等缺点,待进一步研究改进。
This article proposes a method for screening gastric cancer by inquiring about the history of epidemiology, inspecting gastric juice pH occult blood combined with serum heat resistance test, and ceruloplasmin examination. The suspected case was diagnosed by domestic gastroscopy biopsy. Using this method, two trials were conducted at the Dalian Steel Plant and the Anbo Commune of Xinjin County. A total of 2,018 patients with stomach problems were found. Of the 1,001 people found at Anbo Commune, a high-risk gastric cancer area, 7 were found to have gastric cancer; 3 cases, 2 cases in the middle stage and 2 cases in the early stage, accounting for 3.5% of the examined population. It is preliminarily considered that this gastric cancer screening method has the advantages of safety, simplicity, low cost and effectiveness. In the preliminary screening method combination, the history of epidemiological questioning and the swallowing ball to determine the pH of the gastric juice are important for occult blood status, combined with the serum heat resistance test and ceruloplasmin abnormality. The analysis may have a certain significance for the majority of suspected gastric cancer patients at the grassroots level. In these two census trials, we explored some false-positive or false-negative factors that ruled out the detection of gastric juice pH and occult blood by swallow balls, but there were still ambiguous medical history (such as neurasthenia), unstable occult blood reactions, and blood biochemical results. The lack of specificity and other shortcomings, pending further research and improvement.