目的:了解进展较快的食管和贲门癌前病变的时间,为寻找合适的筛查间隔提供线索。方法:在食管癌高发区河北涉县对40~69岁人群开展重复的内镜筛查。结果:301例重复筛查共观察到40例病情发生进展者,其中7例重度不典型增生中:1例首检为正常,间隔13个月检出重度不典型增生,1例首检为基底细胞增生,间隔7个月检出,4例首检为轻度不典型增生,分别间隔3个月、4个月、4个月、10.5个月检出,1例首检为中度不典型增生,间隔12.5个月检出;6例原位癌及黏膜内癌中:1例首检为轻度不典型增生,间隔48个月检出,2例中度不典型增生分别间隔4个月、13个月检出2例,3例重度不典型增生分别间隔3.5个月、9个月、17.5个月检出;3例浸润性癌中:1例中度不典型增生,间隔50个月检出、2例重度不典型增生间隔14个月和19个月检出。结论:食管和贲门癌前病变的滞留时间变异较大,有必要适当缩短筛查间隔,通过及时复查捕获那些进展较快、多点起源和首检遗漏的癌前病变。 OBJECTIVE: To understand the time of advanced esophageal and cardial precancerous lesions and to provide clues for finding appropriate screening intervals. Methods: Repeated endoscopic screening was performed in 40- to 69-year-olds in Shexian County, a high incidence area of ​​esophageal cancer. Results: A total of 40 cases of progressive atypical hyperplasia were observed in 301 cases of repeat screening. Among them, 7 cases were diagnosed as severe atypical hyperplasia: 1 case was diagnosed as normal, with severe atypical hyperplasia after 13 months and 1 case as basal Proliferation of cells was detected in 7 months, 4 cases were mild dysplasia, and were detected at 3 months, 4 months, 4 months and 10.5 months respectively. One case was moderately atypical Proliferation, 12.5 months intervals were detected; 6 cases of carcinoma in situ and mucosal carcinoma: 1 case of the first test for mild dysplasia, an interval of 48 months were detected, 2 cases of moderate dysplasia were separated by 4 months , 13 cases were detected in 2 cases, 3 cases of severe dysplasia were 3.5 months intervals, 9 months, 17.5 months were detected; 3 cases of invasive carcinoma: 1 case of moderate dysplasia, interval of 50 months Detected, 2 cases of severe dysplasia interval of 14 months and 19 months were detected. Conclusion: The residence time of esophageal and cardial precancerous lesions varies greatly. It is necessary to shorten the screening interval appropriately. Catastrophic precancerous lesions with rapid progression, multiple origin and missed primary examinations should be captured by prompt review.