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目的:研究核黄素强化盐对食管癌高发人群食管癌前状态的影响。方法:用食管脱落细胞学检查方法,比较分析在食管癌高发区四川盐亭县开展核黄素强化营养盐干预5年的前后,试验组与对照组食管上皮增生的检出率、食管正常者的进展率和食管增生者的逆转率,评价核黄素强化盐对人群的食管癌前病变的干预效果。结果:干预试验前,试验组和对照组的食管上皮增生检出率,男性分别为19.6%(47/240)和10.9%(24/222),女性分别为15.5%(36/233)和13.6%(29/213);干预5年后,试验组男性和女性食管上皮增生检出率分别为12.5%(30/240)和12.9%(30/233),比对照组分别降低49.6%(χ2=11.55,P<0.01)和57.0%(χ2=19.68,P<0.01)。与对照相比,试验组男性和女性食管增生转归的比数比分别为3.8(95%CI为1.1～13.2,P<0.05)和10.0(95%CI为2.6～37.9,P<0.01);而在正常人群中,试验组男性和女性食管向癌变进展的比数比分别为0.42(95%CI为0.24～0.76,P<0.01)和0.38(95%CI为0.21～0.68,P<0.01)。结论:在食管癌高发区人群中实施核黄素强化营养盐的干预措施能延缓和逆转食管癌前病变的发展进程,有益于降低食管癌的发病率。
Objective: To study the effect of riboflavin fortified salt on esophageal precancerous lesions in esophageal cancer-prone population. Methods: Esophageal exfoliative cytology method was used to compare the detection rate of esophageal epithelial hyperplasia in the experimental group and the control group before and after the intervention of riboflavin enhanced nutrient salt in Yanting County, Sichuan Province, And the rate of esophageal hyperplasia, and evaluate the intervention effect of riboflavin enhanced salt on esophageal precancerous lesions in the population. Results: Before intervention, the detection rate of esophageal epithelium in experimental group and control group was 19.6% (47/240) and 10.9% (24/222) in male and 15.5% (36/233) in female and 13.6 % (29/213). After 5 years of intervention, the detection rates of esophageal epithelial hyperplasia in male and female were 12.5% (30/240) and 12.9% (30/233) respectively in the experimental group, which were 49.6% lower than those in the control group = 11.55, P <0.01) and 57.0% (χ2 = 19.68, P <0.01). The odds ratio (OR) was 3.8 (95% CI 1.1 to 13.2, P <0.05) and 10.0 (95% CI 2.6 to 37.9, P <0.01), respectively, in the test group compared with the controls. In the normal population, the odds ratios of esophageal to cancerous progression in the test group were 0.42 (95% CI 0.24-0.76, P <0.01) and 0.38 (95% CI 0.21-0.68, P <0.01) . Conclusion: Interventions of riboflavin-fortified nutrients in population with high incidence of esophageal cancer can delay and reverse the development of esophageal precancerous lesions and reduce the incidence of esophageal cancer.