四川省盐亭县2006-2011年居民食管癌筛查结果分析

摘要

Objective To study the prevalence of esophageal cancer and various lesions of esophagus in high risk areas through a screening program for early diagnosis and treatment.Methods Random cluster sampling method was used to select some portions of a natural village as screening object in the high risk areas of esophageal cancer,from 2006 to 2011.Endoscope iodine staining and index biopsy screening methods were used on people with high risk and followed by pathological exams for confirmation.Results The detection rates regarding mild esophageal hyperplasia,moderate and severe esophageal hyperplasia were 5.33％ (803/15 065),1.28％( 193/15 065 ),0.68％( 102/15 065 ) respectively while the detection rates on carcinoma in situ,intramucosal carcinoma and invasive cancer were 0.15％(22/15 065),0.06％(9/15 065),0.29％(43/15 065)respectively.The detection rate in male esophageal hyperplasia was higher than in female.People younger than 65 years old,the detection rates on mild,moderate or severe esophageal hyperplasia and invasive cancer showed an increase with age,with the 60- year-olds group reaching the highest.The detection rates on the above said diseases were 7.72％( 198/2565 ),2.07％(53/2565),1.29％( 33/2565 ),0.51％ ( 13/2565 ) respectively.The detection rates on mild,moderate or severe esophageal hyperplasia varied in different years and with statistically significant differences (P＜0.001) but did not show any obvious trend of changing.Geographical distribution of mild esophageal hyperplasia,moderate esophageal hyperplasia,severe esophageal hyperplasia also significantly varied in different villages (P＜0.001).The highest detection rate in the mountainous villages was seen the highest while the detection rate of village from hilly areas was the lowest.Conclusion There were considerable numbers of patients with precancerous lesions in the general population from the high risk areas.The detection rate of esophageal cancer in the mountain residents was higher than the rate in the hilly areas.Men and the elderly were the key populations calling for esophageal cancer prevention programs to be carried out.%目的 了解食管癌高发区居民食管癌及食管各级病变的患病情况.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部分自然村作为筛查对象,对高危人群采取内镜下碘染色及指示性活检进行筛查,并经病理学诊断确诊,共筛查15 065人.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,60-岁组的检出率最高分别为7.72％ (198/2565)、2.07％(53/2565)、1.29％(33/2565)、0.51％(13/2565)；轻、中、重度食管增生的检出率在不同年份间差异有统计学意义(P＜0.001),但未显示明显的上升或下降趋势；从地理分布看,轻、中、重度食管增生的检出率间存在差异(P＜0.001),最高和最低检出率的乡镇分别属于山区和丘陵.结论 在食管癌高发区人群中存在着相当数量的癌前病变患者,山区居民食管癌检出率较丘陵地区高,男性和老年人是食管癌防治的重点人群.