2015—2018年重庆市农村上消化道癌早诊早治项目内镜筛查结果分析

Endoscopic Screening for Upper Digestive Tract Cancer in Rural Areas of Chongqing,2015—2018

[目的]分析总结2015—2018年重庆市农村地区上消化道癌(食管癌、贲门癌及胃癌)早诊早治项目内镜筛查结果。[方法]选择上消化道癌发病率较高的区县,采取整群抽样的方法,对8236例40~69岁的无症状的人群进行上消化道癌筛查。[结果]2015—2018年完成胃镜筛查8236例,活检2810例,共检出重度异型增生、高级别上皮内瘤变及癌71例,检出率为0.86%,其中食管重度异型增生及癌检出率为0.40%(33例),贲门高级别上皮内瘤变及癌检出率为0.15%(12例),胃高级别上皮内瘤变及癌检出率为0.32%(26例);其中早期病例59例,早诊率为83.10%;治疗病例62例,治疗率87.32%。对未治疗的癌前病变以上患者共348例进行随访,成功随访228例,随访率为65.52%,其中随访中新发现病例5例,全为早期病例,并已全部接受治疗。[结论]开展上消化道癌筛查,不仅普及了当地群众的肿瘤防治知识,还能及时发现癌前病变及早期癌,并通过适宜的干预手段从而阻断疾病的进行性发展,降低癌症的发病率和死亡率,同时,提高了基层医疗单位及工作人员的癌症防控水平。

[Purpose]To analyze the results of endoscopic screening for upper digestive cancer(esophageal cancer,cardiac cancer and gastric cancer)in rural areas of Chongqing from 2015 to 2018.[Methods]In districts and counties with high incidence of upper digestive tract cancer,8236 asymptomatic people aged 40~69 years were selected for screening of upper digestive tract cancer by cluster sampling.[Results]Total 8236 participants underwent gastroscopic screening and 2810 cases of biopsy were performed.A total of 71 cases of severe dysplasia,high-grade intraepithelial neoplasia(HGIEN)and cancer were detected with a detection rate of 0.86%,among which the detection rate of esophageal severe dysplasia and cancer was 0.40%(33 cases),the detection rate of cardiac HGIEN and cancer was 0.15%(12 cases),and the detection rate of gastric HGIEN and cancer was 0.32%(26 cases).Among 71 detected cases there were 59 early cases with an early diagnosis rate of 83.10%;62 cases were treated with a treatment rate of 87.32%.Among 348 patients with precancerous lesions,228 were followed up with a follow-up rate of 65.52%;and 5 new cases were discovered during the follow-up,all of whom were early cases and received appropriate treatment.[Conclusion]Screening for upper digestive cancer can detect precancerous lesions and early cancer in time,and block the progression of the disease through appropriate interventions,which would reduce the cancer morbidity and mortality.