上海市9所医院前瞻性胃癌前病变5年随访研究

FOLLOW-UP OF PATIENTS WITH PRECANCEROUS CHANGE FOR FIVE YEARS FROM 9 HOSPITALSIN SHAGNHAI

对上海市９所医院的２０００例胃癌前变化进行胃镜随访研究。随访时间：第一部分从１９８６年１月～１９９０年３月；第二部分从１９８６年１月～１９９３年６月。随访组每６～１２个月定期复查胃镜，对照组不进行主动胃镜检查，以积分法观察癌前变化。结果：第一部分随访组胃癌发生率为１．８７％（１７／９０９），其中早期胃癌占７０．６％（１２／１７）；对照组胃癌发生率为１．２５％（９／７２１），其中早期胃癌占１１．１％（１／９）。随访组病理积分从４．２５降至２．９５。第二部分仅发现１例早期胃癌（１／２６１）。本研究提示，加强对胃癌高危人群的胃镜随访是早期发现胃癌的有效方法。

collaborative study on the endoscopic follow-up of 2000 patients with precancerous change from 9 hospitals was carried out in two settings. The first was from January,1986 to March, 1990 and the second extended from January,1986 to June,1993.All patients were divided into 2 groups. patients in one group underwent regular endoscopy every 6-12 months. Those in the other group the control group were only scoped upon request indicated.The severity of the precancerous change was graded by scores. The incidence of gastric cancer in the first setting was l.89%(17/909)in the first group,and l2 of the l7 cases belonged to early gastric cancer (EGC)(70.6%).In the control group the incidence of gastric cancer wasl.25%(9/721),but EGC was only ll.1%(1/9).Score of the pathology dropped from 4.25 to 2.95 in the first group. In the second setting only one case of EGC(1/261) was discovered.It was suggested that endoscopic follow-up of high risk patients could defect more EGC.