盐亭县核黄素强化盐干预试验人群食管癌前病变与转归的研究

Effect of riboflavin-fortified-salt intervention on esophageal preancerous lesions among population with high risk in Yanting County

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 investigate the effect of ribo flavin-fortified-salt intervention on esophageal precancerous lesions state. METHODS： The changes of cytological status were analyzed among the subjects with the intervation of riboflavinfortified-salt and the control groups in Yanting County of Sichuan Province. RESULTS： Before the study, the rate of abnormal cytology in the intervention and control were 19.6%（47/240） and 10.9%（24/222） for males, and were 15.5% （36/233） and 13.6% （29/213） for females, respectively. After the five-year intervention, these rates were 12.5%（30/240） and 12.9% （30/233） among men and women in the intervention group, respectively, which were decreased by 49.6%（χ^2= 11. 55,P〈0. 01） for males and 57.0G （χ^2=19.68,P〈0.01） for females as compared with the control group. The odds ratios of the reversion from cytological pre-abnormal persons for males and females were 3.8 （95% CI 1.1 - 13.2, P〈0.05） and 10.0 （95%CI 2.6-37.9,P〈0.01）, compared with the control groups, while the odds ratios of the progression from normal persons were 0.42（95%CI0.24-0.76,P%0.01） and 0.38 （95GCI0.21-0.68,P〈0.01）, for males and females respec tively. CONCLUSION： Implementation with riboflavin fortified salt may contribute to the benefit of the prevention from esophageal cancer in high risk population by retard of the progression and enhance of the reversion of esophageal precancerous le sions.