农村地区高危人群胃癌肝癌筛查效果评估

Effect Evaluation On The Screening Of Stomach And Liver Cancers Among The Population At High Risk In Rural Areas

目的评估农村地区高危人群胃癌、肝癌筛查效果,为相关疾病防治提供依据。方法对适宜年龄段人群（胃癌40~69岁,肝癌35~64岁）开展癌症相关危险因素问卷调查,并按高危人群判定标准,筛选出符合筛查条件的高危人群,经知情同意后,进入临床筛查（胃癌：腔镜＋病理,肝癌：AFP＋B超）。结果检出胃癌4例（0.16%）（其中早期胃癌3例）、癌前病变（异型增生）55例（2.26%）;检出肝癌7例（占0.25%）（其中早期肝癌2例）,肝硬化23例（占0.83%）,AFP异常（≥10μg/L）126例（占9.6%）;检出其他肝脏异常者369人（占12.2%）。肝癌和肝硬化病例中HBsAg阳性比例较高,分别为85.7%（6/7）和82.6%（19/23）。结论定点、定人群、定期开展两癌筛查是发现早期病例的重要手段,同时,应普及防癌知识和提高基层医务人员对早期癌症的识别能力,以提高机会性发现早期癌症的比例。

Objective To Evaluate the effects on the screening of stomach and liver cancer among the population at high risk in rural areas,and provide reference for the prevention and control of related diseases.Methods The target population who aged 40-69 with stomach cancer or aged 35-64 with liver cancer were investigated by cancer related risk factors questionnaire,and the qualified applicants were selected by the criterion of high-risk population for the clinical screening by the combination of mirror cavity and pathological test for stomach cancer and the combination of AFP and type-B ultrasonic for liver cancer after obtaining written informed consent.Result 4 cases were found with stomach cancer（0.16%）,and 3 of them were at early stage,55 cases were found with dysplasia of stomach precancerous lesions（2.26%）.7 cases were found with liver cancer（0.25%）,and 2 of them were at early stage,23 cases were liver cirrhosis（0.83%）,126 cases were abnormal in AFP test（≥10μg/L,9.6%）,369 cases had other abnormal in the liver（12.2%）.The positive rates of HBsAg among those cases with liver cancer and liver cirrhosis were significantly higher,and it were 85.7%（6/7）in the former and 82.6%（19/23）in the latter.Conclusion Periodical screening for fixed population in designated area is an important means of early detection for stomach and liver cancers.Meanwhile,in order to enhance the proportion of opportunistic recognition of cancer at early stage,measures should be taken to popularize cancer prevention and control knowledge and enhance the ability to distinguish the precancerous stage for medical staffs at the basic level.