隐血珠筛检上消化道癌和癌前病变结果报告

The Screening for Upper Digestive Tract Cancer and Precancerous Lesions with Occult Blood Bead Detecor

目的 :用隐血珠筛检食管癌、胃癌及癌前疾病 ,作为进一步研究的数据源。方法 :用隐血珠对盐城市志愿接受检查的健康人群进行筛选 ,阳性者以胃镜和病理检查结果作为诊断金标准。结果 :3450 0人接受隐血珠筛查 ,阳性 72 35人 ,共发现上消化道癌 2 2 1例 ,其中食管癌 111例 ,胃癌 (含贲门癌 ) 110例。根据隐血珠反应程度的不同 ,在 (+)～ ( )的癌检出度分别为 1 11%、5 0 8%和 6 3% ,35岁以上人群癌检出率 6 4 1/ 10万 ,4 0岁以上年龄组的癌检出率较 39岁以下组呈跳跃性上升 (χ2 =4 72 ,P <0 0 0 5) ,且随年龄的增长 ,癌的检出率增高 ,差异非常显著。癌前病变中 ,食管黏膜鳞状上皮中、重度不典型增生的检出率略低于胃腺上皮中、重度不典型增生 (P >0 0 5)。结论 :在上消化道肿瘤高发地区以“隐血珠初筛→胃镜精查→病理确诊”的三级检查法是筛检早期癌及癌前病变的有效办法。

Objestive Esophageal,gastric cancer and relative precancerous lesions were screened by “occult blood bead” (OBB) for further reserch.Methods 34 500 volunteers were screened by OBB test in Yancheng city.Those who scored as (+) will be further diagnosed by gastroscopic and pathological examination.Results 7 235 patients of the 34 500 volunteers were found positive,221 patients with G—I tract cancer were discovered 111 with esophageal cancer and 110 with gastric cancer (including cardiac cancer).The detection rates are 1.11%,5.08% and 6.30% to the subjects presenting +- . From the 100 000 subjects , 641 cancer cases were detected over 35.The detection rate in the group over 40 is higher than that of the group below 39 (χ 2=4.72, P <0.005).The senior the subjects are,the higher the rate will be,the difference is very significant.In the precancerous lesion,the detection rate of severe atypical proliferation in squamous epithelium of esophagus is lower than in glandular epithelium of stomach.It's probably the reason of the similar incidence of esophagoal and gastric cancer in the area.Conclusion The detection of early cancer and precancerous lesions and its interference treatment with the 3 step examination (OBB test gastroscopic pathology) in the general population in the high risk areas of upper G—I cancer is one of the most effective methods to control the death rate and incidence.