2009-2012年武威市凉州区上消化道癌筛查结果分析

Analysis on Screening for Upper Gastrointestinal Cancer in Liangzhou District,Wuwei City,Gansu Province,2009 ~2012

[目的]分析2009-2012年武威市凉州区上消化道癌（食管癌、胃癌）筛查情况。[方法]采用流行病学调查、血清PG检测、内镜活检和病理检查的方法,对武威市凉州区40-69岁无症状、有上消化道病史、食管癌和胃癌家族史志愿者进行上消化道癌筛查。[结果]本组筛查共8007人,上消化道癌总检出率为1.80%（144/8007）,食管癌检出率为0.54%（43/8007）,胃癌检出率为1.26%（101/8007）。上消化道癌早诊率为72.22%（104/144）。2009-2010年PG检测3507人,PG阳性组（n=1307）中胃癌和高级别上皮内瘤变检出率分别为0.84%（11/1307）、0.31%（4/1307）;而PG阴性组中（n=2200）则分别为0.36%（8/2200）、0.14%（3/2200）。PG阳性与PG阴性组间胃癌及其癌前病变检出率差异有显著性（P〈0.01）。3507人检出重度异型增生/原位癌及食管癌14例,其中PG阴性检出食管癌4例,重度异型增生/原位癌2例;PG阳性组中检出食管癌4例,重度异型增生/原位癌4例。[结论]在上消化道癌高发区直接应用内镜对上消化道癌进行筛查,才能最大限度地降低上消化道癌的漏诊。

[Purpose] To investigate the results of screening for upper gastrointestinal cancer（esophageal cancer,gastric cancer） in Liangzhou district,Wuwei city from 2009 ~2012. [Methods]The people（40~69 years） with history of upper gastrointestinal tract disease,esophageal and gastric cancer family history in Liangzhou district,Wuwei city were screened by using epidemiological investigation,serum PG detection,endoscopic biopsy and pathological examination. [Results] Of 8007 screened people,the detection rate of digestive tract cancer was 1.80%（144/8007）,the detection rate of esophageal cancer and gastric cancer was 0.54%（43/8007）,1.26%（101/8007） respectively. The early detection rate of upper gastrointestinal cancer was 72.22%（104/144）. A total of 3507 person were detected with PG,the detection rate of gastric carcinoma and high-grade intraepithelial neoplasia was 0.84%（11/1307）,0.31%（4/1307） in PG positive group（n=1307）,0.36%（8/2200）,0.14%（3/2200）in PG negative group（n=2200） respectively,there were significant difference between PG positive and PG negative group（P 0.01）. Of 3507 people,14 cases with severe hyperplasia/cancer and esophageal carcinoma were found,including 4 cases of esophageal carcinoma and 2 cases of severe hyperplasia/carcinoma in situ in PG negative group,4 cases of esophageal carcinoma and 4 cases of severe hyperplasia/carcinoma in situ in PG positive group. [Conclusions] Application of endoscopic screening for upper gastrointestinal cancer in high risk region,can maximum reduce the missed diagnosis of upper gastrointestinal tract cancer.