数字胃肠机在食管癌门诊机会性筛查中的应用

Application of digital gastrointestinal machine in outpatient opportunistic screening of esophageal carcinoma

目的探讨数字胃肠机在食管癌门诊机会性筛查中的应用价值。方法在甘肃省武威肿瘤医院2011-01-01—2013—10-31门诊就诊的人群中进行食管癌筛查，所有接受筛查者在检查前签署知情同意书，按筛查流程进行癌症防治知识和食管癌危险因素流行病学调查，详细询问病史及一般体格检查。采用大平板数字胃肠机（德国西门子A×10Mlumi—nosdRF）气钡双重造影，发现食管有病变者均相对应地行内镜检查，最终确诊均以病理组织学为依据。结果共用数字胃肠机检查2599人，其中男1747人，女852人；40～69岁2058人，占受检人数的79．18％。检出食管癌165例，检出率为6．35％。早期食管癌4例（2．42％），中晚期食管癌161例（97．58％）。其中男129例，检出率为7．38％；女36例，检出率为4．23％。男女性检出率差异有统计学意义，X2=9．61，P〈0．01。食管癌数字胃肠造影检查与病理诊断比较，灵敏度为98．19％，特异度为99．68％。年龄组检出率有随年龄的增长而升高的趋势，55～80岁组占总检出人数的93．94％。结论数字胃肠造影机会性筛查较之自然人群筛查，食管癌检出率高，是食管癌筛查的有效手段，作为食管癌的初筛方法具有可行性。≥55岁的人群应为食管癌防治的重点。

OBJECTIVE To evaluate the application value of digital gastrointestinal machine in Outpatient oppor- tunistic screening of esophageal carcinoma. METHODS Screening for esophageal, cancer in the outpatients who voluntari- ly joined this study with informed consents. According to the screening process, the author made epidemiology investiga- tion for cancer prevention and treatment knowledge and esophageal cancer risk factors, then inquired thorough history and examined carefully. With German original SIEMENS （Siemens） AXIOM luminos DRF, a number of patients were sus- pected in esophagus and these patients would be followed with endoscope examination, final diagnosis were based on path- ological histology. RESULTS In 2 599 patients of digital gastrointestinal machine examination, the male was 1 747,the female was 852. Patients aged 40 to 69 were 2 058, accounting for 79.18%. Totally 165 cases were diagnosed, among which 129 were male and 36 were female. Esophageal cancer detection rate was 6.35%, and the male was 7.38%0 ,the fe- male was 4. 23%. Early esophageal cancer patients were 4 eases, accounting for 2.42%. Advanced esophageal cancer pa- tients were 161 cases, accounting for 97.58 %. Detection rate 2（2 analysis for different sex： X2 = 9.61 （ P 〈 0.01 ）, the difference was statistically significant. To compare with pathological diagnosis, the sensitivity of digital gastrointestinal examination was 98.19%, the specificity was 99.68%. Age group detection rate had increasing tendency followed age＇s growing. The proportion of patients aged 55 to 80 was 93.94%. CONCLUSIONS Detection rate of digital gastrointesti- nal machine screening in esophageal carcinoma is above the natural population screening. It is an effective method for e- sophageal cancer screening, and it may be acted as a primary screening method. The patients aged over 55 should be the focus of esophageal carcinoma prevention and treatment.