长春市宽城区及周围农村上消化道癌筛查结果分析

Result of screening of upper gastrointestinal cancer in Kuancheng District of Changchun and surrounding rural areas

目的分析长春市宽城区及周围农村上消化道癌前病变及高危人群发病、分布情况,为早诊及治疗提供依据。方法搜集年龄40~69岁的高危人群为筛查对象,采取电子内镜下食管碘染色、胃靓胭脂染色及指示性活检,经病理学诊断确诊。结果 2013-10至2016-11间共筛查4037人,城区占62.62%;2528人中癌症32例(1.27%),早癌23例(0.91%);食管低级别上皮内瘤变132例(5.22%),胃低级别上皮内瘤变33例(1.31%),萎缩性116例(4.59%)。周围农村1509人中,癌症23例(1.52%),早癌10例(0.66%);食管低级别上皮内瘤变93例(6.16%);胃低级别上皮内瘤变32例(2.12%);萎缩性87例(5.77%)。将在癌症患者中早期、中晚期的城区与周围农村病理类型检出情况比较,分布有统计学差异(P1=0.034<0.05),食管低级别上皮内瘤变、胃低级别上皮内瘤变、萎缩性胃炎城区与周围农村病理类型检出情况比较,分布无统计学差异(P2=0.526>0.05)。结论对高危人群进行内镜筛查发现上消化道癌前病变及癌发病率高,且农村人群晚期检出率较城市高;城市人群对筛查接受度高。

Objective To find out about the incidence and distribution of populations at high risk of precancerous lesions of upper gastrointestinal cancer and upper gastrointestinal cancer in Kuancheng District of Changcbun and surrounding rural areas so as to provide reference for early detection of upper gastrointestinal cancer. Methods High-risk populations aged 40 to 69 and living in Kuancheng District and surrounding rural areas were screened. The high risk populations were subjected to esophagusmueosa iodin dyein,indigo carmine dyeing and indicative biopsies under an endoscope. Results Between October 2013 and November 2016 ,a total of 4037 cases were screened ,2528 of whom were from urban neighborhoods. Among these urban residents, there were 32 cases of cancer （ 1.27 % ） ,23 cases of precancerous lesions （ 0.91% , 132 cases oflow-grade intraepithelial neoplasia of the esophagus （ 5.22% ）, 33 ea- ses of low-grade gastric intraepithelial neoplasia（ 1.31% ） , 116 cases of CAG（ 4.59% ）. Among the 1509 cases screened from rural are- as,there were 23 cases of cancer（ 1.52% ） , 10 cases of precancerous lesions（0.66% ） ,93 cases of low-grade intraepithelial neoplasia of the esophagus（6.16% ） ,32 cases of low-grade gastric intraepithelial neoplasia（2.12% ） ,and 87 cases of CAG（5.77% ）. The distri- bution of populations with upper gastrointestinal cancer was significantly different between urban and rural areas （ PI = 0. 034 〈 0.05 ） , but there was no significant difference between urban and rural areas in the distribution of populations withlow-grade intraepithelial neo- plasia of the esophagus, low-grade gastric intraepithelial neoplasia or CAG （ P2 = 0. 526 〉 0.05 ）. Conclusions According to endoscopy of high-risk populations, the incidence of precancerous lesions of upper gastrointestinal cancer and upper gastrointestinal cancer is high. The detection rate of advanced upper gastrointestinal cancer is higher in rural areas than in urban areas. Screening seems more accepta- ble to urban residents.