食管癌防治的新策略

New tactics of esophageal cancer prevention

目的 寻找降低食管癌高发区食管癌发病率和死亡率的有效方法。方法 对重度不典型增生的人群根据病理学、细胞学和γ GT反应的不同进行了三年的研究。结果 γ GT阴性反应者或 40岁以下伴γ GT阳性的患者未发生癌变 ,γ GT阳性伴重增Ⅰ级患者的癌变率为 5 7%,而γ GT阳性伴重增Ⅱ级患者的癌变率为 14 3%。结论 食管癌高发区的预防应以γ GT转阴而定。在食管癌预防中应将重增患者依据γ GT反应进行分类 ,仅对γ GT阳性伴重增的患者进行干预 ,可明显提高食管癌防治中的效价比。此方法简单且符合中国国情。

Aim To look for the effective method reducing incidence and mortality of esophageal cancer in the high incidence area.Methods The population with severe atypical hyperplasia was studied for 3 years on the basis of the pathology,cytology and difference of γ-GT.Results The subject with negative γ-GT reaction and positive γ-GT reaction below 40 years old didn't suffer from cancer.The cancerous incidence of the subject with severe atypical hyperplasia I and positive γ-GT reaction was 5.7%.The cancerous incidence of the subject with severe atypical hyperplasia Ⅱ and positive γ-GT reaction was 14.3%.Conclusions Preventive effect of esophageal cancer in the high incidence area should be decided according to γ-GT reaction from positive to negative.The subject with severe atypical hyperplasia should be classifed according to γ-GT reaction in the prevention of esophageal cancer.The ratio between the consumption and efficacy in prevention of esophageal cancer rises so long as positive γ-GT reaction in combination with severe atypical hyperplasia is adopted in the prevention of esophageal cancer.It is a simple method and suitable for Chinese condition.