河北磁县上消化道癌早诊早治项目内镜筛查结果分析

Endoscopic Screening Results of Upper Gastrointestinal Cancer in the Early Diagnosis and Treatment Program in Ci County,Hebei Province

目的:总结分析8 149例无症状人群内镜筛查结果。方法:回顾整理磁县2011~2013年40~69岁高危人群的内镜筛查资料,按性别、年龄统计上消化道癌及其癌前病变的检出率及阳性病例的治疗率。结果:纳入分析对象8 149例,男性3 424例,女性4 725例,男女比例为0. 72∶1,检出阳性病例174例,检出率2. 14%(男性检出109例,检出率为3. 18%,女性检出65例,检出率为1. 38%),早诊率91. 38%,治疗率86. 21%,内镜治疗率为48. 43%。174例患者中,男性为109例,女性65例,男女比例1. 68∶1,年龄介于44和70岁之间,平均年龄(53. 63±7. 63)岁。所有病例中以60~64岁比例最高,为35. 06%(61/174),其次是55~59岁及65~69岁年龄组,分别为27. 01%(47/174)、20. 11%(35/174)。食管阳性病例111例,占总阳性病例63. 79%(111/174);贲门阳性病例42例,占24. 14%(42/174),胃阳性病例21例,占12. 07%(21/174)。结论:磁县食管癌高发区40~69岁人群存在大量无症状上消化道癌及其癌前病变的患者,检出率与性别、年龄关系密切。在高危人群中开展消化内镜筛查能有效发现大量的上消化道癌前病变及早期癌,通过及时干预治疗,从而降低上消化道癌发病率和死亡率。

Objective:To summarize and analyze the endoscopic screening results of 8,149 asymptomatic patients.Methods:Endoscopic screening data of high-risk people aged 40-69 in Ci county from 2011 to 2013 were reviewed,and the detection rate of upper gastrointestinal cancer and its precancerous lesions and treatment success rate of positive cases in different genders and ages were calculated.Results:A total of 8,149 cases were included in the analysis,including 3,424 males and 4,725 females,with a male to female ratio of 0.72∶1.In total,174 positive cases were detected,with a detection rate of 2.14%(109 males,detection rate:3.18%;65 females,detection rate:1.38%).The early diagnosis rate was 91.38%,the treatment success rate of86.21%,and the treatment success rate of endoscopy was 48.43%.Among the 174 patients aged 44-70 years(average 60 years),109 were males and 65 were females,with a male to female ratio of 1.68∶1.In all cases of upper gastrointestinal cancer,the proportion of patients aged 60-64 was the highest(35.06%,61/174),followed by those aged 55-59(27.01%,47/174)and 65-69(20.11%,35/174),respectively.A total of 111 positive cases were detected in esophagus(63.79%,111/174),42 in cardia(24.14%,42/174),and 21 in stomach(12.07%,21/174).Conclusion:There are a large number of asymptomatic 40-69-year-olds with upper gastrointestinal cancer and precancerous lesions in Ci County where the incidence of esophageal cancer is high.The detection rate is closely related to gender and age.Endoscopic screening for high-risk population can effectively detect upper gastrointestinal cancer and its precancerous lesions from an early stage,and reduce the incidence and mortality of upper gastrointestinal cancer through timely intervention and treatment.