食管癌筛查和早诊早治的实践与经验

Practice and Experience of Screening and Early Diagnosis and Treatment of Esophageal Cancer

目的评价内镜下食管碘染色+指示性活检在高发区高危人群早期食管癌及食管黏膜异型增生诊断中的意义及应用价值。方法对本地区食管癌高发区的高危人群进行食管癌筛查与早诊早治,对其基本临床资料、筛查结果、治疗效果进行分析,并总结相关的经验。结果2010年10月至2019年4月,本区共对20031人进行检查,对8432例患者进行病理活检,根据病理检测结果,其中进展期癌患者共188例,检出率为0.9%,其中包括食管癌、贲门癌与胃癌等,分别为80例、75例与33例;轻度不典型增生患者共975例,检出率为4.9%;中度不典型增生患者共288例,检出率为1.43%;重度不典型增生患者共205例,检出率为1.02%。重度不典型增生以上级别病变共计393例,占1.96%。结论内镜下食管碘染色+指示性活检在高发区高危人群早期食管癌及食管黏膜异型增生诊断中具有较高的应用价值与显著的临床意义。

Objective To evaluate the significance and application value of esophageal iodine staining+indicator biopsy in the diagnosis of esophageal and esophageal mucosal dysplasia in high-risk population of high-risk area.Methods Screening and early diagnosis and early treatment of esophageal cancer were carried out in the highrisk population in the high-incidence area of esophageal cancer in our region.the basic clinical data,screening results and treatment effects were analyzed,and the relevant experiences were summarized.Results October 2010 to April 2019,a total of 20031 patients in our region have been examined and 8432 patients have been biopsied.according to the results of pathological examination,188 patients with advanced cancer have been diagnosed,the detection rate is 0.9%,including esophageal cancer.There were 80 cases of cardiac carcinoma,75 cases of gastric carcinoma and 33 cases of gastric carcinoma.There were 975 cases of mild atypical hyperplasia,the detection rate was 4.9%.The positive rate was 1.43%in 288 patients with moderate atypical hyperplasia.There were 205 patients with severe atypical hyperplasia,the detection rate was 1.02%.There were 393 cases(1.96%)of severe atypical hyperplasia.Conclusion The endoscopic esophageal iodine staining+indicator biopsy has high application value and significant clinical significance in the diagnosis of early esophageal cancer and esophageal mucosal dysplasia in the high-risk population of the high-risk group.