应用内镜普查研究食管癌高发区贲门癌的发病情况

Survey of Cardia Cancer Through Screening of Endoscopic Examination in High Incidence of Esophageal Cancer in China

目的:了解食管癌高发区贲门癌的发病情况,制定更为有效的防治策略。方法:在食管癌高发区应用电子内镜直接碘染色检查法对高危人群共行3次内镜普查。结果:1)贲门癌的癌前病变即贲门腺上皮重度不典型增生的检出率为0.62%～1.50%。2)早期贲门癌的检出率分别为0.44%、0.68%及0.64%。中晚期贲门癌检出率分别为0.22%、0.17%及0.21%。3)91.30%～95.00%贲门重度不典型增生及早期贲门癌病变位于贲门时钟位(顺时针)10点位～2点位。大多数贲门癌前病变及早期贲门癌内镜下主要表现为贲门粘膜糜烂或浅溃疡。4)食管癌与贲门癌检出率之比为2.4～4.1:1。结论:在食管癌高发区直接应用内镜进行普查,除对食管癌及其癌前病变有较高的检出率外,对贲门癌及其癌前病变也有较高的检出率,因此在食管癌高发区也应重视贲门癌的防治及研究工作。

Objective:To explore cardia cancer incidence and mortality through screening of endoscopic examination,to manage strategies of prevention and treatment of cardia cancer in high incidence area of esophageal cancer in china.Methods:Three times screening were complet-ed through endoscopic examination in high risk population.According to pathology result,esophageal carcinoma,cardia cancer and premalignant lesion were diagnosised.Results:(1)Inci-dence rate of precancerous lesion of cardia cancer is0.62%to1.50%through endoscopic eamina-tion.(2)Eearly cardia cancer is0.44%,0.68%,and0.64%respectively.(3)Advanced cardia can-cer is0.22%,0.17%,and0.21%respectively.(4)over ninety percent precancerous lesion and early cardia cancer are located at ten clock to2clock according clockwise.(5)Ratio of Esophageal cancer and cardia cancer is about 2.4-4.1:1in high incidence area of esophageal cancer.Con clusion:Cardia cancer and precancerous lesion is relatively high through endoscopic examination in high incidence area of esophageal cancer.Endoscopic examination have much more high specificity and sensitivity for precancerous lesion and early Cardia cancer.