AIM: To examine the efficacy and complications of colonoscopic resection of colorectal polypoid lesions. METHODS: We retrospectively reviewed 1354 polypectomies performed on 1038 patients over a ten- year period. One ...AIM: To examine the efficacy and complications of colonoscopic resection of colorectal polypoid lesions. METHODS: We retrospectively reviewed 1354 polypectomies performed on 1038 patients over a ten- year period. One hundred and sixty of these were performed for large polyps, those measuring ≥ 20 mm. Size, shape, location, histology, the technique of polypectomy used, complications, drugs assumption and associated intestinal or extra intestinal diseases were analyzed. For statistical analysis, the Pearson χ2 test, NPC test and a Binary Logistic Regression were used. RESULTS: The mean patient age was 65.9 ± 12.4 years, with 671 men and 367 women. The mean size of polyps removed was 9.45 ± 9.56 mm while the size of large polyps was 31.5 ± 10.8 mm. There were 388 pedunculated and 966 sessile polyps and the most common location was the sigmoid colon (41.3%). The most frequent histology was tubular adenoma (55.9%) while for the large polyps was villous (92/160 -57.5%). Coexistent malignancy was observed in 28 polyps (2.1%) and of these, 20 were large polyps. There were 17 procedural bleeding (1.3%) and one perforation. The statistical analysis showed that cancer is correlated to polyp size (P < 0.0001); sessile shape (P < 0.0001) and bleeding are correlated to cardiac disease (P = 0.034), tubular adenoma (P = 0.016) and polyp size.CONCLUSION: The endoscopic resection is a simple and safe procedure for removing colon rectal neoplastic lesions and should be considered the treatment of choice for large colorectal polyps. The polyp size is an important risk factor for malignancy and for bleeding.展开更多
AIM: To analyze the clinical risk factors for early variceal rebleeding after endoscopic variceal ligation (EVL).METHODS: 342 cirrhotic patients with esophageal varices who received elective EVL to prevent bleeding or...AIM: To analyze the clinical risk factors for early variceal rebleeding after endoscopic variceal ligation (EVL).METHODS: 342 cirrhotic patients with esophageal varices who received elective EVL to prevent bleeding or rebleeding at our endoscopy center between January 2005 and July 2010.were included in this study.The early rebleeding cases after EVL were confirmed by clinical signs or endoscopy.A case-control study was performed comparing the patients presenting with early rebleeding with those without this complication.RESULTS: The incidence of early rebleeding after EVL was 7.60%,and the morbidity of rebleeding was 26.9%.Stepwise multivariate logistic regression analysis showed that four variables were independent risk factors for early rebleeding: moderate to excessive ascites [odds ratio (OR) 62.83,95% CI: 9.39-420.56,P < 0.001],the number of bands placed (OR 17.36,95% CI: 4.00-75.34,P < 0.001),the extent of varices (OR 15.41,95% CI: 2.84-83.52,P = 0.002) and prothrombin time (PT) > 18 s (OR 11.35,95% CI: 1.93-66.70,P = 0.007).CONCLUSION: The early rebleeding rate after EVL is mainly affected by the volume of ascites,number of rubber bands used to ligate,severity of varices and prolonged PT.Effective measures for prevention and treatment should be adopted before and after EVL.展开更多
AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and th...AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and the benefit-cost ratios(BCRs)of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV(international dollar-I$55 million)and BCR(2.52).Screening six times between 40-70 years at a 5-year interval[i.e., six times(40)f-strategy]yielded the highest NPV(I$99 million)and BCR(3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.展开更多
AIM: To identify risk factors to help predict which patients are likely to fail to appear for an endoscopic procedure. METHODS: This was a retrospective, chart review, cohort study in a Canadian, tertiary care, academ...AIM: To identify risk factors to help predict which patients are likely to fail to appear for an endoscopic procedure. METHODS: This was a retrospective, chart review, cohort study in a Canadian, tertiary care, academic, hospital-based endoscopy clinic. Patients included were: those undergoing esophagogastroduodenoscopy, colonoscopy or flexible sigmoidoscopy and patients who failed to appear were compared to a control group. The main outcome measure was a multivariate analysis of factors associated with truancy from scheduled endoscopic procedures. Factors analyzed included gender, age, waiting time, type of procedure, referring physician, distance to hospital, first or subsequent endoscopic procedure or encounter with gastroenterologist, and urgency of the procedure. RESULTS: Two hundred and thirty-four patients did not show up for their scheduled appointment. Compared to a control group, factors statistically significantly associated with truancy in the multivariate analysis were: non-urgent vs urgent procedure (OR 1.62, 95% CI 1.06, 2.450), referred by a specialist vs a family doctor (OR 2.76, 95% CI 1.31, 5.52) and office-based consult prior to endoscopy vs consult and endoscopic procedure during the same appointment (OR 2.24, 95% CI 1.33, 3.78). CONCLUSION: Identifying patients who are not scheduled for same-day consult and endoscopy, those referred by a specialist, and those with non-urgent referrals may help reduce patient truancy.展开更多
AIM:To evaluate the effect of pantoprazole with a somatostatin adjunct in patients with acute non-variceal upper gastrointestinal bleeding(NVUGIB).METHODS:We performed a retrospective analysis of a prospective databas...AIM:To evaluate the effect of pantoprazole with a somatostatin adjunct in patients with acute non-variceal upper gastrointestinal bleeding(NVUGIB).METHODS:We performed a retrospective analysis of a prospective database in a tertiary care university hospital.From October 2006 to October 2008,we enrolled 101 patients with NVUGIB that had a high-risk stigma on endoscopy.Within 24 h of hospital admission,all patients underwent endoscopic therapy.After successful endoscopic hemostasis,all patients received an 80-mg bolus of pantoprazole followed by continuous intravenous infusion(8 mg/h for 72 h).The somatostatin adjunct group(n=49)also received a 250-μg bolus of somatostatin,followed by continuous infusion (250μg/h for 72 h).Early rebleeding rates,disappearance of endoscopic stigma and risk factors associated with early rebleeding were examined.RESULTS:Early rebleeding rates were not significantly different between treatment groups(12.2%vs 14.3%,P=0.766).Disappearance of endoscopic stigma on the second endoscopy was not significantly different between treatment groups(94.2%vs 95.9%,P=0.696).Multivariate analysis showed that the complete Rockall score was a significant risk factor for early rebleeding(P =0.044,OR:9.080,95%CI:1.062-77.595).CONCLUSION:The adjunctive use of somatostatin was not superior to pantoprazole monotherapy after successful endoscopic hemostasis in patients with NVUGIB.展开更多
AIM:To investigate perception of natural orifice transluminal endoscopic surgery(NOTES)as a potential technique for appendectomy.METHODS:One hundred patients undergoing endoscopy and 100 physicians were given a questi...AIM:To investigate perception of natural orifice transluminal endoscopic surgery(NOTES)as a potential technique for appendectomy.METHODS:One hundred patients undergoing endoscopy and 100 physicians were given a questionnaire describing in detail the techniques of NOTES and laparoscopic appendectomy.They were asked about the reasons for their preference,choice of orifice,and extent of complication risk they were willing to accept.RESULTS:Fifty patients(50%)and only 21 physicians(21%)preferred NOTES(P<0.001).Patients had previously heard of NOTES less frequently(7%vs73%,P<0.001)and had undergone endoscopy more frequently(88%vs 36%,P<0.001)than physicians.Absence of hernia was the most common reason for NOTES preference in physicians(80%vs 44%,P= 0.003),whereas reduced pain was the most common reason in patients(66%vs 52%).Physicians were more likely to refuse NOTES as a novel and unsure technique(P<0.001)and having an increased risk of infection(P<0.001).The preferred access site in both groups was colon followed by stomach,with vagina being rarely preferred.In multivariable modeling,those with high-school education[odds ratio(OR):2.68,95% confidence interval(CI):1.23-5.83]and prior colonoscopy(OR:2.10,95%CI:1.05-4.19)were more likely to prefer NOTES over laparoscopic appendectomy.There was a steep decline in NOTES preference with increased rate of procedural complications.Male patients were more likely to consent to their wives vaginal NOTES appendectomy than male physicians(P=0.02).CONCLUSION:The preference of NOTES for appendectomy was greater in patients than physicians and was related to reduced pain and absence of hernia rather than lack of scarring.展开更多
In order to explain the formation process of slope hazards, and to identify the key factors leading to instability of a slope, Emeishan basalt saprolite in vadose zones of the Touzhai landslide in Zhaotong, Yunnan, wa...In order to explain the formation process of slope hazards, and to identify the key factors leading to instability of a slope, Emeishan basalt saprolite in vadose zones of the Touzhai landslide in Zhaotong, Yunnan, was studied. The formation and evolution of Emeishan basalt saprolite was examined using, amongst other techniques, field investigations,thin section analysis, scanning electron microscopy(SEM) observations, chemical analysis, physical and water-physical property tests of rock masses. Field observations revealed that the majority of the weathered rock blocks were presented as a concentric layer structure in which an internal corestone was enveloped with several layers of external saprolized crust. Chemical and mineralogical analysis identified that iron was the most sensitive element and that the weathering progress usually started with the oxidation of Fe2+ to Fe3+ in rock blocks. Alkaline elements such as Si, Ca, Mg, Na and K were also dissolved and Fe and Al were concentrated in saprolized crusts. Results indicated that loss on ignition(LOI) also increased significantly. SEM results showed that the weathering intensity of thebasalt blocks decreased gradually from the outside to the inside, and the mineral morphology significantly differed on both sides of the weathering front. The saprolized crusts presented cellular microstructure features due to the generation of micropore and clay minerals. Thin section analysis showed that plagioclase was relatively more stable than pyroxene and chlorite during weathering. With a centripetal propagation of the weathering front, saprolized crusts became thicker and corestones became smaller; fresh Emeishan basalt blocks gradually turned into saprolized blocks. Due to the loose structure and low strength of saprolite, the quality of the Emeishan basalt mass significantly deteriorated, this being a potentially important factor which caused the Touzhai landslide to occur.展开更多
OBJECTIVE Ci-xian County is located in the north of Chinaand is a high-risk area for esophageal cancer(EC).In 2004,theincidence rate of EC in the county was 127/100,000 and 93/100,000in the male and female population,...OBJECTIVE Ci-xian County is located in the north of Chinaand is a high-risk area for esophageal cancer(EC).In 2004,theincidence rate of EC in the county was 127/100,000 and 93/100,000in the male and female population,respectively,and that ofgastric cancer(GC)was 72/100,000 and 36/100,000.Since 2001 acohort screening,supported by a special national fund,utilizingendoscopic examination with iodine staining for the targetpopulation at the age ranging from 40 to 69 years was carried out,so as to reduce the incidence and mortality rates in the high-riskareas of EC.METHODS In October 2001,4 townships in the Ci-xian County,Hebei,China were selected,with 22,016 cases in the interventiongroup(IVG)and 33,410 in the control group(CG).The totalpopulation coverage reached 55,000.There were 3257 males and3339 females in the IVG with the age ranging from 40 to 69 years,and 4299 males and 4430 females in the CG with the same rangeof the age.Endoscopic screening with iodine staining was used inthe IVG,with a screening rate of 53.2%.During the screening byendoscopic examination,97 cases were found to have esophagealsquamous epithelium,carcinoma-in-situ at the cardiac glandularepithelium or intra-mucosal carcinoma.Additionally,102cases were identified to have severe atypical hyperplasia in theesophagus and gastric cardia.The natural incidence rate of cancerand the mortality were observed in the CG.The ICD-0 version wasused in the tumor incidence and death registration coding.Duringa period from June to September 2008,based on the information ofthe tumor registration database of the incidence and mortality inthe Ci-xian County,the cohort groups were studied and followed.RESULTS There were 133 patients with untreatable EC and48 with GC in the IVG,while there were 259 and 37 patients inthe CG who died of esophageal and gastric cancer,respectively.The relative risk(RR)of death was 0.76 in the male patients withEC,95%CI(0.59-0.98),P=0.038,and in the female patients theRR was 0.51,95%CI(0.35-0.75),P=0.000.The RR of death in theGC patients was 2.45,(1.40-4.29)in the male,P=0.01,and 0.99,(0.47-1.99),in the female cases,P=0.906.CONCLUSION Six years after a cohort screening of a largepopulation by endoscopic examination with iodine staining inareas at high risk for EC,the death risk in the male and femalepatients with EC has decreased compared with that in the controlgroup.The difference between the 2 groups was statisticallysignificant.However,no protective method used to decrease thedeath risk in GC patients has been found during this period ofendoscopic screening.展开更多
文摘AIM: To examine the efficacy and complications of colonoscopic resection of colorectal polypoid lesions. METHODS: We retrospectively reviewed 1354 polypectomies performed on 1038 patients over a ten- year period. One hundred and sixty of these were performed for large polyps, those measuring ≥ 20 mm. Size, shape, location, histology, the technique of polypectomy used, complications, drugs assumption and associated intestinal or extra intestinal diseases were analyzed. For statistical analysis, the Pearson χ2 test, NPC test and a Binary Logistic Regression were used. RESULTS: The mean patient age was 65.9 ± 12.4 years, with 671 men and 367 women. The mean size of polyps removed was 9.45 ± 9.56 mm while the size of large polyps was 31.5 ± 10.8 mm. There were 388 pedunculated and 966 sessile polyps and the most common location was the sigmoid colon (41.3%). The most frequent histology was tubular adenoma (55.9%) while for the large polyps was villous (92/160 -57.5%). Coexistent malignancy was observed in 28 polyps (2.1%) and of these, 20 were large polyps. There were 17 procedural bleeding (1.3%) and one perforation. The statistical analysis showed that cancer is correlated to polyp size (P < 0.0001); sessile shape (P < 0.0001) and bleeding are correlated to cardiac disease (P = 0.034), tubular adenoma (P = 0.016) and polyp size.CONCLUSION: The endoscopic resection is a simple and safe procedure for removing colon rectal neoplastic lesions and should be considered the treatment of choice for large colorectal polyps. The polyp size is an important risk factor for malignancy and for bleeding.
文摘AIM: To analyze the clinical risk factors for early variceal rebleeding after endoscopic variceal ligation (EVL).METHODS: 342 cirrhotic patients with esophageal varices who received elective EVL to prevent bleeding or rebleeding at our endoscopy center between January 2005 and July 2010.were included in this study.The early rebleeding cases after EVL were confirmed by clinical signs or endoscopy.A case-control study was performed comparing the patients presenting with early rebleeding with those without this complication.RESULTS: The incidence of early rebleeding after EVL was 7.60%,and the morbidity of rebleeding was 26.9%.Stepwise multivariate logistic regression analysis showed that four variables were independent risk factors for early rebleeding: moderate to excessive ascites [odds ratio (OR) 62.83,95% CI: 9.39-420.56,P < 0.001],the number of bands placed (OR 17.36,95% CI: 4.00-75.34,P < 0.001),the extent of varices (OR 15.41,95% CI: 2.84-83.52,P = 0.002) and prothrombin time (PT) > 18 s (OR 11.35,95% CI: 1.93-66.70,P = 0.007).CONCLUSION: The early rebleeding rate after EVL is mainly affected by the volume of ascites,number of rubber bands used to ligate,severity of varices and prolonged PT.Effective measures for prevention and treatment should be adopted before and after EVL.
基金Supported by The National Science and Technology Pillar Program of the 11th National Five-Year Plan of China,No. 2006BAI02A15
文摘AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and the benefit-cost ratios(BCRs)of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV(international dollar-I$55 million)and BCR(2.52).Screening six times between 40-70 years at a 5-year interval[i.e., six times(40)f-strategy]yielded the highest NPV(I$99 million)and BCR(3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.
文摘AIM: To identify risk factors to help predict which patients are likely to fail to appear for an endoscopic procedure. METHODS: This was a retrospective, chart review, cohort study in a Canadian, tertiary care, academic, hospital-based endoscopy clinic. Patients included were: those undergoing esophagogastroduodenoscopy, colonoscopy or flexible sigmoidoscopy and patients who failed to appear were compared to a control group. The main outcome measure was a multivariate analysis of factors associated with truancy from scheduled endoscopic procedures. Factors analyzed included gender, age, waiting time, type of procedure, referring physician, distance to hospital, first or subsequent endoscopic procedure or encounter with gastroenterologist, and urgency of the procedure. RESULTS: Two hundred and thirty-four patients did not show up for their scheduled appointment. Compared to a control group, factors statistically significantly associated with truancy in the multivariate analysis were: non-urgent vs urgent procedure (OR 1.62, 95% CI 1.06, 2.450), referred by a specialist vs a family doctor (OR 2.76, 95% CI 1.31, 5.52) and office-based consult prior to endoscopy vs consult and endoscopic procedure during the same appointment (OR 2.24, 95% CI 1.33, 3.78). CONCLUSION: Identifying patients who are not scheduled for same-day consult and endoscopy, those referred by a specialist, and those with non-urgent referrals may help reduce patient truancy.
基金Supported by A grant of the Korea Healthcare technology R&D Project,Ministry for Health,Welfare&Family Affairs,Republic of Korea NO.A091047 Medical Research Institute Grant (2009-1),Pusan National University
文摘AIM:To evaluate the effect of pantoprazole with a somatostatin adjunct in patients with acute non-variceal upper gastrointestinal bleeding(NVUGIB).METHODS:We performed a retrospective analysis of a prospective database in a tertiary care university hospital.From October 2006 to October 2008,we enrolled 101 patients with NVUGIB that had a high-risk stigma on endoscopy.Within 24 h of hospital admission,all patients underwent endoscopic therapy.After successful endoscopic hemostasis,all patients received an 80-mg bolus of pantoprazole followed by continuous intravenous infusion(8 mg/h for 72 h).The somatostatin adjunct group(n=49)also received a 250-μg bolus of somatostatin,followed by continuous infusion (250μg/h for 72 h).Early rebleeding rates,disappearance of endoscopic stigma and risk factors associated with early rebleeding were examined.RESULTS:Early rebleeding rates were not significantly different between treatment groups(12.2%vs 14.3%,P=0.766).Disappearance of endoscopic stigma on the second endoscopy was not significantly different between treatment groups(94.2%vs 95.9%,P=0.696).Multivariate analysis showed that the complete Rockall score was a significant risk factor for early rebleeding(P =0.044,OR:9.080,95%CI:1.062-77.595).CONCLUSION:The adjunctive use of somatostatin was not superior to pantoprazole monotherapy after successful endoscopic hemostasis in patients with NVUGIB.
基金Supported by Grant NT 11234-3 of the Czech Ministry of Healththe Institutional Research Plan AV0Z10300504
文摘AIM:To investigate perception of natural orifice transluminal endoscopic surgery(NOTES)as a potential technique for appendectomy.METHODS:One hundred patients undergoing endoscopy and 100 physicians were given a questionnaire describing in detail the techniques of NOTES and laparoscopic appendectomy.They were asked about the reasons for their preference,choice of orifice,and extent of complication risk they were willing to accept.RESULTS:Fifty patients(50%)and only 21 physicians(21%)preferred NOTES(P<0.001).Patients had previously heard of NOTES less frequently(7%vs73%,P<0.001)and had undergone endoscopy more frequently(88%vs 36%,P<0.001)than physicians.Absence of hernia was the most common reason for NOTES preference in physicians(80%vs 44%,P= 0.003),whereas reduced pain was the most common reason in patients(66%vs 52%).Physicians were more likely to refuse NOTES as a novel and unsure technique(P<0.001)and having an increased risk of infection(P<0.001).The preferred access site in both groups was colon followed by stomach,with vagina being rarely preferred.In multivariable modeling,those with high-school education[odds ratio(OR):2.68,95% confidence interval(CI):1.23-5.83]and prior colonoscopy(OR:2.10,95%CI:1.05-4.19)were more likely to prefer NOTES over laparoscopic appendectomy.There was a steep decline in NOTES preference with increased rate of procedural complications.Male patients were more likely to consent to their wives vaginal NOTES appendectomy than male physicians(P=0.02).CONCLUSION:The preference of NOTES for appendectomy was greater in patients than physicians and was related to reduced pain and absence of hernia rather than lack of scarring.
基金funded by the Joint Funds of the Natural Science Foundation of China with the Natural Science Foundation of Yunnan (Grant No. U1502232,U1033601)the Research Fund for the Doctoral Program of Higher Education of China(Grant No. 20135314110005)
文摘In order to explain the formation process of slope hazards, and to identify the key factors leading to instability of a slope, Emeishan basalt saprolite in vadose zones of the Touzhai landslide in Zhaotong, Yunnan, was studied. The formation and evolution of Emeishan basalt saprolite was examined using, amongst other techniques, field investigations,thin section analysis, scanning electron microscopy(SEM) observations, chemical analysis, physical and water-physical property tests of rock masses. Field observations revealed that the majority of the weathered rock blocks were presented as a concentric layer structure in which an internal corestone was enveloped with several layers of external saprolized crust. Chemical and mineralogical analysis identified that iron was the most sensitive element and that the weathering progress usually started with the oxidation of Fe2+ to Fe3+ in rock blocks. Alkaline elements such as Si, Ca, Mg, Na and K were also dissolved and Fe and Al were concentrated in saprolized crusts. Results indicated that loss on ignition(LOI) also increased significantly. SEM results showed that the weathering intensity of thebasalt blocks decreased gradually from the outside to the inside, and the mineral morphology significantly differed on both sides of the weathering front. The saprolized crusts presented cellular microstructure features due to the generation of micropore and clay minerals. Thin section analysis showed that plagioclase was relatively more stable than pyroxene and chlorite during weathering. With a centripetal propagation of the weathering front, saprolized crusts became thicker and corestones became smaller; fresh Emeishan basalt blocks gradually turned into saprolized blocks. Due to the loose structure and low strength of saprolite, the quality of the Emeishan basalt mass significantly deteriorated, this being a potentially important factor which caused the Touzhai landslide to occur.
文摘OBJECTIVE Ci-xian County is located in the north of Chinaand is a high-risk area for esophageal cancer(EC).In 2004,theincidence rate of EC in the county was 127/100,000 and 93/100,000in the male and female population,respectively,and that ofgastric cancer(GC)was 72/100,000 and 36/100,000.Since 2001 acohort screening,supported by a special national fund,utilizingendoscopic examination with iodine staining for the targetpopulation at the age ranging from 40 to 69 years was carried out,so as to reduce the incidence and mortality rates in the high-riskareas of EC.METHODS In October 2001,4 townships in the Ci-xian County,Hebei,China were selected,with 22,016 cases in the interventiongroup(IVG)and 33,410 in the control group(CG).The totalpopulation coverage reached 55,000.There were 3257 males and3339 females in the IVG with the age ranging from 40 to 69 years,and 4299 males and 4430 females in the CG with the same rangeof the age.Endoscopic screening with iodine staining was used inthe IVG,with a screening rate of 53.2%.During the screening byendoscopic examination,97 cases were found to have esophagealsquamous epithelium,carcinoma-in-situ at the cardiac glandularepithelium or intra-mucosal carcinoma.Additionally,102cases were identified to have severe atypical hyperplasia in theesophagus and gastric cardia.The natural incidence rate of cancerand the mortality were observed in the CG.The ICD-0 version wasused in the tumor incidence and death registration coding.Duringa period from June to September 2008,based on the information ofthe tumor registration database of the incidence and mortality inthe Ci-xian County,the cohort groups were studied and followed.RESULTS There were 133 patients with untreatable EC and48 with GC in the IVG,while there were 259 and 37 patients inthe CG who died of esophageal and gastric cancer,respectively.The relative risk(RR)of death was 0.76 in the male patients withEC,95%CI(0.59-0.98),P=0.038,and in the female patients theRR was 0.51,95%CI(0.35-0.75),P=0.000.The RR of death in theGC patients was 2.45,(1.40-4.29)in the male,P=0.01,and 0.99,(0.47-1.99),in the female cases,P=0.906.CONCLUSION Six years after a cohort screening of a largepopulation by endoscopic examination with iodine staining inareas at high risk for EC,the death risk in the male and femalepatients with EC has decreased compared with that in the controlgroup.The difference between the 2 groups was statisticallysignificant.However,no protective method used to decrease thedeath risk in GC patients has been found during this period ofendoscopic screening.
