论文部分内容阅读
目的:食管和贲门上皮不典型增生是癌前病变,分为轻度,中度和重度三个级别。2000年WHO建议用上皮内瘤变取代不典型增生,将轻度和中度归为低级别内瘤变,并将贲门腺癌称为食管-胃交界腺癌。本文探讨食管癌高发区食管和食管-胃交界部低级别上皮内瘤变癌变危险性和时间演变规律,为食管癌二级预防提供科学数据。方法:选择磁县2个乡于2001年10月～2002年10月,开展内镜碘染色队列筛查,干预乡0～85岁总人口数为22 016例,其中40～69岁共计6 596例,男性3 257例,女性3 339例,除去禁忌症、外出打工、拒绝参加者外,实际内镜筛查3 506例,筛查率53.2%。病理以WHO诊断为标准,将食管鳞状上皮轻度和中度不典型增生及食管-胃交界部轻度不典型增生划为低级别内瘤变人群,共诊断616例;内镜筛查无癌前病变和非癌诊断的作为正常人群共2478例。2008年6～9月对该队列人群进行随访核实。其中有174例失访,随访率95.0%。结果:低级别内瘤变人群和内镜病理正常人群随访分别为3 970.7人·年和16120.0人·年,低级别内瘤变人群癌变率251.7/10万人·年,正常人群68.2/10万人·年;中位癌变时间分别是38个月和47个月。与正常人群比较,LIN癌变相对危险度RR=3.69(1.57～8.69),P=0.001。结论:低级别内瘤变人群是一组高危险人群,每年内镜复查是必要的。
Objective: Esophageal and cardiac dysplasia is precancerous lesions, divided into mild, moderate and severe three levels. In 2000, WHO recommended to replace atypical hyperplasia with intraepithelial neoplasia, to classify mild and moderate low grade neoplasia, and to refer to cardia adenocarcinoma as esophageal-gastric junction adenocarcinoma. This article explored the esophageal cancer esophageal and esophageal-gastric junction of low-grade intraepithelial neoplasia risk of cancer and the evolution of time for secondary prevention of esophageal cancer provide scientific data. Methods: Two townships in Cixian County were selected from October 2001 to October 2002 to carry out endoscopic iodine staining cohort screening. The total number of population aged 0-85 years old was 22 016, of which, 40 59 For example, there were 3 257 males and 3 339 females. In addition to contraindications, migrant workers and refusal of participants, the actual endoscopic screening was 3 506 cases with a screening rate of 53.2%. The pathology of WHO diagnosis as the standard esophageal squamous mild and moderate dysplasia and esophageal - gastric junction of mild dysplasia were classified as low-grade group of patients with neoplasia, a total of 616 cases were diagnosed; endoscopic screening A total of 2478 normal subjects were diagnosed as precancerous lesions and non-cancerous. From June to September 2008, the cohort of patients were followed up for verification. Among them, 174 cases were lost to follow-up, with a follow-up rate of 95.0%. Results: The follow-up rates of low-grade endothelium-induced neoplasia and normal endoscopic pathology were 3 970.7 person-years and 16120.0 person-years respectively, and the low-grade endothelium-related cancers were 251.7 / 100 000 person-years and 68.2 / 100 000 Person · years; median cancer time is 38 months and 47 months. Compared with the normal population, the relative risk of canceration of LIN was RR = 3.69 (1.57-8.69), P = 0.001. Conclusions: Low-grade endothelia is a group of high-risk groups, and annual endoscopy is necessary.