首页 >>2015年10期
河南省12个市、县食管癌筛查效果分析
作者:张萌 李鑫 张韶凯 陈琼 王福让 张亚冰 刘曙正 郭兰伟 陆建邦 孙喜斌
全文:PDF(915.56 KB)HTML

摘要:

目的  评价河南省食管癌筛查效果。方法  2009—2013年在河南省上消化道癌12个高发市、县中,以行政村为单位,选取40~69岁年龄组居民为筛查目标人群,共88 263名,进行内窥镜检查和病理学诊断。对食管癌前病变患者进行定期随访,轻度异型增生每3年随访1次,中度异型增生每年随访1次,重度异型增生/原位癌应进行临床治疗,拒绝治疗者每年至少随访1次。计算食管轻、中、重度增生以及原位癌、各期癌变的检出率,比较初次筛查与随访筛查的检出率和早诊率。结果  在首次筛查中,检出轻度异型增生及以上病变8 434例,病变检出率为9.56%。其中轻、中度异型增生7 224例,检出率为8.18%,重度异型增生及原位癌789例(0.89%),早期癌239例(0.27%),中、晚期癌182例(0.21%)。重度异型增生/原位癌和早期癌病变1 028例,早诊率为84.96%(1 028/1 210)。2012—2013年应随访筛查4 230例轻度和中度异型增生病例,实际随访筛查2 853例,随访率为67.45%,确诊早期病变94例,检出率为3.29%,早诊率为100%。随访筛查的食管病变检出率和早诊率均高于首次筛查的结果指标(P<0.001)。结论  在河南上消化道癌症高发地区开展食管癌内镜筛查效果明显,加强随访筛查可提高筛查效果。

关键词:食管肿瘤;多相筛查;检出率

Abstract:

Objective  To evaluate effect of screening of esophageal cancer at rural areas in Henan province.Methods  At rural areas with high incidence of upper gastrointestinal carcinoma in Henan province total of 88 263 persons with 40 to 69 years old were set to the target population of the screening by the 12 cities and countries and endoscope and pathology diagnosis were performed during 2009-2013. For patients with precancerous lesions, follow-up visits were conducted and defined as follows: once in three years for patients with mild dysplasia, once per year for moderate hyperplasia patients, the patients with severe intraepithelial neoplasia/carcinoma in situ should be treat, at least once per year for those one who didn't under treatment. The result data of screening were summarized and detection rates of esophagus hyperplasia, carcinoma in situ, early and middle-late cancer were calculated, as well as the early diagnosis rate. The result between first round and follow-up screening was compared.Results  Target population were examined in first round screening. There were 8 434 persons with above mild dysplasia and the detection rate was 9.56%, among them there were 7 224 (8.18%) cases with light-middle hyperplasia, 789 (0.89%) cases with serious dysplasia or cancer in situ, 239 (0.27%) cases with early cancer and 182 (0.21%) cases with middle-late cancer. The sum of serious dysplasia or cancer in situ and early cancer was 1 028 and the early detection rate was 84.96% (1 028/1 210). From 2012 to 2013,the follow-up screening for persons with light-middle hyperplasia which should be followed 4 230 cases, there were 2 853 people to take in screening and compliance was 67.45%. Total of 94 cases were diagnosed with cancer in situ or early cancer. The detection rate and the early detection rate were 3.29% and 100%, respectively. The rates of detection and early detection in phase of follow-up screening were statistically significantly higher than that in first round screening respectively (P<0.001).Conclusion  At rural areas of high incidence upper gastrointestinal carcinoma in Henan province, the screening with endoscope had good effect and strengthening the follow-up screening could increase the effect.

Key words: Esophageal neoplasms;Multiphasic screening;Detection rate

发表日期:2015/10

引用本文:

图/表:

  • 10.3760/cma.j.issn.0253-9624.2015.10.008.T001:表1 2009—2013年河南省12个市、县食管癌筛查结果[例数(%)]

    10.3760/cma.j.issn.0253-9624.2015.10.008.T001:表1 2009—2013年河南省12个市、县食管癌筛查结果[例数(%)]

  • 10.3760/cma.j.issn.0253-9624.2015.10.008.T002:表2 2009—2013年河南省12个市、县食管癌重度异型增生以上病变检出情况及早诊率

    10.3760/cma.j.issn.0253-9624.2015.10.008.T002:表2 2009—2013年河南省12个市、县食管癌重度异型增生以上病变检出情况及早诊率

  • 10.3760/cma.j.issn.0253-9624.2015.10.008.T003:表3 2012—2013年河南省12个市、县食管癌轻度和中度异型增生病例随访筛查结果

    10.3760/cma.j.issn.0253-9624.2015.10.008.T003:表3 2012—2013年河南省12个市、县食管癌轻度和中度异型增生病例随访筛查结果

参考文献:

[1]FerlayJ, SoerjomataramI, ErvikM, et al.GLOBOCAN 2012 v1.0.Cancer Incidence and Mortality Worldwide: IARC CancerBase No.11[M]. Lyon: International Agency for Research on Cancer,2013 [2014-01-20].
[2]卫生部疾病预防控制局,癌症早诊早治项目专家委员会.癌症早诊早治项目技术方案(2011年版)[M].北京:人民卫生出版社,2011:8.
[3]陈万青,郑荣寿,曾红梅,等.2011年中国恶性肿瘤发病和死亡分析[J].中国肿瘤,2015,24(1):1-10.
[4]王成增,孙喜斌.2014河南省肿瘤登记年报[M].北京:军事医学科学出版社,2014.
[5]ZengH, ZhengR, GuoY, et al.Cancer survival in China, 2003-2005: A population-based study[J]. Int J Cancer, 2015, 136(8):1921-1930.
[6]王霄,樊晋川,王安荣,等.四川省食管癌早诊早治效果评价[J].中国肿瘤,2012,21(3):197-199.
[7]王国清,郝长青,赖少清,等.碘染色在食管癌高发区直接内镜普查中的应用和效果[J].中华消化内镜杂志,2003,20(6):377-379.
[8]纪鹏,赵德利,宋秀玲,等.肥城市食管癌筛查及早诊早治模式探索[J].中国肿瘤,2009,18(9):748-751.
[9]张立玮,温登瑰,王士杰,等.食管癌高发区贲门癌、胃癌流行强度分析及其对内镜筛查的启示[J].肿瘤防治研究,2005,32(12):792-795.
[10]YangJ, WeiWQ, NiuJ, et al. Estimating the costs of esophageal cancer screening, early diagnosis and treatment in three high risk areas in China[J]. Asian Pac J Cancer Prev, 2011,12(5):1245-1250.
[11]YangJ, WeiWQ, NiuJ, et al.Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China[J]. World J Gastroenterol, 2012,18(20):2493-2501.
[12]马雅婷,连士勇,刘志才.河南省林州市食管癌人群现时生存分析[J].中华预防医学杂志,2009,43(12):1100-1104.

用户评论 0条

用户名: 密码: 登陆 注册
 
  • 9
  • 3
  •  4 : 页次:0/0页 共0条记录 5条/每页
    关于我们 | 专家风采 | 会员注册 | 继续教育
    地 址:北京东城区东四西大街42号 邮 编:100710
    电话:010-85158365/85158377 传真:010-85158262
    版权所有 中华医学会及中华预防医学杂志编辑部
    京ICP备 07035254 号