河南9万例高危人群上消化道癌内镜筛查及早诊早治分析

Analysis of Results of Endoscopic Screening and Early Diagnosis and Treatment of Upper Digestive Tract Carcinoma More than 9 Million High-Risk Groups in Henan

摘要: 目的：探讨在河南上消化道癌高发地区开展内镜筛查和早诊早治项目的过程和结果。方法：选择河南上消化道癌高发地区的12个市县，将40~69岁设定为目标人群。除外胃镜检查禁忌症者，按照国家《癌症早诊早治技术方案》，对筛查对象的食管、贲门、胃进行内镜检查并以组织学诊断进行评价。结果：5年来共筛查9万多例，在进入分析的89,495例中，发现各类癌前病变以解剖部位食管、贲门、胃来分，依次为26,199例(29.27%)、23,337例(26.08%)和3248例(5.20%)；共检出上消化道癌病例2095例，检出率2.34%，其中，食管1.38%，贲门0.73%，胃0.33%。早期病例1706例，占81.72%。对3000多例进行了近期随访筛查，对林州5年治疗情况做了简要报告。结论：在上消化道癌高发地区，对40~69岁高危人群开展内镜筛查和实施早诊早治是可行的，对各类癌前病变进行干预并对各类早期阶段癌变开展微创治疗，将会对防治上消化道癌，降低死亡率起到积极地作用。

Abstract: Objective: To study the process and results of endoscopic screening and early diagnosis and treatment for the cancer of upper digestive tract in high-incidence areas in Henan. Methods: 12 high-incidence cities and counties of upper gastrointestinal carcinoma in Henan province were included in this study. People aged 40-69 were set to the target population. Except contraindications for endoscopy, in accordance with the national technical scheme of early cancer diagnosis and treatment, endoscopic screening and histologic diagnosis for human esophagus, cardia and gaster of the target people were carried out. Results: During the 5-year period, more than 90,000 cases had a total sieve check, and in the 89,495 cases which entered the analysis, various precancerous in anatomy parts esophagus, cardia and gaster were found: 26,199 subjects (29.27%) in esophagus, 23,337 subjects (26.08%) in cardia and 3248 subjects (5.20%) in gaster respectively. A total of 2095 cases were found to have cancers (2.34%), followed by anatomy parts for 1.38%, and 0.73% and 0.33% respectively, among them 1706 cases had early stage with an early diagnosis rate was 81.72%. More than 3000 cases have been followed-up screening in near future, and we made a brief report on the 5-year treatment in Linzhou. Conclusion: The results of this study demonstrate that endoscopic screening and early diagnosis and treatment for the target population aged at 40 - 69 is feasible in high-incidence areas of upper digestive tract carcinoma. We could intervene various types of precancerous lesions and have minimally invasive treatments to cancer developing in the early stages, which have positively effects on the prevention and treatment of upper digestive tract cancer and reducing mortality.