摘要
目的：了解进展较快的食管和贲门癌前病变的时间，为寻找合适的筛查间隔提供线索。方法：在食管癌高发区河北涉县对40-69岁人群开展重复的内镜筛查。结果：301例重复筛查共观察到40例病情发生进展者，其中7例重度不典型增生中：1例首检为正常。间隔13个月检出重度不典型增生，1例首检为基底细胞增生，间隔7个月检出，4例首检为轻度不典型增生，分别间隔3个月、4个月、4个月、10．5个月检出。1例首检为中度不典型增生，间隔12．5个月检出；6例原位癌及黏膜内癌中：1例首检为轻度不典型增生，间隔48个月检出，2例中度不典型增生分别间隔4个月、13个月检出2例，3例重度不典型增生分别间隔3．5个月、9个月、17．5个月检出；3例浸润性癌中：1例中度不典型增生，间隔50个月检出、2例重度不典型增生间隔14个月和19个月检出。结论：食管和贲门癌前病变的滞留时间变异较大，有必要适当缩短筛查间隔，通过及时复查捕获那些进展较快、多点起源和首检遗漏的癌前病变。
Aim： To investigate sojourn time of rapid developing esophageal and cardia precancerous lesions. Methods：Periodic endoscopic screening was performed among 301 residents aged from 40 to 69 years in the high-incidence areas for esophageal cancer in Shexian, Hebei province. Results： Sojourn time for severe dysplasia （SD） was： 13 months after a baseline diagnosis of normal epithelium in 1 subject, 7 months after a baseline diagnosis of base cell hyperplasia（BCH） in 1 subject, 3 months, 4 months, 4 months, and 10.5 months after baseline diagnoses of mind dysplasia（mD） in 4 subjects, and 12.5 months after a baseline diagnosis of moderate dysplasia （MD） in 1 subject; Sojourn time for cancer in situ or intramucosal carcinoma was： 48 months after a baseline diagnosis of mD in 1 subject, 4 months and 13 months after baseline diagnoses of MD in 2 subjects, and 3.5 months, 9 months, and 17.5 months after baseline diagnoses of SD; and sojourn time for invasive cancer was： 50 months after a baseline diagnosis of MD in 1 subject, 14 months and 19 months after baseline diagnoses of SD in 2 subjects. Conclusion： Periodic screening with shorter intervals should be considered to control the number of interval cases due to rapid development, muhifocal carcinogenesis, and false negative results in endoscopic biopsy sampling.
出处
《郑州大学学报（医学版）》
CAS
北大核心
2007年第1期62-66,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
河北省自然科学基金资助项目C2005000797
河北省科学技术研究与发展计划06276104D
河北省普通高校强势特色学科建设基金资助项目
关键词
食管肿瘤
癌
责门肿瘤
内镜筛查
癌前病变
滞留时间
间期癌
esophageal neoplasm
carcinoma
cardia neoplasm
endoscopic screening
precancerous lesion
sojourn time
interval case
