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

 目的 分析涉县等食管癌高发区贲门癌、胃癌的流行强度，明确其防治任务，探讨具体控制途径。方法 对比分析涉县、林县、磁县全人群肿瘤登记的食管癌、贲门癌、胃癌发病率与死亡率以及内镜筛查6233例40-69岁人群三种癌及癌前病变的检出率。结果 太行山南麓食管癌高发区食管癌、贲门癌和胃癌发病率或死亡率的合计占到全身恶性肿瘤的70％～80％。涉县2000-2004年贲门癌发病率男女性分别为69．9／10万和41．5／10万，死亡率男女性分别为54．3／10万和33．2／10万。高发区运用内镜碘染色指导活检技术筛查，食管鳞状上皮癌前病变及早期癌的检出率高，但贲门和胃腺上皮癌前病变及早期癌的检出率相对较低。结论 太行山南部食管癌高发区存在贲门癌和胃癌共同高发的现象，要想通过旱诊早治从整体上降低该地区上消化道癌的死亡率，必须加强内镜对贲门和胃腺上皮癌前病变及早期癌检出的研究。

Epidemic Strength of Cardia Cancer and Stomach Cancer in High Risk Region of Esophageal Cancer and Implication for Endoscopic Screening

Objective To estimate the epidemic strength of cardia cancer and stomach cancer in the high risk region of esophageal cancer such as She County, so to provide meaningful clues to upper gastrointestinal cancer control in the region. Methods By comparisons of the incidence and mortality rates of esophageal cancer, cardia cancer and stomach cancer obtained through population based cancer registry in the adjacent counties of Cixian, Linxian and Shexian of 6233 local residents aged 40 to 69 years old. Results Esophageal cancer, cardia cancer, and stomach cancer constitute about 70-80 percent of all malignant disease combined by incidence or mortality. The incidence rates for cardia cancer for the male and female from 2000 through 2004 were 69.9/100,000 and 41.5/100,000, and the mortality rates were 54.3/100, 000 and 33.2/100,000 respectively in the Shexian County. Endoscopic survey with iodine staining can effectively detect squamous cell precancerous lesions in the esophagus, but is insufficient for the detection of early carcinoma and precancerous lesions in the cardia and stomach. Conclusion The south Taihang mountain region is a high risk area not only for esophagus cancer, but also for cardia cancer and stomach cancer. To control upper gastrointestinal tract cancer as a whole in the place, special attention should be paid to the control of cardia cancer and stomach cancer by endoscopic screening.