摘要目的 观察食管癌高发区社区居民食管癌前状态和病变的分布情况,为该病的病因及二级预防提供依据.方法 在山东省肥城市食管癌高发社区,对9536名高危人群采用碘染色内镜普查,取活检1507例进行食管癌各种病变的病理诊断.对病理活检结果按性别及年龄分布的构成比和各疾病的检出率比较采用χ2检验.结果 1507例活检病理诊断分类的男女构成比差异没有统计学意义.将轻、中度不典型增生为癌前状态、重度不典型增生为癌前病变划分,以所有参加普查人数为分母,男性食管癌前状态和癌前病变的检出率分别为6.98%(294/4214)和1.23%(52/4214),而女性则分别为3.68%(196/5322)和0.47%(25/5322);男女比较,χ2值分别为52.349和15.267,P值均＜0.05,差异均有统计学意义.按年龄组分析,重度不典型增生病变主要分布在50～岁到65～岁年龄组,原位癌是45～到50～岁年龄组的构成比最高,早期癌主要分布在45～到65～岁5个年龄组.按乡镇分布分析显示,高发乡镇食管癌前病变和癌的检出率高.结论 该地区居民食管癌前状态和病变的分布情况为该地食管癌的一、二级预防提供了科学基础.

abstractsObjective To observe the distribution of the pre-cancerous condition and pathological changes of esophageal cancer of the community residents in high-incidence area, and to provide etiological evidences for secondary prevention. Methods An iodine-staining endoscope census was conducted in 9536 residents with high-risk factors at Feicheng, a high esophageal cancer incidence community in Shandong province. Of which, 1507 pathologic biopsies were performed and χ2 test administrated. Results There was no statistical significance found in biopsy pathologic diagnosis between females and males among 1507 samples. The mild and medium atypical hyperplasia was taken as pre-cancerous condition and severe atypical hyperplasia was taken as pre-caneerous lesion. Taking all the population attending census as denominator,the detection rate of the precancerous state and precancerous lesion were 6.98% (294/4214) and 1.23% (52/4214) for the males, and 3.68% (196/5322)and 0. 47% (25/5322)for the females, respectively. A statistical significance was observed when comparing males with females ( χ2 were 52. 349 and 15. 267,respectively, P ＜ 0. 05 ). Analyzed by age group, severe atypical hyperplasia pathological changes were mainly distributed in the age group of 50 - and 65 -. The constituent ratio between 45 - and 50 - was the highest for CIS. Early carcinoma was mainly distributed in five age groups from 45 - to 65 -. It showed that high incidence town had a high detection rate of cancer and pathological changes of esophageal cancer in the analysis of urban and rural distribution. Conclusion The distribution of the pre-cancerous state and pathological changes of esophageal cancer of the residents should have provided a scientific basis for the primary and secondary prevention.