[1]王立东#.内窥镜在食管癌高发区高危人群筛查中的局限和对策[J].郑州大学学报(医学版),2009,(01):11-12.
 WANG Lidong.Limitation and strategies on endoscopic examination in highrisk subject screening for esophageal cancer in highincidence area[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2009,(01):11-12.
点击复制

内窥镜在食管癌高发区高危人群筛查中的局限和对策()
分享到:

《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2009年01期
页码:
11-12
栏目:
食管癌研究
出版日期:
2009-01-01

文章信息/Info

Title:
Limitation and strategies on endoscopic examination in highrisk subject screening for esophageal cancer in highincidence area
作者:
王立东#
河南省食管癌重点开放实验室;郑州大学第一附属医院;郑州大学基础医学院郑州450052
Author(s):
WANG Lidong
Henan Key Laboratory for Esophageal Cancer Research;the First Affiliated Hospital; College of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450052
关键词:
内窥镜食管肿瘤高危人群筛查
Keywords:
endoscope esophageal neoplasm highrisk subjectscreening
分类号:
R735.1
摘要:
内窥镜和黏膜活检组织病理学检查是目前食管癌高发区无症状高危人群筛查最有效的方法之一。但无症状高危人群筛查中,近80%的居民食管上皮组织病理属于正常范围,也就是说,在无症状高危人群筛查中存在内窥镜应用过度的现象,加之内窥镜检查复杂的规范程序、昂贵的价格以及有经验的内窥镜医师的缺乏等,导致其成本较高而效率较低,不能满足大范围人群筛查的要求。作者提出食管癌普查的三级筛查制度,第一级筛查为无创的血清学检查,通过检测血液中有关肿瘤相关分子的水平间接了解食管上皮增生状态;第二级为脱落细胞学检查;内窥镜活检、组织病理学检查为第三级筛查。3者结合,可以降低内窥镜应用的频率,降低筛查成本,提高检出效率,适应于大范围人群筛查。三级筛查模式与现行农村(社区)合作医疗制度相结合是该模式推广应用的重要保证。
Abstract:
Endoscopic biopsy and histopathological examination remain one of the critical methods for highrisk subject screening for esophageal cancer (EC) on the symptomfree subjects in highincidence area for EC. Almost 80% of the symptomfree subjects are of normal esophageal epithelia. Based on that, overexamination of endoscope exists during symptomfree subjects screening. Furthermore, the application of endoscopy in largescale screening on symptomfree subjects in highincidence area is limited because of the complicated protocol, highcost, and short of experienced endoscopists. The author suggests threestep screening method. The first step is noninvasive serological screening, which indirectly reflect the esophageal epithelial lesions by determining the blood level of neoplasmrelated molecules. Esophageal exfoliative cytology is the secondstep screening. Endoscopic and histopathological examinations are the thirdstep. The thirdstep screening method will decrease the screening cost and improve the efficiency of endoscopic examination for largescale screening for highincidence subject for EC. It is crucial to combine the threestep screening method with present cooperative medical system in rural village and community in city for extensive application of this threestep screening method.

参考文献/References:

[1]Fan YJ, Song X, Li JL, et al. Esophageal and gastric cardia cancers on 4238 Chinese patients residing in municipal and rural regions:a histopathological comparison during 24year period[J]. World J Surg, 2008, 32(9):1 980
[2]Wang LD, Yang HH, Fan ZM, et al. Cytological screening and 15 years’ followup (19862001) for early esophageal squamous cell carcinoma and precancerous lesions in a highrisk population in Anyang County, Henan Province, Northern China[J].Cancer Detect Prev, 2005, 29(4):317
[3]Wang LD,Zhou Q,Feng CW,et al.Intervention and followup on human esophageal precancerous lesions in Henan,northern China,a highincidence area for esophageal cancer [J].Gan To Kagaku Ryoho,2002,29( Suppl 1):159
[4]杜芳,王立东,齐义军,等. 利用肿瘤相关抗原微阵列检测食管和贲门癌及癌前病变患者血清中多个自身抗体的变化特征[J].中华肿瘤防治杂志,2006,13(17):1 289

相似文献/References:

[1]庞霞,郑湘予,李晟磊,等.食管鳞癌组织中半乳糖凝集素3和Bcl2蛋白的表达*[J].郑州大学学报(医学版),2010,(01):8.
 PANG Xia,ZHENG Xiangyu,LI Shenglei,et al.Expression of Galectin3 and Bcl2 protein in esophageal squamous cell carcinoma tissue[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2010,(01):8.
[2]张威,陈玉,亚国伟,等.RNA干扰对EC9706细胞mTOR表达及细胞生长与凋亡的影响*[J].郑州大学学报(医学版),2010,(01):11.
 ZHANG Wei,CHEN Yu,YA Guowei,et al.Effect of mTOR siRNA on the expression of mTOR gene,growth and apoptosis of human esophageal carcinoma EC9706 cells[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2010,(01):11.
[3]崔玲玲),李春阳),王旗),等.食管鳞癌组织中EphrinB2、半胱氨酸蛋白酶8蛋白和mRNA的表达*[J].郑州大学学报(医学版),2010,(01):21.
 CUI Lingling),LI Chunyang),WANG Qi),et al.Expression of EphrinB2 and Caspase8 protein and mRNA in esophageal squamous cell carcinoma tissue[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2010,(01):21.
[4]吴欣爱),王筱璨),樊青霞),等.食管鳞状细胞癌组织中乏氧诱导因子1α蛋白和mRNA的表达[J].郑州大学学报(医学版),2010,(02):183.
 WU Xinai),WANG Xiaocan),FAN Qingxia),et al.Expression of HIF1α protein and mRNA in esophageal squamous cell carcinoma tissue[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2010,(01):183.
[5]王彦平),代丽萍),吴晓冰),等.细胞色素P4501A1 Ile/Val位点基因多态性与食管癌关系的meta 分析*[J].郑州大学学报(医学版),2010,(02):186.
 WANG Yanping),DAI Liping),WU Xiaobing),et al.Metaanalysis of cytochrome P4501A1 Ile/Val gene polymorphism with esophageal carcinoma[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2010,(01):186.
[6]刘欣欣,赵江沙,印宏坤,等.食管鳞状细胞癌组织中表皮调节素、双调蛋白及表皮生长因子受体mRNA的表达[J].郑州大学学报(医学版),2010,(02):189.
 LIU Xinxin,ZHAO Jiangsha,YIN Hongkun,et al.Expression of epiregulin,amphiregulin,and epidermal growth factor receptor mRNA in esophageal squamous cell carcinoma tissue[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2010,(01):189.
[7]陈妍琼),赵志华),张蕾)#,等.食管鳞状细胞癌组织中KiSS1蛋白和微血管密度的检测*[J].郑州大学学报(医学版),2009,(06):1127.
 CHEN Yanqiong),ZHAO Zhihua),ZHANG Lei),et al.Expressions of KiSS1 protein and detection of MVD in esophageal squamous cell carcinoma tissue[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2009,(01):1127.
[8]陈玉,亚国伟,张威,等.雷帕霉素靶蛋白RNA干扰联合雷帕霉素对人食管癌移植瘤生长和移植瘤组织中雷帕霉素蛋白基因表达的影响*[J].郑州大学学报(医学版),2009,(06):1135.
 CHEN Yu,YA Guowei,ZHANG Wei,et al.Effects of RNAi combined with rapamycin on expression of mTOR gene in tumor tissue of nude mice transplanted with human esophageal cancer cells[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2009,(01):1135.
[9]史祖宣,李克,樊青霞#.食管鳞状细胞癌组织中神经性钙黏附蛋白和mRNA的表达*[J].郑州大学学报(医学版),2009,(06):1138.
 SHI Zuxuan,LI Ke,FAN Qingxia.Expression of Ncadherin protein and mRNA in esophageal squamous cell carcinoma tissue[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2009,(01):1138.
[10]张蕾),贺付成),张云汉)#.食管鳞癌组织中分化相关基因NDRG1的表达及肿瘤诱导分化治疗的研究进展*[J].郑州大学学报(医学版),2009,(05):933.

备注/Memo

备注/Memo:
#通讯作者,男,1958年生,博士,教授,研究方向:食管和贲门癌变机制和防治研究,Email:ldwang@zzu.edu.cn
更新日期/Last Update: 2010-05-18