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目的:探讨食管鳞状上皮重度不典型增生的癌变史。方法:对1992年11月和1997年4月普查确诊的158例为对象建立SPSS数据库,统计累积癌变率和已癌变病例的中位癌变时间;并以确诊后的第1年癌变仍生存患者为参照,分析各年癌变危险度,全部病程117个月。结果:10年累积癌变率81.66%;中位癌变时间59.4个月;第2年至第10年的癌变危险度和可信区间分别为:RR2=4.25(0.89~20.32);RR3=3.37(0.67~16.96);RR4=6.19(1.33~28.77);RR5=8.36(1.83~38.08);RR6=9.46(2.07~43.14);RR7=4.15(0.79~21.81);RR8=2.57(0.42~15.68);RR9=0;RR10=41.60(9.09~190.39)。结论:食管鳞状上皮重度不典型增生属高危人群,与早期食管癌关系密切。
Objective: To investigate the history of esophageal squamous cell dysplasia with severe dysplasia. Methods: SPSS database was established in 158 cases confirmed by census in November 1992 and April 1997. The cumulative cancer rates and the median carcinogenesis time of cancerous cases were statistically analyzed. The patients who survived in the first year after diagnosis were Reference, analysis of cancer risk in each year, all the course of 117 months. Results: The cumulative canceration rate in 10 years was 81.66%; the median time to canceration was 59.4 months; the risk of cancer and the confidence interval from 2 years to 10 years were RR2 = 4.25 (0.89-20.32); RR3 = 3.37 ~ 16.96); RR4 = 6.19 (1.33-28.77); RR5 = 8.36 (1.83-38.08); RR6 = 9.46 (2.07-43.14); RR7 = 4.15 (0.79-21.81); RR8 = 2.57 = 0; RR10 = 41.60 (9.09 ~ 190.39). Conclusions: Severe esophageal squamous dysplasia is a high risk group with a close relationship with early esophageal cancer.