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目的:了解食管和贲门癌前病变进展较快者的滞留时间,为寻找合适的筛查间隔提供线索。方法:在涉县对40～69岁人群开展重复的内镜筛查。结果:8例重度不典型增生者中从首检为正常间隔13个月检出1例,从首检为基底细胞增生间隔7个月检出1例,从首检为轻度不典型增生分别间隔3～10.5个月检出4例,从首检为中度不典型增生分别间隔12.5、43.4个月检出2例;8例原位癌或黏膜内癌中由首检为基底细胞增生分别间隔18和51.7个月检出2例,由首检为轻度不典型增生间隔48个月检出1例,由首检为中度不典型增生分别间隔4、13个月检出2例,由首检为重度不典型增生分别间隔3.5～17.5个月检出3例;4例浸润性癌中由轻度不典型增生间隔13个月检出1例,由中度不典型增生间隔50个月检出1例,由重度不典型增生间隔14和19个月检出2例。结论:首检过后对基底细胞增生和轻度不典型增生应间隔一年复查一次,对中度不典型增生应半年内复查一次,以防止其中进展较快者发展为癌。
OBJECTIVE: To understand the residence time of advanced esophageal and cardial precancerous lesions and to provide clues for finding suitable screening intervals. Methods: Repeated endoscopic screening of 40-69-year-olds in Shexian County. Results: Among the eight cases of severe dysplasia, one case was detected from the first examination at the normal interval of 13 months, one case was detected at the first examination for basal cell hyperplasia at 7 months, and the first test was atypical dysplasia 4 cases were detected at intervals of 3 to 10.5 months, 2 cases were detected at the interval of 12.5 and 43.4 months respectively from the first test, and the first test was basal cell hyperplasia in 8 cases of carcinoma in situ or mucosa Two cases were detected at 18 and 51.7 months. One case was detected 48 months after the first test was mild atypical hyperplasia. Two cases were detected at the interval of 4 and 13 months respectively. 3 cases were diagnosed as severe atypical hyperplasia 3.5 to 17.5 months respectively. In 4 cases of invasive carcinoma, one case was diagnosed at mild atypical hyperplasia interval of 13 months and 50 cases at moderate atypical hyperplasia interval One case was detected in each month, and two cases were detected at 14 and 19 months after severe atypical hyperplasia. Conclusion: After the first inspection of basal cell hyperplasia and mild dysplasia should be reviewed one year intervals, moderate dysplasia should be reviewed within half a year to prevent the progress of those who progress to cancer.