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JCO：内镜筛查和干预可降低食管癌死亡率

2015-05-06 徐媛媛译 MedSci原创

低食管癌内镜筛查
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对于食管鳞状细胞癌(ESCC)没有全球适用的筛查建议。从20世纪70年代起，在中国食管鳞状细胞癌高发地区就开始内镜筛查。本研究旨在评估内镜筛查及干预项目是否可降低ESCC导致的死亡率。 研究人员招募了40-69岁的食管鳞状细胞癌(ESCC)高发患者。14个村庄作被选为干预社区，10个不与干预社区临近的村庄被选为对照组。干预组的参与者接受一次用卢戈碘染色的内镜筛查，并对发现的异常增生或隐蔽的癌症进行

对于食管鳞状细胞癌(ESCC)没有全球适用的筛查建议。从20世纪70年代起，在中国食管鳞状细胞癌高发地区就开始内镜筛查。本研究旨在评估内镜筛查及干预项目是否可降低ESCC导致的死亡率。

研究人员招募了40-69岁的食管鳞状细胞癌(ESCC)高发患者。14个村庄作被选为干预社区，10个不与干预社区临近的村庄被选为对照组。干预组的参与者接受一次用卢戈碘染色的内镜筛查，并对发现的异常增生或隐蔽的癌症进行治疗。所有干预组的参与者和对照组中十分之一的参与者完成调查问卷的填写。研究人员对比了两组之间累积ESCC发生率及死亡率。

来自干预组中6827位符合标准的参与者中有3319位参与者(48.62%)接受了筛查。对照组中6200位符合标准参与者中有797位参与者接受了调查。在10年的随访中，ESCC患者有652位，其中有致死性疾病的为542位。与对照组相比，干预组的累积ESCC死亡率明显下降(3.35% v 5.05%; P < .001)，而且与对照组相比，干预组的累积ESCC发病率明显降低（4.17% v 5.92%; P < .001)。

研究发现内镜筛查和干预可以显著降低食管癌死亡率。癌前发现病变以及接受治疗也可以减少这种高度致命性癌症的发生。

原始出处

Wen-Qiang Wei, Zhi-Feng Chen, Yu-Tong He, Hao Feng, Jun Hou, Dong-Mei Lin, Xin-Qing Li, Cui-Lan Guo, Shao-Sen Li, Guo-Qing Wang, Zhi-Wei Dong, Christian C. Abnet and You-Lin Qiao?.Long-Term Follow-Up of a Community Assignment, One-Time Endoscopic Screening Study of Esophageal Cancer in China.JCO.2015

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1891188, encodeId=4b97189118864, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Wed Jul 29 21:15:00 CST 2015, time=2015-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261874, encodeId=341812618e49a, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri May 08 01:15:00 CST 2015, time=2015-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437098, encodeId=200f143e098ba, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri May 08 01:15:00 CST 2015, time=2015-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=22786, encodeId=decf22e864b, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed May 06 19:21:00 CST 2015, time=2015-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=22719, encodeId=d53e22e19db, content=食管癌因为没有有效的治疗措施，因此早期筛查变得至关重要。如果对于一些有有效的治疗方法的肿瘤，早期筛查的作用就被弱化了，如前列腺癌，乳腺癌等。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Wed May 06 10:43:00 CST 2015, time=2015-05-06, status=1, ipAttribution=)]
    2015-07-29 lidong40

    #JCO#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1891188, encodeId=4b97189118864, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Wed Jul 29 21:15:00 CST 2015, time=2015-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261874, encodeId=341812618e49a, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri May 08 01:15:00 CST 2015, time=2015-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437098, encodeId=200f143e098ba, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri May 08 01:15:00 CST 2015, time=2015-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=22786, encodeId=decf22e864b, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed May 06 19:21:00 CST 2015, time=2015-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=22719, encodeId=d53e22e19db, content=食管癌因为没有有效的治疗措施，因此早期筛查变得至关重要。如果对于一些有有效的治疗方法的肿瘤，早期筛查的作用就被弱化了，如前列腺癌，乳腺癌等。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Wed May 06 10:43:00 CST 2015, time=2015-05-06, status=1, ipAttribution=)]
    2015-05-08 jiafufeng@yaho

    #内镜#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1891188, encodeId=4b97189118864, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Wed Jul 29 21:15:00 CST 2015, time=2015-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261874, encodeId=341812618e49a, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri May 08 01:15:00 CST 2015, time=2015-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437098, encodeId=200f143e098ba, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri May 08 01:15:00 CST 2015, time=2015-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=22786, encodeId=decf22e864b, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed May 06 19:21:00 CST 2015, time=2015-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=22719, encodeId=d53e22e19db, content=食管癌因为没有有效的治疗措施，因此早期筛查变得至关重要。如果对于一些有有效的治疗方法的肿瘤，早期筛查的作用就被弱化了，如前列腺癌，乳腺癌等。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Wed May 06 10:43:00 CST 2015, time=2015-05-06, status=1, ipAttribution=)]
    2015-05-08 zhouqu_8

    #食管#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1891188, encodeId=4b97189118864, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Wed Jul 29 21:15:00 CST 2015, time=2015-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261874, encodeId=341812618e49a, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri May 08 01:15:00 CST 2015, time=2015-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437098, encodeId=200f143e098ba, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri May 08 01:15:00 CST 2015, time=2015-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=22786, encodeId=decf22e864b, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed May 06 19:21:00 CST 2015, time=2015-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=22719, encodeId=d53e22e19db, content=食管癌因为没有有效的治疗措施，因此早期筛查变得至关重要。如果对于一些有有效的治疗方法的肿瘤，早期筛查的作用就被弱化了，如前列腺癌，乳腺癌等。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Wed May 06 10:43:00 CST 2015, time=2015-05-06, status=1, ipAttribution=)]
    2015-05-06 huaxipanxing

    看看

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1891188, encodeId=4b97189118864, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Wed Jul 29 21:15:00 CST 2015, time=2015-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261874, encodeId=341812618e49a, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri May 08 01:15:00 CST 2015, time=2015-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437098, encodeId=200f143e098ba, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri May 08 01:15:00 CST 2015, time=2015-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=22786, encodeId=decf22e864b, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Wed May 06 19:21:00 CST 2015, time=2015-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=22719, encodeId=d53e22e19db, content=食管癌因为没有有效的治疗措施，因此早期筛查变得至关重要。如果对于一些有有效的治疗方法的肿瘤，早期筛查的作用就被弱化了，如前列腺癌，乳腺癌等。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Wed May 06 10:43:00 CST 2015, time=2015-05-06, status=1, ipAttribution=)]
    2015-05-06 lovetcm

    食管癌因为没有有效的治疗措施，因此早期筛查变得至关重要。如果对于一些有有效的治疗方法的肿瘤，早期筛查的作用就被弱化了，如前列腺癌，乳腺癌等。

    0

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