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目的:比较分析河南食管癌高发区林州居民和山西长治的林州移民食管、贲门和胃窦内镜病理结果,进一步了解遗传和环境因素对食管和贲门癌变的影响。方法:从移居到山西长治100a的林州移民村中选择1个自然村并在河南林州选择1个与移民迁居前相近的自然村作为调查现场,随机对该2个自然村中30岁以上的居民进行食管/胃内镜检查和黏膜活检组织病理学检查。结果:①食管:移民村食管中段基底细胞过度增生(BCH)检出率高于林州居民(38%vs28%,P<0.05);②贲门:移民村慢性浅表性贲门炎(CSG)、不典型增生(DYS)和肠上皮化生(IM)的检出率均高于林州居民(P<0.05),但两地区慢性萎缩性贲门炎(CAG)和贲门腺癌(GCA)的检出率相似(P>0.05);③胃窦:移民村胃窦部DYS和IM检出率均高于林州居民(P<0.05),但2地区胃窦部CSG、CAG和GCA检出率均相似(P>0.05)。结论:林州居民移民到山西长治100a后,自然人群食管癌和贲门癌检出率、食管重度癌前病变检出率仍与林州原住地居民相似,而移民贲门和胃窦部重度癌前病变检出率均高于林州居民。环境和时间变化均未明显影响食管和贲门癌前病变和癌的发生率,提示遗传因素在其发生中可能起重要作用。
OBJECTIVE: To comparatively analyze the endoscopic findings of esophagus, cardia and gastric antrum in Linzhou residents in Linzhou, Henan Province, with high incidence of esophageal cancer and in Changzhi, Shanxi, and further understand the influence of genetic and environmental factors on the carcinogenesis of esophagus and gastric cardia. Methods: One natural village was selected from the Linzhou immigrant village relocated to Changzhi 100a, Shanxi Province and one natural village close to the former immigrant was chosen as the survey site in Linzhou, Henan Province. Randomly the residents over the age of 30 in the two natural villages Esophageal / gastric endoscopy and mucosal biopsy histopathological examination. Results: ① The esophagus: The detection rate of basal cell hyperplasia (BCH) in the middle esophagus in immigrant village was higher than that in Linzhou County (38% vs 28%, P <0.05); ② Cardia: chronic superficial cardia gonitis (CSG) The detection rate of atypical hyperplasia (DYS) and intestinal metaplasia (IM) was higher than that of Linzhou residents (P <0.05). However, the detection rate of chronic atrophic cardia (CAG) and gastric cardia adenocarcinoma (P> 0.05). (3) The detection rate of DYS and IM in gastric antrum of immigrant village was higher than that of forest resident (P <0.05), but the detection rate of CSG, CAG and GCA in gastric antrum All were similar (P> 0.05). Conclusion: After the residents of Linzhou immigrated to Changzhi of Shanxi for 100a, the detection rate of esophageal and cardiac cancer and esophageal cancer were still similar to those of native Linzhou residents. However, Lesion detection rate was higher than Linzhou residents. Environmental and temporal changes did not significantly affect the incidence of esophageal and cardiac precancerous lesions and cancer, suggesting that genetic factors may play an important role in its occurrence.