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目的探讨食管癌高、低发区人群食管粘膜上皮组织学改变，为癌前病变防治提供依据。方法高（林州市）、低发区（范县、清丰县）分别取无症状居民食管活检２２９人和１８７人，均分为４组，２５岁～３４岁、３５岁～４４岁、４５岁～５４岁及≥５５岁，常规石蜡ＨＥ制片，按标准诊断归类。结果高、低发区食管上皮萎缩、棘层肥厚、炎细胞浸润相应年龄组比较无显著差异，基底细胞增生高发区３５岁～４４岁、４５岁～５４岁组显著大于低发区相应组（Ｐ＝０．０３１２，Ｐ＝０．０２７３），非典型增生４５岁～５４岁、≥５５岁组高发区显著大于低发区相应组（Ｐ＝０．０１９６，Ｐ＝０．０２６３）。高、低发区总体人群比较除棘层肥厚、炎细胞浸润无差异外，余各病变间均有极显著差异（Ｐ＜０．０１）。结论食管上皮萎缩、基底细胞增生应作为较狭义的癌前病变对待，食管上皮棘层肥厚、炎细胞浸润似与食管癌变无关。
Objective To investigate the histological changes of esophageal mucosal epithelium in high and low incidence areas of esophageal cancer and provide evidence for the prevention and treatment of precancerous lesions. Methodology (Linzhou City) and low-incidence areas (Fan County and Qingfeng County) took 229 and 187 esophageal biopsies from asymptomatic residents, respectively, and were divided into 4 groups, aged 25 to 34, 35 to 44 and 45. Aged -54 years old and ≥ 55 years old, routine paraffin HE tablets, classified according to the standard diagnosis. Results There was no significant difference in esophageal epithelium atrophy, acanthosis hypertrophy, and inflammatory cell infiltration in the corresponding high and low incidence areas. The basal cell hyperplasia area was significantly higher in the 35-44-year-old and 45-54-year-old groups than in the low-risk area. P=0.0312, P=0.0273), the high-risk area of atypical hyperplasia 45-54 years old, ≥ 55-year-old group was significantly greater than the corresponding group of low-risk area (P=0.0196, P=0.0263). The overall population of high and low incidence areas had significant difference (P<0.01) among other lesions except acanthosis hypertrophy and inflammatory cell infiltration. Conclusion Esophageal epithelial atrophy and basal cell hyperplasia should be treated as narrowly defined precancerous lesions. Esophageal epithelial hypertrophy and inflammatory cell infiltration are not related to esophageal canceration.