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河南食管癌高发区食管贲门双源癌前病变病理特征

Histopathological prevalence of concurrent esophageal and gastric cardia precancerous lesions from the same patient at high-incidence area for esophageal cancer in Henan

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【作者】王立东；杜娴娟；李吉林；王能超；焦新英；李学民；韩锁利；任景丽；刘娜；范宗民；何欣；王苒；陈志国；李江曼；郭志刚；孔国强；

【Author】 WANG Lidong1),DU Xianjuan1),LI Jilin2),WANG Nengchao1),JIAO Xinying2),LI Xuemin1,3),HAN Suoli1),REN Jingli1,4),LIU Na1),FAN Zongmin1),HE Xin1),WANG Ran1),CHEN Zhiguo1,5),LI Jiangman1),GUO Zhigang1,5),KONG Guoqiang1)1)Henan Key Laboratory for Esophageal Cancer Research;College of Basic Medical Sciences;the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052 2)Department of Pathology,Yaocun Esophageal Cancer Hospital,Linzhou 456592 3)Department of Pathology,Cixian Hospital,Cixian 056500 4)Department of Pathology,the Second Affiliated Hospital,Zhengzhou University,Zhengzhou 450014 5)Cancer Research Center,Xinxiang Medical University,Xinxiang 453003

【机构】河南省食管癌重点开放实验室；郑州大学基础医学院；郑州大学第一附属医院；林州市姚村食管癌医院病理科；磁县医院病理科；郑州大学第二附属医院病理科；新乡医学院癌症研究中心；

【摘要】目的:比较分析河南食管癌高发区同一个体食管鳞状上皮不典型增生(eDYS)和贲门腺上皮不典型增生(gDYS)即食管贲门双源癌前病变(cDYS)的病理特征。方法:选取林州地区临床病理诊断为单发贲门癌(n=3119)、单发下段食管癌(n=516)和食管贲门双源癌(n=115)手术切除标本的癌旁组织,及河南食管癌高发区无症状人群食管内镜黏膜活检组织(n=4315),采用连续取材、石蜡包埋、切片和组织病理学方法,分析cDYS的变化特征和规律。结果:ESCC组、GCA组、CC组eDYS检出率分别为75.8%(391/516)、22.4%(700/3119)、63.5%(73/115),gDYS检出率分别为21.9%(113/516)、61.4%(1915/3119)、37.4%(43/115)。4315例无症状居民内镜普查eDYS、gDYS检出率分别为4.8%(206/4315)和5.3%(229/4315)。ESCC组、GCA组cDYS检出率分别为19.6%(101/516)、17.6%(548/3119),2组相似(P>0.05),但均低于CC组的29.6%(34/115)(P<0.05)。手术切除标本癌旁组织中cDYS检出率18.2%(683/3750),高于无症状普查人群cDYS的检出率0.7%(29/4315)(P<0.05)。手术切除标本cDYS的高发年龄段均为50～69岁,比无症状人群cDYS高发年龄段40～59岁高10岁(P<0.05)。结论:食管贲门双源癌前病变是常见的病理变化,是食管贲门双源癌发生的重要组织基础。更多还原

【Abstract】 Aim:To characterize the histopathological prevalence of concurrent esophageal and gastric cardia precancerous lesions from the same patient (cDYS) at high-incidence area for esophageal cancer in Henan.Methods:The surgical specimens including single gastric cardia adenocarcinoma (GCA,n=3 119),single lower segment esophageal cancer (ESCC,n=516) and concurrent esophageal and gastric cardia adenocarcinoma (CC,n=115) and esophageal/gastric cardia biopsies from the symptom-free subjects (n=4 315) were collected from high risk area in Henan for histopathological analysis on cDYS. All the surgical specimens were collected serially,paraffin embedded and sectioned. Results:The prevalence of eDYS in the tissue adjacent to ESCC,GCA,CC were 75.8%(391/516),22.4%(700/3 119),63.5%(73/115),those of gDYS were 21.9%(113/516),61.4%(1 915/3 119),37.4%(43/115).Of the 4 315 symptom-free subjects examined by endoscopy,the prevalence of eDYS and gDYS were 4.8%(206/4 315) and 5.3%(229/4315),and the prevalence of cDYS was similar between the tissue adjacent to ESCC and GCA (19.6% vs 17.6%,P>0.05),but was 29.6%(34/115) lower in the tissue adjacent to CC (P<0.05).The detection rate of cDYS in surgically resected specimens was 18.2%(683/3 750),apparently 0.7%(29/4 315) higher in biopsy tissues from the symptom-free subjects.The high-incidence age of cDYS in the surgically resected specimens was 50~69 years;that in the symptom-free subjects was 40~49 years;the former was higher than the latter (P<0.05).Conclusion:It is suggested that cDYS was a common pathological change and was the important histological basis for CC.更多还原

【关键词】双源癌；双源癌前病变；食管肿瘤；鳞状细胞癌；贲门肿瘤；腺癌；不典型增生；
【Key words】 concurrent cancer； concurrent precancerous lesions； esophageal neoplasm； squamous cell carcinoma； gastric cardiac neoplasm； adenocarcinoma； dysplasia；

【基金】国家杰出青年科学基金资助项目30025016;国家自然科学基金资助项目30670956;河南省医学科技攻关基金资助项目20058;河南省高校创新人才工程基金资助项目1999125

【文献出处】郑州大学学报(医学版) ,Journal of Zhengzhou University(Medical Sciences) , 编辑部邮箱 ,2009年02期

【分类号】R735
【被引频次】8
【下载频次】228

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