【摘要】 目的 :通过贲门癌高、低发区 1975例无症状居民普查 ,进一步了解贲门上皮病变的特征及其与性别、年龄的关系 ,加深对贲门癌变多阶段演进的形态学变化特征的了解。方法 :对食管癌高发区 10 0 6无症状居民 ,低发区 2 0 8无症状居民进行纤维内镜检查、粘膜活检和组织病理检查。结果 :高发区 10 0 6例活检标本中 ,共发现 9例早期贲门腺癌患者 (GCA ,0 .9% ) ,33例间变患者 (DYS ,3.3% ) ,10 2例慢性萎缩性贲门炎患者 (CAG ,10 .1% )和2 6 9例慢性浅表性贲门炎患者 (CSG ,2 6 .7% ) ,以及 5 93例正常贲门上皮 (NOR ,5 8.9% )。 9例早期GCA均发生在男性 ,间变患者男性明显高于女性 ;低发区 :2 0 8例普查对象中 ,未发现早期GCA ,但发现 2例DYS(1.0 % ) ,7例CAG(3.4 % ) ,118例CSG(5 6 .7% )和 81例正常贲门上皮 (38.9% )。男性CAG较女性常见 ,2例DYS中 ,男女各 1例。结论 :贲门癌高发区居民GCA、DYS、CAG的发现率明显高于低发区 ,进一步证实贲门癌的地域性分布特征 ,提示DYS和CAG是贲门癌重要的癌前病变更多还原

【Abstract】 Aim: To characterize the prevalence of gastric cardia lesions, to correlate these lesions with sex and age through mass survey on 1 975 symptom free subjects from the high and low incidence area and to expand the knowledge on morphological changes in multistage carcinogenesis of gastric cardia adenocarcinoma (GCA). Methods: Endoscopy, mucosal biopsy and histopathology were applied.Results: In high incidence area, of the 1006 biopsy samples examined, 9 cases were identified as early GCA (0.9%),33 cases,as dysplaisa(DYS,3.3%),102 cases,as chronic atrophic gastritis(CAG,10.1%), 269 cases,as chronic superficial gastritis(CSG, 26.7%), and 593 cases,as normal(NOR, 58.9%). The detection rates of DYS were higher in males than in females;In low incidence area, of the 208 biopsy samples examined, no early GCA was identified. But 2 cases were identified as DYS(1.0%),one in male, the other in female.seven cases were identified as CAG(3.4%), 118 cases as CSG(56.7%)and 81 cases as normal(38.9%).Conclusion:The results confirm the dramatic geographic distribution of GCA, and suggest that DYS and CAG may be the severe precancerous lesions of GCA.更多还原