由于食管癌和贲门癌外科治疗上的相似性,华北食管癌高发现场肿瘤登记1986年以前存在把贲门腺癌归入食管鳞癌的现象[1],虽然强调了食管鳞状上皮癌的高发,但在一定程度上忽略了贲门和非贲门胃腺癌的流行强度.

To investigate the natural history of fast developing esophageal and cardia precursors.

Aim: To investigate sojourn time of rapid developing esophageal and cardia precancerous lesions.Methods:Periodic endoscopic screening was performed among 301 residents aged from 40 to 69 years in the high-incidence areas for esophageal cancer in Shexian, Hebei province.Results: Sojourn time for severe dysplasia (SD) was: 13 months after a baseline diagnosis of normal epithelium in 1 subject, 7 months after a baseline diagnosis of base cell hyperplasia(BCH) in 1 subject, 3 months, 4 months, 4 months, and 10.5 months after baseline diagnoses of mind dysplasia(mD) in 4 subjects, and 12.5 months after a baseline diagnosis of moderate dysplasia (MD) in 1 subject; Sojourn time for cancer in situ or intramucosal carcinoma was: 48 months after a baseline diagnosis of mD in 1 subject, 4 months and 13 months after baseline diagnoses of MD in 2 subjects, and 3.5 months, 9 months, and 17.5 months after baseline diagnoses of SD; and sojourn time for invasive cancer was: 50 months after a baseline diagnosis of MD in 1 subject, 14 months and 19 months after baseline diagnoses of SD in 2 subjects. Conclusion: Periodic screening with shorter intervals should be considered to control the number of interval cases due to rapid development, multifocal carcinogenesis, and false negative results in endoscopic biopsy sampling.

Objective: To investigate the development period of atypical hyperplasia in patients with a rapid progression of precancerous esophageal and cardiac lesions in order to provide clues for establishing a suitable screening interval. Methods: Periodic endoscopic screening was performed for the population aged 40 to 69 years old in Shexian county. Results: In 8 cases of severe atypical hyperplasia (SAH), one case had a normal result at the initial test (IT) with a 13-month interval (i.e. the time between examinations), one case had basal cell hyperplasia (BCH) at the IT with a 7-month interval, 4 cases had slight atypical hyperplasia (SAH) at the IT with a 3 to 10.5-month interval and 2 cases had moderate atypical hyperplasia (MAH) at the IT with a 12.5 to 43.4-month interval. In 8 cases of cancer in situ or intramucosal carcinoma, 2 cases had BCH at the IT with an 18 to 51.7-month interval, 1 case had SAH at the IT with a 48-month interval, 2 cases had MAH at the IT with a 4 to 13-month interval and 3 cases had SAH at the IT with a 3.5 to 17.5-month interval. In 4 cases of invasive carcinoma, 1 case had SAH at the IT with a 13-month interval, 1 case had MAH at the IT with a 50-month interval and 2 cases had SAH at the IT with a 14 to 19-month interval. Conclusion: After the initial tests, the interval between reexaminations should be once a year for BCH and SAH and once every 6 months for MAH in order to prevent rapid development to more advanced stages.

ObjectiveTo discuss the epidemic strength of cardia and distant stomach cancers in the high risk region of esophageal cancer along the south Taihang mountain such as in Shexian, Linxian, and Cixian Counties, and to clarify the tasks for the control of upper gastrointestinal tract cancer as a whole in the region.MethodsComparisons of incidence and mortality rates of esophageal, cardia and stomach cancers were made between Cixian, Linxian and Shexian Counties with reference to detection rates of cancer in situ and precancerous lesions of the three upper gastrointestinal cancers by endoscopic screening. The screening was performed from 1999 through 2004 in the three adjacent counties including a total of 6233 local residents aged 40 to 69 years old.ResultsThe incidence rates for cardia cancer for the male and female from 2000 through 2004 were 69.9 and 41.5, and the mortality rates were 54.3 and 33.2 respectively in Shexian County. Esophageal, cardia, and stomach cancers constitute about 70∼80 percent of all malignant disease by incidence or mortality rates. Endoscopic survey with iodine staining can effectively detect squamous cell precancerous lesions in the esophagus, but the method is inadequate for the detection of adeno precancerous lesions of the cardia and stomach.ConclusionThe south Taihang mountain region is a high risk area not only for esophagus cancer, but also for cardia and stomach cancers. To control upper gastrointestinal tract cancers as a whole in the region, special attention should be paid to the control of cardia and stomach cancers. Presently, to find effective screening methods for detecting cardia and stomach precancerous lesions is especially important.

目的 调查血液系统恶性肿瘤患者医院感染发生率及有关危险因素。方法 对我院几种血液系统恶性肿瘤患者 2 88例发生医院感染情况进行回顾性调查。结果 2 88例患者中发生医院感染 189例 ,感染率 6 5 5 % ,共发生医院感染 36 6例次 ,例次感染率 12 7 1%。结论 医院感染部位以呼吸道、口腔及败血症为主 ,而且主要发生于诱导缓解期。同时针对各种危险因素提出相应对策。