| Background: Esophageal cancer and gastric cancer are common upper gastrointestinal tumors with insidious early symptoms.Most patients have been diagnosed as advanced stage due to obvious gastrointestinal symptoms.The5-year survival rate is low,but the 5-year survival rate of early-stage cancer is as high as 95%.Opportunistic screening for upper gastrointestinal cancer has been carried out in many regions of our country,and early cancer screening has a long way to go.Different endoscopic staining methods are used for upper gastrointestinal cancer screening,but the clinical value of early gastric cancer and precancerous lesion detection needs further study.Objective: To evaluate the effect of opportunistic screening of upper gastrointestinal cancer in Guangxi in 2019,and to explore the clinical value of different endoscopic staining methods in the diagnosis of early gastric cancer and precancerous lesions in opportunistic screening of upper gastrointestinal cancer.Methods: 1.Collect the opportunistic screening data of 21 upper gastrointestinal cancers in Guangxi from the Guangxi upper gastrointestinal cancer opportunistic screening management system in 2019,and analyze the differences in the detection rate and early diagnosis rate of tumorous lesions in different gender and age groups.2.Analyze the data of early gastric cancer and precancerous lesions diagnosed in 5 opportunistic screening institutions for upper gastrointestinal cancer in Guangxi in 2019,and compare the clinical value of different endoscopic staining methods for the diagnosis of early gastric cancer and precancerous lesions.Results: 1.In 2019,5897 subjects in Guangxi completed opportunistic screening for upper gastrointestinal cancer and biopsy tissue for pathological examination.There were 882,178,and 5392 biopsies of the esophagus,cardia,and stomach,respectively,with a biopsy rate of 14.96%,3.02%,91.44%.The detection rate of esophageal tumors in men was 2.19% higher than that in women(0.36%),and the difference between the two was statistically significant(P<0.01).The detection rate of gastric neoplastic lesions in men was3.04% higher than that in women(1.48%).The difference between the two was statistically significant(P<0.01).The early diagnosis rate of esophageal cancer in men and women were27.36% and 40.00%,respectively.There was no statistically significant difference between the two(P=0.55).The rates of early diagnosis of gastric cancer in men and women were 30.61% and 30.49%,respectively.There was no statistically significant difference between the two(P=0.984).The detection rate of neoplastic lesions in the esophagus and stomach(including the cardia)increased with age,and the difference in the detection rate of neoplastic lesions between age groups was statistically significant(P<0.01);There was no positive correlation between the early diagnosis rate of esophageal cancer and gastric(including cardia)cancer with age.There was no significant difference in the early diagnosis rate between age groups(P>0.05).2.Included 1052 cases of early gastric cancer and precancerous lesions,534 cases of non-atrophic gastritis(50.76%),24 cases of atrophic gastritis(2.28%),313 cases of intestinal metaplasia(29.75%),low-grade intraepithelial tumors there were 149 cases(14.16%)of changes and 32 cases(3.04%)of early gastric cancer.In the comparison of the detection rate of early gastric cancer,the electronic staining endoscopy group was higher than that of the white light endoscopy group,and the(electronic staining + IC)group was higher than the(electronic staining + ME)group.The differences were statistically significant(all P values<0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of electronic staining endoscopy for early gastric cancer diagnosis are 76.47%,99.24%,76.47%,99.24%,98.52%,respectively.Compared with white light endoscopy,the positive predictive value of the electronic staining endoscopy group for early gastric cancer diagnosis was higher than that of the white light endoscopy group(76.47% vs 16.67%),and the difference was statistically significant(P<0.05).The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of the(electronic staining + IC)group for the diagnosis of early gastric cancer were90.91%,90.48%,71.43%,97.44%,90.57%,and(electronic staining)Compared with the +ME group,the positive predictive value of the(electron staining + IC)group for early gastric cancer diagnosis was higher than that of the(electron staining + ME)group(71.43% vs 16.67%),and the difference was statistically significant(P<0.05).Conclusion: 1.Opportunistic screening for upper gastrointestinal cancer can effectively increase the detection rate of upper gastrointestinal tumors in Guangxi,thereby increasing the rate of early diagnosis.2.In the screening of upper gastrointestinal cancer,electronic staining endoscopy is superior to white light endoscopy in the detection of early gastric cancer.For suspicious lesions under white light endoscopy,further electronic staining combined with indigo carmine staining is recommended.Each screening agency can select corresponding staining methods according to the actual conditions of the endoscopy center equipment and facilities,so as to improve the detection of upper gastrointestinal lesions. |
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