| Research Background:Digestive system Tumor endoscopic screening is aimed at endoscopic examination to detect early tumors,giving early intervention and timely treatment,improving patient quality of life and improving prognosis.Esophageal,stomach,and intestinal tumors as a good model for screening tumors in the population because of the high incidence and high mortality in the esophagus,stomach and intestine tumors worldwide.Early epithelial low-grade neoplasia and high-grade neoplasia to develop cancer takes a long time.For gastrointestinal adenoma and other precancerous lesions and early cancer endoscopic screening and endoscopic intervention,you can achieve a small pain,the prognosis is good or even most of the early cancer to obtain radical treatment.Saving the patient also greatly saves the medical resources.Purpose:The natural population of our hospital as the object,the40-69-year-old high-risk groups for digestive endoscopy screening,in accordance with the "early Chinese cancer screening and endoscopic diagnosis and treatment consensus","World Health Organization" 2010 intestinal tumor classification Consensus guidelines for early cancer screening than conventional routine endoscopy can improve the rate of early cancer screening.Repeated biopsy of suspicious lesions,and confirmed by pathology,and Barrett esophageal,adenomatous polyps and other precancerous lesions in patients with microscopic treatment and follow-up work for the digestive tract early cancer endoscopic screening,early detection And polyp relapse work to provide theoretical basis.MethodDuring the period from June 2014 to May 2015,patients undergoing routine white endoscopy were examined in the digestive endoscopy room of Matsubara City Central Hospital.Multiple biopsies were performed on suspicious lesions and were diagnosed by pathology.On the precancerous disease and early cancer patients underwent microscopic intervention and follow-up work.Selected from June 2015 to June 2016 during the early cancer screening patients,in accordance with the "early Chinese cancer screening and endoscopic diagnosis and treatment consensus opinion","China’s early gastric cancer screening and endoscopic diagnosis and treatment consensus"," China’s early colon cancer screening and endoscopic diagnosis and treatment consensus " and other gastrointestinal cancer screening consensus consensus in the standard,increase the chemical staining endoscopy,electronic staining endoscopy(NBI,FICE),magnifying endoscopy and other methods for sieve Check,can be more biopsy lesions,and through pathological diagnosis,precancerous disease and early cancer patients underwent microscopic intervention and follow-up work.Use SPSS 22.0 to analyze the exported data for statisticalanalysis.Result:(1)Between June 2014 and May 2015,9560 patients had no shedding in 12056 patients,and low-grade intraepithelial neoplasia and high-grade intraepithelial neoplasia and esophageal cancer were detected in the esophageal A total of 450 cases,the detection rate of 4.71%,high-grade intraepithelial neoplasia / mucosal carcinoma in 3 cases,52 cases of invasive carcinoma,low-grade intraepithelial neoplasia 395 cases;esophageal cancer number of esophageal cancer accounted for 5.45 %.At present,283 cases of retrospective follow-up of patients who underwent low-grade intraepithelial neoplasia and high-grade intraepithelial neoplasia were treated with microscopic treatment.There were 2 cases of high grade neoplasia and 281 cases of low grade tumor.Six months after the review,low-grade intraepithelial neoplasia recurrence in 4 cases,the recurrence rate of 1.42%,10 cases of recurrence,recurrence rate of 3.5%,two cases of high-grade epithelial tumor after six months were not found recurrence and recurrence.June 2015 to June 2016 during the period in accordance with the "early Chinese cancer screening and endoscopic diagnosis and treatment consensus" norms,increase the chemical staining endoscopy,electronic staining endoscopy(NBI,FICE),zoom endoscopy and other methods Screening.A total of 720 cases of esophageal low grade intraepithelialneoplasia and high grade intraepithelial neoplasia and esophageal cancer were detected in 9855 cases of endoscopic screening.The detection rate was 7.3%,high grade intraepithelial neoplasia / mucosal carcinoma 8 cases,invasive carcinoma in 50 cases,low-grade intraepithelial neoplasia in 662cases;esophageal cancer screening cases accounted for 13.7% of the total number of esophageal cancer.At present,patients with low grade intraepithelial neoplasia and high grade intraepithelial neoplasia endoscopic treatment of patients included in the follow-up review of 420 cases,including high-grade tumor in 4 cases,416 cases of low-grade tumor.Six months after the review,low-grade intraepithelial neoplasia recurrence in 7 cases,the recurrence rate of 1.68%,15 cases of recurrence,the recurrence rate of 3.6%.4 cases of high-grade epithelial tumor after six months were not found recurrence and recurrence.During the period from June 2014 to May 2015,a total of 830 cases of low-grade intraepithelial neoplasia and high-grade intraepithelial neoplasia and gastric cancer were detected in 9560 cases of endoscopy.The rate of 8.68%,8 cases of high grade intraepithelial neoplasia / mucosal carcinoma,98 cases of invasive carcinoma,724 cases of low grade intraepithelial neoplasia;the number of gastric precancerous screening accounted for 7.54% of the total number of gastric cancer.At present,low-grade intraepithelial neoplasia and high-grade intraepithelial neoplasia patients underwent microscopic treatment of patients included inthe follow-up review of 450 cases,including high-grade tumor in 6 cases,444 cases of low-grade tumor.Six months after the review,low-grade intraepithelial neoplasia in 28 cases,the recurrence rate of 6.22%,38 cases of recurrence,recurrence rate of 8.44%,6 cases of high-grade epithelial tumor after six months were not found recurrence and recurrence.June 2015 to June 2016 during the period in accordance with the "early cancer screening in China and endoscopic diagnosis and treatment consensus" norms,increase the chemical staining endoscopy,electronic staining endoscopy(NBI,FICE),magnifying endoscopy and other methods for sieve check.A total of 1106 cases of low-grade intraepithelial neoplasia and high-grade intraepithelial neoplasia and gastric cancer were found in 9855 cases of gastroscopy screening.The detection rate was11.22%,high grade intraepithelial neoplasia / mucosal carcinoma Cases,invasive cancer in 98 cases,low-grade intraepithelial neoplasia in 717cases;gastric cancer screening out of the total number of gastric cancer accounted for 13.27%.At present,low-grade intraepithelial neoplasia and high-grade intraepithelial neoplasia patients underwent microscopic treatment of patients included in the follow-up review of follow-up 450 cases,including high-grade tumor / mucosal carcinoma in 6 cases,444 cases of low-grade tumor.Six months after the review,low-grade intraepithelial neoplasia recurrence in 15 cases,the recurrence rate of3.33%,30 cases of recurrence,recurrence rate of 6.66%,6 cases ofhigh-grade epithelial tumor after six months were not found recurrence and recurrence.Between June 2014 and May 2015,4680 patients who were enrolled in the colonoscopy and completed follow-up were found to have low-grade intraepithelial neoplasia and high-grade intraepithelial neoplasia and colorectal cancer Cases,the detection rate was 38.71%,high-grade intraepithelial neoplasia / mucosal carcinoma in 20 cases,150 cases of invasive carcinoma,low-grade intraepithelial neoplasia 1642 cases;colon early cancer screening cases accounted for 11.76% of the total number of colon cancer.At present,889 cases of follow-up of patients with low grade intraepithelial neoplasia and high grade intraepithelial neoplasia were performed after microscopic treatment.Among them,there were 15 cases of high grade tumor / mucosal carcinoma and 874 cases of low grade tumor.Six months after the review,low-grade intraepithelial neoplasia recurrence in 30 cases,the recurrence rate of 3.37%,then 180 cases,recurrence rate of20.24%,6 cases of high-grade epithelial tumor after six months were not found recurrence and recurrence.Between June 2015 and June 2016,5680 cases of colonoscopy and follow-up were followed to increase the number of chemical endoscopes,electrons,and electron microscopy in accordance with the standard of "Early Colon Cancer Screening and Endoscopic Diagnosis and Treatment Consensus" Staining endoscopy(NBI,FICE),magnification endoscopyand other methods for screening.A total of 2272 cases of low-grade intraepithelial neoplasia and high-grade intraepithelial neoplasia and colorectal cancer were detected.The detection rate was 40%.There were35 cases of high grade intraepithelial neoplasia / mucosal carcinoma,180 cases of invasive carcinoma,2057 cases of intraepithelial neoplasia;colonic cancer precancerous cases accounted for 16.27% of the total number of colon cancer.At present,1023 cases of follow-up of patients with low grade intraepithelial neoplasia and high grade intraepithelial neoplasia were performed after microscopic treatment.There were 22 cases of high grade neoplasia / mucosal carcinoma and 1001 cases of low grade tumor.Six months after the review,low-grade intraepithelial neoplasia recurrence in 32 cases,recurrence rate of 3.19%,185 cases of recurrence,recurrence rate of 18.48%,22 cases of high-grade epithelial tumor after six months of review,1 case of recurrence of mucosal cancer,Surgical treatment,pathology is still mucosal cancer recurrence rate of4.54%,no recurrence cases were found.Conclusion:The application of endoscopic early cancer screening system can greatly improve the clinical early cancer screening rate in order to early endoscopic intervention,save a lot of medical resources,so that patients get better medical services,promote medical treatment in the field of technological progress,So that more patients get treatment. |
PDF Full Text Request