[Abstract] Objective To study the incidence of cardia cancer in recent years, the high incidence of esophageal cancer in the state forest. By Linzhou esophageal cancer early detection and treatment demonstration base target population screening, gastroscopy esophageal iodine staining indicative biopsy and pathologically confirmed number of esophageal and gastric cardia and cardia crest roots biopsy, the occurrence of for analysis. Results of the census of 3163 cases of high-risk groups, esophageal cancer 15 cases the cardia 22 cases. The conclusion Linzhou high incidence of esophageal cancer cardia same high-fat, routine biopsy of the cardia spinal roots early detection of precancerous lesions and early cancer of the cardia.
Key words cardia; esophageal; endoscopic screening
Prevalence Analysis of Gastric Cardiac Cancer Diagnosed by Endoscope Examination in Esophageal Cancer High Risk Area in Linzhou City
LIU Zhi cai, LIAN Shi yong, HAO Chang qing, WANG Yu xiang, LI Bian yun, WEI Jian rong, CHENG Lan ping
The Tumor Hospital of Linzhou City, Linzhou 456550, China Abstract: Objective To investigate the gastric cardiac cancer prevalence in esophageal cancer high risk area in Linzhou city. Methods Endoscope examination with iodine staining and index biopsy screening method was used in esophageal cancer early detection and early treatment demonstration field station in Linzhou city. We also biopsy in cardiac ridge area where is the high incidence area of cardiac cancer. All esophageal cancer and gastric cardiac cancer was confirmed from biopsy pathological diagnosis. Results Fifteen cases of esophageal cancer and 22 cases gastric cardiac cancer were found in 3163 subjects who attended the screening. Conclusion The prevalence of gastric cardiac cancer is also in high level in esophageal cancer high risk area in Linxian. Regularly biopsy at cardiac ridge area can detect precancerous lesion and early stage gastric cardiac cancer.
Key words: Gastric cardiac cancer; Esophageal cancer; Survey with endoscope
Linzhou esophageal cancer epidemic investigation found that in recent years, the incidence of esophageal squamous cell carcinoma of the region there is a clear downward trend, however, the cardia in the prevalence of high incidence of esophageal, pending further study. In this paper, the state forest from 2005 to 2006 of esophageal cancer early detection and treatment of the partial results of the GCA for analysis.
1 Materials and Methods
1.1 Linzhou focus on prevention and treatment of esophageal cancer site in 2004 by the Ministry of Health, the National esophageal cancer early detection and treatment demonstration base. In Linzhou from 2005 to 2006, esophageal and cardiac screening of high-risk groups in the target population.
1.2 Select the Linzhou Stream town of 34,221 cases as the target population of the screening, of which 40 to 69-year-old high-risk groups the proportion of 70% of the 10,425 cases of endoscopic screening. From 2005 to 2006, part of the village of 5,010 patients with high-risk groups in the target population the endoscopic screening 3,513 cases (compliance 70.1 percent).
1.3 2005 1505 cases of high-risk groups by endoscopy and esophageal iodine staining (1.2% iodine solution preparation methods: iodine 12g, potassium iodide 24g, distilled water 1 000ml) indicative biopsy, iodine stain negative by conventional incisorteeth 25cm bite seized; cardia suspicious lesions, lesion biting examination.
1.4 2006 2008 in the high-risk groups by endoscopy and esophageal iodine staining indicative biopsy, iodine staining negative biting examination; For the cardia suspicious lesions, lesion biting examination, no abnormal findings, spinal roots in the cardia conventional bite seized.
1.5 a biting examination pathological check gastroscopy biopsy immediately organizational flattening, the mucosal basal level attached to the filter paper, placed in 10% neutral formalin or 75% to 80% alcohol fixed, fixed-time 10h。">> 10h. Will be fixed to a good organization to remove the filter paper, dehydration, organized after the wax dipped to slice vertically oriented embedded serial sections 6 to 8 pieces of tissue. With conventional HE staining Fengpian.
Table 3 cardia cancer and esophageal cancer incidence rate compares to cardia incidence of esophageal cancer in the target population in Table 1 to Table 2 of the target population from Table 1 to 3 can be seen that in Linzhou in the high-risk population census of the target population, GCA number and proportion is more than the number and proportion of the incidence of esophageal cancer.
3.1 The high incidence of esophageal the cardia same high-fat Zhang Liwei et al  reported a high incidence of esophageal the Hebei of Cixian and Shexian cardia, the incidence of gastric cancer is the same at a higher level. The results of the screening, the high incidence of esophageal Linzhou crowd cardia cancer incidence is quite high, in the past, just the lack of the cardia precancerous lesions and early cardia effective diagnostic tool.
3.2 focus cardia high incidence of biopsy sites can be advanced diagnostic cardia Wang Guoqing  in the high incidence of esophageal endoscopy screening in 26,400 cases of natural populations found esophagogastric junction line 10 to 1:00 clock orientation presence of a mucosal folds mucosa ridge, endoscopic biopsy pathologically confirmed gastric cardia 510 cases, including 417 cases of early gastric cardia mucosa dorsal root accounted for 78.4% (327 cases). Comparative clinical studies and prospective studies also confirmed the the cardia spinal roots mucosal abnormal changes should be regarded as a precancerous condition, should be regularly followed up. Indeed for the high incidence of gastric cardia sites [3 4].
This group of 2008, 2006 cases cardia spinal roots biopsy found cardia adenocarcinoma 11 cases, including two cases of gastric cardia endoscopic cardia mucosal hyperemia, four cases showed mucosal erosion, five cases of mass erosion; cardia gland epithelial severe dysplasia 17 cases, including three cases of endoscopic cardia did not reveal any abnormalities, seven cases showed mucosal hyperemia, seven cases showed mucosal erosion. This shows that the high incidence of esophageal gastric cardia spinal roots of conventional biopsy can improve the detection rate of gastric cardia, to advance the purpose of the diagnosis of gastric cardia .
3.3 Screening results analysis from endoscopic screening results Linzhou esophageal cancer early detection and treatment demonstration base from 2005 to 2006, 3513 patients with high-risk groups, he discovered the cardia 22 cases, accounting for the discovery of esophageal and gastric cardia 59% of patients. The Linzhou incidence of esophageal cancer from 1998 to 2002 men and women are 82.5/10 and 65.5/10 000, cardia cancer incidence rate of 40.5/10 and 26.5/10 000; 1987 SHAO Fang et al  report 6123 Surgical treatment of esophageal cancer and cardiac patients, the esophageal and gastric cardia ratio of 1:0.5. However, the high-risk population census results show that the proportion of esophageal and gastric cardia 1:1.5, significantly higher than the data in the above information, which may be these cardia cancer patients do not have any symptoms, endoscopy, there is no obvious pathological performance, but the routine biopsy of the gastric cardia high incidence sites cardia advance diagnosis, these patients may be a few years after the onset has not happened, perhaps because of the death of other diseases and gastric cardia. To be sure, the discovery of this group of endoscopic screening, GCA and early detection and treatment research will provide important data and information of the High Risk Area.