Standard Assessing Research Of Endoscopic Biopsy By Endoscopy Screening In High Risk Area Of Esophageal Cancer

Objective: Finding new features of premalignant lesions and esophageal carcinoma under chromoendoscopy or good combinations to modify standard chromoendoscopy could contribute to the development of a more applicable population-level screening program for esophageal carcinoma.Methods: The current study was carried out on the basis of an ongoing population-based screening program of esophageal carcinoma by upper digestive tract endoscopy with iodine staining in hua county, China from November 2011 through June 2014. 9421 consecutive villagers had underwent endoscopy examination and 984 villagers were under suspicion of high-grade ESD or ESCC based on endoscopists’ own experience through chromoendoscopy inspections. However,among these 9421 villagers, only 72 people were dignosesd as high-grade ESD or ESCC by histologic examination. By acquiring and re-evaluate the endoscopic image, searching for new features or a combination of better indicators.Result: 1. 98.4%(62/63) of esophageal squamous cell carcinoma and severe dysplasia appear in 56-69 age group. The ratio between the 45-55 years and 56-69 years have significant difference by Fisher’s exact test in both groups of negative esophageal lesions and positive esophageal lesions(P <0.001). 2. The positive predictive value of the parallel combination of optimization is 16%. 3 In subjects with a positive family history of esophageal cancer, the sensitivity of the optimized parallel combination is 100%, positive predictive value is 16.85%. 4 Compared with women, men’s endoscopic image index has different diagnostic efficiency. A combination of indicators of women can better discover esophageal lesions. Men need to assist "family history" and "age" to improve the efficiency of diagnosis of esophageal lesions.Conclusions: 1,Compared with the series combination, parallel combination is better guiding significance for esophageal cancer screening.2,Women’s some abnormal esophageal endoscopic performance might be in a good indicator of the esophageal malignant lesions, and compared with women, men of esophagus endoscopic some indicator of the abnormal expression of esophageal malignant lesions is not very obvious.3, Family history of esophageal cancer have good implications in the diagnosis of esophageal malignant lesions. If health resources of the area are very limited,screening age can be increased from 45 years old that is widely used now to 50 years old, even55years old.