Application Of A Novel Esophageal Cell Collector For Screening Of People At High Risk Of Early Esophageal Cancer And Precancerous Lesions

Background: The incidence of esophageal malignancies is increasing year by year.Esophageal cancer has often progressed to the middle and late stages when it is detected,and its prognosis and survival quality are poor,with a low 5-year survival rate.The causes of esophageal cancer are closely related to lifestyle habits(smoking and alcohol consumption)and dietary habits(preferring pickled food and hot food).Early detection of esophageal cancer is of great significance to reduce the mortality rate of esophageal cancer.However,there is still a lack of a simpler,safer and more efficient means of esophageal cancer screening than gastrointestinal endoscopy.Objective: To evaluate the value of a new esophageal cell collector-esophageal exfoliative cytology in early esophageal cancer and precancerous lesion screening and its diagnostic efficacy.Methods: The study was a multicenter study.The gastroscopy and the new esophageal cell collector-esophageal exfoliative cytology were performed in the population of the People’s Hospital of Sichuan Province,the Nanchong Central Hospital,and the People’s Hospital of Yanting County,who met the appropriate conditions for health check-ups,were included in the study.The gastroscopy-histopathology results were used as the gold standard to effectively evaluate the screening ability of the new esophageal cell collector in different esophageal lesions(accuracy,sensitivity,specificity,positive predictive value,negative predictive value,Jorden index,positive likelihood ratio,negative likelihood ratio).Its screening efficacy for early esophageal cancer and precancerous lesions was evaluated by area under the ROC curve,95% confidence interval,sensitivity,and specificity.Results: The new esophageal cell collector-esophageal exfoliative cytology has the best screening ability for high-grade intraepithelial neoplasia(sensitivity=90.91%,specificity=99.737%,positive predictive value=71.43%,negative predictive value=99.93%,Jorden index=0.906).For the screening of esophageal cancer and precancerous lesions,the area under the ROC curve was 0.946(0.899～0.994).The sensitivity was 84.20% and the specificity was 96.20% when the Jorden index was taken as 0.804.Conclusions: The new esophageal cell collector,esophageal exfoliative cytology,performs well as a screening test for early esophageal cancer and precancerous lesions.It has a specificity of over 90% in screening different esophageal lesions.It is suitable as a screening method for early esophageal cancer,and is expected to be popularized in the population,providing a new choice for the early detection and treatment of esophageal malignant tumors and precancerous lesions.