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Clinical studies of indicative biopsies in opportunistic screening in high risk population of oesophageal cancer

This research is aimed to improve detectable rate of early oesophageal cancer and precancerous lesion with opportunistic screening and indicative biopsies guided by different doses of iodine staining/NBI (Narrow Band Imaging) in high risk population of oesophageal cancer. Local patients aged 40 to 69 treated in our digestive system department were screened. Following randomized grouping, high-risk patients were stained with different does of iodine (low: 5~7 ml; high: 10~15 ml) for endoscopy and NBI endoscopy, and indicative biopsies was conducted in suspicious esophageal lesions; Pathology results were considered as the final diagnosis. Diagnostic criteria are divided into: mild dysplasia, moderate dysplasia, severe dysplasia and (or) carcinoma in situ, intramucosal carcinoma, submucosal carcinoma and invasive cancer. The results indicated that in first stage: In 2014, a total of 1624 people attended opportunistic screening for esophageal cancer. Among them, detectable rate of early esophageal cancer was 1.23%, accounting for 20.41% of all esophageal cancer, improved significantly compared with that in 2013 (χ2=5.511, P=0.019). The second stage: in 2015, a total of 1948 people participated in esophageal opportunistic screening. There was no significant difference between detectable rates of early esophageal cancer and precancerous lesion with different esophageal endoscopies (P>0.05), a higher incidence of adverse reactions can be seen in low-dose iodine staining group compared with high-dose group (χ2=6.566, P=0.01). In conclusion, the combination of opportunistic screening and indicative biopsies guided by different doses of iodine staining/NBI can effectively improve the detectable rate of early esophageal cancer and precancerous lesion, wherein the low-dose iodine staining endoscopy is more suitable for mass screening.

Author(s): Jie Gao, Ailan Xian, Tingfeng Wu, Fangli Men, Ni Guo