Precancerous lesion of the esophagus, its developm
Professor Wang Guoqing, specialist of endoscopy of chest surgery, hospital of oncology, the Chinese Academy of Medical Sciences, for searching the causality of onset of esophageal cancer, since the 1990's of the 20th century, had conducted a systemic in depth observation and study on the precancerous changes of esophageal cancer and had discovered its developmental trend as well as proposed the countermeasures for its control.
In the high incidence area of esophageal cancer surrounding the Taihang mountainous regions, Professor Wang used the direct endoscopic examination, iodine staining of the esophageal mucous membrane and methods of instructional multiple point biopsy during eight times of survey for a natural population group with the age range of 40-69 years, including totally 5400 persons. Following iodine staining of each case, multiple point forcep-biting biopsy was done for the non-stained areas (i.e. the positive areas). The results showed that the detected rate of squamous cell esophageal cancer was 3 % - 5 %; that of severe atypical proliferation of squamous esophageal epithelium was 3 %-5 %; the medium degree of atypical proliferation of the esophageal epithelium was 9 %-16 % and that of the mild proliferation of the esophageal epithelium was 12 %-24 %.
Professor Wang considered that for the severe cases of atypical proliferation, an active countermeasure must be taken, and proposed a new concept of "advanced treatment of cancer of esophagus being the management of severe atypical proliferation". The advantageous point of the treatment of severe non-typical proliferation lay on a curative expectation; so it is amenable to adopt the local minimal incisional therapy with the endoscope, such as the various kinds of mucous membrane exsection, electric cautery with argon ion and laser therapy etc. and esophagectomy is not indicated for cases with severe atypical proliferation; at least the latter procedure is not indicated during the short term, because from the pathological point of view, the sever non-typical proliferation of the esophageal epithelium is not yet a cancer lesion., http://www.100md.com
In the high incidence area of esophageal cancer surrounding the Taihang mountainous regions, Professor Wang used the direct endoscopic examination, iodine staining of the esophageal mucous membrane and methods of instructional multiple point biopsy during eight times of survey for a natural population group with the age range of 40-69 years, including totally 5400 persons. Following iodine staining of each case, multiple point forcep-biting biopsy was done for the non-stained areas (i.e. the positive areas). The results showed that the detected rate of squamous cell esophageal cancer was 3 % - 5 %; that of severe atypical proliferation of squamous esophageal epithelium was 3 %-5 %; the medium degree of atypical proliferation of the esophageal epithelium was 9 %-16 % and that of the mild proliferation of the esophageal epithelium was 12 %-24 %.
Professor Wang considered that for the severe cases of atypical proliferation, an active countermeasure must be taken, and proposed a new concept of "advanced treatment of cancer of esophagus being the management of severe atypical proliferation". The advantageous point of the treatment of severe non-typical proliferation lay on a curative expectation; so it is amenable to adopt the local minimal incisional therapy with the endoscope, such as the various kinds of mucous membrane exsection, electric cautery with argon ion and laser therapy etc. and esophagectomy is not indicated for cases with severe atypical proliferation; at least the latter procedure is not indicated during the short term, because from the pathological point of view, the sever non-typical proliferation of the esophageal epithelium is not yet a cancer lesion., http://www.100md.com