Background and purpose:Postoperative recurrence of esophageal cancer is one of the main factors that affect the patients’ prognosis and quality of life. This study mainly investigated the clinical features of thoracic stomach cancer (TSC) after surgical treatment for esophageal carcinoma. Methods:We retrospectively reviewed 51 cases of postoperative TSC in our hospital. Results:10.97% of the cases with TSC were diagnosed by endoscopy. There were 13 cases who also had anastomotic recurrence. The locations of 46 cases (90.2%) in 51 patients were same as the primary cancer. 48 cases of them were squamous cell carcinoma and 3 cases were adenocarcinoma at the time of esophagectomy for esophageal carcinoma. Endoscopic manifestations were puffiness-infiltrating type 39.2%(20/51), massive type 15.7%(8/51), ulcerative type 7.8%(4/51) and ulcer-infiltrating type 33.3%(17/51) and diffuse infiltrating type 3.9(2/51). Conclusion:The incidence of TSC after surgical treatment for esophageal carcinoma was high. The main cause was that the local residual cancer invaded the gastric wall. The gastroscopic features of TSC were different from gastric cancer. The follow up with endoscopy for the postoperative patients with esophageal carcinoma is a primary way to diagnose TSC.

OBJECTIVETo summarize the results of endoscopic screening of esophageal, gastric cardiac and gastric cancers in the high-risk population, and analyze the influencing factors such as age, gender and biopsy rate on their detection and early diagnosis rates.

METHODSNine high incidence cities and counties of esophageal cancer in Henan province were included in this study. People aged 40-69 years were set to the target population. Excluding contraindications for gastroscopy, in accordance with the national technical scheme of early cancer diagnosis and treatment, gastroscopic screening and biopsy pathology for human esophageal, cardiac and gastric cancers were carried out.

RESULTSDuring the 3-year period, a total of 40 156 subjects were screened. Among them, 18 459 cases of various precancerous lesions (46.0%) were detected. The cancer detection rate was 2.3% (916 cases), including 763 cases of early cancers. The diagnosis rate of early cancers was 83.3%. Precancerous lesions were detected in 9297 cases (23.2%) for esophagus and 9162 cases (22.8%) for gastric cardia as well as stomach, respectively.

CONCLUSIONSThe results of this study demonstrate that endoscopic screening is feasible for early detection, diagnosis and treatment of esophageal, gastric cardia and gastric cancers among high risk population in high incidence area. Exploration analysis of relevant affecting factors may help to further improve the screening project for early diagnosis and treatment of those cancers.

Adult ; Age Distribution ; Aged ; Biopsy ; Cardia ; China ; Early Detection of Cancer ; Esophageal Neoplasms ; diagnosis ; Female ; Gastroscopy ; Humans ; Male ; Mass Screening ; Middle Aged ; Precancerous Conditions ; diagnosis ; Stomach Neoplasms ; diagnosis

OBJECTIVETo evaluate effect of screening of esophageal cancer at rural areas in Henan province.

METHODSAt rural areas with high incidence of upper gastrointestinal carcinoma in Henan province total of 88,263 persons with 40 to 69 years old were set to the target population of the screening by the 12 cities and countries and endoscope and pathology diagnosis were performed during 2009-2013. For patients with precancerous lesions, follow-up visits were conducted and defined as follows: once in three years for patients with mild dysplasia, once per year for moderate hyperplasia patients, the patients with severe intraepithelial neoplasia/carcinoma in situ should be treat, at least once per year for those one who didn't under treatment. The result data of screening were summarized and detection rates of esophagus hyperplasia, carcinoma in situ, early and middle-late cancer were calculated, as well as the early diagnosis rate. The result between first round and follow-up screening was compared.

RESULTSTarget population were examined in first round screening. There were 8,434 persons with above mild dysplasia and the detection rate was 9.56%, among them there were 7,224 (8.18%) cases with light-middle hyperplasia, 789 (0.89%) cases with serious dysplasia or cancer in situ, 239 (0.27%) cases with early cancer and 182 (0.21%) cases with middle-late cancer. The sum of serious dysplasia or cancer in situ and early cancer was 1 028 and the early detection rate was 84.96% (1,028/1,210). From 2012 to 2013, the follow-up screening for persons with light-middle hyperplasia which should be followed 4,230 cases, there were 2 853 people to take in screening and compliance was 67.45%. Total of 94 cases were diagnosed with cancer in situ or early cancer. The detection rate and the early detection rate were 3.29% and 100%, respectively. The rates of detection and early detection in phase of follow-up screening were statistically significantly higher than that in first round screening respectively (P<0.001).

CONCLUSIONAt rural areas of high incidence upper gastrointestinal carcinoma in Henan province, the screening with endoscope had good effect and strengthening the follow-up screening could increase the effect.

Early Detection of Cancer ; Esophageal Neoplasms ; Humans ; Incidence ; Rural Population ; Time-to-Treatment