Photocrosslinking silver nanoparticles-aloe vera-silk fibroin composite hydrogel for treatment of full-thickness cutaneous wounds.

Damage to the skin causes physiological and functional issues. The most effective treatment approach is the use of wound dressings. Silk fibroin (SF) is a promising candidate biomaterial for regulating wound healing; however, its antibacterial properties and biological activity must be further improved. In this study, a photocrosslinking hydrogel was developed to treat full-thickness cutaneous wounds. The composite hydrogel (Ag-AV-SF hydrogel) was prepared by introducing the silver nanoparticles (AgNPs) and aloe vera (AV) as the modifiers. In vitro study exhibited great antibacterial ability, biocompatibility and cell-proliferation and -migration-promoting capacities. It also showed the pH-response releasing properties which release more AgNPs in a simulated chronic infection environment. The healing effect evaluation in vivo showed the healing-promoting ability of the Ag-AV-SF hydrogel was stronger than the single-modifiers groups, and the healing rate of it reached 97.02% on Day 21, higher than the commercial wound dressing, silver sulfadiazine (SS) cream on sale. Additionally, the histological and protein expression results showed that the Ag-AV-SF hydrogel has a greater effect on the pro-healing regenerative phenotype with M2 macrophages at the early stage, reconstructing the blood vessels networks and inhibiting the formation of scars. In summary, the Ag-AV-SF hydrogel developed in this study had good physical properties, overwhelming antibacterial properties, satisfactory biocompatibility and significantly promoting effect on cell proliferation, migration and wound healing. Overall, our results suggest that the Ag-AV-SF hydrogel we developed has great potential for improving the wound healing in clinical treatment.

Clinicopathologic Predictive Factors of Cervical Lymph Node Metastasis in Differentiated Thyroid Cancer / Factores clinicopatológicos predictivos de metástasis ganglionares cervicales en el cáncer de tiroides diferenciado

BACKGROUND: Cervical lymph node metastasis (LNM) has been proven to be a predictor for locoregional recurrence in differentiated thyroid carcinoma (DTC). Clinicopathological features could be effective predictive factors for central and lateral LNM of DTC, and provide references to surgeons for cervical neck dissection. METHODS: Retrospective analysis of clinicopathological data was performed on 420 patients who underwent initial surgery from 2010 to 2015. RESULTS: The incidence of central and lateral LNM was calculated. Of 420 patients, 247 (58.8%) exhibited central LNM, and 185 (44.1%) exhibited lateral LNM. There were 29 (6.9%) cases confirmed to have skip metastasis. Univariate and multivariate analysis revealed that tumour location, tumour size, multifocality, capsular invasion, affected lobes, and age were independent predictors of central LNM. Tumour location, capsular invasion, affected lobes, and tumour size were independent predictors of lateral LNM. CONCLUSIONS: Our findings suggest that tumour location, affected lobes, capsular invasion, age, tumour size and multifocality may be taken as predictive factors for cervical LNM of DTC. Meticulous perioperative evaluation of cervical LNM and prophylactic cervical lymph node dissection that aims to remove the occult lymph nodes may be an option for DTC with risk factors

ANTECEDENTES: Las metástasis ganglionares cervicales (LNM) han demostrado ser un factor predictivo de recidiva locorregional en el cáncer de tiroides diferenciado (DTC). Las características clinicopatológicas podrían ser factores predictivos efectivos para LNM central y lateral en el DTC, y aportar referencias a los cirujanos de cara a la disección de los ganglios del cuello. MÉTODOS: Análisis retrospectivo de datos clinicopatológicos realizado en 420 pacientes sometidos a cirugía inicial desde 2010 a 2015. RESULTADOS: Se calculó la incidencia de las LNM centrales y laterales. De los 420 pacientes, 247 (58,8%) reflejaron LNM central y 185 (44,1%) LNM lateral. Se produjeron 29 (6,9%) casos confirmados de metástasis discontinuas. El análisis univariante y multivariante reveló que la localización, el tamaño del tumor, la multifocalidad, la invasión capsular, los lóbulos afectados y la edad eran factores predictivos independientes de la LNM central. La localización tumoral, la invasión capsular, los lóbulos afectados y el tamaño del tumor eran factores predictivos independientes de la LNM lateral. CONCLUSIONES: Nuestros hallazgos indican que la localización tumoral, los lóbulos afectados, la invasión capsular, la edad, el tamaño del tumor y la multifocalidad pueden considerarse factores predictivos para la LNM cervical de DTC. La evaluación meticulosa perioperativa de la LNM cervical y la disección profiláctica de los ganglios cervicales, cuyo objetivo es extirpar los ganglios ocultos, puede ser una opción para el DTC con factores de riesgo

Clinicopathologic Predictive Factors of Cervical Lymph Node Metastasis in Differentiated Thyroid Cancer.

BACKGROUND: Cervical lymph node metastasis (LNM) has been proven to be a predictor for locoregional recurrence in differentiated thyroid carcinoma (DTC). Clinicopathological features could be effective predictive factors for central and lateral LNM of DTC, and provide references to surgeons for cervical neck dissection. METHODS: Retrospective analysis of clinicopathological data was performed on 420 patients who underwent initial surgery from 2010 to 2015. RESULTS: The incidence of central and lateral LNM was calculated. Of 420 patients, 247 (58.8%) exhibited central LNM, and 185 (44.1%) exhibited lateral LNM. There were 29 (6.9%) cases confirmed to have skip metastasis. Univariate and multivariate analysis revealed that tumour location, tumour size, multifocality, capsular invasion, affected lobes, and age were independent predictors of central LNM. Tumour location, capsular invasion, affected lobes, and tumour size were independent predictors of lateral LNM. CONCLUSIONS: Our findings suggest that tumour location, affected lobes, capsular invasion, age, tumour size and multifocality may be taken as predictive factors for cervical LNM of DTC. Meticulous perioperative evaluation of cervical LNM and prophylactic cervical lymph node dissection that aims to remove the occult lymph nodes may be an option for DTC with risk factors.

Response of Fingernail Growth to Out-of-Field Low-Dose X ray in Cancer Patients Receiving Radiotherapy.

The entire body of a patient with cancer is exposed to low-dose levels of radiation (mGy) during radiation therapy. The safety and biological impact of such exposure to low-dose radiation on the human body are largely unknown. The fingernail is a highly proliferative tissue, and its growth can be monitored during radiation treatment to analyze early effects of low-dose radiation. The fingernails of 30 patients who received external beam radiotherapy (EBRT) were used in this study to investigate the change in nail growth during fractionated radiotherapy. Lead shields were applied to some fingers to create dose variance within individual patients. The absorbed dose was measured, and the relationship between the dose and change in nail growth rate was analyzed. Other factors, including serum albumin, hemoglobin level, body weight index, age, gender and chemotherapy, were also subjected to multivariate analysis. Fingernails from patients received an average of 0.96 mGy per treatment fraction. We observed a surprising decline in fingernail growth rate during radiotherapy, which was more prominent in the nonshielded fingernails with a relatively high-absorbed dose. Such growth delay could be observed as early as one week postirradiation and lasted the entire treatment course. Using fingernail growth as a novel marker for radioresponse, the current study showed that exposure to very low-dose ionizing radiation has previously unrecognized early effects on human tissue.

Thyroid functional parameters and correlative autoantibodies as prognostic factors for differentiated thyroid cancers.

To evaluate the effect of preoperative thyroid functional parameters and thyroid autoantibodies on aggressive clinicopathologic features and lymph node metastasis (LNM) of differentiated thyroid cancer patients. Four hundred twenty consecutive patients with initial surgery were enrolled from July 2010 to July 2015. The associations between aggressive clinicopathologic and LNM factors and thyroid functional & autoantibodies parameters were analyzed. Higher levels of TSH, TGAb or TMAb were found in patients with tumor size≥1 cm (all P<0.05), especially when TSH≥2.5 ulU/ml (P=0.03) and TGAb≥1 (P=0.01). Higher levels of TSH and TGAb and lower levels of T3 and T4 were found in patients with capsular invasion (all P<0.05), particularly when TSH≥2.5ulU/ml (P=0.03) and TGAb≥1 (P=0.005). The patients with multifocality had higher TAbs level (TAbs>1). Higher level of TSH was also found in patients with central LNM (P=0.001) and lateral LNM (P=0.002), especially with TSH≥2.5ulU/ml (P=0.003 and P=0.03). TGAb level was also found higher in patients with central LNM (P=0.02) and lateral LNM (P=0.01), especially with TGAb≥1 (P<0.05 and P=0.01). Higher level of TMAb was found in patients with lateral LNM (P<0.05). Moreover, multivariable analysis revealed that only TGAb was an independently predictive factor for primary tumor size≥1cm (P=0.01); and TSH level (P=0.01) and TGAb≥1 (P<0.05) were associated independently with central LNM. Thus, TSH level and TGAb≥1 were significantly independent predictors for central LNM, and might help make the decision of central neck dissection.

The Neutrophil-to-Lymphocyte Ratio Correlates with Age in Patients with Papillary Thyroid Carcinoma.

AIM: The aim of this study is to explore the relationship between the neutrophil-to-lymphocyte ratio (NLR) and clinicopathological features in patients with papillary thyroid carcinoma (PTC). METHODS: We performed an analysis of 843 patients, including 321 patients with PTC, 83 patients with thyroid adenoma and 439 patients with nodular goiter (NG). Thyroglobulin and thyrotropin were measured in each patient. Neutrophils, lymphocytes, and platelets were counted. Statistical analysis was used to correlate the NLR with demographic and histopathologic characteristics of the patients. RESULT: Age correlated with NLR and lymphocyte number in patients with PTC and NG. In patients aged >45 years, those with PTC had a higher NLR and a lower lymphocyte count than those with NG. Patients with PTC aged <45 years had a higher leukocyte count and a lower NLR than those aged ≥45 years. Patients with clinical stage I/II PTC had a lower NLR and a higher lymphocyte count than patients with stage III/IV. CONCLUSIONS: Younger patients with PTC had a higher lymphocyte count but a lower NLR than older patients with PTC. The NLR and lymphocyte counts were associated with the clinical stage. Thus, a higher NLR and a lower lymphocyte count may be prognostic for stratifying patients with thyroidal goiters and are risk factors of PTC for older patients.

Selectively predictive calcium supplementation using NCCN risk stratification system after thyroidectomy with differentiated thyroid cancer.

BACKGROUND: Hypocalcemia is a common complication following thyroidectomy. To explore reasonable and simple methods for predicting postoperative hypocalcemia and identify the optimal strategies for selective calcium supplement are meaningful for surgeon. METHODS: Based on the NCCN risk stratification system, patients were divided into 4 groups (A-D): low-risk group A, who only underwent limited thyroidectomy (LT) and high-risk groups B, C and D, who had received total thyroidectomy (TT) and selective central and/or lateral neck dissection (SND). After surgery, group C patients were orally given calcium gluconate and group D patients were intravenously given calcium 2 g/day for 7 days, while group B patients did not receive any calcium supplement. Serum calcium and parathyroid hormone (PTH) levels were collected before and after surgery. The incidence of asymptomatic and symptomatic hypocalcemia in each group was recorded. RESULTS: A total of 132 patients with differentiated thyroid carcinoma (DTC) were included who received surgical treatment. No a significant change was observed in serum calcium and PTH levels in group A, while significant decreases in serum calcium and PTH levels were seen in group B (P < 0.05). Intravenous calcium supplement in group D resulted in a more rapid recovery in serum calcium levels (P < 0.05). The incidences of symptomatic hypocalcemia and asymptomatic hypocalcemia were significantly lower in group A and group D respectively compared to the other groups (All P values < 0.05). In group B, a highest asymptomatic and symptomatic hypocalcemia incidence was detected. CONCLUSION: Selective calcium supplementation for DTC based on NCCN risk stratification system could be recommended for the high-risk patients.

NiO/nanoporous graphene composites with excellent supercapacitive performance produced by atomic layer deposition.

Nickel oxide (NiO) is a promising electrode material for supercapacitors because of its low cost and high theoretical specific capacitance of 2573 F g(-1). However, the low electronic conductivity and poor cycling stability of NiO limit its practical applications. To overcome these limitations, an efficient atomic layer deposition (ALD) method is demonstrated here for the fabrication of NiO/nanoporous graphene (NG) composites as electrode materials for supercapacitors. ALD allows uniform deposition of NiO nanoparticles with controlled sizes on the surface of NG, thus offering a novel route to design NiO/NG composites for supercapacitor applications with high surface areas and greatly improved electrical conductivity and cycle stability. Electrochemical measurements reveal that the NiO/NG composites obtained by ALD exhibited excellent specific capacitance of up to ∼ 1005.8 F g(-1) per mass of the composite electrode (the specific capacitance value is up to ∼ 1897.1 F g(-1) based on the active mass of NiO), and stable performance after 1500 cycles. Furthermore, electrochemical performance of the NiO/NG composites is found to strongly depend on the size of NiO nanoparticles.

[Meta-analysis of the clinical significance of thyroidectomy combined with central neck dissection in differentiated thyroid carcinoma at the first treatment].

OBJECTIVE: To compare the differences in recurrence rates and surgical complications between thyroidectomy alone and thyroidectomy combined with central neck dissection as initial treatments to differentiated thyroid cancer and evaluate the clinic significance of central neck dissection for these patients. METHODS: The literatures published in 1998-2013 were searched in Wanfang database, Chongqing VIP database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Pubmed, Medline and Beijing Kangjian foreign medical journal full text service. According to the inclusion and deletion criteria, 30 articles were included. Of them 26 articles involved in complications, hypocalcemia and recurrent laryngeal nerve palsy as two major complications were involved in 26 articles and 24 articles respectively, and 26 articles involved in recurrence rate. RevMan5.0 software package was used to perform meta-analysis. RESULTS: Total complication rate in experimental group (plus central neck dissection) was 13.08% higher than that in control group (thyroidectomy only), the odds ratio (OR) [95% confidence interval (95%CI)] was 2.32[2.02, 2.67], Z value was 11.80, P < 0.01. Hypocalcemia in the experimental group was 11.80% higher than that in control group, OR value [95%CI] was 2.58[2.21, 3.02], Z was 11.98, P < 0.01. The rates of recurrent laryngeal nerve paralysis were low in both experimental group (5.26%) and control group(3.95%), and OR value [95%CI] was 1.22 [0.94, 1.58], Z was 1.48, P = 0.14. Recurrence rate in experimental group was 2.23% lower than that in control group, OR value [95%CI] was 0.78 [0.63,0.97], Z was 2.35, P = 0.03. CONCLUSION: Central compartment dissection as initial treatment to differentiated thyroid cancer may reduce the risk of recurrence, but increases the incidence of total complications and hypocalcemia, and has no significant effect on the rate of the recurrent laryngeal nerve paralysis.

Modified partial superficial parotidectomy versus conventional superficial parotidectomy improves treatment of pleomorphic adenoma of the parotid gland.

BACKGROUND: Surgical treatment of pleomorphic adenoma of the parotid gland remains a subject of major debate. The investigators compared postoperative complications and surgical parameters between modified partial superficial parotidectomy and conventional superficial parotidectomy. METHODS: Clinical records of 129 patients were reviewed and analyzed for clinical characteristics. RESULTS: Compared with the conventional superficial parotidectomy group, the modified partial superficial parotidectomy group had significantly lower rates of auricular numbness, Frey's syndrome, and obvious facial asymmetry (all P values <.05). The distance between the primary tumor capsule and satellite nodules ranged from .06 to 8.48 mm, and the greatest distance between the primary tumor capsule and satellite nodules was observed in tumors >4 cm. Furthermore, satellite nodules were more common in tumors >4 cm than in tumors <2 cm or tumors between 2 and 4 cm (all P values <.05). CONCLUSIONS: Modified partial superficial parotidectomy compares favorably surgically and clinically with conventional superficial parotidectomy in certain patients.

Expression of angiopoietin-2 and vascular endothelial growth factor receptor-3 correlates with lymphangiogenesis and angiogenesis and affects survival of oral squamous cell carcinoma.

BACKGROUND: Both Ang-2 and VEGFR-3 are major regulators of angiogenesis and lymphangiogenesis, respectively, and thus may affect prognosis of OSCC. We sought to determine the associations between Ang-2 and VEGFR-3 expression and survival of OSCC. METHODS: Ang-2 and VEGFR-3 expression was determined immunohistochemically in tumor tissues from 112 patients with OSCC; OSCC-adjacent noncancerous oral tissue from 85 OSCC patients; and normal oral mucosa from 37 cancer-free individuals. A log-rank test and Cox proportional hazard models were used to compare survival among different groups with expression of Ang-2 and VEGFR-3. RESULTS: Ang-2 and VEGFR-3 expression was upregulated in OSCC compared to nontumor tissue (all P<0.05). High Ang-2 expression positively correlated with microvessel density (MVD) (P<0.01), and high VEGFR-3 expression positively correlated with lymph node metastasis (P<0.01) and lymphatic vessel density (LVD) (P<0.01). The patients with high expression of Ang-2 alone or in combination with VEGFR-3 had a significantly worse survival than in patients with low expression of Ang-2 or any other co-expression status (all P<0.05), respectively. Furthermore, multivariable analysis showed that patients with high expression of Ang-2 alone or in combination with VEGFR-3 had a significantly increased risk of death compared with those with low expression of Ang-2 or any other co-expression status (HR, 2.7, 95% CI, 1.1-6.2 and 5.0, 1.3-15.4, respectively). CONCLUSIONS: These results suggest that increased expression in tumors of Ang-2 may individually, or in combination with VEGFR-3, predict poor prognosis of OSCC.

Systematic evaluation on the use of acellular dermis matrix graft in prevention Frey syndrome after parotid neoplasm surgery.

OBJECTIVE: To study the effectiveness and safety of acellular dermal matrix (ADM) graft in preventing Frey syndrome after parotid neoplasm surgery, we reviewed foreign reported clinical randomized controlled trials systematically. Based on this review, we aimed to assess the effectiveness of ADM graft and provide reliable evidence for clinical application. METHODS: We reviewed foreign-language databases, such as MEDLINE, applied meta-analysis with Rev.Man 5, and drew forest plots with odds ratio as effect size. RESULTS: Three trials were recruited. The morbidity of Frey syndrome in experimental group was significantly lower than that in control on both subjective index and objective index, with odds ratios at 0.03 (95% confidence interval, 0.01-0.11) and 0.03 (95% confidence interval, 0.01-0.12), respectively. There was no significant difference between ADM group and blank control in total adverse reactions and complication incidence, whereas results differed for a kind of specific adverse reaction or complication. CONCLUSIONS: Based on existing research data, implanting ADM could effectively prevent Frey syndrome, and its poor prognosis effects did not significantly increase, which suggested that its total safety was reliable. Nevertheless, further investigations about the difference on a specific adverse reaction or complication were still needed.

High interstitial fluid pressure promotes tumor cell proliferation and invasion in oral squamous cell carcinoma.

It has been shown that interstitial fluid pressure (IFP) is elevated in many solid tumors. The elevated IFP in tumors is responsible, at least in part, for the poor blood supply, inadequate delivery of therapeutic agents to solid tumors and poor treatment response in patients. The present study was carried out to examine alterations in malignant phenotypes in oral squamous cell carcinoma cells subjected to conditions mimicking IFP and to identify the relevant molecular mechanisms. We investigated tumor cell proliferation and invasion using SCC-4 and SCC-9 cells subjected to an increased extracellular pressure of 0, 15 and 30 mmHg in vitro. The results revealed that the increased IFP resulted in a marked increase in cancer cell proliferation, survival and invasion in vitro and altered the expression of >1,800 genes involved in invasion and metastasis, the heat shock pathway, the p38 and JNK signaling pathway, apoptosis and the cell growth and differentiation signaling pathway. These results suggest the important potential clinical application of measuring IFP, which can be used as a generic marker of prognosis and response to therapy.

Epidemiology of esophageal cancer in Yanting - regional report of a national screening programme in China.

BACKGROUND AND OBJECTIVES: Yanting in Sichuan Province is one of the highest risk areas of esophageal cancer (EC) in the world. We here summarize the epidemiology of EC in Yanting using data from the national screening programme during 2006-2011. METHODS: Random cluster sampling was used to select a proportion of natural villages from six towns in Yanting, and residents aged 40-69 years old were invited for screening. Participants were screened using endoscopy with iodine staining and then confirmed by histological examinations. RESULTS: The overall detection rates of low-grade hyperplasia (LH), moderate hyperplasia (MH), high-grade hyperplasia (HH), carcinoma in situ (CIS), intramucosal carcinoma (IC) and invasive carcinoma (INC) were 5.33%, 1.28%, 0.68% , 0.15% , 0.06% and 0.29%, respectively. The detection rates of LH, MH, HH and INC increased with age, reaching the peak among those aged 60-65 years, and the prevalences of LH and MH were higher among men than among women. In addition, the detection rates of hyperplasia were much higher in mountainous than in hilly areas. CONCLUSIONS: Among the high risk population, there are a great number of people with early-stage EC or precancerous conditions who do not have presenting symptoms. In particular, the elderly, men, or those living in mountainous areas are the most vulnerable population. It is therefore important to reinforce health education and screening services among such high risk populations.

Angiopoietin-2 expression is correlated with angiogenesis and overall survival in oral squamous cell carcinoma.

This study sought to determine the expression of angiopoietin-2 (Ang-2) and vascular endothelial cell growth factor (VEGF) in oral squamous cell carcinoma (OSCC) and assess their correlations with tumor progression, angiogenesis, vessel maturation, and clinical survival. Tumor tissue from 102 OSCC patients, adjacent noncancerous oral tissue from 79 OSCC patients, and normal oral mucosa from 35 control patients were examined for Ang-2 and VEGF expression using conventional immunohistochemistry. Microvessel density (MVD) and vessel maturation index (VMI) were assessed by double-label immunohistochemistry staining using anti-CD34 and anti-alpha-smooth muscle actin, respectively. Although the proportion of OSCC samples positive for Ang-2 or VEGF expression was significantly higher than that observed in the adjacent noncancerous tissue and normal oral mucosa (P < 0.001), neither Ang-2 nor VEGF expression was associated with the clinicopathological parameters analyzed in OSCC patients. However, MVD and VMI were significantly associated with the expression of Ang-2 (P = 0.001 and P = 0.014, respectively); VEGF expression was associated MVD (P = 0.004). The MVD of OSCC tissues expressing both Ang-2 and VEGF was significantly higher than observed in the double-negative samples (P < 0.05). Multivariate regression and Kaplan-Meier analyses revealed that Ang-2 was negatively associated with the overall survival of OSCC patients. Expression of Ang-2 was associated with angiogenesis and vessel maturation in OSCC. Further studies will evaluate the prognostic value of determining Ang-2 expression in OSCC.

[Comparison of recurrence and complication by different thyroidectomy in the treatment of differentiated thyroid carcinoma as initial treatment: a meta-analysis].

OBJECTIVE: To compare the total thyroidectomy or subtotal resection and gland lobe and isthmus lobectomy as initial treatment to TNM stage I and II differentiated thyroid cancer. The difference between recurrence rate and surgical complications were analysed. METHODS: The literatures published between 1972-2012 were searched in Pubmed, Medline, Wanfang database, Chinese Biomedical Literature Database, Chinese scientific Journals database and China National Knowledge Infrastructure. According to the inclusion and deletion criteria, 17 articles were included to compare the postoperative recurrence and complications in randomized controlled or case-control studies, involving 13 articles in recurrence rate and 11 articles in complications.RevMan5.0 software package was used to perform meta-analysis. RESULTS: Thirteen articles involved with the recurrence rate, the total case number was 3511. Among these cases, 414 recurred, overall recurrence rate was 11.59%, of which, 150 recurred cases in total or subtotal resection group (experimental group), the recurrence rate was 6.51%; 264 recurred cases in gland lobe lobectomy plus isthmus group (control group), the recurrence rate was 21.83%. Comparing the two groups, the odds ratio (OR) and their 95% confidence interval (95%CI) was 0.26 [0.21,0.33], Z value was 11.33, P < 0.01, which showed that the recurrence rate in experimental group was significantly lower than that in control group.Eleven articles involved with the complications, the total case number was 2388, 166 cases had postoperative complications. The complication rate was 6.95%, of which, 109 cases in experimental group, the complication rate was 8.52%; 57 cases in control group, the complication rate was 5.15%. Compared with the two groups, OR values and their 95%CI was 3.63 [2.47, 5.33], Z was 6.58, P < 0.01, the experimental group had significantly higher incidence of complications. CONCLUSION: For I and II differentiated thyroid cancer, total thyroidectomy or subtotal resection may reduce the chance of recurrence, but the postoperative complications is higher; while gland lobe and isthmus lobectomy has lower postoperative complications, but may increase the risk of relapse.

[Results of a screening program on high incidence area of esophageal cancer in Yanting Sichuan from 2006 to 2011].

OBJECTIVE: To study the prevalence of esophageal cancer and various lesions of esophagus in high risk areas through a screening program for early diagnosis and treatment. METHODS: Random cluster sampling method was used to select some portions of a natural village as screening object in the high risk areas of esophageal cancer, from 2006 to 2011. Endoscope iodine staining and index biopsy screening methods were used on people with high risk and followed by pathological exams for confirmation. RESULTS: The detection rates regarding mild esophageal hyperplasia, moderate and severe esophageal hyperplasia were 5.33% (803/15 065), 1.28% (193/15 065), 0.68% (102/15 065) respectively while the detection rates on carcinoma in situ, intramucosal carcinoma and invasive cancer were 0.15% (22/15 065), 0.06% (9/15 065), 0.29% (43/15 065) respectively. The detection rate in male esophageal hyperplasia was higher than in female. People younger than 65 years old, the detection rates on mild, moderate or severe esophageal hyperplasia and invasive cancer showed an increase with age, with the 60-year-olds group reaching the highest. The detection rates on the above said diseases were 7.72% (198/2565), 2.07% (53/2565), 1.29% (33/2565), 0.51% (13/2565) respectively. The detection rates on mild, moderate or severe esophageal hyperplasia varied in different years and with statistically significant differences (P < 0.001) but did not show any obvious trend of changing. Geographical distribution of mild esophageal hyperplasia, moderate esophageal hyperplasia, severe esophageal hyperplasia also significantly varied in different villages (P < 0.001). The highest detection rate in the mountainous villages was seen the highest while the detection rate of village from hilly areas was the lowest. CONCLUSION: There were considerable numbers of patients with precancerous lesions in the general population from the high risk areas. The detection rate of esophageal cancer in the mountain residents was higher than the rate in the hilly areas. Men and the elderly were the key populations calling for esophageal cancer prevention programs to be carried out.