中国全科医学2025，Vol.28Issue(35)：4487-4493,7.DOI:10.12114/j.issn.1007-9572.2025.0175
新型食管细胞收集器在食管病变筛查中的应用价值研究
The Application Value of a Novel Cell Collector for the Esophagus in Screening for Esophageal Lesions
摘要
Abstract
Background China has the highest disease burden of esophageal cancer in the world.Early detection of esophageal cancer and precancerous lesions is key to improving patient survival rates and reducing incidence and mortality rates.Objective To explore the clinical application value of the esophageal novel cell collector in screening esophageal lesions,and to provide a basis for the governmental health departments to formulate more effective cancer prevention and control policies and public health programs.Methods From January 2024 to January 2025,261 patients who completed esophageal novel cell collection,endoscopy,and pathological biopsy were conducted at nine hospitals in the Xinjiang region,including the First Affiliated Hospital of Shihezi University,Hongxing Hospital of the 13th Division,Beitun Hospital of the 10th Division,Kashi Campus of the General Hospital of the 3rd Division,Korla Hospital of the 2nd Division,Fourth Division Hospital,Seventh Division Hospital,Xinjiang Uygur Autonomous Region People's Hospital,and Tumushuk City of Third Division General Hospital.Using pathological biopsy as the gold standard,combined with morphological findings under gastroscopy,the subjects were divided into the early esophageal cancer and precancerous lesion group(n=34),the reflux esophagitis group(n=150),and the esophageal mucosa without abnormalities group(control group)(n=77).The diagnostic efficacy of cytological examination using a novel esophageal cell collector was evaluated in different populations.Results Cytological examination results:4 cases of cancer cells,27 cases of high-grade intraepithelial lesions,12 cases of low-grade intraepithelial lesions,101 cases of atypical squamous cells,111 cases of squamous cell hyperplasia/inflammatory cells,and 6 cases with no intraepithelial lesions or malignant cells.Endoscopic and pathological biopsy results:4 cases of squamous cell carcinoma/adenocarcinoma cells,19 cases of high-grade intraepithelial neoplasia,11 cases of low-grade intraepithelial neoplasia,20 cases of atypical squamous cells,15 cases of inflammatory cells,115 cases of regional edema/cell hyperplasia,and 77 cases of normal cells.The area under the receiver operating characteristic(ROC)curve of the novel esophageal cell collector for screening early esophageal cancer and precancerous lesions in the early esophageal cancer and precancerous lesion group and the control group was 0.933,with a sensitivity of 94.12%,a specificity of 67.53%,a positive predictive value of 56.14%,and a negative predictive value of 96.30%,and an overall accuracy of 75.68%.The area under the ROC curve of the novel esophageal cell collector for screening early esophageal cancer and precancerous lesions in the early esophageal cancer and precancerous lesion group and the reflux esophagitis group was 0.902,with a sensitivity of 94.12%,a specificity of 42.00%,a positive predictive value of 26.89%,a negative predictive value of 96.92%,and an overall accuracy of 51.63%.The new esophageal cell collector was highly safe(with a severe adverse event rate of 0)and highly acceptable(with an average visual analog scale score of 1.3).93.9%(245/261)of participants indicated their willingness to undergo follow-up examinations for esophageal lesions using this method.Conclusion The novel esophageal cell collector demonstrates good diagnostic efficacy for early esophageal cancer and precancerous lesions,reducing the need for unnecessary endoscopic examinations.It features simple operation,high efficiency,safety,and high patient acceptability.关键词
食管癌/癌前病变/新型食管细胞收集器/筛查Key words
Esophageal neoplasms/Precancerous lesions/Novel cell collectors for the esophagus/Screening分类
医药卫生引用本文复制引用
张卉,冯燕,刘永辉,陈卫刚,骆苗苗,于晓杭,林欣,冶丽娜,唐璇,李加学,谢欣宇,赖力..新型食管细胞收集器在食管病变筛查中的应用价值研究[J].中国全科医学,2025,28(35):4487-4493,7.基金项目
兵团财政科技计划项目(2024AB068) （2024AB068）
中亚地区高发疾病的流行病学、发病机制及综合诊治适宜技术研究(2020-PT330-003) （2020-PT330-003）
