Chinese General Practice ›› 2025, Vol. 28 ›› Issue (35): 4487-4493.DOI: 10.12114/j.issn.1007-9572.2025.0175

• Original Research·Appropriate Technology Research • Previous Articles     Next Articles

The Application Value of a Novel Cell Collector for the Esophagus in Screening for Esophageal Lesions

  

  1. 1. Department of Gastroenterology, the First Affiliated Hospital of Shihezi University, Shihezi 832000, China
    2. Department of Gastroenterology, Hongxing Hospital of the 13th Division, Hami 839000, China
    3. Department of Gastroenterology, Beitun Hospital of the 10th Division, Beitun 836000, China
    4. Department of Gastroenterology, Kashi Campus of the General Hospital of the 3rd Division, Kashi 844000, China
    5. Department of Gastroenterology, Fourth Division Hospital, Yining 835000, China
    6. Department of Gastroenterology, Seventh Division Hospital, Kuitun 833200, China
    7. Department of Gastroenterology, Xinjiang Uygur Autonomous Region People's Hospital, Urumqi 830000, China
    8. Department of Gastroenterology, Tumushuke City Campus, Third Division General Hospital, Tumushuke 844000, China
  • Received:2025-03-10 Revised:2025-08-15 Published:2025-12-15 Online:2025-10-15
  • Contact: CHEN Weigang

新型食管细胞收集器在食管病变筛查中的应用价值研究

  

  1. 1.832000 新疆维吾尔自治区石河子市,石河子大学第一附属医院消化内科
    2.839000 新疆维吾尔自治区哈密市,第十三师红星医院消化内科
    3.836000 新疆维吾尔自治区北屯市,第十师北屯医院消化内科
    4.844000 新疆维吾尔自治区喀什市,第三师总医院喀什院区消化内科
    5.835000 新疆维吾尔自治区伊宁市,第四师医院消化内科
    6.833200 新疆维吾尔自治区奎屯市,第七师医院消化内科
    7.830000 新疆维吾尔自治区乌鲁木齐市,新疆维吾尔自治区人民医院消化内科
    8.844000 新疆维吾尔自治区图木舒克市,第三师总医院图木舒克市院区消化内科
  • 通讯作者: 陈卫刚
  • 作者简介:

    作者贡献:

    张卉进行研究设计、研究实施、数据收集、统计分析、论文撰写和定稿;骆苗苗参与研究构思、论文写作指导和定稿;于晓杭参与数据分析、论文起草和定稿;林欣、冶丽娜、唐旋、李加学、谢欣宇、赖力、冯燕、刘永辉参与研究实施、数据收集和整理、论文批判性审阅;陈卫刚负责研究设计和实施指导,数据解释与分析,对文章内容进行批判性审阅和修改,论文定稿。

  • 基金资助:
    兵团财政科技计划项目(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)

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.

Key words: Esophageal neoplasms, Precancerous lesions, Novel cell collectors for the esophagus, Screening

摘要:

背景

我国食管癌疾病负担居全球首位,早期发现食管癌及癌前病变是提高患者生存率、降低发病率和死亡率的关键。

目的

探讨新型食管细胞收集器在食管病变筛查中的临床应用价值,为政府卫生部门制定更有效的癌症防控政策及公共卫生计划提供依据。

方法

选取2024年1月—2025年1月在石河子大学第一附属医院、第十三师红星医院、第十师北屯医院、第三师总医院喀什院区、第二师库尔勒医院、第四师医院、第七师医院、新疆维吾尔自治区人民医院、第三师总医院图木舒克市院区等9家新疆地区医院行新型食管细胞收集器细胞学检查、内镜检查及病理活检者261例。以病理活检为金标准,结合内镜下形态学表现,将受试者分为早期食管癌及癌前病变组(n=34)、反流性食管炎组(n=150)、食管黏膜未见异常组(对照组,n=77)。评价新型食管细胞收集器细胞学检查在不同人群中的诊断效能。

结果

细胞学检查结果:癌细胞4例,鳞状上皮内高度病变27例,鳞状上皮内低级别病变12例,非典型鳞状细胞101例,鳞状细胞增生/炎细胞111例,无上皮内病变及恶性细胞6例。内镜及病理活检结果:鳞状细胞癌/腺癌细胞4例,高级别上皮内瘤变19例,低级别上皮内瘤变11例,非典型鳞状细胞20例,炎细胞15例,区域水肿/细胞增生115例,正常细胞77例。新型食管细胞收集器在早期食管癌及癌前病变组和对照组中筛查早期食管癌及癌前病变的受试者工作特征(ROC)曲线下面积为0.933,灵敏度为94.12%,特异度为67.53%,阳性预测值为56.14%,阴性预测值为96.30%,总符合率为75.68%。新型食管细胞收集器在早期食管癌及癌前病变组和反流性食管炎组中筛查早期食管癌及癌前病变的ROC曲线下面积为0.902,灵敏度为94.12%,特异度为42.00%,阳性预测值为26.89%,阴性预测值为96.92%,总符合率为51.63%。新型食管细胞收集器安全性高(严重不良事件发生率为0),可接受性高(视觉模拟量表平均分为1.3分),93.9%(245/261)患者表示愿意接受此方法进行食管病变的复查。

结论

新型食管细胞收集器对早期食管癌及癌前病变有较好的诊断效能,可减少不必要的内镜检查,且具备操作简单、高效、安全、患者可接受性高等特性。

关键词: 食管癌, 癌前病变, 新型食管细胞收集器, 筛查