Table CDR62877 Esophageal Cancer Screening/食管癌筛查
| ID | Type | Description_en | Description_zh |
|---|---|---|---|
| p1 | Phrase | Esophageal Cancer Screening | 食管癌筛查 |
| p2 | Phrase | Evidence of Harm | 危害证据 |
| p3 | Phrase | Squamous Cell Cancer | 鳞状细胞癌 |
| p4 | Phrase | Esophageal Cancer (PDQ®): Screening | 食管癌（PDQ®）：筛查 |
| p5 | Phrase | Internal Validity : Fair | 可信度： 一般 |
| p6 | Phrase | Consistency : Multiple studies | 一致性： 多项研究 |
| p7 | Phrase | External Validity : Poor | 可推广度： 较差 |
| p8 | Phrase | Natural History, Incidence, and Mortality | 自然病程、发病率及死亡率 |
| p9 | Phrase | The epidemiology of these types varies markedly | 不同类型食管恶性肿瘤的流行病学特征有显著差异 |
| s1 | Sentence | Complications such as perforation and bleeding can occur | 内镜检查可能出现穿孔或出血等并发症 |
| s2 | Sentence | Consistency : Multiple studies, large number of participants | 一致性： 多项研究，大量参与者 |
| s3 | Sentence | Magnitude of Effects on Health Outcomes : Small positive | 对健康结果的影响程度：少量正效应 |
| s4 | Sentence | Esophageal squamous cell carcinoma was not associated with BMI | 而食管鳞状细胞癌与BMI之间并无类似相关性 |
| s5 | Sentence | Study Design : Evidence from cohort or case-control studies | 研究设计： 队列研究或病例对照研究 |
| s6 | Sentence | Study Design : Evidence obtained from cohort or case-control studies | 研究设计： 队列研究或病例对照研究 |
| s7 | Sentence | Studies of primary endoscopic screening have been reported from France and Japan | 此外，法国 和日本则发表了初步内镜筛查的相关研究结果 |
| s8 | Sentence | Endoscopic screening for esophageal adenocarcinoma is expensive, inconvenient, and usually requires sedation | 食管腺癌的内镜筛查较为昂贵、不方便且常需镇静 |
| s9 | Sentence | There is insufficient evidence that population screening for Barrett esophagus reduces cancer mortality | 尚未有足够证据提示针对Barrett食管的人群筛查可以降低腺癌的死亡率 |
| s10 | Sentence | There exists a strong relationship between body mass index (BMI) and esophageal adenocarcinoma | 食管腺癌的发生与体重指数（BMI）间存在明显相关性 |
| s11 | Sentence | Expert-reviewed information summary about tests used to detect or screen for esophageal cancer | 专家总结的食管癌筛查及检出技术信息 |
| s12 | Sentence | Prospective studies have reported annual esophageal cancer incidence rates ranging from 0.2% to 1.9% | 一些已发表的前瞻性研究发现Barrett食管患者的食管腺癌年发病率波动在0.2%到1.9%之间 |
| s13 | Sentence | In the 1960s, squamous cell cancers comprised more than 90% of all esophageal tumors | 在20世纪60年代，鳞状细胞癌占据了所有食管肿瘤的90%以上 |
| s14 | Sentence | Considerable debate has ensued concerning the risk of cancer in patients with Barrett esophagus | 对于Barrett食管患者患癌风险是否增加尚存在争议 |
| s15 | Sentence | The etiological role of human papillomavirus infection in squamous cell cancer is under study | 此外，人乳头瘤病毒感染对鳞状细胞癌发生的作用仍在研究之中 |
| s16 | Sentence | Two histologic types account for the majority of malignant esophageal neoplasms: adenocarcinoma and squamous carcinoma | 绝大多数食管恶性肿瘤为两大组织类型：腺癌和鳞癌 |
| s17 | Sentence | Such studies should become more feasible with the increasing availability of endoscopy in high-risk populations | 随着内镜筛查在高危人群中的普及率逐步提升，上述研究将变得更为可行 |
| s18 | Sentence | Esophageal cytological screening studies have been reported from China, Iran, South Africa, Italy, and Japan | 多个国家相继发表了食管癌细胞学筛查相关研究数据，包括中国、伊朗、 南非、意大利和日本 |
| s19 | Sentence | Past use of lower esophageal sphincter (LES)-relaxing drugs was positively associated with risk of esophageal adenocarcinoma | 食管腺癌的发病风险增加亦与既往应用食管下括约肌（LES）松弛性药物正相关 |
| s20 | Sentence | The intestinal-type epithelium of Barrett esophagus has a characteristic endoscopic appearance that differs from squamous epithelium | Barrett食管的肠上皮具有与鳞状上皮截然不同的典型内镜下表现 |
| s21 | Sentence | Gastric cardia adenocarcinoma and esophageal squamous cell carcinoma were not associated with use of LES-relaxing drugs | 但胃贲门腺癌及食管鳞状细胞癌与应用LES松弛性药物无关 |
| s22 | Sentence | The development of uniform and accurate cytological criteria will require formal cytological-histological correlation studies of esophageal lesions | 因此，统一且准确的食管病灶细胞学诊断标准，需要正式的细胞学-组织学相关性研究 |
| s23 | Sentence | Dysplasia in Barrett epithelium represents an alteration of the columnar epithelium that may progress to invasive adenocarcinoma | Barrett食管上皮的不典型增生表现为柱状上皮，可能进展为侵袭性腺癌 |
| s24 | Sentence | The frequency, severity, and duration of reflux symptoms were positively associated with increased risk of esophageal adenocarcinoma | 返流症状的发生频率、严重程度、持续时间均会增加食管腺癌的发生的风险 |
| s25 | Sentence | It has been estimated that physicians identify only approximately 5% of the population who have Barrett esophagus | 研究者估测医生仅诊断或发现了约5%的Barrett食管患者 |
| s26 | Sentence | In the United States, such efforts have been focused on individuals perceived to be at higher risk | 在美国，类似的研究工作主要集中于食管鳞癌发生风险较高的个体 |
| s27 | Sentence | The likelihood of finding Barrett esophagus on endoscopy is related to the duration of symptoms of gastroesophageal reflux | 内镜下发现Barrett食管相关改变的发生率与胃食管反流症状的持续时间相关 |
| s28 | Sentence | The efficacy of surveillance cytology or endoscopy for high-risk patients with tylosis or long-standing achalasia is not known | 对于患胼胝症或长期贲门失迟缓症的高危人群，进行细胞学或内镜检测的有效性尚不明确 |
| s29 | Sentence | Reports have suggested that gastric infection with H. pylori may protect the esophagus from GERD and its complications | 研究发现，胃幽门螺旋杆菌的感染可能有助于减少GERD及其并发症对食管的损害 |
| s30 | Sentence | Of the new cases, it is estimated that 14,660 will occur in men and 3,510 will occur in women | 新发病例中，预计有14,660例男性患者，3,510例女性患者 |
| s31 | Sentence | The interval between endoscopic evaluations is typically determined by histologic findings, in accordance with published guidelines by gastroenterological committees | 内镜随访的时间间隔取决于组织学结果，以胃肠道疾病协会发表的指南为准则 |
| s32 | Sentence | Other techniques to potentially identify dysplastic epithelium that could then be sampled extensively include chromoendoscopy and laser-induced fluorescence spectroscopy | 其他可能识别不典型增生上皮并取标本的方法包括染色内镜 以及激光诱导荧光光谱分析法 |
| s33 | Sentence | The results of a population-based case-controlled study suggest that symptomatic gastroesophageal reflux is a risk factor for esophageal adenocarcinoma | 一项基于人群的病例对照研究结果强烈提示有症状的胃食管返流病是食管腺癌的高危因素 |
| s34 | Sentence | For patients with no dysplasia, surveillance endoscopy at an interval of every 2 to 3 years has been recommended | 对于不存在不典型增生的患者，推荐每隔2到3年复查一次内镜 |
| s35 | Sentence | GERD should be treated prior to surveillance endoscopy to minimize confusion caused by inflammation in the interpretation of biopsy specimens | 为了减少GERD本身的炎症反应对活检结果判读的干扰，应在实施内镜检测前治疗GERD |
| s36 | Sentence | Concern over publication bias has led some authors to suggest that the risk may be lower than the literature suggests | 考虑到文献偏倚的存在，部分学者认为真实的发病率可能会低于文献数据 |
| s37 | Sentence | Based on fair evidence, screening would result in no (or minimal) decrease in mortality from esophageal cancer in the U.S. population | 充分证据表明，在美国人群中进行筛查不会引起食管癌死亡率下降或仅仅只有轻微下降 |
| s38 | Sentence | Magnitude of Effects on Health Outcomes : Fair evidence for no reduction in mortality; good evidence for uncommon but serious harms | 对健康结果的影响程度：充分证据证明死亡率未下降；确凿证据提示存在罕见但严重的副作用 |
| s39 | Sentence | In 2014, it is estimated that 18,170 Americans will be diagnosed with esophageal cancer, and 15,450 will die of this malignancy | 据估测，2014年将有18,170例美国人被诊断患有食管癌，有15,450例患者将因这一恶性肿瘤死亡 |
| s40 | Sentence | Patients whose duodenal ulcers were treated successfully with antibiotics developed reflux esophagitis twice as often as those in whom infection persisted | 十二指肠溃疡患者使用抗生素完全治愈后发生反流性食管炎的几率是感染持续存在患者的2倍 |
| s41 | Sentence | A risk of 0.5% per year for development of adenocarcinoma is now thought to be a reasonable estimate for Barrett esophagus | 目前普遍认为在Barrett食管患者中，0.5%的食管腺癌年发病率可能是较为合理的估计值 |
| s42 | Sentence | An interesting hypothesis relates the rise in incidence of esophageal adenocarcinoma to a declining prevalence of Helicobacter pylori infection in Western countries | 在西方国家，一个有趣的假说将食管腺癌的发生率增加与幽门螺旋杆菌的患病率下降联系在一起 |
| s43 | Sentence | According to this theory, H. pylori infections that cause pangastritis also cause a decrease in gastric acid production that protects against GERD | 这一假说认为幽门螺旋杆菌感染在引起全胃炎的同时，也导致胃酸分泌减少，从而降低GERD的发生及危害 |
| s44 | Sentence | In black women aged 55 to 69 years, the incidence rate is slightly higher than white women aged 70 years and older | 而鳞状细胞癌在55-69岁间黑人女性中发病率则稍高于其在70岁以上白人女性中的发病率 |
| s45 | Sentence | Although widely adopted in clinical practice, these practices are based on uncontrolled series and the opinion of expert gastrointestinal endoscopists and pathologists | 尽管上述指南建议在临床实践中被广泛采用，仍需注意上述建议主要是基于非对照病例系列研究及胃肠道疾病的内镜专科医师和病理学家的意见 |
| s46 | Sentence | The adjusted odds ratio (OR) was 7.6 (95% CI, 3.8–15.2) among persons in the highest BMI quartile compared with persons in the lowest | BMI最高四分位区间的人群对比BMI最低四分位区间人群的校正后比值比（OR）为7.6（95%CI，3.8-15.2） |
| s47 | Sentence | Incidence rates generally increase with age in all racial/ethnic groups but squamous cell cancer is consistently more common in blacks than in whites | 鳞状细胞癌的发病率通常随着年龄增长而增加，这一特点与人种无关，但鳞癌在黑人中的发病率则始终高于同年龄段白人 |
| s48 | Sentence | Screening for esophageal cancer by the use of blind nonendoscopically directed balloon cytological sampling for squamous cell carcinoma is minimally inconvenient and uncomfortable | 采用非内镜引导球囊细胞学盲法取样筛查食管鳞癌几乎不引起不舒适或不方便 |
| s49 | Sentence | The most important epidemiological difference between squamous cell cancer and adenocarcinoma, however, is the strong association between gastroesophageal reflux disease (GERD) and adenocarcinoma | 食管腺癌和鳞癌有着不同的流行病学特点，其中最重要的一点在于胃食管反流病（GERD）与腺癌存在密切关系 |
| s50 | Sentence | Individuals who are informed they have Barrett esophagus may consider themselves to be ill even though their risk of developing cancer is very low | 尽管Barrett食管的患癌风险较低，诊断为Barrett食管的患者仍会误以为自己病情较重 |
| s51 | Sentence | For patients with high-grade dysplasia, two options have been recommended: surgical resection or repeated endoscopic evaluation until the diagnosis of intramucosal carcinoma is made | 对于存在高级别不典型增生的患者，指南建议两个选择：直接手术切除或者重复内镜评估直至诊断为黏膜内癌 |
| s52 | Sentence | The technique of random, four-quadrant biopsies taken every 2 cm in the columnar-lined esophagus for standard histological evaluation has been recommended by some clinicians | 部分临床医生推荐采用随机四象限活检术用于组织学评估，该技术将食管柱状上皮取材区域分为四个象限，分别取材一次，各取材点间隔2cm |
| s53 | Sentence | Among black men, the incidence rate for those aged 55 to 69 years is close to that of white men aged 70 years and older | 实际上鳞状细胞癌在55-69岁间黑人男性中的发病率与其在70岁以上白人男性中的发病率基本相近 |
| s54 | Sentence | Obese persons (those with BMI >30 kg/m2 ) had an OR of 16.2 (95% CI, 6.3–41.4) compared with the leanest persons (BMI <22 kg/m2 ) | 肥胖人群（BMI＞30Kg/m2）与消瘦人群（BMI＜22Kg/m2）相比，OR为16.2（95%CI，6.3-41.4） |
| s55 | Sentence | Long-standing GERD predisposes to Barrett esophagus, the condition in which an abnormal intestinal epithelium replaces the stratified squamous epithelium that normally lines the distal esophagus | 长期GERD可引起Barrett食管，后者源于异常肠上皮取代了远段食管的正常复层鳞状上皮 |
| s56 | Sentence | Surveillance of Barrett esophagus involves the use of tests to identify preneoplastic changes or curable neoplasms in patients who are known to have Barrett esophagus | Barrett食管的监测包括通过检查方法在确诊Barrett食管的患者中识别出癌前病变或可治愈的肿瘤 |
| s57 | Sentence | However, GERD is very common; surveys have found that approximately 20% of adult Americans experience symptoms of GERD, such as heartburn, at least once each week | 但GERD本身非常常见，研究发现约20%的成年美国人出现过烧心等GERD症状，且每周至少一次 |
| s58 | Sentence | Note: Separate PDQ summaries on Esophageal Cancer Prevention , Esophageal Cancer Treatment , and Levels of Evidence for Cancer Screening and Prevention Studies are also available | 注：食管癌的预防、食管癌的治疗以及癌症筛查与预防研究相关资料见于本站相关链接信息 |
| s59 | Sentence | Barrett esophagus is strongly associated with gastroesophageal reflux disease (GERD), and the changes of Barrett esophagus can be found in approximately 10% of patients who have GERD | Barrett食管与胃食管反流病有显著相关性，约10%的GERD患者有Barrett食管相关改变 |
| s60 | Sentence | Potential psychological harms may occur in those identified as having Barrett esophagus who may consider themselves to be ill even though their risk of developing cancer is low | 另外，对于明确诊断为Barrett食管的患者，尽管其患癌风险较低，但仍有可能使得他们误以为自己病情较重，从而带来潜在的精神心理伤害 |
| s61 | Sentence | For patients with low-grade dysplasia, surveillance every 6 months for the first year has been recommended, followed by annual endoscopy if the dysplasia has not progressed in severity | 而对于存在低级别不典型增生的患者，指南建议自诊断起第一年内每隔6个月复查一次内镜，如果不典型增生的严重程度没有进展，自第二年起可延长至每年一次复查内镜 |
| s62 | Sentence | Efforts at early detection of squamous cell cancer of the esophagus have concentrated on cytological or endoscopic screening of populations in countries where there is a high incidence | 食管鳞状细胞癌的早期筛查工作主要集中于针对高发病率国家目标人群的细胞学或内镜筛查 |
| s63 | Sentence | Based on solid evidence, screening would result in uncommon but serious side effects associated with endoscopy which may include perforation, cardiopulmonary events and aspiration, and bleeding requiring hospitalization | 确凿证据显示，食管癌筛查会导致少见但严重的内镜相关并发症，包括穿孔、心肺功能异常、误吸及出血等需要住院治疗的状况 |
| s64 | Sentence | Although these programs have demonstrated that it is possible to detect squamous cell cancers in an early asymptomatic stage, no data on efficacy (e.g., mortality reduction) have been published | 尽管这些检查可以在无症状阶段发现早期食管癌，但目前尚无有疗效相关数据（如死亡率下降）发表 |
| s65 | Sentence | Among daily, long-term users (>5 years) of LES-relaxing drugs, the estimated incidence rate ratio was 3.8 (95% confidence interval [CI], 2.2–6.4) compared with persons who had never used these drugs | 长期（＞5年）每日应用LES松弛性药物的人群食管腺癌的发病率是从未应用此类药物的人群的3.8倍（95%置信区间[CI]，2.2-6.4） |
| s66 | Sentence | Although the overall incidence of squamous cell carcinoma of the esophagus is declining, this histologic type remains six times more likely to occur in black males than in white males | 虽然鳞状细胞癌的总发病率有所下降，但这一组织类型在黑人男性中的发病率是白人男性发病率的6倍以上 |
| s67 | Sentence | The incidence of complications including perforation, respiratory arrest, and myocardial infarction, has been estimated to be 0 to 13 per 10,000 procedures with an associated mortality of 0 to 0.8 per 10,000 procedures | 穿孔、呼吸暂停及心肌梗死三大并发症的发生率在每1万次操作中约有0到13例，相关死亡率在每1万次操作中约有0-0.8例 |
| s68 | Sentence | While risk factors for squamous cell carcinoma of the esophagus have been identified (such as tobacco, alcoholism, malnutrition, and infection with human papillomavirus), the risk factors associated with esophageal adenocarcinoma are less defined | 多项危险因素（包括烟草、酒精、营养不良及人乳头瘤病毒感染）已被证实与食管鳞状细胞癌的发生相关，，而与食管腺癌相关的危险因素却很少被发现 |
| s69 | Sentence | The incidence of esophageal adenocarcinomas has risen considerably for the past 2 decades, such that it is now more prevalent than squamous cell cancer in the United States and Western Europe, with most tumors located in the distal esophagus | 但因食管腺癌的发病率在过去20年间有所升高，现在好发于食管末端的腺癌已取代鳞状细胞癌成为美国和西欧最常见的食管癌类型 |
| s70 | Sentence | In a series of 701 individuals, 4% of those with symptoms for less than 1 year had Barrett esophagus on endoscopy, whereas Barrett esophagus was found in 21% of those with more than 10 years of symptoms of GERD | 一项纳入701例参与者的研究发现，GERD症状持续不足1年的患者中仅有4%经内镜检查发现了Barrett食管相关改变；而在GERD症状持续超过10年的患者中，这一比例高达21% |
| s71 | Sentence | Comparisons of both Chinese and U.S. cytological diagnoses with concurrent histological findings showed low (14% to 36%) sensitivities for the cytological detection of biopsy-proven cancers. Specificity ranged from 90% to 99% with a positive predictive value of 23% to 94% | 中国和美国的筛查研究均发现，细胞学联合组织学检查确诊肿瘤的敏感性较低（14%-36%），特异性为90-99%，而其阳性预测值则从23%到94%不等 |
| s72 | Sentence | Certain factors are essential in the implementation of an effective surveillance protocol, including low risk of the surveillance method, correct histological diagnosis of dysplasia, proof that surgical resection for high-grade dysplasia will decrease the risk of cancer, and successful resection of cancer | 监测的有效实施必须满足多个必要因素，包括监测方法的低危害性、对不典型增生的正确组织学诊断、证明高级别不典型增生的手术切除能降低患癌风险，和肿瘤的成功切除 |
| s73 | Sentence | Squamous cell carcinoma of the esophagus does not have a highly prevalent predisposing condition, although the incidence increases in persons who have had long-standing exposure to tobacco and alcohol, achalasia, head and neck squamous cell cancer attributable most likely to long-standing alcohol and/or tobacco exposure, tylosis, history of lye ingestion, celiac sprue, and, in South America and China, hot liquid ingestion | 尽管尚未发现食管鳞状细胞癌的重要癌前病变，但已发现多个与食管鳞状细胞癌发病率增加相关的因素，包括：长期暴露于烟草或酒精、贲门失弛缓症、长期酒精和（或）烟草暴露引起的头颈部鳞状细胞癌、胼胝症、碱液摄入史、乳糜泻与好发于南美及中国的热饮摄入史 |