摘 要
食管癌作为全球常见的恶性肿瘤之一，其早期筛查对于提高患者生存率和改善预后具有重要意义。本研究旨在系统评价现有食管癌早期筛查方法的效果，并提出优化建议。通过对国内外相关文献的系统回顾与荟萃分析，结合我国实际情况，选取内镜检查、细胞学检测、影像学检查等常用筛查手段为研究对象，以灵敏度、特异度、阳性预测值、阴性预测值为主要评价指标，同时考虑成本效益比及患者依从性等因素。研究发现，内镜检查在灵敏度方面表现优异，但存在成本较高、患者接受度低等问题；细胞学检测操作简便且成本较低，然而灵敏度相对不足；影像学检查虽能提供直观解剖结构信息，但在早期微小病灶检出上存在一定局限。基于上述结果，提出构建多学科协作模式下的综合筛查体系，整合多种筛查技术优势，制定个性化筛查方案，加强基层医疗机构培训，推广适宜技术应用，提高全民健康意识，从而实现食管癌早期筛查效率与效果的全面提升，为公共卫生政策制定提供科学依据，推动食管癌防控工作向精准化方向发展。
关键词：食管癌早期筛查；内镜检查；细胞学检测；影像学检查；多学科协作模式
Abstract
Esophageal cancer, as one of the most common malignant tumors globally, early screening plays a crucial role in improving patient survival rates and prognosis. This study aims to systematically evaluate the effectiveness of existing early screening methods for esophageal cancer and propose optimization recommendations. By conducting a systematic review and me ta-analysis of relevant domestic and international literature, and considering China's specific circumstances, this study selected commonly used screening methods such as endoscopic examination, cytological testing, and imaging examinations as research subjects. The primary evaluation indicators included sensitivity, specificity, positive predictive value, and negative predictive value, while also taking into account cost-effectiveness ratios and patient compliance. The findings revealed that endoscopic examination exhibited excellent performance in terms of sensitivity but was associated with high costs and low patient acceptance. Cytological testing was simple to perform and cost-effective, yet its sensitivity was relatively insufficient. Imaging examinations provided, but had limitations in detecting early micro-lesions. Based on these results, it is proposed to construct an integrated screening system under a multidisciplinary collaborative model, combining the advantages of various screening technologies, formulating personalized screening plans, strengthening training in primary healthcare institutions, promoting the application of appropriate technologies, and enhancing public health awareness. These measures aim to comprehensively improve the efficiency and effectiveness of early esophageal cancer screening, providing scientific evidence for public health policy formulation, and advancing esophageal cancer prevention and control towards precision-oriented development.
Keywords：Esophageal Cancer Early Screening；Endoscopic Examination；Cytological Testing；Imaging Studies；Multidisciplinary Collaboration Model
目 录
摘 要 I
Abstract II
引 言 1
第一章 食管癌早期筛查现状分析 2
1.1 筛查方法发展历程回顾 2
1.2 当前主要筛查技术概述 2
1.3 现有筛查模式存在的问题 3
第二章 筛查方法效果评价指标体系 4
2.1 敏感性与特异性评估 4
2.2 成本效益比分析 4
2.3 患者依从性考察 5
第三章 影响筛查效果的关键因素 7
3.1 医疗资源可及性研究 7
3.2 人群风险特征分析 7
3.3 技术操作规范性探讨 8
第四章 筛查方法优化路径探索 10
4.1 新技术应用前景展望 10
4.2 综合筛查模式构建 10
4.3 政策支持体系完善 11
结 论 13
参考文献 14
致 谢 15
