Esophageal Cancer Screening and High-Risk Factor Investigation in High-Risk Populations of Mongolian and Han Ethnicities
Objective To assess the screening efficacy of a novel esophageal cell collector and esophageal exfoliated cell cytology examination for esophageal cancer and investigate risk factors associated with cytological examination results in the Han and Mongolian ethnic groups.Methods ①A total of 1196 high-risk individuals with esophageal cancer were selected for treatment at the Second Affiliated Hospital of Baotou Medical College.Esophageal cells were collected,and endoscopic examination and mucosal biopsy of the esophagus were performed.The pathological examination of the digestive tract endoscopic biopsy tissue was used as the gold standard to verify the diagnostic efficacy of cytological examination.① In this study,9256 Han and 572 Mongolian individuals who participated in esophageal cancer screening in the Baotou area were selected as the research subjects.General information,dietary habits,lifestyle habits,and other information of the subjects were collected through a questionnaire survey.Esophageal cells were collected using a new type of esophageal cell collector,and logistic regression analysis was used to identify the risk factors for positive cytology in Han and Mongolian populations.Results ① The novel esophageal cell collector and esophageal exfoliated cell cytology examination demonstrated excellent screening capabilities for esophageal cancer,with sensitivity(92.86％),specificity(99.58％),positive predictive value(PPV)of 72.22％,negative predictive value(NPV)of 99.92％,positive likelihood ratio(PLR)of 221.10,negative likelihood ratio(NLR)of 0.07,Youden index of 0.92,and an area under the ROC curve of 0.961(0.923-1.0).The optimal cutoff value was 2.50,yielding a sensitivity of 92.90％and specificity of 88.20％.②The cytological positivity rate among the Mongolian population(2.27％)was higher than that among the Han population(1.12％).The proportion of alcohol drinkers,those with a preference for hot and spicy foods,and those consuming pickled foods was higher in the Mongolian population than in the Han population.Logistic regression analysis revealed risk factors for the Han population:gender(OR=0.381,95％CI:0.256-0.568),age(OR=1.091,95％CI:1.067-1.116),alcohol consumption(OR=1.693,95％CI:1.150-2.492),and smoking(OR=2.127,95％CI:1.439-3.143).Risk factors for the Mongolian population were gender(OR=0.174,95％CI:0.047-0.638),age(OR=1.124,95％CI:1.052-1.200),and alcohol consumption(OR=3.945,95％CI:1.074-14.489).Conclusion ①The novel type of esophageal cell collector-esophageal exfoliative cytology examination has good screening efficacy for esophageal cancer.② Gender,age,alcohol consumption,and hot eating habits are the main risk factors for positive cytological diagnosis in the Mongolian population,while gender,age,alcohol consumption,and smoking are the main risk factors for positive cytological diagnosis in the Han population.
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