食管癌前病变进展预测指标的前瞻性队列研究

内镜检查辅以碘染色技术是筛查食管癌及其癌前病变的有效措施，目前已在我国110个县/区广泛开展发现大量癌前病变患者。但癌前病变患者的随诊和分流已成为需要迫切解决的关键问题。不同级别癌前病变组织中特异性蛋白标志物/谱可预测病变进展，有望实现食管癌前病变个体化筛查。本研究是以人群为基础的多中心队列随访研究，依托前期已建立的食管癌高发区癌前病变前瞻性队列，采取盲法设计，首先应用高通量荧光原位杂交、免疫组化方法，筛选出不同级别食管癌前病变表达差异的预测候选蛋白标志物/谱，其次前瞻性评价候选预测分子指标/谱在食管癌前病变进展过程中的作用。最后结合环境危险因素及临床相关信息，建立个体化风险预测模型，全链条开展癌前病变进展分子预测指标评价研究，为食管癌前病变精准化筛查及治疗提供循证医学证据。

Endoscopy examination with Lugol’s iodine staining for esophageal cancer screening has been conducted in 100 counties/regions in China since its evident effects in screening and plenty of patients with different precancerous lesions have been diagnosed. Appropriate follow-up for patients with different precancerous lesions, however, becomes an acute problem in screening procedure. Specific protein molecular markers could solve the problem by predicting the prognosis of various stages of precancerous lesions. This project is a multi-center, population-based, prospective cohort study conducted in four high-risk areas of esophageal cancer. Based on the cohort established, we select differently expressed molecular predictors of esophageal squamous cell carcinoma precancerous of different stages with blinding method. Then evaluate the influence of the molecular predictors on the progress of esophageal precancerous lesions with high throughput fluorescence in situ hybridization and immunohistochemistry methods. Finally set up an individual hazard predictive model using the molecular predictors combined with risk factors and clinical information and thus provide evidence on individual screening and treatment of esophageal precancerous lesion.