Objective  Studying the prognosis of esophageal precancerous lesions in Feicheng City and to provide scientific basis for the prevention and control of esophageal squamous cell carcinomas.

  Methods  Retrospective analyze the data of subjects who were not given any medical treatment after endoscopic pathological diagnosis and accepted secondary endoscopic follow-up screening in oFeicheng City from 2006-2016. Describe the results of reexaminations and calculate the cumulative progression rate and progression time to analysis the outcomes of esophageal precancerous lesions.

  Results  A total of 1, 834 cases of precancerous esophageal lesions were included in our study, of which 1, 148 (62.6%) were reversed and 148 (8.1%) were advanced. A total of 234 (12.8%) cases were reversed to normal state, and 17 (0.9%)cases progressed to esophageal cancer. The proportions of precancerous lesions progressing to esophageal cancer from high to low are: severe dysplasia/carcinoma in situ (4.9%), moderate dysplasia (1.3%), mild dysplasia (0.2%); and the median times of cancerous changes from high to low are: mild dysplasia (5.62 years), moderate dysplasia (1.76 years) and severe dysplasia/carcinoma in situ (1.61 years). The 9-year cumulative progression of mild dysplasia to severe dysplasia/carcinoma in situ and above is much less than moderate dysplasia (1.81% vs. 9.98%). The cumulative carcinoma progression rate of severe dysplasia/carcinoma in situ was consistently higher than that of moderate and mild esophageal carcinoma.

  Conclusions  More than half of the precancerous lesions will be reversed to normal or lower-grade lesions. The cumulative carcinogenesis rate of esophageal precancerous lesions increased with the grade of the lesion, and the median time to progression decreased with increasing lesion grade. The time interval for most precancerous lesions to progress to esophageal cancer was roughly consistent with the follow-up interval in the technical plan for the early diagnosis and treatment of cancer. The follow-up frequency for patients with mild dysplasia should be reduced to once every two years.