AIM： To study the main environmental and lifestyle factors that account for the regional differences in esophageal cancer （EC） risk in low- and high-risk areas of Jiangsu Province, China. METHODS： Since 2003, a po...AIM： To study the main environmental and lifestyle factors that account for the regional differences in esophageal cancer （EC） risk in low- and high-risk areas of Jiangsu Province, China. METHODS： Since 2003, a population-based casecontrol study has been conducted simultaneously in lowrisk （Ganyu County） and high-risk （Dafeng County） areas of Jiangsu Province, China. Using identical protocols and pre-tested standardized questionnaire, following written informed consent, eligible subjects were inquired about their detail information on potential determinants of EC, including demographic information, socio-economic status, living conditions, disease history, family cancer history, smoking, alcohol drinking, dietary habits, frequency, amount of food intake, etc. Conditional logistic regression with maximum likelihood estimation was used to obtain Odds ratio （OR） and 95 % confidence interval （95% CI）, after adjustment for potential confounders. RESULTS： In the preliminary analysis of the ongoing study, we recruited 291 pairs of cases and controls in Dafeng and 240 pairs of cases and controls in Ganyu, respectively. In both low-risk and high-risk areas, EC was inversely associated with socio-economic status, such as level of education, past economic status and body mass index. However, this disease was more frequent among those who had a family history of cancer or encountered misfortune in the past 10 years. EC was also more frequent among smokers, alcohol drinkers and fast eaters. Furthermore, there was a geographic variation of the associations between smoking, alcohol drinking and EC risk despite the similar prevalence of these risk factors in both low-risk and high-risk areas. The dose-response relationship of smoking and smoking related variables, such as age of the first smoking, duration and amount were apparent only in high-risk areas. On the contrary, a dose-response relationship on the effect of alcohol drinking on EC was observed only in low-risk areas. CONCLUSION： The environmental risk factors, together with genetic factors and gene-environmental interactions might be the main reason for this high-risk gradient in .liangsu Province, China.展开更多
Barrett's esophagus is a condition resulting from chronic gastro-esophageal reflux disease with a documented risk of esophageal adenocarcinoma. Current strategies for improved survival in patients with Barrett'...Barrett's esophagus is a condition resulting from chronic gastro-esophageal reflux disease with a documented risk of esophageal adenocarcinoma. Current strategies for improved survival in patients with Barrett's adenocarcinoma focus on detection of dysplasia. This can be obtained by screening programs in high-risk cohorts of patients and/or endoscopic biopsy surveillance of patients with known Barrett's esophagus (BE). Several therapies have been developed in attempts to reverse BE and reduce cancer risk. Aggressive medical management of acid reflux, lifestyle modifications, antireflux surgery, and endoscopic treatments have been recommended for many patients with BE. Whether these interventions are cost-effective or reduce mortality from esophageal cancer remains controversial. Current treatment requires combinations of endoscopic mucosal resection techniques to eliminate visible lesions followed by ablation of residual metaplastic tissue. Esophagectomy is currently indicated in multifocal high-grade neoplasia or mucosal Barrett's carcinoma which cannot be managed by endoscopic approach.展开更多
OBJECTIVE:To explore the association among lifestyle,clinical examination,polymorphisms in CDH1 gene and Traditional Chinese Medicine(TCM)syndrome differentiation of gastric cancer(GC). METHODS:A hospital-based popula...OBJECTIVE:To explore the association among lifestyle,clinical examination,polymorphisms in CDH1 gene and Traditional Chinese Medicine(TCM)syndrome differentiation of gastric cancer(GC). METHODS:A hospital-based population of 387 GC patients was investigated in Jiangsu province.Relevant information regarding lifestyle and clinical examination were collected by a standard questionnaire.Four known single nucleotide polymorphisms(SNPs)in CDH1 were investigated by polymerase chain reaction-ligation detection reaction methods.Statistical analysis was conducted by SPSS 16.0 software.RESULTS:The results showed that meal duration and the status of glutamic pyruvic transaminase were significantly associated with TCM syndrome differentiation of GC(both P<0.05).None of the four SNPs in the E-cadherin(CDH1)gene achieved significant differences in their distributions among the nine syndrome types of GC(both P>0.05).However,significant differences were observed in rs13689 genotype distributions between several pairs of syndrome types of GC,suggesting that rs13689 is correlated with the syndrome differentiation of GC.CONCLUSION:Integrated analysis of lifestyle,clinical examination and CDH1 gene polymorphisms can contribute to a better understanding of the GC syndrome types and may improve the efficacy of interventions by stratifying disease according to TCM criteria.展开更多
基金Supported by Jiangsu Provincial Health Department No. RC 2003090
文摘AIM： To study the main environmental and lifestyle factors that account for the regional differences in esophageal cancer （EC） risk in low- and high-risk areas of Jiangsu Province, China. METHODS： Since 2003, a population-based casecontrol study has been conducted simultaneously in lowrisk （Ganyu County） and high-risk （Dafeng County） areas of Jiangsu Province, China. Using identical protocols and pre-tested standardized questionnaire, following written informed consent, eligible subjects were inquired about their detail information on potential determinants of EC, including demographic information, socio-economic status, living conditions, disease history, family cancer history, smoking, alcohol drinking, dietary habits, frequency, amount of food intake, etc. Conditional logistic regression with maximum likelihood estimation was used to obtain Odds ratio （OR） and 95 % confidence interval （95% CI）, after adjustment for potential confounders. RESULTS： In the preliminary analysis of the ongoing study, we recruited 291 pairs of cases and controls in Dafeng and 240 pairs of cases and controls in Ganyu, respectively. In both low-risk and high-risk areas, EC was inversely associated with socio-economic status, such as level of education, past economic status and body mass index. However, this disease was more frequent among those who had a family history of cancer or encountered misfortune in the past 10 years. EC was also more frequent among smokers, alcohol drinkers and fast eaters. Furthermore, there was a geographic variation of the associations between smoking, alcohol drinking and EC risk despite the similar prevalence of these risk factors in both low-risk and high-risk areas. The dose-response relationship of smoking and smoking related variables, such as age of the first smoking, duration and amount were apparent only in high-risk areas. On the contrary, a dose-response relationship on the effect of alcohol drinking on EC was observed only in low-risk areas. CONCLUSION： The environmental risk factors, together with genetic factors and gene-environmental interactions might be the main reason for this high-risk gradient in .liangsu Province, China.
文摘Barrett's esophagus is a condition resulting from chronic gastro-esophageal reflux disease with a documented risk of esophageal adenocarcinoma. Current strategies for improved survival in patients with Barrett's adenocarcinoma focus on detection of dysplasia. This can be obtained by screening programs in high-risk cohorts of patients and/or endoscopic biopsy surveillance of patients with known Barrett's esophagus (BE). Several therapies have been developed in attempts to reverse BE and reduce cancer risk. Aggressive medical management of acid reflux, lifestyle modifications, antireflux surgery, and endoscopic treatments have been recommended for many patients with BE. Whether these interventions are cost-effective or reduce mortality from esophageal cancer remains controversial. Current treatment requires combinations of endoscopic mucosal resection techniques to eliminate visible lesions followed by ablation of residual metaplastic tissue. Esophagectomy is currently indicated in multifocal high-grade neoplasia or mucosal Barrett's carcinoma which cannot be managed by endoscopic approach.
基金Supported by National Natural Science Foundation of China(30973715 and 81001502)Jiangsu Natural Science Foundation(BK2008461)+2 种基金Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)Research Fund for the Doctoral Program of Higher Education of China(20103237110011)Young Teachers in Nanjing University of Chinese Medicine
文摘OBJECTIVE:To explore the association among lifestyle,clinical examination,polymorphisms in CDH1 gene and Traditional Chinese Medicine(TCM)syndrome differentiation of gastric cancer(GC). METHODS:A hospital-based population of 387 GC patients was investigated in Jiangsu province.Relevant information regarding lifestyle and clinical examination were collected by a standard questionnaire.Four known single nucleotide polymorphisms(SNPs)in CDH1 were investigated by polymerase chain reaction-ligation detection reaction methods.Statistical analysis was conducted by SPSS 16.0 software.RESULTS:The results showed that meal duration and the status of glutamic pyruvic transaminase were significantly associated with TCM syndrome differentiation of GC(both P<0.05).None of the four SNPs in the E-cadherin(CDH1)gene achieved significant differences in their distributions among the nine syndrome types of GC(both P>0.05).However,significant differences were observed in rs13689 genotype distributions between several pairs of syndrome types of GC,suggesting that rs13689 is correlated with the syndrome differentiation of GC.CONCLUSION:Integrated analysis of lifestyle,clinical examination and CDH1 gene polymorphisms can contribute to a better understanding of the GC syndrome types and may improve the efficacy of interventions by stratifying disease according to TCM criteria.
