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Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China 被引量:33
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作者 Juan Yang wen-Qiang wei +3 位作者 Jin Niu Zhi-Cai Liu Chun-Xia Yang You-Lin Qiao 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第20期2493-2501,共9页
AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and th... AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and the benefit-cost ratios(BCRs)of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV(international dollar-I$55 million)and BCR(2.52).Screening six times between 40-70 years at a 5-year interval[i.e., six times(40)f-strategy]yielded the highest NPV(I$99 million)and BCR(3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies. 展开更多
关键词 Cost-benefit analysis esophageal cancer ENDOSCOPY SCREENING high-risk area
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EPIDEMIC STRENGTH OF CARDIA AND DISTANT STOMACH CANCER IN THE HIGH RISK REGION OF ESOPHAGEAL CANCER AND THEIR IMPLICATION TO EDOSCOPIC SCREENING 被引量:11
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作者 张立玮 温登瑰 +10 位作者 李英赛 于卫芳 王顺平 尔立绵 丛庆文 王俊和 李素平 李永伟 马彩芬 单宝恩 王士杰 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2006年第2期111-115,共5页
Objective: To discuss the epidemic strength of cardia and distant stomach cancers in the high risk region of esophageal cancer along the south Taihang mountain such as in Shexian, Linxian, and Cixian Counties, and to... Objective: To discuss the epidemic strength of cardia and distant stomach cancers in the high risk region of esophageal cancer along the south Taihang mountain such as in Shexian, Linxian, and Cixian Counties, and to clarify the tasks for the control of upper gastrointestinal tract cancer as a whole in the region. Methods: Comparisons of incidence and mortality rates of esophageal, cardia and stomach cancers were made between Cixian, Linxian and Shexian Counties with reference to detection rates of cancer in situ and precancerous lesions of the three upper gastrointestinal cancers by endoscopic screening. The screening was performed from 1999 through 2004 in the three adjacent counties including a total of 6233 local residents aged 40 to 69 years old. Results: The incidence rates for cardia cancer for the male and female from 2000 through 2004 were 69.9 and 41.5, and the mortality rates were 54.3 and 33.2 respectively in Shexian County. Esophageal, cardia, and stomach cancers constitute about 70~80 percent of all malignant disease by incidence or mortality rates. Endoscopic survey with iodine staining can effectively detect squamous cell precancerous lesions in the esophagus, but the method is inadequate for the detection of adeno precancerous lesions of the cardia and stomach. Conclusion: The south Taihang mountain region is a high risk area not only for esophagus cancer, but also for cardia and stomach cancers. To control upper gastrointestinal tract cancers as a whole in the region, special attention should be paid to the control of cardia and stomach cancers. Presently, to find effective screening methods for detecting cardia and stomach precancerous lesions is especially important. 展开更多
关键词 high-risk region for esophageal cancer Cardia cancer Stomach cancer Precancerous disease Endoscopic screening
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Age scope of high-risk population for esophageal cancer in Ci county 被引量:1
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作者 Zhi-FengChen JunHou +6 位作者 Zhen-WeiDing Cui-LanGuo Cui-YunQiao Guo-HuiSong Shao-SenLi Jian-HuiZhang Yu-TongHe 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第12期1818-1821,共4页
AIM: To define the age scope of high-risk population for esophageal cancer (EC) in Ci county. METHODS: The results of endoscopic examination of 2 013 subjects, cytological screening of 16 763 persons and records of 9 ... AIM: To define the age scope of high-risk population for esophageal cancer (EC) in Ci county. METHODS: The results of endoscopic examination of 2 013 subjects, cytological screening of 16 763 persons and records of 9 265 patients with EC were analyzed by Ridit methods, the standard age group was 45-49 year group. RESULTS: The average age of patients with moderate esophageal epithelium dysplasia by endoscopic examination was 53.5 years, of severe esophageal epithelium dysplasia, 51.4 years, early EC, 55.6 years. The average age of stage one severe epithelium dysplasia (SEEDⅠ) by cytological screening was 51.2 years, of stage two severe epithelium esophageal dysplasia (SEED Ⅱ) 51.6 years, of advanced EC 61.7 years. In the group of 40-year olds, the value of Ridit by pathological diagnosis was 0.46, 95% CI, 0.45-0.47, that by cytological diagnosis was 0.45, 95% CI, 0.43-0.47. As the age increased at five-year intervals, the value of Ridit increased significantly. CONCLUSION: In Ci county of a high incidence area of EC, the age definition of high-risk population should be above 45 years. 展开更多
关键词 esophageal cancer high-risk population Age Ridit analysis
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Reflections on the New Classification of Tumors by the WHO and Changes in Esophageal Cancer in a High-risk Area 被引量:1
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作者 Zhifeng Chen 《Chinese Journal of Clinical Oncology》 CSCD 2006年第1期61-65,共5页
ABSTRACT In year 2000, a book entitled the Pathology and Genetics of Tumors of the Digestive System was published by the WHO, presenting some new diagnostic criteria and treatment principles. I have analyzed the epide... ABSTRACT In year 2000, a book entitled the Pathology and Genetics of Tumors of the Digestive System was published by the WHO, presenting some new diagnostic criteria and treatment principles. I have analyzed the epidemiologic change of tumors in over 30 years in the high-risk area with esophageal cancer. The following phenomenon was found: accompanied by the sharp decrease in the incidence and mortality of esophageal cancer, there was an increase in the incidence and death rate of stomach cancer involving cardiac cancer. This fact should be considered when analyzing the sharp decrease in esophageal cancer incidence and mortality rate. More attention was given to diagnosis of cardiac cancer; at the same time it is more practical to improve the early screening of cancers. To observe the development of high and low - grade intraepithelial neoplasms will be an urgent task for esophageal cancer research in the high risk area, according to WHO's new classification. 展开更多
关键词 WHO tumor new classification epidemiology esophageal cancer the high-risk area.
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Trends in high-risk rates and screening rates for the population-based cancer screening program on esophageal,stomach and liver cancer in China,2010-2016 被引量:1
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作者 Jiang Li He Li +7 位作者 Hongmei Zeng Rongshou Zheng Maomao Cao Dianqin Sun Siyi He Jiansong Ren Wanqing Chen Jie He 《Journal of the National Cancer Center》 2021年第3期101-107,共7页
Background:A population-based cancer screening program in rural China,targeting three types of cancer that are most prevalent in these areas,including esophageal,stomach,and liver cancer was awarded by the government ... Background:A population-based cancer screening program in rural China,targeting three types of cancer that are most prevalent in these areas,including esophageal,stomach,and liver cancer was awarded by the government in China since 2007.A two-step design with cancer risk assessment based on questionnaire interview and HBsAg test strip and subsequent clinical intervention for high-risk populations was adopted with free of charge at the local hospitals designated in the program.The participate rate including high-risk rates and screening rates was important to find appropriate strategies to improve the overall awareness of the program.Methods:Data from the cancer screening program between 2010 and 2016 were used to calculate higher rate(high-risk population/participants recruited)and screening rate(participants received screening/high-risk pop-ulation).Results:From 2010 to 2016,1,637,429 residents were recruited in the program and filled the questionnaires,350,646(21.4%)for esophagus cancer,273,715(16.7%)for stomach cancer and 1,013,068(61.9%)for liver can-cer.471,974 participants were assessed as high-risk population including 114,786(24.3%)high risk for esophagus cancer,161,809(34.3%)high risk for stomach cancer and 195,379(41.4%)high risk for liver cancer,respec-tively.249,185(52.8%)participants who were assessed as high risk received clinical screening.There were 64,710(26.0%)for esophagus cancer screening,71,365(28.6%)for stomach cancer screening and 113,110(45.4%)for liver cancer screening,respectively.Conclusion:Our findings will provide important references for designing effective population-based screening strategies to enhance the screening acceptance by health action plan in the future. 展开更多
关键词 high-risk Screening esophageal cancer Stomach cancer Liver cancer
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Incidence and mortality rate of esophageal cancer has decreased during past 40 years in Hebei Province,China 被引量:23
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作者 Yutong He Yan Wu +5 位作者 Guohui Song Yongwei Li Di Liang Jing Jin Denggui Wen Baoen Shan 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2015年第6期562-571,共10页
Background: Hebei province is located in North of China with of approximately 6% of whole national population. It is known as a high-risk area for esophageal cancer in China and worldwide. The aim of our study was to... Background: Hebei province is located in North of China with of approximately 6% of whole national population. It is known as a high-risk area for esophageal cancer in China and worldwide. The aim of our study was to estimate the esophageal cancer burden and trend in Hebei Province. Methods: Eight cancer registries in Hebei Province submitted cancer registry data to the Hebei Provincial Cancer Registry Center. All data were qualified and compiled for cancer statistics in 2011. The pooled data were stratified by gender and age group (0, 1-4, 5-9, 10-14...80+). Incidence and mortality rates were age-standardized to World Segi's population standard and expressed per 100,000 persons. In addition, proportions and cumulative incidence/mortality rates for esophageal cancer were calculated. Esophageal cancer mortality data during the periods 1973-1975, 1990-1992, and 2004-2005 were extracted from the national death surveys. Mortality and incidence rate data from Cixian and Shexian were obtained from population-based cancer registries in each county. Results: The estimated number of newly diagnosed esophageal cancer cases and deaths in 2011 in Hebei Province was 24,318 and 18,226, respectively. The crude incidence rate of esophageal cancer was 33.37/100,000 (males, 42.18/100,000 and females, 24.31/100,000). The age-standardized rate by world standard population (ASRW) was 28.09/100,000, ranking third among all cancers. The esophageal cancer mortality rate was 25.01/100,000 (males, 31.40/100,000 and females, 18.45/100,000), ranking third in deaths among all cancers. The mortality rates of esophageal cancer displayed a significant decreasing trend in Hebei Province from 1973-1975 (ASRW =48.69/100,000) to 2004-2005 (ASRW =28.02/100,000), with a decreased rate of 42.45%. In Cixian, the incidence of esophageal cancer decreased from 250.76/100,000 to 106.74/100,000 in males and from 153.86/100,000 to 75.41/100,000 in females, with annual percentage changes (APC) of 2.13 and 2.16, while the mortality rates declined with an APC of 2.46 for males and 3.10 for females from 1988 to 2011. In Shexian, the incidence rate decreased from 116.90/100,000 to 74.12/100,000 in males and from 46.98/100,000 to 40.64/100,000 in females, while the mortality rates declined, with an APC of 4.89 in males from 2003 to 2011. Conclusions: Although the incidence and mortality rates of esophageal cancer remain high, an obvious decreasing trend has been observed in Hebei Province, as well as in high-risk regions, such as Cixian and Shexian, over the past 40 years. 展开更多
关键词 cancer registry esophageal cancer high-risk areas INCIDENCE mortality rate
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Long-term results of paclitaxel plus cisplatin with concurrent radiotherapy for loco-regional esophageal squamous cell carcinoma 被引量:15
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作者 Han-Ting Zhu Da-Shan Ai +10 位作者 Hua-Rong Tang Harun Badakhshi Jian-Hong Fan Jia-Ying Deng Jun-Hua Zhang Yun Chen Zhen Zhang Yi Xia Xiao-Mao Guo Guo-Liang Jiang Kuai-Le Zhao 《World Journal of Gastroenterology》 SCIE CAS 2017年第3期540-546,共7页
AIM To evaluate the long-term effectiveness and late toxicities of paclitaxel(PTX) plus cisplatin(DDP) with concurrent radiotherapy for locally advanced esophageal squamous cancer.METHODS Between 2008 and 2011, 76 pat... AIM To evaluate the long-term effectiveness and late toxicities of paclitaxel(PTX) plus cisplatin(DDP) with concurrent radiotherapy for locally advanced esophageal squamous cancer.METHODS Between 2008 and 2011, 76 patients were enrolled in a phase Ⅱ study on the treatment of loco-regionally advanced esophageal cancer with radiotherapy(68.4 Gy/44 fractions or 61.2 Gy/34 fractions) combined with 4-cycle chemotherapy consisting of DDP(25 mg/m^2 per day for 3 d) and PTX(175 mg/m^2 for 3 h). The primary endpoints were overall survival and progression-free survival, and the secondary endpoints were toxicity and the treatment failure pattern.RESULTS A total of 76 patients were enrolled in this study, of whom 63.2% finished the whole regimen. The 5-year survival rates for the per-protocol population and intent-to-treat population were 25.4% and 26.4%, respectively, and the median survival rates were 23.7 mo and 28.5 mo, respectively. Grade 3 or 4 late toxicity was observed in only one patient(heart failure). In log-rank analysis, the pretreatment stage(stage Ⅱ + Ⅲ: 36.1 mo vs stage Ⅳ: 14.9 mo) and the completed cycle(1-3 cycles: 16.1 mo vs 4 cycles: 35.5 mo) were significant prognostic factors(P = 0.037 < 0.05 and P = 0.013 < 0.05).CONCLUSION Radiotherapy combined with chemotherapy consisting of PTX and DDP is a safe and effective definitive treatment for loco-regionally advanced esophageal squamous cancer. 展开更多
关键词 CHEMORADIOTHERAPY Long-term result Loco-regionally advanced esophageal cancer Phase trial
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Argon plasma coagulation for superficial esophageal squamous-cell carcinoma in high-risk patients 被引量:5
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作者 Kumiko Tahara Satoshi Tanabe +8 位作者 Kenji Ishido Katsuhiko Higuchi Tohru Sasaki Chikatoshi Katada Mizutomo Azuma Kento Nakatani Akira Naruke Myungchul Kim Wasaburo Koizumi 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第38期5412-5417,共6页
AIM: To evaluate the usefulness and safety of argon plasma coagulation (APC) for superficial esophageal squamous-cell carcinoma (SESC) in high-risk patients. METHODS: We studied 17 patients (15 men and 2 women, 21 les... AIM: To evaluate the usefulness and safety of argon plasma coagulation (APC) for superficial esophageal squamous-cell carcinoma (SESC) in high-risk patients. METHODS: We studied 17 patients (15 men and 2 women, 21 lesions) with SESC in whom endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and open surgery were contraindicated from March 1999 through February 2009. None of the patients could tolerate prolonged EMR/ESD or open surgery because of severe concomitant disease (e.g., liver cirrhosis, cerebral infarction, or ischemic heart disease) or scar formation after EMR/ESD and chemoradiotherapy. After conventional endoscopy, an iodine stain was sprayed on the esophageal mucosa to determine the lesion margins. The lesion was then ablated by APC. We retrospectively studied the treatment time, number of APC sessions per site, complications, presence or absence of recurrence, and time to recurrence.RESULTS: The median duration of follow-up was 36 mo (range: 6-120 mo). All of the tumors were macroscopically classified as superficial and slightly depressed type (0-Ⅱc). The preoperative depth of invasion was clinical T1a (mucosal cancer) for 19 lesions and clinical T1b (submucosal cancer) for 2. The median treatment time was 15 min (range: 10-36 min). The median number of treatment sessions per site was 2 (range: 1-4). The median hospital stay was 14 d (range: 5-68 d). Among the 17 patients (21 lesions), 2 (9.5%) had recurrence and underwent additional APC with no subsequent evidence of recurrence. There were no treatment-related complications, such as bleeding or perforation. CONCLUSION: APC is considered to be safe and effective for the management of SESC that cannot be resected endoscopically because of underlying disease, as well as for the control of recurrence after EMR and local recurrence after chemoradiotherapy. 展开更多
关键词 Argon plasma coagulation Superficial esophageal cancer Squamous-cell carcinoma high-risk patient Endoscopic therapy
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高原地区低剂量食管癌根治性放疗后放射性肺炎影响因素分析
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作者 赵冬梅 王丽 +3 位作者 柏晗 卢飞 李岚 夏耀雄 《食管疾病》 2024年第2期102-106,共5页
目的基于纵向队列分析高原地区低剂量食管癌根治性放疗后放射性肺炎(radiation pneumonia,RP)发生的影响因素。方法回顾性分析2020年7月至2023年6月在云南省肿瘤医院放疗科进行根治性放疗的172例食管癌患者资料,按照美国国立癌症研究所... 目的基于纵向队列分析高原地区低剂量食管癌根治性放疗后放射性肺炎(radiation pneumonia,RP)发生的影响因素。方法回顾性分析2020年7月至2023年6月在云南省肿瘤医院放疗科进行根治性放疗的172例食管癌患者资料,按照美国国立癌症研究所常见不良反应术语评定标准5.0版(CTCAE 5.0)进行放射性肺炎的评级,分别收集临床因素、传统独立剂量学特征和剂量区间变化特征。对用于预测是否发生症状性放射性肺炎的特征进行相关性分析,使用结构聚类法进行特征筛选,使用逻辑回归(logisitc regression,LR)进行多因素分析,并用Python进行可视化展示。结果全组172例患者发生RP 81例(47.09%),其中1级53例(30.8%),2级13例(7.5%),3级12例(6.9%),4级3例(1.7%);123例(71.51%)患者接受≤50.4 Gy的低剂量照射;多因素分析显示体力评分(performance Status,PS),间质性肺炎(interstitial pneumonia,IP),处方剂量(plan_dose)是放射性肺炎发生的独立预后因素。结论低剂量背景下高原地区食管癌根治性放疗是安全的,对体力评分较差及既往合并间质性肺炎的患者应谨慎决定放疗剂量。 展开更多
关键词 高原地区 食管癌 放射治疗 剂量学、放射性肺炎
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食管癌地域性差异研究进展
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作者 陈瑜 蔡文科 +2 位作者 罗小迪 贺永能 涂东 《肿瘤防治研究》 CAS 2024年第6期488-494,共7页
食管癌是一种常见的消化道恶性肿瘤,显著的地域性差异是食管癌临床流行病学突出特征之一,主要表现在发病率、发病类型、发病年龄和基因突变等方面,这些差异可能与人们的饮食习惯、生活方式、环境因素等有关。近年来关于食管癌地域性差... 食管癌是一种常见的消化道恶性肿瘤,显著的地域性差异是食管癌临床流行病学突出特征之一,主要表现在发病率、发病类型、发病年龄和基因突变等方面,这些差异可能与人们的饮食习惯、生活方式、环境因素等有关。近年来关于食管癌地域性差异的研究逐渐深入,因此,本文将对食管癌在不同地域,包括亚洲(中国、印度、日本等)、欧洲、美洲(美国)、非洲等的发病率、发病类型、基因突变、表观遗传学、风险因素、预后等差异进行概述,帮助医生和公共卫生专家更好地了解食管癌的风险因素和病因,进而制定更加有效的预防和治疗策略,减少食管癌的发生和死亡率。 展开更多
关键词 食管癌 地域差异性 发病率 基因突变 风险因素
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Associations between cancer family history and esophageal cancer and precancerous lesions in high-risk areas of China 被引量:5
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作者 Jiachen Zhou Kexin Sun +6 位作者 Shaoming Wang Ru Chen Minjuan Li Jianhua Gu Zhiyuan Fan Guihua Zhuang Wenqiang Wei 《Chinese Medical Journal》 SCIE CAS CSCD 2022年第7期813-819,共7页
Background:Family clustering of esophageal cancer(EC)has been found in high-risk areas of China.However,the relationships between cancer family history and esophageal cancer and precancerous lesions(ECPL)have not been... Background:Family clustering of esophageal cancer(EC)has been found in high-risk areas of China.However,the relationships between cancer family history and esophageal cancer and precancerous lesions(ECPL)have not been comprehensively reported in recent years.This study aimed to provide evidence for identification of high-risk populations.Methods:This study was conducted in five high-risk areas in China from 2017 to 2019,based on the National Cohort of Esophageal Cancer.The permanent residents aged 40 to 69 years were examined by endoscopy,and pathological examination was performed for suspicious lesions.Information on demographic characteristics,environmental factors,and cancer family history was collected.Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL.Results:Among 33,008 participants,6143(18.61%)reported positive family history of EC.The proportion of positive family history varied significantly among high-risk areas.After adjusting for risk factors,participants with a family history of positive cancer,gastric and esophageal cancer or EC had 1.49-fold(95%confidence interval[CI]:1.36-1.62),1.52-fold(95%CI:1.38-1.67),or 1.66-fold(95%CI:1.50-1.84)higher risks of ECPL,respectively.Participants with single or multiple first-degree relatives(FDR)of positive EC history had 1.65-fold(95%CI:1.47-1.84)or 1.93-fold(95%CI:1.46-2.54)higher risks of ECPL.Participants with FDRs who developed EC before 35,45,and 50 years of age had 4.05-fold(95%CI:1.30-12.65),2.11-fold(95%CI:1.37-3.25),and 1.91-fold(95%CI:1.44-2.54)higher risks of ECPL,respectively.Conclusions:Participants with positive family history of EC had significantly higher risk of ECPL.This risk increased with the number of EC positive FDRs and EC family history of early onset.Distinctive genetic risk factors of the population in high-risk areas of China require further investigation.Trial registration:ChiCTR-EOC-17010553. 展开更多
关键词 esophageal cancer Family history high-risk area Cross-sectional study
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岑溪地区食管癌高危因素与食管病变的相关性研究
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作者 覃勇军 陈洪永 玉晓锋 《智慧健康》 2023年第15期41-45,共5页
目的回顾性研究岑溪地区食管癌发病高危因素及食管病变相关性特征。方法以2020年7月-2022年11月于本院行健康检查者共5000名为研究对象行回顾性临床研究,以受试者食管癌发病与否分组,分为食管癌组(n=207)、无食管癌组(n=4793)。以问卷... 目的回顾性研究岑溪地区食管癌发病高危因素及食管病变相关性特征。方法以2020年7月-2022年11月于本院行健康检查者共5000名为研究对象行回顾性临床研究,以受试者食管癌发病与否分组,分为食管癌组(n=207)、无食管癌组(n=4793)。以问卷调查形式收集受试者一般资料,饮食习惯、生活习惯等信息,分析岑溪地区食管癌高危因素类型,食管原发病变与食管癌发病相关性。结果①确诊食管癌者男性占比、农村居住占比,吸烟、酗酒者占比,合并慢性食管炎、幽门螺杆菌感染及其他类型消化系统疾病者占比均高于无食管癌者,差异有统计学意义(P<0.05);②食管癌患者辛辣食物、生食、腌制食物经常食用占比,快速进食占比,吸烟>20支/日者占比及饮酒≥1次/日者占比均高于无食管癌者,水果、蔬菜经常食用占比(14.98%、17.87%)低于无食管癌者,差异有统计学意义(P<0.05);③经Logistics回归性分析后可知,性别、居住地区、吸烟、酗酒,合并慢性食管炎、幽门螺杆菌感染,经常食用辛辣食物、生食、腌制食品与食管癌发病呈正相关性,食用水果、蔬菜与食管癌发病呈负相关性,差异有统计学意义(P<0.05)。结论性别,不良饮食习惯、吸烟、酗酒,幽门螺杆菌感染及慢性食管炎均是导致岑溪地区人口食管癌发病的主要风险因素类型,需结合当地气候环境、饮食文化及生活习惯开展相关医疗卫生干预,以实现对食管癌发生风险的控制。 展开更多
关键词 岑溪地区 食管癌 高危因素 食管病变
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食管癌高发区贲门癌、胃癌流行强度分析及其对内镜筛查的启示 被引量:34
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作者 张立玮 温登瑰 +10 位作者 王士杰 李英赛 于卫芳 王晓玲 王俊和 李素平 李永伟 王顺平 尔立绵 丛庆文 马彩芬 《肿瘤防治研究》 CAS CSCD 北大核心 2005年第12期792-795,共4页
目的分析涉县等食管癌高发区贲门癌、胃癌的流行强度,明确其防治任务,探讨具体控制途径。方法对比分析涉县、林县、磁县全人群肿瘤登记的食管癌、贲门癌、胃癌发病率与死亡率以及内镜筛查6233例40~69岁人群三种癌及癌前病变的检出率。... 目的分析涉县等食管癌高发区贲门癌、胃癌的流行强度,明确其防治任务,探讨具体控制途径。方法对比分析涉县、林县、磁县全人群肿瘤登记的食管癌、贲门癌、胃癌发病率与死亡率以及内镜筛查6233例40~69岁人群三种癌及癌前病变的检出率。结果太行山南麓食管癌高发区食管癌、贲门癌和胃癌发病率或死亡率的合计占到全身恶性肿瘤的70%~80%。涉县2000~2004年贲门癌发病率男女性分别为69.9/10万和41.5/10万,死亡率男女性分别为54.3/10万和33.2/10万。高发区运用内镜碘染色指导活检技术筛查,食管鳞状上皮癌前病变及早期癌的检出率高,但贲门和胃腺上皮癌前病变及早期癌的检出率相对较低。结论太行山南部食管癌高发区存在贲门癌和胃癌共同高发的现象,要想通过早诊早治从整体上降低该地区上消化道癌的死亡率,必须加强内镜对贲门和胃腺上皮癌前病变及早期癌检出的研究。 展开更多
关键词 食管癌高发区 贲门癌 胃癌 癌前病变 内镜筛查
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上消化道癌家族史发病年龄与食管鳞状上皮癌预后的研究 被引量:8
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作者 温登瑰 张立玮 +3 位作者 赵秀清 魏丽珍 张健慧 王士杰 《中国肿瘤临床》 CAS CSCD 北大核心 2006年第9期485-488,共4页
目的:研究经手术治疗的上消化道癌家族史阳性和阴性的食管鳞状上皮癌患者首发年龄及预后的差别。方法:运用t检验、Kaplan-Meier法和Cox比例风险模型的校正Wald检验分析比较了河北医科大学四院胸外科1985~1994年间手术治疗的上消化道癌... 目的:研究经手术治疗的上消化道癌家族史阳性和阴性的食管鳞状上皮癌患者首发年龄及预后的差别。方法:运用t检验、Kaplan-Meier法和Cox比例风险模型的校正Wald检验分析比较了河北医科大学四院胸外科1985~1994年间手术治疗的上消化道癌家族史阳性(n=495)和阴性(n=1297)的来自高发区的食管鳞状上皮癌两组之间发病年龄和生存曲线的差别,并研究了两组病例年龄与预后的关系。结果:发现尽管上消化道癌家族史阳性的食管鳞状上皮癌患者与阴性者相比发病年龄显著提前(51.9±8.3比53.4±8.3,P<0.00),但前者的生存曲线低于后者,该生存曲线的差别在50岁以上组和UICC0~Ⅰ期组经Cox模型的校正Wald检验达显著水平(50岁以上组家族史阳性和阴性者相比术后3、5、10年生存率分别为55.2比60.2、48.8比54.5、44.5比49.4,PWald=0.03;UICC0~Ⅰ期组家族史阳性和阴性者相比术后3、5、10年生存率分别为87.5比94.7、87.5比91.6、87.5比91.6,PWald=0.02);按家族史分层分析年龄与预后的关系发现:家族史阳性组中50岁以下者生存曲线显著高于50岁以上者(两者相比3、5、10年生存率分别为63.4比55.3、60.6比48.9、58.5比44.6,PWald=0.03);但家族史阴性组中50岁以下者与50岁以上者相比生存曲线无差别(二者相比3、5、10年生存率分别为62.3比60.2、54.6比54.5、50.9比49.4,PWald=0.67),尽管两者平均发病年龄相差14.4岁。结论:就来自高发区的食管鳞状细胞癌手术病例而言,上消化道癌家族史阳性者比阴性者发病年龄显著提前,但预后较差,提示遗传背景对食管癌的发生和预后都有一定影响。另外发现家族史阳性组中50岁以下者的预后好于50岁以上者,提示早期发现可能有助于改善家族史阳性患者的预后。 展开更多
关键词 食管鳞状细胞癌 上消化道癌家族史 发病年龄 预后 高发区
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三峡库区食管癌高死亡率区的土壤环境特征研究 被引量:4
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作者 黄成敏 何毓蓉 冯子道 《环境与健康杂志》 CAS CSCD 北大核心 2002年第1期32-34,共3页
目的探讨三峡库区食管癌高死亡率区的土壤环境特征。方法对比食管癌高、低死亡率区土壤类型、利用方式及土壤一般特性 ,尤其是在微量元素含量上的差异。结果食管癌高死亡率区土壤主要分布石灰性紫色土 ,土壤偏碱性 ,含钙高 ,土壤肥力低 ... 目的探讨三峡库区食管癌高死亡率区的土壤环境特征。方法对比食管癌高、低死亡率区土壤类型、利用方式及土壤一般特性 ,尤其是在微量元素含量上的差异。结果食管癌高死亡率区土壤主要分布石灰性紫色土 ,土壤偏碱性 ,含钙高 ,土壤肥力低 ;低死亡率区主要是水稻土 ,土壤偏酸性 ,含钙低 ,土壤肥力高。同时食管癌高死亡率区土壤中微量元素含量水平明显低于食管癌低死亡率区。 展开更多
关键词 土壤环境 食中 死亡率 三峡库区 土壤特征 肿瘤发生
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利用染色体区段混合BAC探针鉴定食管癌细胞中的染色体畸变 被引量:3
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作者 郝佳洁 王春丽 +5 位作者 顾文跃 程潇钰 张钰 徐昕 蔡岩 王明荣 《遗传》 CAS CSCD 北大核心 2014年第6期558-565,共8页
染色体畸变是恶性肿瘤细胞的重要遗传学特征,文章旨在应用BAC DNA克隆鉴定食管癌细胞中的染色体臂和染色体区段的畸变。针对染色体各区段选取5~10个1 Mb BAC DNA,分别混合制备成特定染色体区段的BAC DNA混合克隆,然后将染色体臂上覆盖... 染色体畸变是恶性肿瘤细胞的重要遗传学特征,文章旨在应用BAC DNA克隆鉴定食管癌细胞中的染色体臂和染色体区段的畸变。针对染色体各区段选取5~10个1 Mb BAC DNA,分别混合制备成特定染色体区段的BAC DNA混合克隆,然后将染色体臂上覆盖所有区段的上述混合克隆进一步混合制备成特定染色体臂BAC DNA混合克隆。利用简并寡核苷酸引物聚合酶链反应(Degenerate oligonucleotide primed PCR, DOP-PCR)标记染色体臂探针,利用切口平移法(Nick translation)标记染色体区段探针,并对食管癌细胞中期染色体进行荧光原位杂交(Fluorescence in situ hybridization, FISH)分析。正常人外周血淋巴细胞中期染色体FISH结果显示,上述方法标记的探针具有较高的特异性。进一步利用染色体臂混合探针,确定了多个食管癌细胞中的染色体重排所涉及的特定染色体臂;利用染色体区段混合探针,鉴定出KYSE140的t(1q;7q)衍生染色体中1q上的断点范围位于1q32-q41。文章成功建立了1 Mb BAC DNA混合克隆探针标记技术,并鉴定出多个食管癌细胞中的染色体臂和染色体区段畸变,不仅为利用 M-FISH 技术鉴定肿瘤细胞中的染色体畸变提供了更为准确的方法,而且还可能进一步将该法推广应用于恶性血液病的核型分析以及产前诊断。 展开更多
关键词 染色体畸变 BAC DNA 染色体臂和区段 荧光原位杂交 食管癌细胞
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食管癌高发区上消化道癌整体高发对病因及预防的启示 被引量:13
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作者 温登瑰 王士杰 《中国肿瘤临床》 CAS CSCD 北大核心 2008年第20期1150-1153,共4页
目的:探讨食管癌高发区食管癌和贲门癌集中高发对病因和预防的启示作用。方法:通过分析涉县、林州、阳城、磁县1988年1月至2002年12月年男女性食管、贲门、非贲门胃癌发病率的分布,揭示太行山南部食管癌高发区上消化道癌整体高发的特点... 目的:探讨食管癌高发区食管癌和贲门癌集中高发对病因和预防的启示作用。方法:通过分析涉县、林州、阳城、磁县1988年1月至2002年12月年男女性食管、贲门、非贲门胃癌发病率的分布,揭示太行山南部食管癌高发区上消化道癌整体高发的特点,然后根据既往移民研究的结果、亚硝胺类动物诱癌的特点以及表观遗传流行病学和生物进化论的原理,对该地域上消化道癌的病因形成假说,并探讨通过改良饮水进行病因学预防的重要性。结果:涉县、林州、阳城、磁县食管、贲门、非贲门胃癌三者发病率的合计均占全身恶性肿瘤的70%~80%。纯山区的涉县以贲门和非贲门的胃腺癌多见,占上消化道癌60%以上;而山区、丘陵、平原各1/3的磁县以食管鳞癌多见,占70%以上;林州和阳城大部分为山区,食管鳞癌和胃腺癌各占约50%。高发区这种上消化道癌的部位构成随地势变化的现象与亚硝胺类动物诱癌实验的结果相似,可能与不同地势下亚硝胺的种类或丰度的差别有关。亚硝胺可通过先天启动、后天积累、二次促癌,以片起源或多点起源的方式导致上消化道癌整体高发。结论:太行山南部食管癌高发区存在环境致癌因素,在该地域寻找能标定个体风险或早期事件的生物学指标是一个今后应致力研究的方向,但通过先期改良饮水等病因预防措施也许有助于更快地把超额的发病率降低到国外人群的水平。 展开更多
关键词 食管癌高发区 表观遗传流行病学 癌变 上消化道癌
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胸部上中段食管癌术后不均一靶区照射物理指标及临床反应观察 被引量:2
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作者 周锡垒 于长华 +4 位作者 潘鹏 韩济华 朱卫国 李涛 陶光洲 《现代肿瘤医学》 CAS 2016年第5期736-739,740,共5页
目的:总结胸部上中段食管癌术后不均一靶区照射的物理指标和近期放疗反应。方法:采用CMS治疗计划系统,对20例胸部上中段食管癌术后病理为T3/T4期和/或淋巴结阳性的患者,采用调强放射治疗。设定不同的淋巴引流区,对高危区给予63Gy/30次... 目的:总结胸部上中段食管癌术后不均一靶区照射的物理指标和近期放疗反应。方法:采用CMS治疗计划系统,对20例胸部上中段食管癌术后病理为T3/T4期和/或淋巴结阳性的患者,采用调强放射治疗。设定不同的淋巴引流区,对高危区给予63Gy/30次、中危区60Gy/30次、低危区54Gy/30次照射,设定临床公认的组织安全目标函数,研究该计划的可行性和近期反应。结果:Ⅰ、Ⅱ级放射性气管炎发生率为30%,Ⅰ、Ⅱ级放射性食管炎发生率为40%,Ⅲ级放射性食管炎发生率为5%,Ⅰ、Ⅱ级中性粒细胞减少发生率为70%,Ⅰ、Ⅱ级血小板减少发生率为10%,Ⅰ、Ⅱ级血红蛋白减少发生率为10%,恶心呕吐发生率为50%。肺V20在15.124.5Gy之间,均低于27Gy目标值;胃V40在10.119.9Gy之间,远低于40Gy目标值;脊髓在4244Gy之间,低于45Gy目标值;PTV1、PTV2、PTV3适形指数在0.9190.966之间,适形指数良好。结论:在提高高危区、中危区剂量的情况下,调强治疗患者可耐受。不均一靶区调强照射应用于食管癌术后预防性照射近期反应可耐受。是否提高远期生存率,有待进一步观察。 展开更多
关键词 食管癌 调强放射治疗 急性放射反应 非均一靶区
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染色体缩合调控子2对食管癌小鼠细胞增殖的影响及其机制研究 被引量:1
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作者 陈民彪 黄明芳 +1 位作者 廖绪强 蔡仁中 《中国现代医学杂志》 CAS 北大核心 2021年第24期19-24,共6页
目的探讨染色体缩合调控子2(RCC2)对食管癌小鼠细胞增殖的影响及其作用机制。方法提取食管癌小鼠食管组织及原代细胞,分组进行转染,采用CCK-8检测细胞增殖水平,RT-PCR和Western blotting检测RCC2、SOX2及增殖细胞核抗原(PCNA)、锌指蛋白... 目的探讨染色体缩合调控子2(RCC2)对食管癌小鼠细胞增殖的影响及其作用机制。方法提取食管癌小鼠食管组织及原代细胞,分组进行转染,采用CCK-8检测细胞增殖水平,RT-PCR和Western blotting检测RCC2、SOX2及增殖细胞核抗原(PCNA)、锌指蛋白(Snail)的表达,荧光素酶实验分析RCC2与SOX2的靶向关系。结果RCC2在食管癌组织中表达上调(P<0.05);过表达RCC2后食管癌小鼠细胞增殖水平升高,而抑制RCC2表达后细胞增殖水平降低(P<0.05);过表达RCC2后细胞中SOX2和SOX2靶基因PCNA、Snail相对表达量升高(P<0.05),而抑制RCC2表达后SOX2、PCNA、Snail相对表达量降低(P<0.05);荧光素酶实验结果显示RCC2与SOX2存在靶向调控关系。结论RCC2通过上调SOX2及其靶基因表达,提高食管癌小鼠细胞增殖能力,促进肿瘤细胞的发生、发展。 展开更多
关键词 食管癌 细胞增殖 染色体缩合调控子2 性别决定区Y框蛋白2 小鼠
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局部脑氧饱和度-脑电双频谱指数-目标导向血流动力学多模式对老年胸腔镜食管癌根治术患者术后谵妄的影响 被引量:16
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作者 薛华燕 石小龙 杜睿 《实用医院临床杂志》 2021年第6期129-132,共4页
目的观察局部脑氧饱和度(r SO2)-脑电双频谱指数(BIS)-目标导向血流动力学多模式对老年胸腔镜食管癌根治术患者术后谵妄的影响。方法纳入2019年1月至2021年3月我院行择期全麻下胸腔镜食管癌根治术的老年患者80例,采用随机数字表法分为... 目的观察局部脑氧饱和度(r SO2)-脑电双频谱指数(BIS)-目标导向血流动力学多模式对老年胸腔镜食管癌根治术患者术后谵妄的影响。方法纳入2019年1月至2021年3月我院行择期全麻下胸腔镜食管癌根治术的老年患者80例,采用随机数字表法分为观察组与对照组各40例。对照组实施常规麻醉监测管理,观察组实施基于r SO2-BIS目标导向血流动力学多模式麻醉管理。比较两组术中情况,术中各时间点血流动力学参数,术后3 d内谵妄发生情况,术后并发症发生情况及术后恢复情况。结果两组手术时间、术中失血量、术中补液量、丙泊酚用量、瑞芬太尼用量比较,差异均无统计学意义(P>0.05);两组入室后、诱导后、插管即刻、插管后3 min、术中1 h、手术结束时平均动脉压(MAP)、心率(HR)比较,差异均无统计学意义(P>0.05);观察组术后3 d内谵妄总发生率低于对照组(P<0.05);两组术后并发症总发生率比较,差异无统计学意义(P>0.05);观察组术毕至呼之睁眼时间、术后住院时间均短于对照组(P<0.05)。结论老年胸腔镜食管癌根治术中实施基于r SO_2-BIS目标导向血流动力学多模式麻醉管理预防术后谵妄的发生,且有利于患者术后恢复。 展开更多
关键词 局部脑氧饱和度 脑电双频谱指数 血流动力学多模式 老年 胸腔镜食管癌根治术 术后谵妄
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