河北省肿瘤防治现场的建设与发展

河北省4个肿瘤病发现场防治点，近10多年来的防治工作有了很大的进展。肿瘤防治人员常年坚持下乡普查普治，使我省宫颈癌的发病率和死亡率有大幅度下降。磁县和涉县食管癌防治点食管癌发病和死亡也有些下降的趋势。我国食管癌的病因流行病学、治疗、预历研究部处十国、社先水平、虽然防治现场工作成绩如此突出。但是也暴露了防治现场存在着一定的困难和差距、就我们从实践中获得的体会，今后要注意以下几点：一、加强党的领导是搞好现场建设的关键我省磁县、涉县食管癌防治点．赞皇胃癌防治点和赤城县宫颈癌防治点都证明，能够坚持下来，并…     

食管癌高发区上消化道恶性肿瘤死亡趋势分析

目的分析河北省食管癌高发区磁县、涉县29年（1974-2002年）上消化道恶性肿瘤的死亡情况,为肿瘤防治提供依据。方法对比分析磁县、涉县同时期20世纪70年代（1974-1976年）、90年代（1990-1992年）、21世纪初（2000-2002年）全人群肿瘤登记的食管癌、贲门癌、非贲门胃癌的死亡率。结果自20世纪70年代到21世纪初,磁县、涉县食管癌粗死率均呈现明显下降趋势,磁县食管癌粗死率下降了40.96/10万,下降了32.21%;而同时期涉县下降了65.74/10万,下降了50.06%。磁县贲门癌和非贲门胃癌的粗死率呈现曲线波动,变化不大,20世纪70年代贲门癌死亡占上消化道恶性肿瘤死亡的5.67%,到90年代占4.58%,21世纪初占8.15%。而涉县贲门癌呈现明显上升趋势,非贲门胃癌呈现明显下降趋势,发现贲门癌在上消化道恶性肿瘤死亡中所占比重越来越大,由20世纪70年代的6.28%上升到新世纪的30.17%。磁县、涉县人群中男性贲门癌的死亡率高于女性。磁县山区贲门癌死亡率高于丘陵和平原,年平均死亡率达到11.61/10万,且有上升趋势。结论29年来磁县、涉县食管癌死亡呈显著下降趋势,磁县贲门癌、非贲门胃癌死亡均呈曲线波动;涉县贲门癌死亡率呈明显上升趋势,非贲门胃癌死亡率呈下降趋势。     

磁县食管癌发病分析

[目的]总结1974年-1996年河北省磁县食管癌发病情况，进一步分析人群和地理分布特点；[方法]20世纪70年代初磁县肿瘤防治现场就建立了肿瘤登记系统。利用肿瘤三级防癌网进行肿瘤发病登记。[结果]1974年为142.80/10万，女性为95.18/10万，男女性比例为1.50:1。全人群年龄别发病率随年龄的增长而上升。地理分布方面，磁县山区，丘陵食管癌发病率有明显的下降趋势，平原食管癌发病率有上升趋势。[结论]磁县食管癌发病率呈下降趋势，其中山区下降显著，但全县仍处于高发水平。     

磁县1969～2000年食管癌死亡动态分析

目的本文总结河北省磁县1969～2000年食管癌死亡情况,分析食管癌死亡的时间、人群和地理分布特点.方法利用磁县肿瘤登记处食管癌死亡数据,按照国际疾病分类第9次修订版(ICD-9)进行恶性肿瘤3位数编码,使用EPI软件进行数据整理分析.结果1969～2000年磁县食管癌死亡率总体有下降趋势.趋势检验:x2=563.40,P＜0.001.男性年平均死亡率为129.21/10万,女性年平均死亡率为81.41/10万,男女性比例为1.61:1.全人群年龄别死亡率随年龄的增长而上升.地理分布方面,磁县山区、丘陵、平原食管癌死亡率总体有下降趋势.其中,山区、丘陵70年代、80年代平稳,90年代有下降趋势.平原70年代平稳,80年代上升,90年代下降.结论经过二十多年的食管癌防治工作,磁县食管癌死亡率呈现下降趋势,其中山区下降显著,但全县仍处于高死亡率水平.     

2011—2016年河北省肿瘤登记地区食管癌发病和死亡流行情况分析

目的 食管癌是最常见的消化道恶性肿瘤之一,河北省则位于食管癌的高发区。本研究旨在分析2011—2016年河北省食管癌最新的流行趋势和特征。方法 对河北省27个肿瘤登记处的食管癌发病和死亡资料进行统计分析。按城乡、性别和年龄组分析发病率和死亡率。采用中国2000年普查人口和Segi′s世界人口计算年龄标准化率。应用灰色模型对高发区磁县和涉县的死亡率进行预测。结果 2011—2016年,河北省共报告食管癌14 905例,死亡9 933例,粗发病率为21.73/10万,粗死亡率为14.48/10万。发病率和死亡率均呈男性高于女性,农村高于城市的特点。河北省食管癌发病率和死亡率有下降趋势(P＜0.001)。磁县、涉县高发区发病率和死亡率呈长期下降趋势,预测未来十年食管癌死亡率将继续下降。结论 河北省食管癌发病率和死亡率呈稳步下降趋势,但其疾病负担仍然较重。食管癌的一级预防、早发现、早治疗应更关注农村居民和男性人群。     

阳城县食管癌和宫颈癌两癌高发现象分析

[目的]探讨山西阳城县存在食管癌和宫颈癌同时集中高发的现象。[方法]通过对阳城县1998～2002年肿瘤登记资料的整理分析,计算阳城县男女性食管癌和女性宫颈癌的发病率,并与环太行山区其他三县（市）林州、磁县、涉县的同期资料进行比较分析。[结果]1998～2002年阳城县食管癌新发病例2266例,粗发病率115.09/10万。阳城、涉县、磁县、林州四县（市）男性食管癌中标率在74.5/10万～122.3/10万之间,占所有恶性肿瘤的31.0%～47.4%;女性食管癌中标率在51.8/10万～77.8/10万之间,占所有恶性肿瘤的29.2%～50.5%,食管癌仍然是威胁这些地区居民健康的主要恶性肿瘤之一。宫颈癌发病率阳城为66.5/10万、涉县9.7/10万、磁县3.0/10万、林州1.8/10万,阳城宫颈癌发病率明显高于其他三县（市）（χ2=142.49,P=0.000）。[结论]山西阳城县存在食管癌和宫颈癌同时集中高发的特点,现场应该实施综合性预防措施,该地区是否存在相同的致病原因和条件,尚需进一步探讨。     

省级肿瘤防办职能和任务的探讨

河北省卫生厅肿瘤防治研究办公室成立于1971年，当80年代全国肿瘤防办撤销以后。河北省肿瘤防办没有撤消而是继续开展工作。切多年来防办在河北省肿瘤防治研究工作中起了一定的推动作用。今年4月份省卫生厅决定慢性病归口防疫处，省肿瘤防办也归口防疫处领导。因此，防办的主要任务就由原来的防治试点研究转变为今后的全民防治工作。一、历史的回顾河北省肿瘤防办以往20多年在卫生厅科教处的领导下主要完成了以下几项任务。1．肿瘤防治试点的建设河北省卫生厅1叨3、1978年分别决定建立磁县、涉县食管癌防治点，19M年建立了赞皇县胃癌防治点…     

河北磁县居民十年恶性肿瘤发病资料分析

目的河北磁县是我国恶性肿瘤高发现场之一.本文分析了该县1988～1997年恶性肿瘤发病情况和特点,为今后的防治工作提供科学依据.方法发病资料取自磁县肿瘤登记处,采用ICD-9编码,全部发病资料录入微机,采用EPI软件进行统计分析.结果磁县1988～1997年恶性肿瘤新发病例12806例,其中男性7670例,女性5136例.男女性世界标化发病率分别为408.94/10万和234.69/10万.男性恶性肿瘤发病率较为稳定,女性呈波浪式下降,各年标化发病率均为男性高于女性.磁县十年中常见肿瘤前五位是:食管癌、胃癌、肺癌、肝癌、结直肠癌.男性食管癌发病率有下降趋势,胃癌则有上升趋势.女性胃癌、乳腺癌有上升趋势.除儿童期为白血病居第一位外,其余各年龄段均以食管癌居首位.结论危害磁县居民健康的肿瘤主要是消化系统肿瘤和肺癌.男性居民应作为主要的防治人群.     

河北省磁县食管癌早诊早治普查进展

磁县是食管高发区,是中国较早的食管癌防治研究现场之一,20世纪70年代建立肿瘤防治现场以来,积累了宝贵流行病学资料。食管癌的早诊早治普查经历了从细胞学拉网筛查到目前直接采用电子胃镜辅碘染色指示活检普查。磁县加快食管癌高发现场开发,积极开展食管癌早诊早治研究,规范食管癌早诊早治示范基地的建设、管理、考核、评价,以促进食管癌预防与控制工作健康发展。磁县2006年成立了"食管癌普查中心",旨在进一步推广食管癌早诊早治可持续发展,为降低磁县食管癌死亡率,提高居民生存率作出贡献。     

河北磁县1983～1997年恶性肿瘤死亡分析

目的分析1983～1997年磁县恶性肿瘤死亡情况.方法死亡资料来自磁县肿瘤登记处,采用ICD-9编码,EPI软件统计分析.结果1983～1997年,男性恶性肿瘤平均死亡率223.71/10万,女性142.69/10万.1983～1987年,男女恶性肿瘤死亡的前三位均是食管癌、胃癌和肺癌,分别占肿瘤死亡总数的84.1%和77.2%;1988～1997年男女死亡位次变化为食管癌,胃癌和肝癌;分别占肿瘤死亡总数的80.9%和75.2%.男性食管癌死亡率和中调率下降16.2%和20.8%,女性下降3.7%和10.3%,男性肝癌死亡率和中调率上升26.0%和22.9%,女性上升16.8%和15.0%;女性宫颈癌死亡率和中调率分别下降54.17%和56.47%,乳腺癌和直肠癌、结肠癌和肛门癌上升.结论食管癌和胃癌仍是磁县主要死亡的恶性肿瘤,但男女食管癌死亡率和中调率下降,上升最显著的是男女肝癌,下降最显著的是宫颈癌.     

Bacteria and cancer--antagonisms and benefits

There is considerable historical and recent evidence concerning the antagonisms between acute bacterial infections or their toxins and cancer and allied diseases. These data provide renewed incentives to undertake clinical programmes with mixed bacterial vaccines in many countries at the present time.     

VEGF及KDR在大肠腺瘤和腺癌中的表达及意义

目的：探讨VEGF和KDR在大肠腺瘤和大肠腺癌中的表达及临床病理特征的关系。方法：大肠腺瘤和大肠腺癌组织标本各100例,采用免疫组织化学染色法检测VEGF和KDR在标本中的表达情况。结果：VEGF和KDR在大肠腺癌组中的阳性表达明显高于大肠腺瘤组（P〈0.05）;在正常大肠黏膜均未见VEGF和KDR表达的阳性染色;VEGF阳性表达组中KDR的阳性表达率为70%,显著高于VEGF阴性表达组中KDR的阳性表达率16%,两组比较有统计学意义（P〈0.01）。结论：大肠腺癌组织中KDR的表达与肿瘤大小、转移情况、浸润深度密切相关;VEGF和KDR在大肠腺瘤中的表达与患者的年龄、性别及分型均无相关性,而与增生程度相关（P〈0.05）。在大肠腺癌患者中VEGF及KDR表达更高,二者具有协同效应。     

Religiosity and physical and emotional functioning among African American and White colorectal and lung cancer patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

Genetic polymorphisms of alcohol and aldehyde dehydrogenases and risk for esophageal and head and neck cancers

Alcoholic beverages are causally related to cancer of the oral cavity, pharynx, larynx and esophagus. Ethanol is oxidized to acetaldehyde and then to acetate by alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), both of which have genetic polymorphisms. A review of case-control studies of the effects of ALDH2, ADH2 and ADH3 genotypes shows consistently positive associations between inactive heterozygous ALDH2 and the less-active ADH2 genotypes and the risk for esophageal cancer in East Asian heavy drinkers and this enzyme-related vulnerability may extend to light-to-moderate drinkers. Some studies suggest similar associations with the risk for head and neck cancer in moderate-to-heavy-drinking Japanese. An established carcinogen in experimental animals, acetaldehyde can interact with human DNA. ALDH2-associated cancer susceptibility fits into a scenario in which acetaldehyde plays a critical role in the development of human cancer. Alcohol flushing and drinking behavior may partly explain this carcinogenic effect in carriers of less-active ADH2 genotypes. Whether the ADH3 genotype influences head and neck cancer risk in Western nations is controversial. Professional and public education about risky conditions connected to the ALDH2 and ADH2 genotypes and environmental factors is important in a new strategic approach to the prevention of alcohol-related cancers in East Asians. The use of simple tests to identify inactive ALDH2 on the basis of alcohol flushing responses could benefit many people, by helping them to identify their own cancer risks. Such testing could also help clinicians diagnose esophageal cancer earlier, through the use of endoscopic screening in the high-risk population.     

Religiosity and Physical and Emotional Functioning Among African American and White Colorectal and Lung Cancer Patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

New and emerging radiosensitizers and radioprotectors

The combination of chemotherapy and radiation has led to clinical breakthroughs in several disease sites, and current work continues to define optimum combinations of proven chemotherapy as well as more recently available, noncytotoxic agents. Administration of systemic therapies allows modulation of radiation response to improve tumor control (radiosensitization) or to prevent normal tissue toxicity (radioprotection). Substantial progress has been made in identifying the targets of standard chemotherapeutic radiation sensitizers and protectors as well as in the introduction of a new generation of molecularly targeted therapies in combination with radiation. We have reviewed the most recent, predominantly early phase clinical trials combining systemic agents with radiation. Although the proof of an improved schedule ultimately needs to come from well-run Phase III trials, the search among schedules could be shortened by the use of surrogate endpoints such as presence of active drug metabolites in the tumor. This has been accomplished only in a few cases and needs to become a more standard part of radiation sensitizer and protector trials.