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1.
13248例食管癌和贲门癌外科治疗   总被引:10,自引:0,他引:10  
周福有  韩孝存 《中国肿瘤》2003,12(5):256-257
[目的]总结食管癌和贲门癌外科治疗经验。[方法]回顾性分析安阳市肿瘤医院胸外科1976年~2001年13248例食管癌和贲门癌手术治疗资料。[结果]食管癌和贲门癌手术切除率分别为94.8%和93.1%,总切除率94.3%。食管癌和贲门癌手术死亡率分别为1.7%和1.0%,总手术死亡率1.5%、食管癌术后5年、10年生存率分别为31.6%和10.3%,贲门癌术后5年、10年生存率分别为18.5%和5.0%,总5年、10年生存率分别为26.9%和8.4%。[结沦](1)食管癌和贲门癌的手术适应证逐渐扩大,手术切除率不断提高,术后死亡率明显降低。(2)对食管癌应扩大切除范围,对胸上、中段食管癌应采用右侧剖胸切除,以提高长期生存率。(3)提高食管癌和贲门癌的早期诊断率是食管癌临床工作的重点之一。  相似文献   

2.
河南省林州市1985~2002年食管癌发病死亡趋势分析   总被引:4,自引:5,他引:4  
[目的]分析林州市1985-2002年食管癌流行特征及变化趋势,为林州市肿瘤预防提供科学依据。[方法]对1985~2002年食管癌发病、死亡资料进行分析,计算粗发病率、粗死亡率、中国标化发病率、死亡率等,并分不同年段进行了比较。[结果]1985~2002年男女性食管癌粗发病率分别为89.39/10万和71.12/10万。男女性食管癌粗死亡率分别为78.09/10万和59.98/10万。1998-2002年与1985~1988年低年龄组(20~39岁)发病率比较男性下降幅度66.40%,女性下降幅度75.56%。高年龄组(75岁以上)男性下降幅度59.40%,女性下降幅度42.52%。[结论]食管癌总体发病率处于下降趋势。不同年段和各年龄组比较都有下降趋势。  相似文献   

3.
依据林县食管癌发病、死亡登记资料,对1959~1990年间26582例食管癌患者的生存率进行了分析。结果表明14514例男性食管癌患者1、3、5、10、20年的观察生存率分别为百分之37.65、9.71、5.55、2.12和0.19;12068例女性患者同时期的观察生存率分别为百分之39.84、10.96、2.58和0.21。男女食管癌患者5年相对生存率则分别为6.88%和7.69%,说明食管癌患者的生存情况很差,应进一步加强防治研究工作。  相似文献   

4.
[目的]探讨在高发区高危人群中发现早期癌及癌前病变的有效途径。[方法]林州市“食管癌早诊早治示范基地”依据中国癌症基金会对基地高危人群筛查方案.2005~2007年在林州市合涧镇的目标人群中按照顺应性70%的要求,对8432例40~69岁的6048例人群进行了内镜+食管碘染色+指示性活检和贲门脊根部活检。[结果]发现癌症患者100例,其中食管癌38例,贲门癌54例,胃癌7例,下咽癌1例.其中早期癌83例.检出率1.65%;癌前病变(高级别上皮内瘤变)148例,检出率2.45%。[结论]提高高危人群对癌症的认知度,推广食管碘染色和贲门脊根部常规活检技术.是提高食管贲门癌早期发现的关键。  相似文献   

5.
刘志才  连士勇 《中国肿瘤》1999,8(9):403-404
目前,外科治疗仍然是食管、责门癌的主要治疗手段。在河南省林州市,每年经外科治疗的食管、贵门癌病人大约有2000余例,其中林州病人占l/4,外地(主要来源于周边省市,如山东、山西、河北、湖北。安徽及河南省其它市县)病人占3/4。我院1988年一1998年10余年间共收治食管、贲门癌患者3867例,其中食管癌2708例,贲门癌1159例,术后并发症的发生率为6%(233/3867),手术切除死亡率为0.78%(30/3867),5年生存率为33.7%,其中早期食管癌的5年生存率在叨%以上。本文就笔者在食管癌高发区对食管癌外科治疗中几个方面的体会作一探…  相似文献   

6.
[目的]探讨紫杉醇联合顺铂同步放化疗治疗术后食管癌的临床疗效。[方法]2000年10月~2007年10月.52例根治术后的Ⅱ~Ⅲ期食管癌患者均接受紫杉醇联合顺铂化疗同步放疗.放疗剂量:50Gy/25F,5周。[结果]28例(54%)患者发生了Ⅲ/Ⅳ级放化疗毒副反应,主要为白细胞下降/中性粒细胞减少、血小板减少和放射性食管炎。中位生存时间为37.2个月,1、3年生存率分别为82.19%、47.13%。2年局控率、无远处转移生存率和无进展生存率分别为60.01%、71.38%和42.01%。[结论]同步放化疗治疗Ⅱ~Ⅲ期术后食管癌患者可行,毒副反应可耐受。  相似文献   

7.
中国食管癌胃癌高发区贲门癌流行趋势分析   总被引:1,自引:3,他引:1  
陈万青  张思维  陈志峰 《中国肿瘤》2008,17(12):998-1000
[目的]探讨食管癌胃癌高发区中贲门癌的发病特征。[方法]对中国30个肿瘤登记处1988~2002年的胃癌发病登记资料进行分析。[结果]全国30个登记处中,江苏扬中,山东临朐和广西扶绥因没有亚部位编码,只分析其它27个登记处的胃癌资料。27个市(县)胃癌新发病例58584例,其中贲门癌12609例,贲门癌占胃癌的21.52%。27个市(县)中食管癌和胃癌高发的有8个.其贲门癌占全部胃癌的39.43%.而其它非高发地区为13-30%。在资料较为完整的食管癌高发区中,磁县的胃癌发病率15年间无显著变化.但贲门癌发病率有升高趋势:而林州的胃癌和贲门癌发病率变化趋势均不明显。而城市地区中的天津、北京,胃癌发病率呈下降趋势,其中天津的贲门癌发病率显著下降。[结论]食管癌和胃癌高发区中贲门癌在胃癌中所占比例明显高于其它地区,其中食管癌高发区尤为突出。食管癌高发区和城市地区比较,贲门癌发病的流行趋势显著不同.影响胃癌发病率。因此对贲门癌的防治应引起重视。  相似文献   

8.
食管癌和贲门癌2638例外科治疗分析   总被引:3,自引:0,他引:3  
陈景起  卢诗杰 《癌症》1991,10(2):125-127,131
1975至1988年外科治疗食管癌和贲门癌2638例,总切除率79.0%,其中食管癌切除率84.4%(1362/1613),贲门癌切除率70.3%(721/1025)。术后六项主要并发症发生率12.3%,其中吻合口瘘率4.1%。总手术死亡率2.1%,切除死亡率2.5%。切除术后5年及10年生存率分别为食管癌22.4%和15.1%,贲门癌15.3%和13.8%。分析表明影响术后5年生存率主要因素为临床病理分期。本文并对切除率,手术并发症及防治措施,提高远期生存率方面进行讨论。  相似文献   

9.
实验改水对林州市食管癌发病率和死亡率的影响   总被引:5,自引:1,他引:5  
[目的]探讨实验改水对林州市食管癌发病率、死亡率的影响。[方法]对2001-2003年林州市15个乡867126人,将调查村按照改水类型分为:实验改水村:①深机井、井深≥100米、集中供水:②污染指数小于1.5;③改水〉16年;非实验改水村:未能完全达到上述3条标准者;调查分析食管癌发病率和死亡率的变化。[结果]1959-2003年林州市食管癌发病率和死亡率呈现由相对偏低,逐渐升高.然后下降的趋势。2001~2003年实验改水村与1971~1973年比较,发病率下降34.02%,死亡率下降44.76%,下降具有显著性意义。2001~2003年非实验改水村与1971~1973年比较,发病率下降1.7%,死亡率下降5.2%,无统计学意义。[结论]实验改水降低林州市食管癌发病率和死亡率。应加强饮用水管理,改水、改厕、改善环境卫生、防止浊漳河水、渠水的渗漏,保护水源是预防食管癌的重要措施之一。  相似文献   

10.
扬中市主要恶性肿瘤发病率及生存率分析   总被引:9,自引:1,他引:9  
[目的]探讨扬中市主要恶性肿瘤发病流行情况及生存率状况。[方法]对1991~2004年恶性肿瘤发病报告系统资料整理,随访全部病例用EXCEL录入、SPSS软件进行分析。[结果]1991~2004年间扬中市新发恶性肿瘤病人13707例,年均粗发病率为355.71/10万,世界标化率为301.03/10万。发病前5位依次为胃癌、食管癌、肝癌、肺癌和肠癌。前5位恶性肿瘤中.除肝癌、肺癌外,男性主要恶性肿瘤生存率均高于女性。生存率较高的是肠癌、食管癌、胃癌.5年生存率分别为45.19%、33.85%、32.31%;肺癌、肝癌的生存率相对较低,5年生存率分别为19.81%、12.11%。[结论]扬中市恶性肿瘤发病率呈高发状态并呈下降趋势。扬中市主要恶性肿瘤的5年、10年生存率总体并不高,均在30%左右。除肝癌、肺癌外,男性主要恶性肿瘤生存率均高于女性。  相似文献   

11.
三阴性乳腺癌与基底细胞样乳腺癌临床病理分析   总被引:1,自引:1,他引:0  
目的研究CK5/6、CK14在三阴性乳腺癌(triple negativebreast carcinoma,TNBC)中的表达情况,并探讨基底细胞样乳腺癌(basal—like breast carcinoma,BLBC)与TNBC的关系。方法利用免疫组化方法从浸润性乳腺癌中筛选TNBC病例,然后利用CK5/6和CK14从TNBC中筛选出BLBC的病例,分析两者的临床与病理资料及免疫组化表达情况并复习有关文献。结果TNBC的发病率占浸润性乳腺癌的16.1%。TNBC中的CK5/6和CK14表达有正相关性(γ=0.463)。应用CK5/6、CK14从TNBC中筛选出的BLBC的百分率为54%。结论BLBC与TNBC有大部分交叉。CK5/6和CK14可以用来从TNBC中筛选出大部分的BLBC的病例。BLBC相对其他类型乳腺癌,预后不良,有必要将其从TNBC中鉴别出来。  相似文献   

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13.
Parathyroid carcinoma is a rare endocrine malignancy. The reported incidence is from 0.5 to 5% of primary hyperparathyroidism cases in various series. The cause is unknown, but clinical correlations with different genetic syndromes exist. Mutations in the HPRT2 gene seem to play a significant role in the pathogenesis of this disease. Men and women are equally affected, usually in the fourth or fifth decade of life. Most patients will present with signs and symptoms of hypercalcaemia. Cases of non-functioning carcinoma are exceedingly rare. Surgical resection is the most effective method of treatment and palliation. A significant proportion of patients will experience recurrence, and will need further surgical and, eventually, medical management of hypercalcaemia. The disease is progressive but slow growing. Most patients will require multiple operations to resect recurrent disease. The main cause of morbidity and mortality is the sequela of uncontrolled chronic hypercalcaemia rather than tumour burden. The current paper will review the epidemiology, pathogenesis, clinical presentation and diagnostic work-up of this disease. Surgical management in different scenarios is reviewed in detail, followed by other types of treatment and management of incurable disease.  相似文献   

14.
Carcinoma Penis     
Between 1954 and 1984, 102 cases of carcinoma of the penis were seen at the Peter MacCallum Cancer Institute. Their mean age was 62.5 years. Nearly twice as many patients were referred in the last decade as in the first, and this observation may be linked to the reduction in numbers of neonatal circumcisions in the last forty years. The material reported is selected by referral patterns of recurrence following surgery elsewhere or the patient's preference for conservative management. As a result the overall survival figures have little meaning. However it is apparent that where possible and where acceptable, partial surgical amputation is more likely to achieve local cure and to be less disturbing for patients with invasive disease. Radiotherapy can be effective in controlling superficial primaries and may be curative in early, or rarely in late, stage nodal disease. Prevention by circumcision in infancy is still the best policy.  相似文献   

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17.
Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world. Most patients still present late in the course of the disease so that curative therapy is rarely possible. Strategies developed to improve the prognosis include primary prevention, directed at the underlying liver diseases, secondary prevention by cancer surveillance and early intervention, and more effective therapies. Only childhood vaccination against hepatitis B (HBV) infection has been clearly documented to reduce the incidence of HCC. Eradication of the hepatitis B and C viruses by interferon in noncirrhotic patients may reduce the incidence of HCC. Removal of iron by phlebotomy in noncirrhotic patients with genetic hemochromatosis will largely prevent HCC. Many physicians offer secondary prevention by surveillance and early intervention involving repeated abdominal ultrasound and serial serum α-fetoprotein estimations in order to identify early malignant lesions, but such strategies have yet to be proven to reduce mortality from HCC. Nonetheless, early detection would seem to offer a greater chance for application of potentially curative therapy. Different surveillance strategies may be necessary in different patient groups. For example, in chronic hepatitis C the increased risk of HCC seems to be confined to patients with established cirrhosis, whereas even noncirrhotic patients with HBV have a substantially increased risk of HCC. In high-risk patients, such as those with cirrhosis following chronic viral hepatitis, several factors can be identified which appear to confer additional risk. Examples are hepatocyte dysplasia found on biopsy, or non-neoplastic vascular nodules on computed tomography scanning. The management of such patients needs urgent resolution. Potentially curative treatment options include resection, liver transplantation, and alcohol injection or radiofrequency ablation. Resection in ideal candidates may provide up to 60% survival at 5 years. Liver transplantation may result in a 5-year survival of up to 70%. However, the shortage of organ donors means that tumor progression while on the waiting list will disqualify some patients, while others will die before an organ becomes available. Local ablation has been reported to be as effective as resection and is applicable to a larger proportion of patients. Of the palliative forms of therapy only chemoembolization has been shown to provide a significant improvement in life-span, although other forms of adjuvant and palliative therapy are under investigation.  相似文献   

18.
目的:分析子宫内膜癌淋巴结转移模式并比较子宫内膜癌与宫颈癌淋巴结转移分布的不同.方法:回顾性分析接受系统的盆腔和腹主动脉旁淋巴结切除的104例子宫内膜癌以及253例宫颈癌患者淋巴结转移情况,比较二者的不同.结果:与宫颈癌相比,子宫内膜癌淋巴结转移率较高(22.1%vs 16.2%),并且子宫内膜癌的淋巴结转移与病理分级(G_1:12.1%;G_2:21.4%;G_3:34.5%)、肌层浸润深度(≤1/2:11.9%>1/2:29%)有关;子宫内膜癌单纯盆腔淋巴结转移率偏低(34.8% vs 68.3%),单纯腹腔淋巴结转移率偏高(4.3%vs 0),盆腹淋巴结共同受累的发生率偏高(60.9%vs 31.7%).宫颈癌中腹主动脉旁淋巴结转移的患者100%有盆腔淋巴结转移,而内膜癌93.3%的腹主动脉旁淋巴结阳性的患者有盆腔淋巴结转移.内膜癌与宫颈癌最易受累淋巴结均为闭孔淋巴结(内膜癌:73.9%、宫颈癌:70.7%),受累最少的均为腹股沟淋巴结(内膜癌:8.7%、宫颈癌:7.3%),与宫颈癌相比,子宫内膜癌腹主动脉旁淋巴结(65.2%vs 31.7%)、骶前淋巴结(21.7%vs 17.1%)的受累几率较高,而髂外淋巴结受累的几率偏低(17.4%vs 41.5%).结论:子宫内膜癌淋巴结转移方式不同于宫颈癌,虽然内膜癌主要向盆腔淋巴结转移,但是仍然存在直接向腹主动脉旁淋巴结转移的病例并且各病理分级的内膜癌均有淋巴结转移的可能.  相似文献   

19.
IntroductionIn this study we aim to compare clinicopathological characteristics and cancer specific survival between patients treated with radical cystectomy for pure squamous cell carcinoma (SCC) and urothelial carcinoma with squamous differentiation (SqD).Patients and MethodsWe reviewed data of 1737 consecutive patients treated with radical cystectomy and urinary diversion between January 2004 and February 2014. Only patients with pure SCC or SqD were included in the analysis. Squamous differentiation was defined as intercellular bridges or keratinization in the tumor. Clinicopathological data and recurrence free survival (RFS) were compared between patients diagnosed with SCC and SqD.ResultsSCC and SqD were found in 318 and 223 patients, respectively. Mean age was 57 ± 8.3 years in SCC and 58.8 ± 7.8 in SqD (P = .008). A higher proportion of female patients was observed in SCC group compared to SqD (31.8% vs. 22% P < .0001). Patients with SqD were more likely to have extravesical (58.3% vs. 46.2%: P = .006) and nodal positive disease (34.5% vs. 14.5%: P < .0001) than pure SCC patients. Bilharzial eggs were found in 61% of SCC vs. 46% of SqD (P = .001).; The median (IQR) follow up period for SCC and SqD was 63 (12-112) months and 23 months (9-74.7), respectively. The 5-year RFS for SCC and SqD were 77% and 59.8 %, respectively (P < .0001).; Multivariate cox regression analysis identified advanced pT stage (OR: 1.9, 95% CI: 1.3-2.86, P = .0001), nodal positive disease (OR: 1.6, 95% CI: 1.1-2.48, P = .01) and SqD histology (OR: 1.6, 95% CI: 1.14-2.31, P = .007 as independent predictors of 5-year RFS.ConclusionPatient with SCC had significantly higher 5-year RFS in comparison to SqD. The higher rate of extravesical disease and lymph node metastasis in SqD patients is indicative of aggressive behavior of this histologic type.  相似文献   

20.

Purpose

Medullary breast carcinomas (MBC) have been known to represent a rare breast cancer subtype associated with a more favorable prognosis than invasive ductal carcinomas (IDC). The purpose of this study was to compare the clinicopathologic characteristics and outcomes of MBC with those of IDC.

Methods

We retrospectively reviewed medical records of patients with invasive breast cancer who were managed surgically from August 1995 to June 2010.

Results

Fifty-two patients were identified with MBC and 5,716 patients were identified with IDC. The clinicopathologic features, disease-free survival (DFS), and overall survival (OS) of patients with MBC were compared with those of patients with IDC. The MBC group presented at a younger age (p=0.005) and had a significant association with a higher histological grade (p=0.003) and nuclear grade (p<0.001) as well as negative estrogen receptor (p<0.001) and progesterone receptor (p<0.001) status. Lymphatic invasion was absent (p<0.001) and lymph node metastasis was rare (p<0.001). The DFS and OS did not differ significantly between the two groups (5-year DFS: 88.0% vs. 89.2%, p=0.920; 5-year OS: 93.4% vs. 94.4%, p=0.503). In multivariate analysis, the factors associated with DFS and OS were nuclear grade, histological grade, tumor size, lymph node metastasis, estrogen receptor status, progesterone receptor status, and human epidermal growth factor receptor 2 status, chemotherapy, and hormone therapy. However, DFS and OS were not significantly different between IDC and MBC according to histological type itself (DFS: hazard ratio 0.85, 95% confidence interval 0.12-6.05, p=0.866; OS: hazard ratio 1.49, 95% confidence interval 0.21-10.77, p=0.692).

Conclusion

Although MBC has specific clinicopathologic features, its prognosis does not differ from IDC and is determined by prognostic factors such as tumor size and lymph node metastasis. Therefore, patients with MBC also require the same intensive treatment provided for IDC.  相似文献   

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