COMBINED PRE.OPERATIVE IRRADIATION AND SURGERY lN ESOPHAGEAL CARCINOMA REPORT OF 408 CASES

The clinical data and evaluation of 408 selected patients with esophageal carcinoma treated by combined preoperative irradiation and surgery are reported. The majority of these patients had tumors of poor or questionable re- sectability as evaluated on clinical grounds be- fore treatment. The primary tumors were located in the upper and middle thirds of the esophagus in 79.9To and were yp-TNM Stages III and IV in 81.6%. In only 18.4To was the tumor found to have no extra-esophageal invasion or lymph node metastasis. Iri this group the resectability rate was 81.9To, operative mortality 3.4To and the 15- and 10-year survival rates were 31.6To and 21.9To. During the same time period 736 patients with tumors more distally located and of better resectability were treated by surgery alone. In 43.8'70 0f these the tumor was located in the lower third of the esophagus. The operative mortality was 3.0% and the 5-year survival rate 27.6To in this group. Comparison of the results of the 2 groups led to the conclusion that adjuvant preoperative irradiation used in the present series enhanced surgical results. Rationales and guidelines for application of combined therapy are also discussed.     

几种无机抗酸剂体外抗酸性能的测试及评价

目的:评价几种无机抗酸剂的体外抗酸性能。方法:采用动态制酸力实验—Rossett-Rice法。结果:得到了抗酸剂的pH-时间变化曲线。中国产和德国产的铝碳酸镁片、镁加铝混悬液、镁加铝片及铝镁加混悬液均起效迅速(2min左右),作用持久,超过1h。复方氢氧化铝片虽起效较慢(11min),但作用持久。复方铝酸铋片虽然起效时间短、作用时间长,但是pH值超过5。甘羟铝片、磷酸铝凝胶没能使pH值升至3。结论:大部分抗酸剂符合理想抗酸剂条件。     

RULE OF CARCINOGENETIC DEVELOPMENT OF GASTRIC CARDIA OBSERVED BY ENDOSCOPY

Objective： To study the rule of development of early cancer of gastric cardiac in vivo. Methods： A prospective cohort was held in the high incidence area of cancer of esophagus and stomach in china. One hundred and six persons were examined regularly by endoscopy to observe the change of pro-cancer lesions of gastric cardiac by taking biopsy specimen. All specimens were diagnosed through normal pathological process. Results： The 106 subjects were examined twice in 1998 and 2002. Of 8 normal persons, 3 stayed normal, 4 turned to chronic gastritis, 1 developed early gastric cardiac cancer. Of 61 persons with chronic gastritis, 11 were observed to have gland atrophy, 4 with mild atypical hyperplasia, and 2 with highly atypical hyperplasia. Of 9 subjects showing atrophic chronic gastritis, 5 revealed no change, and 4 became chronic gastritis. Of 22 subjects who revealed mild atypical hyperplasia, 17 resolved, 4 showed no change, and 1 advanced to highly atypical hyperplasia. One person with highly atypical hyperplasia reverted to mild atypical hyperplasia. Of 5 subjects with early gastric cardiac cancer without any treatment, 1 became advanced cancer, 1 still stayed in early cancer stage, 3 turned to atypical hyperplasia. Conclusion： 1. The development of early cancer of gastric cardia would proceed through the stages of chronic gastritis, gland atrophy, and atypical hyperplasia. 2. The early cancer and pre-cancer lesions of gastric cardia is reversible, though possessing malignant possibility.     

食管癌高危人群的预防与控制研究进展

食管癌是人类常见的消化道恶性肿瘤 ,位于全球肿瘤发病的第八位 ,肿瘤死亡的第四位。全世界每年约有 48万 (1 996 )人发生食管癌 ,占总癌新发生病例的 4.6 %;死亡 45 .6万人 ,占总癌死亡病例的6 .4%。食管癌主要流行地区是不发达国家 ,我国是食管癌高发地区 ,食管癌位居肿瘤死亡的第四位。世界年龄调整死亡率中国最高 ,男性 2 7.73 /1 0万 ,女性 1 3 .6 3 /1 0万 ,合计 2 0 .40 /1 0万。食管癌受累地区遍及大江南北十余个省市 ,覆盖人口近两亿 ,高发区人口大约为九千万 ,严重威胁着人民的生命和健康。研究表明 ,食管癌的发生发展是一个多因…     

贲门不同位点癌前病变情况调查

目的：寻找与贲门癌发生相关的癌前病变。方法：通过对我国食管癌高发区河北省涉县 186例受检者的内镜普查,在贲门区不同位点（贲门脊根部－内镜下 12°点位和对侧－内镜下 6°点位）取活检,进行病理学检查。对比研究我国食管癌高发区河北省涉县居民贲门区粘膜的不同位点上贲门癌发生的差异和癌前病变的差异。进行分组χ 2检验, P< 0.05有显著差异。结果：检出贲门癌 11例。 10例发生在贲门脊根部－内镜下 12°点位占 90.9％, 1例发生在对侧－内镜下 6°点位占 9.01％。贲门区粘膜的不同位点上癌前病变的类型相同,都可为慢性浅表性胃炎、慢性胃炎、慢性活动性胃炎和慢性萎缩性胃炎以及肠化、萎缩和不典型增生;但慢性活动性胃炎在 12°点位检出率明显高于 6°点位, P< 0.05,与贲门癌的检出位点相一致。结论：我国食管癌高发区居民贲门区粘膜的不同位点上癌及癌前病变存在差异;慢性活动性胃炎可能与贲门癌的发生有密切关系。     

我国食管癌高发区居民贲门癌前 病变情况的调查

在食管癌高发区,贲门癌的发生率较高。据流行病学调查,我国食管癌高发区,贲门癌的发病率约为 50/10万,食管癌∶贲门癌约为 6 ∶ 4[1]。研究贲门癌前病变,对探索贲门癌在体内发生发展的规律具有重要意义。本研究调查分析了我国食管癌贲门癌高发区河北省涉县 [2]当地居民的贲门区粘膜的癌前病变情况,现将结果报告如下。 1 对象与方法 对象为我国食管癌高发区河北省涉县偏店、固新两乡当地居民,经舌诊法初筛,选出青紫舌者 201例,年龄 35～ 65岁,中位年龄 55岁。男 122人,女 79人。对 201人进行上消化道内镜检查,在食管胃交界线下方 2～ 3 cm长的管状贲门区粘膜取活检,活检组织迅速经中性福尔马林液固定,常规脱水,石蜡包埋,切片, HE染色,进行病理学诊断。病理诊断参照全国慢性胃炎研讨会共识意见的慢性胃炎病理诊断标准和分类标准 [3]。     

抗酸药研究进展

综述了传统抗酸剂与一类铝镁复合物新型抗酸剂。指出新型抗酸剂具有温和、持久的抗酸性能 ,在消化溃疡的治疗中疗效确切 ,不良反应小 ,是一种值得研究开发的新型抗酸药     

碘染色在食管癌高发区直接内镜普查中的应用和效果

目的 研究碘染色在食管癌高发区直接内镜普查中的应用和效果以及对比碘染色前后癌和异型增生的发现率。方法 在高发现场对3022例40—69岁人群进行内镜检查，观察并记录食管黏膜颜色、形态和黏膜下血管纹理，碘染色后再观察其颜色变化，并行组织括检。结果 经活检组织学诊断，并发现食管癌131例，中度和重度异型增生659例。碘染色前后发现食管癌分别为57例、111例，发现中度和重度异型增生154例、505例。统计学上差异有显著性意义。结论 内镜检查中碘染色可明显提高浅表食管癌和异型增生的发现率。     

巨食管症合并胃底巨大平滑肌瘤食道裂孔疝一例

患者女,26岁。1988年4月4日入院。10年前开始出现渐进性吞咽困难,间歇发作,进流质时偶有呕吐。近四年来进食后心悸不适,一年前出现呕血和柏油样便。本次以大量呕血,来院就诊。检查:T37℃,BP14/9 kPa,轻度贫血,表浅淋巴结不肿大,气管居中,心肺听诊阴性,腹部检查未见异常。胸部X线及食道吞钡检查见:纵隔阴影增宽,内有积液,约占     

食管癌的组织发生学研究

食管癌的组织发生学研究刘复生，杨谷晨，王国清，薛新华，果红（中国医学科学院，中国协和医科大学，北京肿瘤研究所，１０００２１）采用连续切片、［３Ｈ］ｄＴｈｄ自显影、显微分光光度计、核仁组成区技术以及ｄｉｅｔｈｙｉｎｉｔｒｏｓａｎ：ｎｅ动物诱癌试验等，研...