部分城市居民健康预期寿命的初步分析

为评价居民的生存质量，利用我国居民死亡资料和国家卫生服务总调查的部分资料，借鉴Ｓｕｌｉｖａｎ方法的基本原理，对部分城市居民的健康预期寿命进行了分析。结果显示，居民健康预期寿命占期望寿命的比重男性大于女性，大城市小于中小城市；随着年龄的增加，此比重呈下降趋势。提示我国部分城市居民的生存质量随年龄的增加而下降，女性居民的生存质量比男性差，大城市居民的生存质量低于中小城市。     

某焦炉厂焦炉工肺癌的生存及预后

目的评价焦化工肺癌的疾病预后及其影响因子。方法分析70例焦炉工肺癌的年龄、暴露工龄、潜隐期、诊断年龄、治疗方法和生存时间,采用Kaplan-Meier法绘制生存曲线,Cox回归评价影响因子。结果 Cox回归评价显示患者的暴露工龄、潜隐期、发病年龄等因素对患者的生存期无影响,均P0.05,外科治疗病例的生存时间长于非外科治疗病例,中位数生存时间分别为885和181 d;Cox回归也提示外科治疗是肺癌预后的保护性因子。结论焦炉工的职业接触史与肺癌的预后无联系,肺叶切除或全肺切除术是焦炉工肺癌的首选治疗。     

呼吸系统疾病住院病例流行病学分析

目的 观察1996～2003年间呼吸系统疾病住院病例构成特点及其变化趋势。方法 采用回顾性调查方法，对同济医学院附属协和医院呼吸内科住院病例进行分析。结果 8年间慢性支气管炎所占比例逐步下降，其构成比由27．37％（1996年）降至15．02％（2003年），肺癌、肺炎、肺结核构成比分别从9．22％，11．55％，3.71％上升至13．88％。18．02％．6．66％。气胸、肺结核、结核性胸膜炎以〈40岁中青年为主，随年龄增长，该3种疾病的构成比逐步下降；慢性支气管炎在〉50岁中老年中明显上升；肺癌随年龄增长构成比缓慢增高。以60～69岁年龄段为最高。结论 1996～2003年间，住院病例的构成发生变化，逐步演变为以慢性支气管炎、肺癌、肺炎3种疾病共同为主；肺结核的构成比呈现上升趋势；疾病构成与年龄相关。     

肺癌病人5年生存率及生存因素分析

[目的]了解肺癌病人5年生存率及影响肺癌病人5年生存的因素。[方法]对19931996年到河北省职工医学院附属医院外科治疗的86例肺癌患者进行为期5年的随访观察，对10个可能影响肺癌生存的因素用Cox回归模型进行分析；使用寿命表分析肺癌病人的5年生存率。[结果]肿瘤偏大或虽不大但累及的周围组织、结构较多，有远端淋巴转移是影响肺癌病人5年生存的危险因素；对癌肿采取手术治疗、化疗，首发症状距就诊时间长是其保护因素；肺癌病人的1～5年生存率分别为76．77％、49．78％、33．57％、21．36％和14．24％，中位生存时间为23．9月。[结论]肿瘤的大小、治疗手段、淋巴转移和首发症状距就诊时间与肺癌的病人5年生存有关。     

低浓度甲苯对果蝇寿命的影响

目的：为观察甲苯对果蝇寿命的影响。方法：采用黑腹果蝇Ｏｒｅｐｏｎ／Ｃ品系，分别在培养管中以０ｍｇ／ｍ３，１００ｍｇ／ｍ３，３７５ｍｇ／ｍ３和１０００ｍｇ／ｍ３浓度甲苯染毒，观察果蝇生存情况。结果：随染毒浓度增大，雌雄两性果蝇均表现为平均生存时间（平均寿命）显著缩短。三个浓度组中，雄性果蝇分别减寿１２．９％，１５．４％和２２．７％；雌性果蝇分别减寿７．５％，１３．７和２６．６％，有明显的浓度－反应关系。从果蝇的生存曲线来看，随着观察时间的推移，可以观察到雌雄果蝇生存总数均逐渐下降，且随浓度增加，下降速度加快，生存曲线终止时间（最长寿命）提前。结论：可以认为在这些浓度下，甲苯可以缩短果蝇寿命，加速果蝇老龄化的速度。     

核工业职工全因死亡的动态分析

应用ＩＣＤ－９死因分类原则和流行病学调查方法，在核工业１１个代表性单位进行了全因死亡调查。结果表明：死亡有逐年增高趋势，并随年龄增长而增加；而平均死亡年龄，工龄均有逐年增高趋势。肿瘤死亡表现为逐年增高，其中肺癌死亡在７０年代中期开始增加，１９８５－１９９０年增加明显；肝癌，胃癌１９７５年呈增加趋势，但差异无显著性。     

1976-2006年盐城市30岁以上居民肺癌死亡变化趋势

目的了解1976-2006年江苏省盐城市30岁以上居民肺癌死亡变化情况，探讨其变化规律和发展趋势，为肺癌防治提供科学依据。方法收集盐城市死因监测点1976-2006年肺癌死亡资料，对肺癌死亡率进行性别、年龄、时间及出生队列分析。结果1976-2006年30岁以上居民合计因肺癌死亡4946例，年均死亡率为4926／10万。其中男性肺癌年均死亡率为68．77／10万，女性为29．61／10万，男性高于女性（P〈0．01）。1976-1980年肺癌年均死亡率为18．75／10万，标化率为17．75／10万；2006年死亡率为93．23／10万，标化率为96．64／10万。30岁以上人群肺癌死亡率随着年龄增加而明显上升，各年龄组肺癌死亡率比的95％CI均大于1。结论1976-2006年盐城市30岁以上居民肺癌死亡率呈逐年上升趋势，且随年龄增加而上升。     

肝癌年龄别发病(死亡)率曲线数学模型拟合的研究

目的：研究对肝癌发病死亡率实际数据的数学拟合模型，有助于指导肝癌预防实践工作。方法：选择香港、上海、天津等8个点的肝癌年龄别发病（死亡）率资料，采用改进的模型对这8处资料进行数学公式模拟，给出了各参数的值，拟合相关系数在0．72～0．99之间，拟合度在0．51～0．98之间。结果：发现年龄别发病（死亡）率曲线的极值即众数Ratemax值降低，则发病（死亡）率曲线高度下降；a值减小，则发病（死亡）率在小年龄时上升，反之则发病（死亡）率曲线右移至大年龄时上升；b值下降发病（死亡）率曲线左移往小年龄；c值下降发病（死亡）率曲线基点升高。结论：肝病预防要抓小，抓早。     

血浆凝血因子水平与肺癌患者临床分期、远端转移和早期诊断相关性的临床研究

目的探讨血浆凝血因子[纤维蛋白原(fibrnogen,FIB)、D-二聚体(D-dimer,D-D)、血小板(platelet,PLT)和同型半胱氨酸(homocyseeine,Hcy)]水平与肺癌患者临床分期、远端转移和早期诊断相关性的临床研究。方法测定了103例肺癌和103例良性肺部疾病患者血浆FIB、D-D、PLT和Hcy水平,并进行了肺癌病理特征、临床分期、远端转移和单一或联合指标检测的对比性研究。受试者工作曲线(ROC曲线)评估凝血因子对肺癌远端转移的诊断效能。结果 103例肺癌患者血浆FIB和PLT水平较之103例良性肺部疾病患者明显降低(P 0. 01);血浆D-D和Hcy明显增高(P 0. 01)。血浆凝血因子水平与临床分期和远端转移有关,而与性别、年龄和病理类型无关。ROC曲线评价FIB、D-D、PLT和Hcy肺癌远端转移时,曲线下面积(AUC)分别为0. 883、0. 686、0. 702和0. 917,灵敏度随单一和联合指标检测的增加而增高。结论血浆凝血因子水平与肺癌临床分期和远端转移有关,是评价肺癌远端转移和早期诊断的有价值指标。     

北京市传染性非典型肺炎病死率分析

目的 分析北京市传染性非典型肺炎不同人群、地区等病死率的变化，探讨相关问题。方法 对北京市传染性非典型肺炎疫情报告卡数据库中有关变量，结合卫生部公布的有关数据采用相对数计算等方法进行分析比较。结果 北京市共有传染性非典型肺炎患者2521例，死亡193例，病死率为7．656％；病死率随年龄增长呈上升趋势；随疾病流行过程进展，北京地区SARS病死率呈下降趋势；与全球其他地区相比，北京地区病死率处在较低水平。结论 随年龄的增加，传染性非典型肺炎患者死亡的概率也随之增大；北京地区SARS病死率下降趋势明显，病死率较低，表明北京在降低SARS病死率方面的工作取得一定效果。     

Clinical epidemiology of primary lung cancer in Tunisia. 100 cases

BACKGROUND: Lung cancer is frequent and its incidence is increasing inTunisia and in all over the world. Few published Tunisian studies have described epidemiology of lung cancer. AIM: To report the clinical features and outcomes of lung cancer in Tunisia from a retrospective review of 100 consecutive patients seen in F.S.I. hospital in La Marsa. METHODS: a retrospective study was carried out 100 cases of bronchial carcinoma seen in pulmonology department between 2000 and 2004. We analysed diagnosis modalities, histological subtypes, staging of the disease, treatment strategies and survival. Survival rates were calculated using Kaplan-Meier method. RESULTS: mean age was 59.5 years,sex-ratio at 19.92% of patients were smokers; the average of tobacco consumption was 48.5 PY. The diagnosis was histologically proven in 90% of the cases. Specimen were obtained by bronchoscopy (53.4% of cases), fine-needle lung biopsy (30%), metastasis biopsy (7.7%), surgical biopsy (7.7%) and more rarely by thoracoscopy (1.2%). Histologically, 39% were squamous carcinomas, 30% adenocarcinomas and 8.7% small cell carcinomas. 51% of non small cell lung carcinomas were stage IV, 26% stage IIIB, 9% stage IIIA and 14% were stage I or II. 6 of 10 patients with small cell carcinomas were with disseminated disease. 18 of 21 patients with resectable tumors receive surgery. Patients with locally advanced tumors received combined chemotherapy and radiotherapy. 14 of 46 stage IV patients received palliative chemotherapy. Survival rate was 18% at 2 years.     

Relationship between delayed diagnosis and the degree of invasion and survival in lung cancer

BACKGROUND AND OBJECTIVES: The aim of this study is to evaluate the relationship between the interval from first symptom to diagnosis (SDI) and the degree of invasion and survival in lung cancer. METHODS: Three hundred seventy-eight patients with lung cancer were included. SDI was defined as the time calculated from the cytohistologic confirmation of the diagnosis of cancer and the first symptoms noted by the patient and attributed to cancer by the physician. The degree of invasion was determined by TNM classification. RESULTS: The median SDI was 2.1 months, and did not correlate with stage. Survival decreased progressively according to TNM classification. Adjusting for age, sex, SDI and TNM, survival was influenced by age (RR=1.02) and by staging [Stage (Ib) RR=1.3; stage (IIIa) RR=2.6; stage (IIIb) RR=4.06; stage (IV) RR=7.5]. SDI was not found to affect survival (RR=1.01; 95% CI: 0.94-1.08). In the small cell group, SDI also failed to modify survival. CONCLUSIONS: The results of this study indicate that SDI has no effect on the stage or survival of patients with lung cancer.     

Trends in survival rates of cancer in Cuba

Reports of population-based survival rates of cancer from developing countries are infrequent. In Latin America, only the Cancer Registry of Puerto Rico has published population-based survival data. The National Cancer Registry of Cuba has achieved three survival studies with cases incident in 1976, 1982 and 1988–1989. This article deals with the global observed and relative survival rates estimated in the latter study. Survival time trends are analysed. In the period 1988–1989, 12,985 primary cancer cases were included from the most common cancer sites, with the exclusion of cancer in situ cases and 8900 cases reported by death certificate only (DCO) (35.8%). The vital status of cases was checked up to 31 December 1994 using a mixed follow-up system with the exclusion of 2900 cases lost to follow-up (11.2%). DCO proportions are shown for the major sites and compared to those of 1982. Observed survival rates were estimated by Kaplan–Meier method using the SPSS Statistical Software. The relative rates were estimated by the Hakulinen's Computer Program Package for Cancer Survival Studies (1988) using life tables from Cuban population. Statistical comparisons of survival curves by year of diagnosis were achieved by using the Log–Rank and Pearson statistic tests. Global results are shown by year of follow-up and a comparative analysis is done in time and with internationals values. Survival rates decreased in the period 1982/1988–1989 for colon, prostate and lung cancer. Prostate cancer shows a low five years relative survival rate when compared with the USA, but its observed rate is comparable with Puerto Rico's. Figures for mouth and lung cancer were comparable with the corresponding figures of the USA and Europe. Breast and cervix cancers rates are comparable with the European mean and the blacks in USA.     

Chest x ray screening for lung cancer at three British chromates plants from 1955 to 1989.

Chest x ray screening for lung cancer had been undertaken over a period of 34 years, initially at yearly intervals, then at eight-monthly intervals, on chromates workers at three plants in the United Kingdom. A review of the records of 229 employees who were diagnosed as having carcinoma of the lung during the screening programme was conducted. Survival data were available on 124 cases (123 now deceased) who constitute the study population. The cases were analysed by age and regularity of attendance for screening. The numbers detected by works x ray screening and by other means were determined with five and 10 year survival rates. A modest but predictable improvement in the five year survival of those who attended regularly for radiography was shown. Taking the total population of cases for whom screening was available, no significant improvement in five year survival was found.     

Chest x ray screening for lung cancer at three British chromates plants from 1955 to 1989.

Chest x ray screening for lung cancer had been undertaken over a period of 34 years, initially at yearly intervals, then at eight-monthly intervals, on chromates workers at three plants in the United Kingdom. A review of the records of 229 employees who were diagnosed as having carcinoma of the lung during the screening programme was conducted. Survival data were available on 124 cases (123 now deceased) who constitute the study population. The cases were analysed by age and regularity of attendance for screening. The numbers detected by works x ray screening and by other means were determined with five and 10 year survival rates. A modest but predictable improvement in the five year survival of those who attended regularly for radiography was shown. Taking the total population of cases for whom screening was available, no significant improvement in five year survival was found.     

某焦化厂焦炉工人肺癌的发病特征

目的分析某焦化厂近40年间焦炉工人肺癌的发病特征。方法收集、整理该焦化厂1970—2008年间焦炉工人肺癌的发病资料,利用SPSS18.0软件并对其发病年龄、潜伏期、生存期及病理特点等进行描述性分析。结果①67例焦炉工人肺癌病例主要分布于炉顶工段,占62.7%;其次为炉侧区,占26.9%;②发病平均年龄为61.4岁,大都集中在50～70岁;③焦炉工人肺癌的潜伏期平均为35a,生存期较短,1、3、5a生存率分别为48.6%、12.9%、8.6%;④病理类型以腺癌为主,占55%;其次为鳞癌,占41%。结论焦炉工人肺癌主要分布于炉顶工段,其潜伏期较长而生存期较短,腺癌占的比例较大。该焦化厂近年来肺癌发病人数增加较快,应当引起重视。     

Lung cancer in the Netherlands in the period 1989-1997: the epidemic is not over yet

OBJECTIVE: To describe and interpret changes in incidence, mortality and survival of lung cancer in the Netherlands in the period 1989-1997. DESIGN: Secondary data analysis. METHODS: Data on the incidence of lung cancer were collected from the Dutch Cancer Registration (1989-1997), on mortality from Statistics Netherlands (CBS; 1989-1994), on the incidence of lung cancer in other European countries from EUROCIM (1990-1994), on survival of Dutch lung cancer patients from the Comprehensive Cancer Centre Amsterdam (1988-1997) and the Comprehensive Cancer Centre South (1988-1992) and on survival of other European lung cancer patients from EUROCARE (1985-1989). Incidence rates were calculated per 100,000 person years and standardized by age according to the European population structure. Survival was calculated as the ratio of observed survival among the lung cancer patients and the expected survival of the general population. RESULTS: The incidence of lung cancer among men decreased from 109 to 93, whereas that among women increased from 18 to 23. The incidence of lung cancer among Dutch men was high in comparison to other European countries, whereas that among women was average. The trends in lung cancer incidence were probably related to the trends in past smoking behaviour. Mortality decreased among men from 106 to 91 and increased among women from 15 to 20. Survival was better for younger patients, a localised tumour, and better for squamous cell carcinoma or adenocarcinoma than for large-cell undifferentiated or small-cell carcinoma. The relative 5-year survival was 12%, the relative 1-year survival 39%; these were good in comparison with other European countries. CONCLUSION: The incidence and mortality of lung cancer among Dutch men decreased, but still in 1997 almost 20 men in the Netherlands died each day of lung cancer. Among women the end of the increase is not in sight and in 1997 over 5 women died each day of lung cancer.     

上海市徐汇区原发性肝癌患者随访队列生存分析

目的了解原发性肝癌患者发病及生存情况，为今后的筛查和干预工作提供依据。方法对上海市徐汇区2001--2004年新发的652名原发性肝癌患者队列随访资料进行分析，描述发病年龄分布，建立Cox比例风险模型，分析生存率的主要影响因素。结果原发性肝癌发病年龄构成呈双峰分布，第1个发病高峰在45—50岁，第2个发病高峰在70～75岁。652名患者中位生存时间为6．9个月。接受手术治疗的患者较未手术患者死亡风险降低（RR=O．3155，95％C1为0．2432-0．4093），手术患者5a累积生存率为40．90％，未手术患者5a累积生存率仅3．95％。性别、年龄、家族史等因素对生存率的影响无统计学意义（P〉0．05）。结论原发性肝癌的筛查和干预工作重点应放在高危人群发病年龄高峰之前，早发现并有手术指征的患者应尽量实施手术治疗，以提高患者生存率。     

Survival and prognostic factors of non small cell lung cancer: analytic review of 211 cases

Prognostic factors have a pivotal role in clinical oncology. They are helpful in the selection of treatment, provide insights into the disease process and the therapeutic response. The number of possibly useful prognostic factors in the lung cancer is large. This study attempts to observe the survival of non small cell lung cancer (NSCLC) and to find prognostic factors and other variables potentially associated with outcome of lung cancer. It's a retrospective study based on 211 patients with NSCLC. Median survival was 6 months with 95% confidence interval: [4.2 - 7.8]. Overall 3 and 5 year survival were respectively 8.3% and 5.2%. Various Prognostic factors have been identified through univariate (Kaplan-Meier) then multivariate (Cox) analyses. In addition to the clinical factors such as age, disease extent and performance status, other variables were found of significant prognostic value, like pretherapeutic leukocyte level. Survival was significantly improved with surgery, radiation and also with chemotherapy, mainly in advanced stage (IIIB and IV).