重庆市万州区结直肠癌死亡趋势分析

目的 GM(1,1)模型是建立在灰色系统理论之上,以时间序列为研究对象,去发现事物发展变化的、连续的和离散的未来时间序列,从而找出事物发展中蕴含的规律.本研究采用Matlab软件建立GM(1,1)数学模型对2005-2014年重庆市万州区结直肠癌死亡情况进行描述,并预测未来3年结直肠癌死亡率,为疾病防治提供参考依据.方法 收集万州区全部52个乡、镇和街道2005-2014年居民恶性肿瘤死亡登记资料,根据结直肠癌死亡数据建立结直肠癌死亡率GM(1,1)灰色模型,并预测2015-2017年本地区结直肠癌的死亡率.结果 计算出本区结直肠癌死亡率GM(1,1)模型为X(t)=exp[119.902e0.016(t-1)-117.958],整体拟合平均误差为5.17%,后验差比值C=0.34,小误差概率P=1,模型精度为Ⅰ级(优).预测结直肠癌死亡率2015年为10.44/10万,2016年为10.86/10万,2017年为11.30/10万.结论 预测模型达到"优"等级,预测未来3年的结直肠癌死亡率呈上升趋势.     

2017年珠海市某区恶性肿瘤发病与死亡分析

目的描述和分析2017年广东省珠海市恶性肿瘤的发病和死亡情况,为今后肿瘤防治工作提供科学依据。方法根据珠海市肿瘤登记处2017年登记的部分恶性肿瘤的发病及死亡资料,统计恶性肿瘤的发病及死亡情况,计算其发病率、死亡率、标准化率等相关指标。结果2017年,该地区新发肿瘤病例为178例,恶性肿瘤的粗发病率为278.30/10万,中国人口标化率(中标率)为183.71/10万,世界人口标化率(世标率)为181.68/10万,0~74岁累积发病率为21.81%,35~64岁世界人口截缩率为347.33/10万,男性恶性肿瘤的发病率高于女性;恶性肿瘤死亡病例113例,死亡率为176.67/10万,中标率为109.38/10万,世标率为107.05/10万,0~74岁累积死亡率为11.58%,35~64岁世界人口截缩调整死亡率为157.53/10万,男性的恶性肿瘤死亡率高于女性。恶性肿瘤年龄别发病率在﹤35岁处于较低水平,从35岁开始,恶性肿瘤的发病率随着年龄呈上升趋势,在80~84岁年龄组达到最高峰;恶性肿瘤年龄别死亡率在45~49岁年龄组迅速升高,在50~54岁年龄组有所回落;恶性肿瘤发病顺位前5位依次为肺癌、肝癌、结直肠癌、鼻咽癌、乳腺癌;恶性肿瘤死亡顺位前5位依次为肝癌、肺癌、结直肠癌、食管癌、胃癌和白血病。结论男性恶性肿瘤的发病率和死亡率相对较高。肺癌、肝癌、结直肠癌、鼻咽癌是肿瘤防治工作的重点癌种,同时需提高肿瘤登记工作的准确性。     

铜川市王益区自然人群结直肠癌筛查结果分析

目的:探索铜川市王益区自然人群结直肠癌的发病情况,并通过积极干预降低结直肠癌的发病率和死亡率.方法:于2013年3月启动铜川市王益区结直肠癌早诊早治筛查工作,采用危险因素量化评估问卷调查表调查结合大便隐血试验(FOBT)的初筛和结肠镜检查的复筛结合作为结直肠癌筛查方案.结果:在应参加筛查的48 254人中,实际参加问卷调查29 580人,顺应率为61.30％ (29 580/48 254);实际大便检查人数24 672人,顺应率为51.13％ (24 672/48 254).初筛确定结直肠癌高危人群5 842人,占筛查人数的19.75％(5 842/29 580).初筛确定结直肠癌高危人群5 842人中有4 214人进一步做电子肠镜检查,顺应率为72.13％(4 214/5 842),检出肠道病变825例,检出率为19.58％ (825/4 214).从性别分布情况分析:男性结直肠病变的检出率显著高于女性(x2=248.260,P=0.000);从年龄分布情况分析:各年龄组结直肠病变检出率相比,差异具有统计学意义(x2=120.625,P=0.000);从病理类型和部位分布情况分析:病理类型所占比重从大到小依次为息肉(50.42％)、管状腺瘤(32.36％)、绒毛状腺瘤(7.15％)、高级别瘤变(6.30％o)、结直肠癌(3.76％);直肠病变分布所占比重从大到小依次为乙状结肠(27.64％)、直肠(24.36％)、降结肠(11.88％)、升结肠(10.55％)、横结肠(9.21％)、肝曲(6.30％)、脾曲(5.21％)、回盲部(4.85％).结论:通过开展本次结直肠癌早诊早治筛查工作,有助于提高结直肠早期癌变的诊断率,同时也为本市癌症筛查工作的开展积累了经验.     

2013—2020年重庆市北碚区胃癌疾病负担变化趋势及预测

目的 了解2013—2020年重庆市北碚区胃癌疾病负担变化趋势,预测2021—2023年胃癌死亡率,为开展胃癌防治工作提供建议。方法 2013—2020年重庆市北碚区胃癌死亡资料来源于“中国疾病预防控制系统人口死亡信息登记管理系统”,计算死亡率、标化死亡率、早逝生命损失年(YLL)、早逝生命损失年(YLL)率、平均减寿年数(AYLL)和期望寿命损失年数(YLEL)等指标,采用指数平滑的非季节性模型预测死亡率。率的标化采用2010年全国普查人口结构。率的比较采用卡方检验。率的趋势分析采用年度变化百分比(APC),并对APC进行t检验。结果 2013—2020年重庆市北碚区胃癌的死亡率和标化死亡率分别由2013年的15.26/10万和11.81/10万下降到2020年的10.66/10万和6.75/10万,APC分别为-6.29%和-8.79%,变化趋势有统计学意义(t值分别为-3.098和-4.690,P＜0.05)。胃癌死亡率随年龄的增加而上升,50岁以下年龄组最低(0.74/10万~2.13/10万),80岁以上年龄组最高(76.21/10万~169.81/10万)。YLL率、AYLL和YLEL分别由2013年的3.63‰、23.77年和0.25年下降到2020年的2.31‰、21.66年和0.16年,APC分别为-7.60%、-1.39%和-7.32%,变化趋势有统计学意义(t值分别为-3.211、-2.308和-4.930,P＜0.05)。指数平滑的简单非季节性模型为最优预测模型,预测2021—2023年胃癌死亡率均为10.66/10万。结论 北碚区胃癌死亡率呈下降趋势,胃癌早死造成的疾病负担较过去有所下降,但疾病负担仍较重,宜继续巩固胃癌的综合防控。     

Clinicopathological analysis for recurrence of stage Ib gastric cancer (according to the second English edition of the Japanese classification of gastric carcinoma)

Background  

The prognosis for patients with stage Ib (second English edition of the Japanese classification of gastric carcinoma) gastric cancer is promising, with an expected 5-year survival of 90%. Despite this relatively high survival rate, the outcome for patients who experience recurrence is poor. To date, however, prognostic and recurrence factors for stage Ib gastric cancer are poorly understood, and appropriate adjuvant chemotherapy protocols have not been developed.     

新型冠状病毒病(COVID-19)疫情期间四川省地市级医院肿瘤患者诊治情况调查分析

目的 调查2019新型冠状病毒病(COVID-19)疫情期间四川省各地市级医院肿瘤患者的诊治情况,分析疫情对肿瘤患者住院和治疗的影响,为不同省份的医疗机构开展肿瘤患者的诊治提供参考。方法 对四川省地市级医院通过问卷表的形式进行调查。采用描述性统计方法分析疫情期间四川省地市级医院肿瘤科患者的诊治情况。结果 调查了四川省37家地市级大中型医院,其中三级甲等医院占78.4%。在调查医院中,疫情一级响应后,肿瘤科患者住院指数和放疗指数<1的医院占比分别为83.7%和93.1%。化疗正常进行或推迟时间≤1周的医院占54.1%,放疗在春节假期后正常进行或延迟时间≤1周的医院占89.7%。疫情二级响应后,肿瘤科患者和放疗患者较一级响应后上升的医院占比分别为78.4%和79.3%。结论 在国务院、四川省委省政府、四川省卫健委、各地市级卫健委的指导下,各医疗机构和肿瘤科临床一线医护人员的共同努力下,COVID-19疫情期间大部分肿瘤患者在四川省各地市级医院得到积极有效的治疗。     

Urgent problems of prostatic cancer diagnosis in a small district clinic

Diagnostic methods in prostatic pathology used in a surgical department of a small town of Pavlovo (Nizhny Novgorod Region) are analysed. Infrared spectroscopy was for the first time used in Pavlovo for diagnosis of cancer. Examination of 57 patients aged 38-89 years has detected prostatic cancer in 16 (28 +/- 5.9%) patients, chronic prostatitis in 6 (10.5 +/- 4%) patients, prostatic adenoma in 34 (59.6 +/- 6.4%) patients, prostatic abscess--in 1 (1.9 +/- 1.7%) patient. Infrared spectroscopy of the blood serum according to the proposed technique provides accurate (91.2 +/- 4.8%, p < 0.01) differential diagnosis of benign and malignant diseases of the prostate.     

What doctors tell patients with breast cancer about diagnosis and treatment: findings from a study in general hospitals. GIVIO (Interdisciplinary Group for Cancer Care Evaluation) Italy.

In a study aimed at assessing whether and how patients with breast cancer are informed on their diagnosis and treatment a large group of physicians participating in a quality of care evaluation program were asked to report what they told patients about diagnosis and treatment. The completeness of such communication was then assessed using an explicit protocol designed to measure precision and lack of ambiguity of reported phrases. By this measure 39% patients received ''thorough'' information on diagnosis and 11% ''detailed'' information on surgery. These proportions become 48% and 14%, respectively, when only cases for whom answers were available are considered. Physicians, however, considered this communication ''thorough'' for 69% of patients. Among patient-related characteristics, age, education and stage of disease were independent predictors of quality of information. Setting-dependent features more than individual provider attitudes seemed to account for at least part of the quality of information sharing behaviour as both hospital size (comparing centres larger than 500 beds and smaller ones) and degree of hospital organization (comparing centres adhering to the Italian Breast Cancer Task Force, FONCaM and those not) were - simultaneously - significant predictors of quality of communication, independently from patients'' case-mix. Physicians'' judgement - measured assuming the explicit protocol as standard - proved to be of acceptable sensitivity only when information was ''Thorough'' by the protocol. However, its specificity and predictive values were consistently low in all three categories defined by the protocol, leading to high misclassification rates. The implications of these findings for studies aimed at assessing the quality of patients-providers communication are discussed.     

The diagnosis of renal cell cancer in relation to hypertension (United States)

Objectives: Renal cell cancer has been associated with hypertension or with drugs to treat it in several studies. We assessed whether the association is explained by more frequent detection of early renal cell cancer among persons being treated for hypertension.Methods: The data were collected in our Case-Control Surveillance Study, in which patients aged 20 to 69 years were interviewed in hospitals in Baltimore, Boston, New York, and Philadelphia during 1976-1996. We compared 134 incident cases of renal cell cancer who were being treated with drugs for hypertension to 193 untreated cases with respect to the route to diagnosis and the stage.Results: The relative risk estimate for having been diagnosed incidentally during a routine examination or workup for another condition, relative to having been diagnosed because of symptoms of renal cell cancer, was 1.3 (95 percent confidence interval, 0.7-2.5). The estimate for diagnosis at stage I or II relative to stage III or IV was 1.2 (0.7-2.1).Conclusion: In Case-Control Surveillance Study data, the relative risk estimate for renal cancer among users of various classes of antihypertensive drugs is 1.8 or 1.9. The present results suggest that this association can, at most, be explained only partially by the selective diagnosis of renal cell cancer among persons being treated for hypertension.     

石家庄市肺癌患者生存分析

目的:了解石家庄市肺癌患者生存情况。方法:对石家庄市2015年确诊的肺癌患者随访至2020年12月31日,运用寿命表法计算生存率和中位生存期,用对数秩检验(log－rank test)检验差别,采用Cox回归模型进行多因素分析。结果:纳入分析的肺癌患者1 537例,平均年龄（66.80±11.46）岁,中位生存期为15.60个月,1年、3年、5年生存率分别为55.05%、38.25%、27.39%。不同性别、区域、年龄、TNM分级、组织学类型的肺癌患者5年生存率差异有统计学意义,5年生存率男性(21.99%)、农村（12.23%）、小细胞癌（13.49%）低于女性（31.99%）、城市（33.68%）和腺癌（40.06%）,且随着年龄和TNM分级的增加而逐渐降低。Cox模型显示性别、区域、组织学类型、TNM分级是肺癌生存的独立影响因素,其中组织学类型和TNM分级对生存影响较大。结论:肺癌预后差,不同区域,不同人群需建立有差异的干预筛查机制,早预防、早筛查、早诊断、早治疗,有助于延长肺癌患者生存时间。     

Alpha-fetoprotein (AFP) variant in the diagnosis of small liver cancer

From May 1983 to June 1986, 40 patients with primary liver cancer, less than 5 cm in diameter, were treated by operation. The smallest lesion was 1.4 x 0.9 x 0.4 cm in size. Fifteen patients came to the hospital for treatment due to the finding of AFP greater than or equal to 31 ng/ml by public survey and 8 with space occupying lesion (SOL) in the liver by ultrasonography (US). The serum AFP levels ranged from 0 to 6800 ng/ml in this group with AFP negative in 6 cases, 31-400 ng/ml in 19 and over 400 ng/ml in 15. The positive rate of AFP was 37.5%. US displayed SOL in 25 cases, suspicious SOL in 5 and negative in 10. The positive rate was 62.5% by US. The overall positive rate was 77.5% by AFP and US combined. In addition, AFP variant was determined by LCA affino-crossed-immunoelectrophoresis autoradiography. LCA-nonreactive-AFP varied from 0 to 100% with a mean value of 57.0 +/- 26.7%. Taking less than 75% as diagnostic criterion for liver cancer, the positive rate of LCA-nonreactive-AFP was 65.0%. 12 patients who were AFP variant positive but SOL suspicious or negative were regularly followed by US for 1-20 months. They all showed distinct SOL. Composite results of AFP, AFP variant and US gave a diagnostic rate of 97.5% for small liver cancer. The determination of AFP variant is helpful in early detection of small liver cancer.