子宫内膜癌误诊2例分析

子宫内膜癌误诊２例分析周素玲，商顺明例１：子宫内膜癌（局限性）诊刮术后全部刮掉张某，５１岁，农民，孕３产３。于１９９４年５月２５日入院。患者绝经１年，血性白带２个月，时多时少，取宫颈活检为子宫颈慢性炎症伴鳞状上皮化生，诊刮官腔深６．５ｃｍ，病理报告“...     

低位直肠癌保肛术30例疗效评估

低位直肠癌保肛术３０例与同期Ｍｉｌｅ＇ｓ术６１例比较，两组获随访率达１００％，均辅以１～１．５年化疗，部分Ｄｕｋｅ＇ｓＣ期患者予以放疗。保肛组２年生存２５例（８３．３％），５年生存２０例（６６．７％）；Ｍｉｌｅ＇ｓ组２年生存５２例（８５．２％），５年生存４０例（６５．６％），两组２年、５年生存率比较差异均无显著性（Ｐ＞０．０５），由于严格掌握保肛指征和规范操作，提高了患者的生活质量。     

肺结节病误诊分析

１一般资料本文４例，男性１例，女性３例；年龄５４～６１岁，平均５３．７。２症状和体征咳嗽４例，均为干咳少痰；气短轻度１例，重度３例，心悸２例，自汗２例，盗汗２例，疲乏无力３例，消瘦２例，白内障２例，视物模糊２例，心率大于１００次／分２例，其中均有偶发室性或房性早搏，四肢发作性麻木１例。３误诊疾病从出现临床症状至确诊时间最长者６年，最短者１．５年，平均５．７年。误诊为慢性纤维空洞型肺结核３例次，支气管肺癌２例次，肺间质纤维化２例次，冠心病１例次。４X线胸片及胸部CT影像（１）肺门阴影呈不规则肿大，…     

小儿结核病误诊8例分析

小儿结核病误诊８例分析杭州市拱墅区人民医院龙啸云，徐筱萍现就１９８６年～１９９３年临床误诊小儿结核病（肺结核６例，结核性脑膜炎２例）作一回顾性分析，探讨其诊断延误的原因，总结经验教训，以提高诊疗水平。１临床资料１．１一般资料：男性５例，女性３例；年龄...     

冠状动脉旁路移植术术与疗效观察

总结了５７例冠状动脉架桥手术治疗的体会。术前均经冠状动脉造影检查证实，采用自体大隐静脉和（或）左乳内动脉作移植血管。结果：死亡２例（３．５％），术后随访３～５年，心绞痛消失率为９１．２％，心功能改善至１级５３例；２组２例。表明冠状动脉旁路移植术能有效地改善心肌缺血，对解除心绞痛，提高痛员生活质量有明显效果。     

蚕豆病6例误诊报告

蚕豆病６例误诊报告石明贤（海安县人民医院儿科，海安２２６６００）蚕豆病在海安地区较少见，为提高对该病的认识，现将近２年来收治的６例蚕豆病资料报告如下。１临床资料１．１一般资料６例均为男孩，年龄为６月１例，～３岁５例。５例在发病前３日内吃过蚕豆；１例患...     

小儿肺结核9例误诊分析

小儿肺结核９例误诊分析杨昭华（胜利石油管理局中心医院，东营市２５７０３４）关键词肺结核；误诊；小儿我科自１９９１年１０月～１９９４年１０月收治小儿肺结核１０例，误诊９例，现总结分析如下。１临床资料１．１一般资料男４例，女５例；年龄８个月～３岁２例，６...     

浙江舟山渔区糖尿病流行病学调查

目的：了解浙江舟山渔区糖尿病（ＤＭ）患病率。方法：１９９４年２月～３月间对舟山地区２个渔村进行糖尿病（ＤＭ）普查。调查人数１０００人（男４７３人、女５２７人），年龄２５岁～６４岁，总受检率占同年龄段当地人口的９０５％。对其中餐后２ｈ血糖≥６６７ｍｍｏｌ／ｄｌ的９０例，做口服７５ｇ葡萄糖耐量试验。结果：发现ＤＭ１６例，标化后患病率为１０３％；糖耐量减低２５例，标化后患病率为２１１％，均低于１９９４年全国普查结果（分别为２５１％和３２％）。结论：ＤＭ患病率低的原因可能与渔民长期海上作业体力活动强及饮食多为海鱼类食物有关。     

卵巢颗粒细胞瘤的综合治疗（附44例分析 ）

４４例卵巢颗粒细胞瘤，其中４１例为首次治疗，３例为复发后治疗，３６例作根治性手术，２２例加放射治疗，２１例作抗癌化疗１－７疗程，２２例治疗已满５－１７年，５年生率８１．２％，其中１例１００％（２３／２３），Ⅱ期６０％（３／５），Ⅲ，Ⅳ期均为零（０／２，０／２），２例保留健侧卵巢和子宫已结婚生育，本文对保留生育功能及根治性手术及术后放疗，化疗及５年生存率进行分析讨论。     

脑肿瘤出血5例误诊分析

脑肿瘤出血５例误诊分析曹冠柏脑肿溜出血无特殊性临床表现，尤其呈卒中样起病者，容易误诊。为提高诊断水平，现将入院时误诊的５例分析报告如下：一、临床资料１、一般资料：男３例，女２例，年龄４７岁１例，６０～６７岁４例；病程２小时至３天；有高血压病史者２例，...     

Uterine cancers in Alberta: trends of incidence and mortality.

Death certificates were reviewed for the 543 Alberta women who died during the period 1969 through 1978 and for whom the underlying cause of death was coded as uterine cancer. To evaluate the recorded cause of death Alberta Cancer Registry records, which existed for 97% of the women, were examined. Calculations from the revised information showed an increase in the mortality of cancer of the corpus uteri and a decrease in the mortality of cancer of the cervix uteri over the 10-year period, but neither was statistically significant. During the same period in Alberta the incidence of cancer of the corpus uteri increased significantly and the incidence of cancer of the cervix uteri decreased significantly.     

宫颈鳞癌和宫颈腺癌卵巢转移比较及危险因素分析

[目的]探讨宫颈鳞癌与宫颈腺癌卵巢转移的特点及高危因素.[方法]分析2004年1月- 2010年1月625例术后病理诊断为宫颈鳞癌和腺癌患者的临床病理资料,其中鳞癌355例,平均年龄50.5岁;腺癌270例,平均年龄49.5岁.比较宫颈鳞癌和腺癌卵巢转移发生率及患者年龄、肥胖、月经情况、组织学类型、分化程度、宫旁浸润、子宫内膜受侵、肿瘤大小、临床分期、淋巴结转移与卵巢转移之间的关系.[结果]625例患者中22例(3.5％)有卵巢转移,宫颈腺癌卵巢转移发生率( 17/270,6.3％)显著高于宫颈鳞癌(5/355,1.4％,P＜ 0.01).41～50岁、绝经前、Ⅱb、肿瘤直径＞4 cm的宫颈腺癌患者卵巢转移发生率均显著高于宫颈鳞癌.宫颈低分化腺癌卵巢转移率高于宫颈低分化鳞癌(P＜0.05).子宫内膜浸润、淋巴结转移与宫颈鳞癌及腺癌卵巢转移均相关,而宫旁浸润与宫颈腺癌卵巢转移相关.临床分期Ⅱb期是宫颈鳞癌卵巢转移的独立显著变量,肿瘤超过4cm是宫颈腺癌卵巢转移的独立显著变量.[结论]宫颈腺癌卵巢转移发生率高于宫颈鳞癌,宫颈鳞癌卵巢转移发生率与临床分期密切相关,而宫颈腺癌卵巢转移与肿瘤大小密切相关.     

中国上海人群肺癌发病的时间趋势及预后因素

目的了解上海肺癌发病的时间趋势及影响生存的预后因素。方法由上海全死因登记报告系统所获得的2002至2004年恶性肿瘤患者死亡个案资料,按国际癌症登记协会（IACR）的肿瘤登记计算指南进行计算。分别按粗率和标率计算1972年至2004年的年度变化百分比（APC）,对上海市发病时间趋势进行估计。采用Cox比例风险模型对影响生存的多因素进行分析,参数包括性别、年龄、居住区域、病理类型、临床分期、首诊医院级别。结果自1972年以来的32年,上海市中心区男性肺癌发病粗率APC增加1．723％,而女性增加2．036％,均呈逐渐增高趋势（P均〈0．01）;但男性肺癌的标化发病率APC为-0．605％,呈下降趋势（P〈0．01）,而女性为-0．136％,呈平稳趋势（P〉0．05）。上海市肺癌发病患者中Ⅲ、Ⅳ期占大多数,分别占35．6％和42．2％。上海市女性肺癌的3年生存率为17．05％,中位生存期（MST）为0．83年,均高于男性的14．01％和0．77年（P均〈0．01）,对各期肺癌的不同性别亚组的生存期分析显示女性生存期均较男性为高（P〈0．05）。Cox多因素分析结果提示性别、年龄、居住区域、病理类型、期别、首诊医院级别对肺癌生存有影响（P均〈0．01）;其中女性、年轻、居住市中心区、鳞癌、早期、高级别医院可能对生存有益,而男性、老年、居住郊区、小细胞癌、晚期、低级别医院这些因素可能对肺癌患者不利。结论上海市肺癌的发病水平逐渐接近欧美国家。女性、年轻、市中心区居住、鳞癌、早期、高级别医院治疗对肺癌的生存有益。各期别女性肺癌的预后均优于男性,但原因尚不清楚。     

育龄期妇女生殖器官癌症发病流行特征

目的为了解上海市杨浦区20～49岁育龄期妇女生殖器官癌症发病现状及流行特征。方法收集1988年至2005年杨浦区共18年的肿瘤报病资料,分析20～49岁女性生殖器官癌症发病情况。结果上海杨浦区20～49岁育龄期妇女乳腺癌、卵巢癌、子宫体癌、宫颈癌和外生殖器癌的平均发病率(1/10万)分别为40.76、7.00、4.34、3.16和0.13;标化发病率(1/10万)分别为50.18、8.60、5.35、3.89和0.16。育龄期妇女的各种生殖器官癌症在总病例中所占的比例相对较高,女性生殖器官癌症的发病率随着年龄的增长逐渐增加。结论继续加强上海市杨浦区女性生殖器官的保健,提高女性癌症防治方面的知识,减少女性生殖器官癌症的发生,仍是今后上海市杨浦区妇女保健工作和癌症防治工作的重要内容。     

Epidemiology of cancer of the cervix: global and national perspective

Cancer of the uterine cervix is one of the leading causes of cancer death among women worldwide. The estimated new cancer cervix cases per year is 500,000 of which 79% occur in the developing countries. Cancer cervix occupies either the top rank or second among cancers in women in the developing countries, whereas in the affluent countries cancer cervix does not even find a place in the top 5 leading cancers in women. The truncated rate (TR) in the age group 35-64 years in Chennai, India, is even higher (99.1/100,000; 1982-95) than rate reported from Cali, Colombia (77.4/100,000, 1987-91). The cervical cancer burden in India alone is estimated as 100,000 in 2001 AD. The differential pattern of cervical cancer and the wide variation in incidence are possibly related to environmental differences. Aetiologic association and possible risk factors for cervical carcinoma have been extensively studied. The factors are: Sexual and reproductive factors, socio-economic factors (education and income), viruses e.g., herpes simplex virus (HSV), human papillomavirus (HPV), human immunodeficiency virus (HIV) in cervical carcinogenesis and other factors like smoking, diet, oral contraceptives, hormones, etc. The accumulated evidence suggests that cervical cancer is preventable and is highly suitable for primary prevention. Sexual hygiene, use of barrier contraceptives and ritual circumcision can undoubtedly reduce cervical cancer incidence. Education, cervical cancer screening of high risk groups and improvement in socio-economic status can reduce cervical cancer morbidity and mortality significantly.     

乳酸杆菌对宫颈肿瘤细胞的黏附抑制作用

目的探讨乳酸杆菌对宫颈肿瘤细胞的黏附与黏附抑制作用。方法采取30例妇女宫颈脱落上皮细胞,与乳酸杆菌震荡培养1-3h、经革兰染色观察宫颈脱落上皮细胞上乳酸杆菌的黏附指数。取对数生长宫颈癌Hela细胞与乳酸杆菌共同培养1-72h,观察不同时间段宫颈癌细胞乳酸杆菌的黏附指数以及细胞活力变化。结果1）乳酸杆菌对宫颈脱落上皮细胞有很好的黏附作用：在培养2h黏附指数达高峰（活菌组39.44±2.5;灭活组85.1±2.9）;灭活组黏附指数在共培养2、3h均明显高于活菌组（P〉0.01）。2）乳酸杆菌对宫颈癌细胞的黏附作用开始随着培养时间增加逐渐增加,两组黏附指数在共培养12h达高峰（活菌黏附指数为25.69±3.1;灭活菌黏附指数为90.49±2.6）,之后逐渐降低。3）在共培养开始短时间内乳酸杆菌并不影响细胞活力;活菌组共培养12h、灭活组共培养24h宫颈癌细胞活力开始下降。结论乳酸杆菌能很好的黏附并抑制宫颈癌细胞的生长;灭活乳酸杆菌对宫颈细胞以及宫颈癌细胞有着更好的黏附抑制作用。     

Age-specific incidence of cancer in Kingston and St. Andrew, Jamaica, 2003-2007

A total of 4981 cancers were recorded in Kingston and St. Andrew during the period 2003-2007: 2536 in males and 2445 in females. Age standardized rates per 100,000 per year (ASR) were 188.8 and 144.2 for males and females respectively, and are relatively unchanged, compared to the previous report (188.6 for males and 144.2 for females, 1998-2002). In males, the leading sites for cancer were prostate, bronchus and large bowel, while in females, they were breast, cervix uteri and large bowel. The leading sites for both genders have been maintained in the same order as in the previous report, but for males, there were increases in the incidence of prostate (ASR 65.5 vs. 78.1 per 100,000 per year) and colorectal (ASR 13.7 vs. 17.2 per 100,000 per year) cancers and a decrease in the incidence of cancer of the bronchus (ASR 22.8 vs. 18.6 per 100,000 per year). For females, there was a modest decrease in incidence of cervical cancer (ASR 19 vs. 17.4 per 100,000 per year) while the incidence of cancers of the breast and large bowel remained relatively stable (ASR 40.1 vs. 43 per 100,000 per year for breast and ASR 13 vs. 12.8 per 100,000 per year for colorectal cancer). These data support the need for urgent institution of formal programmes for prevention and control of cancers of the breast and large bowel in the Jamaican population. Malignancies of unknown primary site were common in both genders and require further investigation.     

老年妇女绝经后阴道流血113例病因分析

目的:探讨老年妇女绝经后阴道流血的病因。方法:对113例绝经后阴道流血的老年患者进行回顾性分析。结果:113例中,良性病变78例,其中子宫颈炎52例,子宫内膜炎10例,子宫肌瘤7例,子宫内膜增生7例,卵巢囊肿2例;恶性肿瘤32例,其中子宫颈癌19例,子宫内膜癌10例,卵巢癌2例,输卵管癌1例;癌前病变3例。113例中,由炎症引起62例。70岁以上年龄组恶性肿瘤发生率为44.00%,70岁以下组为23.86%,两组差异有统计学意义(P<0.05)。结论:老年妇女绝经后阴道流血的病因主要为妇科炎症,其次为恶性肿瘤,了解其病因可达到早期诊断、早期治疗的目的。     

HPV16，HPV18，HSV-2多重感染与宫颈癌的相关性研究

目的探讨HPV16、HPV18、HSV-2多重感染在宫颈癌发病及其进展中的作用。方法选择120例宫颈癌标本及60例正常宫颈组织标本分别作为宫颈癌组及对照组,采用RT—PCR技术进行HPV16、HPV18、HSV-2检测,比较两组HPV16、HPV18、HSV-2感染情况,并分析宫颈癌HPV16、HPV18、HSV-2感染与肿瘤分化程度及肿瘤分期的关系。结果宫颈癌组HPV16、HPV18、HSV-2单独感染及混合感染构成比高于对照组。HPV16、HPV18、HSV-2多重感染与宫颈癌FIGO分期及分化程度呈现相关关系。结论HPV16、HPV18、HSV-2多重感染同宫颈癌发病具有相关性,可能是宫颈癌发病及进展的高危因素。     

Jamaica cancer mortality statistics, 1999

A total of 2697 cancer-related deaths were documented among Jamaicans for the year 1999, accounting for 17.7% of all deaths. Males accounted for 1466 and females for 1231. The age-adjusted cancer mortality rate was 171.7 per 100,000 for males, 122.0 per 100,000 for females and 140.5 per 100,000 for the total population. Leading cancer mortality sites for males were prostate, lung and stomach and in females, breast, cervix uteri and large bowel. Most deaths were recorded in the 55-64 and 65-74 year-age groups. Despite well-established cervical cancer screening programmes, the calculated mortality rate for cancer of the cervix uteri in Jamaican females (15.8 per 100,000) is approximately two and a half times that seen in African-American females.