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目的总结阳城县食管癌早诊早治项目内窥镜筛查情况和早期诊断结果。方法对5073例应用内窥镜检查+碘染色+指示性活组织检查及贲门脊根部定点活组织检查的普查资料进行分析。结果参加筛查的男女比为0.99:1,两组差异无统计学意义(P〉0.05);不典型增生和癌的检出率男性明显高于女性(P〈0.01);食管、贲门、胃的早期诊断率{早期诊断病例[重度不典型增生和(或)原位癌、黏膜内癌1/重度不典型增生和(或)原位癌以上病例)分别为73.33%、71.88%、44.44%。结论在食管癌高发区应用内窥镜检查+碘染色+指示性活组织检查可提高食管癌癌前病变的检出率,同时要重视对早期贲门癌的诊断,建议食管癌高发区常规内窥镜检查时应做碘染色+指示性活组织检查和对贲门脊根部的定点活组织检查,以提高癌前病变的检出率。 相似文献
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癌症早诊早治工作评价指标的探讨 总被引:3,自引:2,他引:1
董志伟 乔友林 王贵齐 张苏展 钱耕荪 唐步坚 游伟程 周琦 张立玮 万德森 陈建国 柳青 袁媛 李纪宾 赵方辉 魏文强 孟祥柱 郑树 王国清 李光琳 雷正龙 孔灵芝 《中国肿瘤》2010,19(10):633-638
[目的]探讨癌症早诊早治工作的评价指标。[方法]分析2006~2009年卫生部早诊早治项目宫颈癌、食管癌/贲门癌、结直肠癌、肝癌、鼻咽癌及胃癌的筛查和早诊早治数据,提出并定义癌症早诊早治工作的初步评价指标。筛查早诊率,检出率和治疗率为工作绩效指标;早期发现成本系数(early detection cost index,EDCI)为综合评价指标。[结果]宫颈癌、食管癌/贲门癌、结直肠癌、肝癌、鼻咽癌及胃癌6种癌症的诊断性筛查检出率分别为:5.6%、2.4%、3.9%、1.3%、5.5%、1.5%;筛查早诊率分别为:93.5%、82.3%、91.9%、58.2%、60.0%、80.0%;治疗率分别为:90.9%、68.4%、100%、69.1%、80.0%、85.0%;早期发现成本系数分别为:0.22、0.42、0.48、0.80、2.45、1.68。[结论]宫颈癌、结直肠癌及食管癌/贲门癌的早诊早治有良好的效益,应进一步推广。 相似文献
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食管癌筛查和早诊早治的实践与经验 总被引:4,自引:2,他引:2
[目的]报告在高发区居民中食管癌筛查和早诊早治的效果和经验。[方法]分析2006—2008年在6个省中的8个县(市)居民中,开展食管癌筛查和早诊早治的资料。总结工作中的效果和经验。[结果]3年内镜检查共39221人,发现食管癌600例,检出率为1.53%。其中早期食管癌515例,早诊率85.83%。同时,发现胃贲门癌413例,检出率为1.05%。其中,早期贲门癌336例,贲门癌的早诊率81.36%。[结论]食管癌内镜筛查可发现大批早期癌和癌前病变,现阶段作为食管癌防治措施是可行的和有效的。 相似文献
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应用内镜下碘染色在食管癌高发区进行普查的意义 总被引:35,自引:0,他引:35
背景与目的:食管癌的死亡率一直居高不下,主要是由于其早诊率较低。为提高食管癌的早诊率,本研究探讨在我国食管癌高发区应用直接内镜下碘染色进行普查提高食管癌早诊率的可行性。方法:应用直接内镜下碘染色在我国食管癌高发区对3164名高危人群进行3次普查,每个普查对象均在着色区取一块活检组织,且每例可疑病例也均在食管的不着色区取活检组织作病理检查,然后将食管鳞状上皮的着色情况与其对应的病理检查结果进行对照。结果:(1)早期食管癌100%碘染色阳性,染色级别多为I级。早期食管癌检出率为1.6%-4.59%,中晚期食管癌的检出率为0.29%-1.09%,食管癌的早诊率均在75%以上。(2)食管鳞状上皮重度不典型增生95.6碘染色阳性,其中91.3%病例碘染色级别为I和Ⅱ级。食管鳞状上皮重度不典型增生检出率为4.49%-7.68%。(3)中度不典型增生96.6%碘染色阳性,73.3%病变染色级别为Ⅱ和Ⅲ级。(4)92.3%轻度不典型增生碘染色阳性,86.5%病变染色级别为Ⅱ和Ⅲ级。(5)而只有0.9%的炎症和0.4%的正常组织碘染色级别为I和Ⅱ级,正常组织大多数为阴性或Ⅲ级。结论:在食管癌高发区应用直接内镜下碘染色进行普查,对早期食管癌及其癌前病变有较高的检出率。 相似文献
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传统的概念认为食管上皮细胞重度不典型增生(SevereDysplasia简称 :SDP)是食管癌前病变。SDP作为肿瘤交界性病变是食管癌Ⅱ级预防和临床内镜诊断治疗研究的重点。本文就该领域的食管癌高发现场人群流行病学 ,临床病理和基础研究以及存在问题进行综述。1 高发现场流行病学流行病学调查分析表明 :食管鳞状上皮癌变的规律为基底细胞增生或单纯增生、轻度不典型增生、中度不典型增生 (MDP)、重度不典型增生、原位癌、早期浸润癌、进展期癌 ,这样一个相互联系不可分隔的渐进谱系过程。食管癌高发区包括细胞学初筛后内镜普查统计[1] :4 0岁… 相似文献
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食管癌发生发展过程中环氧合酶-2蛋白表达的研究 总被引:27,自引:0,他引:27
目的 研究环氧合酶-2(Cox-2)蛋白在食管癌及癌前病变组织中的表达,探讨非类固醇抗炎药在食管癌高危人群中化学预防的可能性。方法 应用免疫组织化学方法检测120例食管癌(原位癌30例,鳞状细胞癌60例,腺癌30例)及其113例增生性病变(单纯增生29例,轻、中、重度不典型增生分别为31例、30例、23例)和27例正常食管黏膜鳞状上皮,以及3例Barrett食管组织中Cox-2蛋白的表达情况。结果 在正常食管黏膜上皮,单纯增生,轻、中、重度不典型增生,原位癌未发现有Cox-2蛋白表达;在6%(4/60)侵袭性鳞状细胞癌和70%(21/30)的食管腺癌中,Cox-2蛋白表达阳性。结论 Cox-2蛋白表达可能与食管腺癌的形成有关,而与鳞状细胞癌的发生发展无关。 相似文献
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降低食管癌发病率和死亡率的现场临床防治策略与方法 总被引:18,自引:0,他引:18
我国是食管癌高发国家。尽管三十年来,食管癌研究已取得重大进展,但食管癌的发病率和死亡率依然居高不下。我们从临床研究角度提出在较短时间内对特定人群,有效降低“两率”的防治策略与方法,与同道们商榷。一、食管鳞状上皮细胞癌变的规律和降低“两率”临床研究的策略据我们在食管癌高发现场2万多例内镜检查、活检标本病理报告和长期内镜随诊结果,鳞状上皮癌变的规律为基底细胞增生或单纯增生→轻度不典型增生→中度不典型增生→重度不典型增生→原位癌→早期浸润癌→进展期癌。1987年一组878例内镜检查,经3年半的随诊,原… 相似文献
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肥城市食管癌筛查及早诊早治模式探索 总被引:1,自引:1,他引:0
[目的]探索肥城市食管癌筛查及早诊早治模式。[方法]分析肥城市2006~2008年中央财政转移支付食管癌早诊早治项目的相关资料,探索肥城市可持续发展食管癌防治新模式。[结果]2006~2008年项目覆盖人口总数为17775人,其中研究组13627人,40~69岁目标人口数为5530人,完成筛查4252人,顺应性为76.89%,任务完成率为106.3%;3年中检出轻度不典型增生469例,中度不典型增生114例,重度不典型增生及原位癌43例,黏膜内浸润癌29例,浸润癌10例。3年食管癌早诊率达87.90%,治疗率达93.90%。[结论]肥城市形成了独特的可持续发展食管癌筛查模式,可有效提高筛查顺应性、早诊早治率,降低食管癌发病率和死亡率。 相似文献
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508例恶性肿瘤患者外周血淋巴细胞亚群分析 总被引:2,自引:0,他引:2
目的 研究肿瘤患者外周血淋巴细胞亚群变化特点.方法 收集天津中医药大学第一附属医院肿瘤患者508例(肺癌256例,胃癌152例,乳腺癌100例),健康志愿者50例,采集入组人员外周血2 ml,应用BD流式细胞仪进行淋巴细胞亚群检测,所得数据采用SPSS 16.0软件进行统计分析.结果 淋巴细胞均数(比例)比较:肿瘤患者淋巴细胞数量降低,健康志愿者为5125 (34.2%)、乳腺癌为3642(24.3%)、胃癌为3178(21.2%)、肺癌为2895(19.3%),依次降低.淋巴细胞亚群总异常病例数分别为肺癌218例(85.2%)、胃癌133例(87.5%)、乳腺癌88例(88.0%);T细胞亚群异常病例数为肺癌83例(32.4%)、乳腺癌32例(32.0%)、胃癌44例(28.9%);CD4 +/CD8+异常病例数为肺癌185例(72.3%)、胃癌108例(71.1%)、乳腺癌84例(84.0%);自然杀伤细胞亚群异常病例数为肺癌32例(12.5%)、胃癌22例(14.5%)、乳腺癌16例(16.0%);B细胞亚群异常病例数肺癌38例(14.8%)、胃癌52例(34.2%)、乳腺癌12例(12.0%).与健康志愿者相比,肺癌患者CD19+%(12.8±5.0∶11.5±5.7,t=3.006,P=0.003)降低;胃癌患者CD4+% (39.2 ±7.7∶35.3±7.6,t=2.315,P=0.023)降低,CD19+% (12.8±5.0∶8.9±4.2,t=3.302,P=0.010)降低;乳腺癌患者CD8+%(24.0±8.1∶29.1 ±13.0,t=2.019,P=0.047)升高.结论 肿瘤患者淋巴细胞数量减少,淋巴细胞亚群异常率增高,不同肿瘤患者淋巴细胞亚群异常变化表现出不同的特点. 相似文献
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Neale RE Purdie DM Murphy MF Mineau GP Bishop T Whiteman DC 《Cancer causes & control : CCC》2004,15(8):829-835
Increasing epidemiological and experimental evidence indicates that the carcinogenic pathway in the breast and female reproductive organs is driven, at least in part, by factors associated with reproduction. We conducted a retrospective cohort study, comparing the risk of ovarian, breast, endometrial, and cervical cancers among women who had records of at least one twin pregnancy, compared with women who had given birth to only single children. Subjects were selected from the Utah Population Database, which consists of multiple linked datasets including genealogy, births and deaths and cancer registries. We used Poisson regression to calculate relative risks, adjusted for the number of pregnancies and the age of the mother at the birth of first and last children, with singleton mothers as the reference group in each case. The risks of breast and ovarian cancers did not differ between mothers of twins and mothers of single children. The risk of endometrial cancer was slightly lower in mothers of twins than in mothers of singleton children (RR = 0.90, 95% CI 0.67-1.21). Conversely the risk of cervical cancer was higher among twin mothers (RR = 1.78, 95% CI 0.88-3.52). This latter finding supports previous data suggesting that reproductive hormones act as cofactors in the etiology of cervical cancer. 相似文献
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Gene Kopelson Rita Linggood 《International journal of radiation oncology, biology, physics》1982,8(6):999-1003
The patterns of clinical-and autopsy-documented tumor spread were evaluated for 15 patients with biopsy-proven infratentorial (8 cerebellar, 2 brainstem, 5 intramedullary spinal cord) glioblastoma. No patient developed clinical nor autopsy evidence of subarachnoid dissemination, even though no patient had received craniospinal axis irradiation. Fully 14 of the 21 previously reported patients with subarachnoid dissemination from infratentorial glioblastoma had this diagnosis made only at autopsy. The overall poor prognosis at present (8 % 3-year survival from the present series and recent literature) along with the demonstrated pattern of local-regional aggressiveness as the major form of initial spread and post-irradiation recurrence, suggests that routine craniospinal axis irradiation may not be indicated for most patients with infratentorial glioblastoma. 相似文献
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The most frequent fatal malignant tumors in the Soviet Union are cancers of the lung, stomach, breast, and cervix uteri. From incidence statistics and population estimates provided by the Department of Statistics of the Ministry of Health, age-adjusted incidence rates for the period 1971–87, using the World standard population, have been computed for the USSR as a whole and for each of the 15 Soviet republics. For six republics believed to have the highest quality of data and relatively homogeneous populations, time-trends are examined over the period. There is important geographical variation in the incidence of malignant tumors in the Soviet Union. The differences between high and low incidence areas are four-fold for cancer of the lung and stomach, three-fold for cancer of the breast and two-fold for cancer of the cervix. Overall in the six republics for which time-trends are examined, cancers of the lung and breast have increased, cancers of the stomach and cervix have decreased. There are some variations in specific age groups in some republics.The authors are in the Institute of Carcinogenesis, Department of Epidemiology of the All-Union Cancer Research Centre of the Academy of Medical Sciences of the USSR, Moscow. Address reprint requests to Dr Zaridze at Kashirskoye sh. 24, Moscow 115478, USSR. 相似文献
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人胃癌细胞腹膜粘附影响因素的实验研究 总被引:6,自引:1,他引:5
目的 探讨影响人胃癌细胞在腹膜粘附的因素,为临床上采取有效措施,减少腹膜转移的发生提供依据。方法 用人胃癌细胞株在小鼠腹膜上培养,以MTT法检测粘附细胞数的体外实验模型,观察腹膜损伤,血液成分和癌胚抗原(CEA)对胃癌细胞在腹膜粘附的影响。结果 腹膜损伤组的粘附细胞数(AD)较对照组明显增高(P〈0.01),血液中的白细胞,血小板组AD值较对照组明显增高(P〈0.01),血浆组AD值亦较对照组增高 相似文献
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X线立体定向放射治疗在脑转移瘤治疗中的作用 总被引:21,自引:0,他引:21
目的探讨X线立体定向放射治疗在脑转移瘤常规放射治疗中的作用。材料与方法在4种预后因素(年龄、疗前KPS评分、有无远处转移及是否单发转移灶)相同或相似的条件下,配对选择两组病例,X线立体定向放射治疗加常规放疗组40例,常规放疗组80例,常规放疗组采用全脑照射30~40Gy/3~4周;在X线立体定向放射治疗加常规放疗组中,X线立体定向放射治疗采用单次照射27例,分次照射13例,单次靶区平均处方剂量为13.4Gy,分次照射方法为5~10Gy/次,每周2次,总量达15~30Gy。结果X线立体定向放射治疗加常规放疗组与单纯常规放疗组比较:1年生存率分别为50%,20%;1年局控率分别为73%,15%;治疗后KPS评分好转的比例分别为88%,56%;疗后1~3个月头部CT、MRI示,影像学上有效率分别为80%,50%,以上结果经统计学处理均有明显差异(P<0.01)。在死因分析中,发现X线立体定向放射治疗加常规放疗组死于头部的比例为22%比单纯放疗组49%的低(P<0.05)。而两组病例的放射并发症发生率相似。结论X线立体定向放射治疗与常规放疗结合治疗脑转移瘤,疗效优于单纯常规放疗 相似文献
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Six patients with metastases to the penis are described. The main characteristics of the primary tumors are described, along with the treatments, the features of the metastasis, and the response to treatment. Although in one patient a survival of 5 years was obtained, metastasis to the penis is generally associated with a dismal prognosis. A brief commentary is made concerning mechanisms of metastases formation. 相似文献
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子宫颈癌放疗后子宫体恶性肿瘤47例临床分析 总被引:1,自引:0,他引:1
Objective To study the characteristics and clinical features of uterine neoplasms developed after radiation therapy for cervical carcinoma.
Methods Clinical data of 47 cases of uterine neoplasms occurred following radiation therapy for cervical carcinoma were retrospectively
reviewed.
Results The median age at uterine neoplasms diagnosis was 62 years (range: 38–77 years), and the median latency period from initial
therapy to development of uterine neoplasms was 14 years (range: 5–35 years). Thirty of 47 cases were endometrial carcinoma,
of which 3 were uterine papillary serous carcinoma (UPSC). Seventeen of 47 patients were uterine sarcoma, all of those were
carcinosarcoma. The distribution by stage, grade, and histology of 30 cases of endometrial carcinoma was as follows: stage
Ib, 1 case; stage Ic, 2 cases; stage II, 6; stage IIIa, 4; stage IIIb, 2; stage IIIc, 11; stage IV, 4 cases; grade 1, two
cases; grade 2, nine; grade 3 (include 3 UPSC patients), seventeen; unknown grade, two; endometriod, 27; UPSC, 3 cases; 7
of 30 cases of endometrial carcinoma had recurrences (23.3%), at median time to recurrence was 24 months, and their median
survival time was 26 months. The overall 3- and 5-year survival rates were 60% and 38%, respectively. Of the 17 cases of uterine
sarcoma, the median survival was 10 months, 6 patients occurred recurrence (35.9%), at a median time to recurrence was 9 months,
and their median survival was 6 months. The overall 3- and 5-year survival rates were 12% and 0, respectively.
Conclusion The main uterine neoplasms development after radiation therapy for cervical carcinoma is endometrial carcinomas, of which
there is a preponderance of high-risk histological subtypes and a poor prognosis. Most of the uterine sarcomas occurred following
radiation therapy for cervical carcinoma are carcinosarcomas and the prognosis is very poor. 相似文献
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颅骨肿瘤119例临床分析 总被引:12,自引:0,他引:12
目的 探讨颅骨肿瘤的常见病理类型、临床特点和治疗方法。方法 回顾性分析119例手术治疗的颅骨肿瘤病例,对其临床症状、影像学资料、治疗方法以及生存情况先进进行分析研究。结果 共行神经外科手术122次,3人行手术2次。全切除手术75次,近全切除手术24次,部分切除手术22次,1例患者行活检手术。外生型肿瘤43例(36.1%),内生型肿瘤27例(22.7%),混合生长型肿瘤49例(41.2%)。随诊85例患者中,78.6%的患者术后恢复了正常的工作和学习,16.6%的患者术后生活可以自理,生活需要照顾以及随访期间死亡的患者各2例。结论 积极的手术治疗可以达到明确诊断,延缓神经功能缺损的发展,延长患者的生存期以及美容等目的。 相似文献