食管鳞癌术后化疗与副作用关联性

目的 探讨食管鳞癌（esophageal squamous cell carcinoma,ESCC）术后化疗方案与预后生存及副作用的关系。 方法 收集2014年6月―2018年11月18日于福建医科大学附属第一医院、福建省肿瘤医院就诊的ESCC患者病例,根据明确的纳入和排除标准,最终纳入188例。使用Kaplan-Meier法计算累计生存概率,log-rank进行组间差异比较,Cox回归分析生存影响因素,应用多组独立样本秩和检验比较化疗方案组间的副作用,采用非条件Logistic回归分析模型分析化疗方案与ESCC术后副作用的相关性。 结果 化疗方案是ESCC预后的影响因素,其中“多西他赛（docetaxel,DOC）+洛铂（luoplatinum,LBP）/奥沙利铂（oxaliplatin,OXA）”、“紫杉醇（paclitaxel,PTX）+LBP/OXA”化疗方案总生存期均优于“DOC+顺铂（cisplatin,DDP）/奈达铂（nedaplatin,NDP）”组化疗方案;化疗方案与ESCC术后出现的血液/骨髓异常等副作用相关（χ²=11.741,P=0.008）,“DOC+LBP/OXA”组较“DOC+DDP/NDP”组化疗方案,会增加白细胞降低发生的风险（OR=4.089,95% CI：1.073~15.585,P=0.039）,减少淋巴细胞水平降低发生的风险（OR=0.257,95% CI：0.075~0.878,P=0.030）。 结论 化疗方案是ESCC术后预后生存及副作用的影响因素,“DOC+LBP/OXA”、“PTX+LBP/OXA”两组化疗方案的预后生存情况优于“DOC+DDP/NDP”化疗方案;“DOC+LBP/OXA”化疗方案相对其它方案可降低副作用的发生风险。     

早期食管鳞癌患者预后因素分析

目的 探讨影响早期食管鳞癌患者术后的预后因素.方法 回顾性选取2010年11月 ～2016年10月解放军总医院收治的271例早期食管鳞癌患者,采用单因素和多因素分析的方法分析其临床特征和5年生存率的关系.结果 早期食管鳞癌患者的5年生存率为64.8％,年龄和肿瘤分化程度与早期食管鳞癌患者的预后有关(P<0.05).性别...     

江苏省泰兴地区食管鳞癌发病与社会经济状况的关联研究

目的　分析江苏省泰兴地区人群社会经济状况与食管鳞癌发病的关系。方法　采用病例对照研究,收集人口学资料、社会经济状况指标及可能的危险因素,使用主成分分析法计算财富得分,利用非条件logistic回归方法调整混杂因素,计算多种社会经济状况指标与食管鳞癌发病的OR值及其95％CI。结果　多因素分析显示,教育程度为高中及以上（OR=0．66,95％CI：0．46～0．96）、人均居住面积≥67 m²（OR=0．71,95％CI：O．54～0．94）、饮用自来水超过5年（OR=0．76,95％CI：0．59～0．98）以及财富得分>0．93（OR=0．63,95％CI：0．48～0．83）食管鳞癌发病危险低。从事商业、服务业人员与从事农、林、牧、渔、水利业生产者相比,发生食管鳞癌的危险性低（OR=0．65,95％CI：0．43～0．97）。结论　社会经济状况与江苏省泰兴地区食管鳞癌发病为负性关联,其相关机制有待进一步研究。     

膳食因素与糖尿病发病关系的研究

膳食因素与糖尿病发病关系的研究于红霞１蔺新英１徐贵发１赵长峰１陈兆堂２糖尿病是一种慢性内分泌障碍性疾病，在诸多因素中，许多与营养有关。为探讨膳食因素与糖尿病的发病关系，本文采用病例－对照的方法进行了对比调查研究。１调查对象及方法１．１病例组为近一年内...     

Caveolin-1在食管鳞癌中的表达及其意义

目的研究正常食管黏膜和食管鳞癌组织中Caveolin-1蛋白的表达,探讨其与食管鳞癌发生发展的关系。方法采用免疫组织化学法分析50例食管鳞癌组织及10例正常食管黏膜中Caveolin-1表达情况。结果食管鳞癌中Caveolin-1的表达高于正常食管黏膜组织,Caveolin-1的表达与食管癌的淋巴结转移密切相关(P0.05),而与年龄、肿瘤最大径、浸润深度无关(P0.05)。结论 Caveolin-1促进了食管癌的生长和转移,可作为食管癌的预后评估因子。     

pNO食管鳞癌nm23、E-cadherin表达与淋巴结微转移关系的研究

目的探讨pN0食管鳞癌nm23、E-cadherin表达与淋巴结微转移的关系。方法采用Evision免疫组化法检测86例pN0食管鳞癌根治术后原发灶nm23、E-cadherin表达,以AE1/AE3为微转移指标检测淋巴结,分析nm23、E-cad-herin表达与淋巴结微转移的关系。结果 86例pN0期食管鳞癌区域淋巴结通过AE1/AE3免疫组化染色,发现31例(36.0%)有淋巴结微转移,并且淋巴结微转移与肿瘤分化程度和浸润深度有密切联系(P﹤0.05);nm23、E-cadherin在pN0期食管鳞癌原发灶表达阳性率分别为65.1%,67.4%,淋巴结微转移与nm23、E-cadherind的表达呈负相关(P﹤0.01)。结论 pN0期食管鳞癌原发灶nm23、E-cadherin表达缺失是淋巴结微转移的高危因素,两者联合检测有望成为评估微转移风险有用指标。     

趋化因子受体CXCR4与食管鳞癌生物学行为的临床研究

目的探讨趋化因子受体CXCR4与食管鳞癌生物学行为的关系。方法对37例食管鳞癌患者实施趋化因子受体CXCR4mRNA与蛋白相对表达量测定,并探讨其与食管鳞癌的生物学行为关系。结果趋化因子受体CXCR4mRNA与蛋白相对表达量,与侵及外膜、淋巴结转移状态及TNM分期有关。结论检测CXCR4对预测食管鳞癌的侵袭、转移有重要的临床价值。     

pNO食管鳞癌nm23、E-cadherin表达与淋巴结微转移关系的研究

目的 探讨pN0食营鳞癌nm23、E-cadherin表达与淋巴结微转移的关系.方法 采用Evision免疫组化法检测86例pN0食管鳞癌根治术后原发灶nm23、E-cadherin表达,以AE1/AE3为微转移指标检测淋巴结,分析nm23、E-cad-herin表达与淋巴结微转移的关系.结果 86例pN0期食管鳞癌区域淋巴结通过AE1/AE3免疫组化染色,发现31例(36.0％)有淋巴结微转移,并且淋巴结微转移与肿瘤分化程度和浸润深度有密切联系(P＜0.05);nm23、E-cadherin在pN0期食管鳞癌原发灶表达阳性率分别为65.1％,67.4％,淋巴结微转移与nm23、E-cadherind的表达呈负相关(P＜0.01).结论 pN0期食管鳞癌原发灶nm23、E-cadherin表达缺失是淋巴结微转移的高危因素,两者联合检测有望成为评估微转移风险有用指标.     

术前白蛋白-球蛋白比值与食管鳞癌患者的预后

目的  探讨术前白球蛋白比（albumin/globulin ratio,AGR）与食管鳞癌（esophageal squamous cell carcinoma,ESCC）患者预后的关系,建立ESCC手术患者生存时间的预测列线图,为ESCC患者的预后预测提供参考依据。 方法  收集2014年2月-2017年9月在福建省肿瘤医院收治的390例接受过手术治疗的ESCC患者的临床资料。利用接受者操作特征曲线（receiver operating characteristic curves,ROC）确定术前AGR的最佳临界值,χ²检验分析AGR与一般临床特征间的相关性,Cox比例风险回归模型分析AGR与ESCC患者预后的关系,进而构建ESCC术后患者预后预测列线图模型。 结果  按术前AGR最佳临界值1.16将患者分为高AGR和低AGR两组,高AGR组1年和3年生存率均高于低AGR组（均有P < 0.05）。多因素分析结果显示：T分期、N分期、AGR是影响ESCC患者预后的因素（均有P < 0.05）,其中T₃-T₄ vs T₁-T₂（HR=1.87,95% CI：1.04~3.35）,N₊ vs N₀（HR=1.89,95% CI：1.13~3.17）,高AGR组vs低AGR组（HR=0.57,95% CI：0.36~0.90）。预测ESCC术后患者预后的列线图一致性指数为0.68（95% CI：0.62~0.73,P < 0.001）。 结论  术前AGR水平是影响ESCC术后患者预后的因素,高AGR组ESCC患者的预后优于低AGR组,列线图有助于临床医生对ESCC术后患者的预后进行个体化预测。     

牡丹区城市居民高血压患病率及膳食习惯与高血压患病的关联性分析

[目的]了解菏泽市城区居民高血压患病情况及饮食习惯与高血压患病的关联性,为高血压防治提供科学依据。[方法]从菏泽市牡丹区2011年7月省部联合减盐防控高血压项目个人问卷中抽取30～69岁的632份进行分析。[结果]调查632人,查出高血压患者80例,患病率为12.66%。高血压患病率,男性为15.19%,女性为10.13%(P>0.05);18～29岁为3.43%,30～39岁为9.21%,40～49岁为12.20%,50～59岁为22.58%,60～69岁为26.97%(P<0.01);嗜荤食的为27.03%,不嗜荤食的为11.76%(P<0.05);嗜油腻的为19.55%,不嗜油腻的为10.82%(P<0.01)。[结论]牡丹区城区居民高血压患病率60～69岁的人群高于其他年龄阶段的;嗜荤食、嗜油腻的高血压患病率高于不嗜荤食、不嗜油腻的。     

Food intake and the occurrence of squamous cell carcinoma in different sections of the esophagus in Taiwanese men

ObjectiveThe main objective of this study was to further elucidate the effect of consuming various foods on the development of squamous cell carcinoma (SCC) in three different sections of the esophagus.MethodsA total of 343 patients with SCC of the esophagus and 755 cancer-free control subjects were recruited for this study from 1996 to 2005.ResultsWe found that intake of vegetables, raw onions/garlic, and fruits are significantly protective against esophageal SSC risk, whereas intake of hot foods can significantly increase its risk. There was a significant inverse relation between the frequency of tea consumption and esophageal SCC risk (P for trend = 0.005), with a 0.5-fold lower risk associated with the intake of unfermented tea (green tea, oolong tea, or jasmine tea). The effects of dietary factors on esophageal SCC were similar in all subsites, with the exception of consumption of coffee. Coffee consumption was more pronounced in having a protective effect in the middle third section compared with the lower third section of the esophagus (adjusted odds ratio 0.4, 95% confidence interval 0.2–0.9), although this protective effect was marginally significant (adjusted odds ratio 0.6, 95% confidence interval 0.4–1.0) against esophageal SCC in all subsites. Our data also suggest that discomfort when eating hot foods may exert a carcinogenic effect by direct contact with the esophageal mucosa and tend to have more harmful effects in the upper than in the lower esophagus. In contrast, vegetables, fruits, and tea with components that are thought to inhibit carcinogenesis by absorbed components affected all subsites similarly.ConclusionOur results add additional information that certain dietary components may affect carcinogenesis locally and systemically.     

膳食视黄醇与食管鳞癌患者预后的关联研究

【目的】探讨膳食视黄醇摄入量与食管鳞癌患者预后的关联。【方法】纳入2014年7月—2019年8月福建医科大学附属第一医院和福建省肿瘤医院经病理确诊的原发性食管鳞癌病例388例,分析视黄醇摄入量与患者基本特征之间的关系,使用Kruskal-Wallis秩和检验分析视黄醇摄入量与营养素之间的关联,运用Cox比例风险回归模型分析膳食视黄醇与食管鳞癌预后关联。【结果】不同视黄醇摄入分组的食管鳞癌患者在性别、年龄、TNM分期、肿瘤长度、营养素摄入特征等的分布均衡可比（P>0.05）。多因素Cox回归分析显示,高视黄醇摄入组的患者预后较好（总生存期：HR=0.279,95%CI:0.150～0.520,P<0.001;无病生存期：HR=0.306,95%CI:0.181～0.516,P<0.001）。【结论】视黄醇摄入量与食管鳞癌患者的预后存在关联,高摄入视黄醇可能改善食管鳞癌患者的预后。     

Exploratory factor analysis of squamous cell carcinoma of the esophagus in Uruguay

In the period 1996--2004, a hospital-based, case-control study on diet and risk of squamous cell carcinoma of the esophagus was conducted in Montevideo, Uruguay. The study included 234 cases and 468 controls, frequency matched on age, sex, and residence. Factor analysis (principal components) was used to identify the major food patterns associated with esophageal cancer. The analysis of food groups led to the identification of four patterns, arbitrarily labeled as traditional, healthy, high-fat, and drinker. The traditional pattern was not associated with risk of esophageal carcinoma, whereas the healthy pattern displayed a strong inverse association with this malignancy [odds ratio (OR) 0.29, 95% confidence interval (CI) 0.17-0.48, P value for trend < 0.0001]. Unexpectedly, the high-fat foods diet was also marginally protective (OR 0.60, 95% CI 0.36-1.01, P value for trend = 0.07). On the other hand, the drinker pattern displayed a twofold increase in risk of esophageal carcinoma (OR 2.03, 95% CI 1.17-3.51, P value for trend = 0.01). The present study suggests that factor analysis might contribute to the elucidation of the contribution of diet on human cancer. Because diet represents a complex set of highly correlated exposures, dietary patterns could be more explicative of the etiology of squamous cell carcinoma of the esophagus than the traditional reductionist approach.     

中学生饮食习惯与体质健康关系分析

目的了解中学生饮食习惯及体质健康状况,分析2者的关系,为改善和促进学生的体质现状提供理论依据。方法本次研究资料来源于对3所学校中学生的调查,通过问卷调查和现场测量的方式分别得到学生饮食习惯和体质健康资料,对资料进行描述和分析。结果尽管大部分中学生都能够达到各项指标的及格标准,但优秀率和良好率都比较低;有21．6％的学生没有认真对待早餐;学生喜欢的食物选项中选择甜食、快餐食物的比例较高,而选择含有优质蛋白质、可以促进孩子生长发育的豆类食物和奶类食物的比例却较低。将饮食习惯和体质康进行回归分析发现,早餐习惯、豆类及快餐食物的选择影响孩子的体质健康。结论被调查中学生的饮食习惯和体质健康状况不甚理想,且饮食习惯影响体质健康状况,因此促进体质健康发展需要对饮食习惯进行正确奇白引导知教育．     

Healthy dietary habits in relation to social determinants and lifestyle factors.

The aim of the present study was to evaluate the importance of social status and lifestyle for dietary habits, since these factors may influence life expectancy. We studied the association of four indicators for healthy dietary habits (fruits and vegetables, fibre, fat and Hegsted score) with sex, age, socio-economic status, education, physical leisure exercise, smoking and personal attention paid to keeping a healthy diet. Data were gathered with a self-administered quantitative food-frequency questionnaire distributed to a representative sample of Norwegian men and women aged 16-79 years in a national dietary survey, of whom 3144 subjects (63%) responded. Age and female sex were positively associated with indicators for healthy dietary habits. By separate evaluation length of education, regular physical leisure exercise and degree of attention paid to keeping a healthy diet were positively associated with all four indicators for healthy dietary habits in both sexes. Socio-economic status, location of residence and smoking habits were associated with from one to three indicators for healthy dietary habits. In a multiple regression model, age, education and location of residence together explained from 1 to 9% of the variation (R2) in the four dietary indicators. Length of education was significantly associated with three of four dietary indicators both among men and women. By including the variable 'attention paid to keeping a healthy diet' in the model, R2 increased to between 4 and 15% for the four dietary indicators. Length of education remained correlated to three dietary indicators among women, and one indicator among men, after adjusting for attention to healthy diet, age and location of residence. Residence in cities remained correlated to two indicators among men, but none among women, after adjusting for age, education and attention to healthy diet. In conclusion, education was associated with indicators of a healthy diet. Attention to healthy diet showed the strongest and most consistent association with all four indicators for healthy dietary habits in both sexes. This suggests that personal preferences may be just as important for having a healthy diet as social status determinants.     

Smac和Livin的表达与宫颈癌的发生发展相关性分析

目的 探讨凋亡相关蛋白Smac、Livin在宫颈癌组织中的表达及临床意义.方法 选取2014年3月至2015年3月汕头市中心医院妇产科宫颈鳞状细胞癌24例(宫颈癌组),宫颈上皮内瘤变(CIN)Ⅰ 15例(CIN Ⅰ组),CIN Ⅱ13例(CIN Ⅱ组),CIN Ⅲ13例(CIN Ⅲ组),正常宫颈组织15例作为正常对照(对照组),采用免疫组化法检测各组的Smac和Livin表达情况.结果 宫颈癌组Smac阳性比例为83.33％,明显高于对照组,差异比较有统计学意义(x2=25.658,P＜0.05);宫颈癌组、CIN Ⅱ组和CIN Ⅲ组Smac阳性比例比较差异无统计学意义(x2=2.204,P＞0.05);宫颈癌组、CIN Ⅱ组和CIN Ⅲ组Livin阳性比例分别为79.17％、76.92％和84.62％,明显高于对照组(x2值分别为19.420、17.279、14.412,均P＜0.05);CIN Ⅰ组与对照组Smac和Livin阳性比例比较差异无统计学意义(x2值分别为0.536、0.000,均P＞0.05);CIN Ⅰ组Smac和Livin阳性比例明显低于CINⅡ组、CINⅢ组和宫颈癌组(x2值分别为20.843、22.611,均P＜0.05);低分化患者Smac阳性比例为42.86％,明显低于高中分化患者(x2=11.657,P＜0.05);宫颈鳞状细胞癌中Smac和Livin的表达呈正相关(r=0.872,P＜0.05).结论 Smac和Livin在宫颈鳞状细胞癌的发生发展中起协同作用.     

Vegetables, fruits, related dietary antioxidants, and risk of squamous cell carcinoma of the esophagus: a case-control study in Uruguay

In 1998-1999, a case-control study on esophageal cancer was conducted in Uruguay. For this purpose, 111 cases with squamous cell carcinoma of the esophagus and 444 controls with conditions unrelated to tobacco smoking, alcohol drinking, or recent changes in the diet were frequency matched on age, gender, residence, and urban/rural status. Vegetables and, more markedly, fruits were associated with strong reductions in risk. On the other hand, 12 of 15 dietary antioxidants displayed significant inverse associations with esophageal cancer risk. The strongest effect was observed for high intake of beta-cryptoxanthin (odds ratio = 0.16, 95% confidence interval = 0.08-0.36). Also, alpha-carotene, lycopene, and beta-sitosterol were associated with significant reductions in risk. Most antioxidants lost their effect when they were further adjusted for a term for all vegetables and fruits. beta-Carotene showed an increased risk with high intakes. On the other hand, vegetables and fruits remained as significant variables after adjustment for each antioxidant, suggesting that other substances or other mechanisms could explain this effect.     

细胞凋亡、血管内皮生长因子与食管鳞癌淋巴结转移及预后的关系

目的探讨食管鳞癌组织中细胞凋亡、血管内皮生长因子（VEGF）的表达与临床病理及预后的关系。方法采用原位DNA末端标记（TUNEL法）、免疫组化（S-P法）及组织病理学等方法，检测61例原发性食管鳞癌组织中细胞凋亡、VEGF的表达。计算出凋亡指数（AI）并测出VEGF的平均吸光度，进行单因素和多因素COX分析。结果AI和VEGF吸光度（A）与肿瘤的分化程度、TNM分期有关。低分化程度组和高TNM分期组VEGF吸光度明显高于高分化程度组及低TNM分期组（P〈0．01），而其AI值明显低于高分化程度组及低TNM分期组（P〈0．01）。浸润深度超过肌层组及有淋巴结转移组VEGF明显高于浸润深度未超过肌层及无淋巴结转移组（P〈0．01），而AI与浸润深度无关（P〉0．05）。单因素分析结果显示患者生存率降低与AI、VEGF、TNM分期、淋巴结转移、分化程度和浸润深度有关。将上述指标进行多因素COX分析，结果显示AI、VEGF是独立的预后因素。结论细胞凋亡和血管形成参与了食管鳞癌的形成；VEGF与食管鳞癌的血管形成密切相关，其表达增高与食管鳞癌的浸润及淋巴结转移有关；AI、VEGF是食管鳞癌独立的预后因素。     

Relationship between oral poor hygiene and broken teeth with oral tongue squamous cell carcinoma

Previous studies on etiology of squamous cell carcinoma (SCC) of the tongue have reported results with respect to long term exposure to cigarette smoking and alcohol abuse. The aim of this study was to investigate risk factors for SCC of the tongue in a set of patients with minimum exposure to cigarette smoking and alcohol. Sixty four cases with diagnosis of oral tongue SCC were reviewed in this study. The patients underwent surgical management at the educational and therapeutic centers, Imam and Buali Hospitals (Hamedan, Iran) between the dates of January 1990 and December 2006. Eighty five percent of patients were older than 40 years of age. Most of patients had poor oral hygiene, dental decay and halitosis. It appears that poor oral hygiene and nutritional deficiency can be considered as risk factors for the SCC of the tongue in west of Iran.