外周血白细胞DNA甲基化与肿瘤发病相关性Meta分析

目的通过Meta分析探讨外周血DNA甲基化与癌症风险相关性。方法分别在4个英文数据库（PubMed,ISI WOK databases,Science Online,OVID）和3个中文数据库（CNKI,万方和VIP）中系统检索文献,检索日期截至2013-08,英文数据库检索的主题词为DNA methylation,blood or leukocyte和cancer,tumor,carcinoma,neoplasm or malignancy,不限制语言,中文数据库检索的主题词为DNA甲基化,外周血或白细胞和肿瘤或癌。文献质量评估应用Newcastle-Ottawa Scale（NOS）。应用固定效应模型（异质性检验I2〈25%）或随机效应模型（异质性检验I2≥25%）估计总体比值比（OR）和95%可信区间（95%CI）。结果共有22项外周血全基因组DNA甲基化和20项外周血特定基因DNA甲基化研究纳入分析,外周血全基因组DNA低甲基化（OR=1.34,95%CI：1.12-1.60,I2=89.1%,P=0.001）和外周血特定位点DNA过甲基化（OR=1.37,95%CI：1.24-1.52,I2=93.2%,P〈0.001）增加肿瘤总体发病风险。肿瘤类型亚族分析发现,外周血全基因组DNA低甲基化水平增加膀胱癌（OR=1.96,95%CI：1.44-2.48,I2=85.1%,P=0.001）、结直肠癌（OR=1.85,95%CI：1.36-2.35,I2=61.1%,P=0.012）、胃癌（OR=1.38,95%CI：1.08-1.68,I2=37.7%,P=0.170）和肝细胞肝癌（OR=1.38,95%CI：1.03-1.73,I2=77.3%,P=0.012）的发病风险。结论外周血DNA甲基化水平与肿瘤发生存在相关性,可能成为流行病学人群筛查的重要生物指标。     

结直肠癌患者血浆Septin9 DNA甲基化联合FOBT检测的临床应用价值

目的:探讨血浆Septin9 DNA甲基化及粪便隐血试验（FOBT）在结直肠癌（CRC）诊断中的应用价值。方法:回顾性收集2017年6月至2022年1月我院收治并经病理检查确诊的101例结直肠良性腺瘤患者、209例结直肠癌患者分别作为良性腺瘤组和结直肠癌组，选取同期在我院进行体检的98例健康人群作为正常对照组，比较三组一般资料及血浆Septin9 DNA甲基化及FOBT阳性情况，比较不同病理特征、不同临床分期结直肠癌患者血浆Septin9 DNA甲基化、FOBT阳性情况，采用受试者工作曲线（ROC）评估血浆Septin9 DNA甲基化、FOBT单项及联合检测对结直肠癌的诊断价值。结果:三组血浆Septin9 DNA甲基化、FOBT阳性率比较，结直肠癌组高于良性腺瘤组及正常对照组，良性腺瘤组高于正常对照组（P<0.05）；肿瘤低分化、淋巴结转移、脉管/神经侵犯的结直肠癌患者血浆Septin9 DNA甲基化和FOBT阳性率高于肿瘤高分化、中分化及未发生淋巴结转移、未发生脉管/神经侵犯的结直肠癌患者（P<0.05）；随着结直肠癌TNM临床分期升高，血浆Septin9 DNA甲基化及FOBT阳性率升高，差异具有统计学意义（P<0.05）；血浆Septin9 DNA甲基化和FOBT联合诊断结直肠癌的敏感度、曲线下面积（AUC）（87.08%、0.885）均高于两者单独诊断（59.33%、0.744和52.63%、0.643，P<0.05）；血浆Septin9 DNA甲基化诊断结直肠癌的特异度、阳性预测值和阴性预测值分别为89.45%、85.52%和67.68%；FOBT分别为76.38%、70.06%和60.56%，两者联合诊断分别为89.95%、90.10%和86.89%。联合诊断优于单项诊断。结论:随着结直肠病变恶性程度的增加，血浆Septin9 DNA甲基化和FOBT阳性率升高，血浆Septin9 DNA甲基化、FOBT联合检测对结直肠癌具有较高的诊断价值，可作为结直肠癌的实验室诊断指标。     

普通感冒与肿瘤发病关系的病例对照研究

目的:观察普通感冒对肿瘤发病风险的影响。方法:2021年1月至2021年5月,连续收集综合医院和社区医院就诊的532例肿瘤患者作为病例组,按年龄、性别、长期居住地进行1∶1匹配,收集同期同地点532名未患肿瘤者作为对照组。通过问卷调查、查阅门诊或住院病历的方式获取患者的临床资料。采用条件logistic回归进行单因素和多因素分析感冒对肿瘤发病风险的影响。结果:单因素分析显示,感冒的频率在病例组和对照组中有统计学差异(P＜0.05)。多因素分析显示,与每年感冒次数少于1次相比,每年患1次感冒（OR=0.461,95%CI:0.327~0.649）,患2次感冒（OR=0.224,95%CI:0.145~0.347）,患3次及以上感冒（OR=0.092,95%CI:0.046~0.182）肿瘤的发病风险降低。结论:一定频率的普通感冒可能与肿瘤发病风险降低有关。     

MDM2 启动子区309 位点基因多态性与乳腺癌风险的关系*

目的:采用病例- 对照研究检测MDM2 启动子区309 位点T>G 单核苷酸多态（SNP 309）在中国女性人群中的频率分布,分析其与中国女性乳腺癌发病风险的关系。方法:提取病例组698 例原发性乳腺癌患者及对照组525 例健康人的外周血单核细胞DNA,采用聚合酶链反应- 限制性片段长度多态性（PCR-RFLP ）分析法,检测MDM2 启动子区309 位点基因多态性,确定此位点三种基因型,即T/T、T/G、G/G 基因型。统计分析病例组和对照组人群MDM2 SNP 309 各基因型频率分布,及各基因型与乳腺癌发病风险的相关性。结果:在研究的病例组与对照组整体人群中,经年龄、月经状态、家族史及生育史等因素校正后,与MDM2 SNP 309 T/T基因型比较,T/G 型及G/G 型与乳腺癌的发病风险无显著相关性（T/G,adjusted OR= 1.2,95%CI:0.8～1.6,P=0.30;G/G,adjusted OR= 1.0,95%CI:0.7～1.5,P=0.88）。 进一步分层分析后显示:在绝经后人群中,与T/T基因型比较,T/G 基因型及G/G 基因型显著增加乳腺癌的发病风险（T/G,adjusted OR= 1.8,95%CI:1.2～3.0,P=0.011;G/G,adjusted OR= 1.9,95%CI:1.2～3.3,P=0.014）。 提示绝经后人群携带T/G 型、G/G 型者比携带T/T基因型者患乳腺癌的风险分别升高约1.8、1.9 倍。在绝经前人群中,各基因型与乳腺癌的发病风险无显著相关性（P>0.05）。 结论:MDM2 启动子309 位点突变型G 等位基因携带者显著增加绝经后女性乳腺癌的发病风险。      

鲁北地区子宫内膜癌发病因素病例对照研究

目的：了解子宫内膜癌发病情况及相关因素,为临床进行预防及治疗提供依据。方法：采用病例-对照流行病学分析方法,对鲁北地区6所三级医院2006-05-01-2011-10-01病理确诊的289例子宫内膜癌患者及174例对照进行统一问卷调查;采用单因素和多因素的Logistic回归分析,以OR和95%可信区间为评价指标,分析与子宫内膜癌有关联的危险性因素。结果：鲁北地区子宫内膜癌患者289例,其中子宫内膜样腺癌259例（90%）;非子宫内膜样腺癌（浆液性腺癌,透明细胞癌等）30例（10%）。Ⅰ期患者219例（76%）,Ⅱ期患者29例（10%）,Ⅲ~Ⅳ期患者共41例（14%）。子宫内膜癌的发病年龄为25~78岁,平均发病年龄为55.41岁,58~61岁为发病高峰。已绝经妇女占62%。单因素分析结果表明,高血压（OR=3.67,χ2=33.70,P=0.00）、糖尿病（OR=1.92,χ2=4.13,P=0.04）、肥胖（OR=4.63,χ2=50.62,P=0.00）、饮用茉莉花茶史（OR=2.63,χ2=19.84,P=0.00）、重体力劳动（OR=1.82,χ2=9.28,P=0.00）、月经不规律（OR=12.68,χ2=107.20,P=0.00）、口服中草药调经（OR=15.21,χ2=68.82,P=0.00）、绝经年龄（OR=1.10,χ2=11.56,P=0.00）、未产（OR=19.07,χ2=15.84,P=0.00）和一级亲属恶性肿瘤家族史（OR=2.91,χ2=12.22,P=0.00）等可增加子宫内膜癌发病风险;使用宫内节育器（intrauterine device,IUD）可降低子宫内膜癌发病风险,OR=0.29,χ2=37.21,P=0.00。多因素Logistic回归分析结果表明,高血压（OR=3.69,95%CI：1.89~7.22）、肥胖（OR=3.06,95%CI：1.62~5.75）、月经不规律（OR=4.53,95%CI：2.13~9.60）、口服中草药调经（OR=9.31,95%CI：2.91~29.76）、绝经年龄晚（OR=1.13,95%CI：1.06~1.20）和一级亲属恶性肿瘤家族史（OR=5.20,95%CI：2.13~12.73）是内膜癌发病的危险因素;使用IUD是内膜癌的保护性因素,OR=0.84,95%CI：0.79~0.88。结论：高血压、肥胖和绝经年龄等因素可影响子宫内膜癌的发生,应针对相关危险因素采取相应的预防措施。     

IL-10基因-592C>A多态性与宫颈癌易感性的Meta分析

目的:系统评估IL-10基因-592C>A多态性与宫颈癌易感性。方法:计算机检索Pubmed、EBSCO、Web of Science、中国知网、万方等数据库,搜集关于IL-10基因-592C>A多态性与宫颈癌易感性的相关研究文献。遵循文献纳入和排除标准,采用RevMan5.2软件进行Meta分析,计算、合并OR值及95%CI,最后进行偏倚分析和敏感性分析。结果:共纳入9篇文献,累计病例2 913例,对照2 037例。Meta分析结果显示,IL-10基因-592C>A多态性与宫颈癌总体发病风险之间未见显著关系(AA+CA vs CC:OR=0.92,95%CI=0.68~1.26,P=0.62;A vs C:OR=1.01,95%CI=0.82~1.23,P=0.95;AA vs CC:OR=1.04,95% CI=0.65~1.64,P=0.88;AA vs CA+CC:OR=1.08,95%CI=0.82~1.43,P=0.58;CA vs CC:OR=0.9,95%CI=0.67~1.19,P=0.45)。根据人群进行亚组分析结果显示,该基因多态性与亚洲人群及西方人群宫颈癌发病风险均无明显相关性（P>0.05）。结论:IL-10基因-592C>A多态性与宫颈癌易感性可能无关。     

DNA修复基因XPD XPC XRCC4基因多态性与结直肠癌易感性的关联性研究

  目的  探讨DNA修复基因XPD rs13181（codon751A/C,Lys751Gln）、rs238406（codon156C/A,Arg156Arg）、XPC rs2279017（i11C/A）和XRCC4 rs3734091（codon247T/C,Ala247Ser）的单核苷酸多态性与结直肠癌易感性的关系。  方法  采用TaqMan技术对2013年4月至2016年1月北京肿瘤医院收治的338例结直肠癌患者（病例组）和315例健康者（对照组）进行多态位点基因型的检测。  结果  XPD rs13181基因型GT和等位基因G增加个体结直肠癌的发病风险（GT>TT,adjusted OR=1.69,95%CI:1.15~2.47,P=0.007;G>T,adjusted OR=1.77,95%CI:1.19~2.64,P=0.005）;XRCC4 rs3734091基因型GT和等位基因T增加个体结直肠癌的易感性（GT>GG,adjusted OR=9.02,95%CI:5.61~14.50,P＜0.001;T>G,adjusted OR=4.06,95%CI:2.49~6.61,P＜0.001）;XPD rs13181和rs238406的单倍体型GT显著降低结直肠癌的发病风险（adjusted OR=0.39,95%CI:0.18~0.85,P=0.018）。XPCrs2279017等位基因G和XRCC4 rs3734091等位基因T的联合效应（adjusted OR=28.43,95%CI:6.85~117.95,P＜0.001）以及XPD rs13181等位基因G和XRCC4 rs3734091等位基因T的联合效应（adjusted OR=10.24,95%CI:4.69~22.35,P＜0.001）显著增加个体结直肠癌的易感性。  结论  XPD rs13181和XRCC4 rs3734091位点的多态性与结直肠癌的易感性相关。      

饮酒与膀胱癌关系的全人群病例对照研究

目的探讨饮酒与膀胱癌发生的关系。方法采用全人群为基础的病例对照研究,共调查1996年1月1日~1998年12月31日期间确诊的上海市区膀胱癌新发病例608例,健康人群对照607例。采用非条件logistic回归分析,调整吸烟等可能的混杂因素,以估计饮酒对膀胱癌发生的危险度及其95%可信区间。结果与不饮酒者相比,男、女性饮酒者患膀胱癌相对危险度分别是1.22(95%CI0.94~1.59)、0.50(95%CI0.13~1.90)。男性随总酒精摄入量增加患膀胱癌的危险有增加趋势,OR值分别为1.10(1~80g/d)和1.56(>80g/d)(趋势检验P=0.043)。男性总酒精摄入量与饮酒年限的联合作用分析表明,与不饮酒者相比,总酒精摄入量超过80g/d、饮酒年限超过40年者患膀胱癌危险度为2.11(95%CI1.11~4.01)。将饮酒分3层、吸烟分4层进行男性饮酒与吸烟的联合作用分析,结果显示总酒精摄入量>80g/d且吸烟≥35包年者的OR值为2.78(95%CI1.46~5.28)。未发现各饮酒种类与男性膀胱癌有显著关联。在不吸烟男性组中的分析显示,饮酒习惯的OR值均没有统计学意义。结论饮酒可能与男性膀胱癌有一定联系,但作用较弱,似乎主要表现为对吸烟男性的作用。     

血清睾酮水平与乳腺癌雌、孕激素受体表达的相关性研究

目的:回顾性研究血清睾酮（testosterone,T）水平与乳腺癌雌激素受体（estrogen receptor,ER）,孕激素受体（progesterone receptor,PR）表达的相关性。方法:回顾性分析2016年1月至2018年12月在南京市妇幼保健院进行体检和治疗的63例健康女性,99例良性肿瘤,204例乳腺癌的临床病理资料,比较三组之间的血清睾酮水平的差异。将所有204例乳腺癌患者根据睾酮水平由低到高排序,按四分位数分为4组,采用Logistic回归比较不同睾酮水平下4组乳腺癌患者ER、PR、Her2表达状态的比值比（OR）。结果:乳腺癌组血清睾酮水平与乳腺良性肿瘤组、健康对照组相比差异均无统计学意义（P＞0.05）。ER+和PR+乳腺癌患者中血清睾酮水平分别高于ER-和PR-患者,而Her2+乳腺癌患者中血清睾酮水平低于Her2-患者,差异均有统计学意义（P＜0.05）。采用Logistic回归计算OR值,根据绝经与否进一步分层,其中T≥0.44 ng/mL组相对于T≤0.22 ng/mL组ER阳性表达的总体OR值为2.46（95%CI=1.04~5.86,P=0.042）,绝经前OR值为3.77（95%CI=1.11~12.80,P=0.034）,绝经后OR值为1.05（95%CI=0.28~3.92,P=0.945）;T≥0.44 ng/mL组相对于T≤0.22 ng/mL组PR阳性表达的总体OR值为3.69（95%CI=1.60~8.49,P=0.002）,绝经前OR值为4.80（95%CI=1.51~15.23,P=0.008）,绝经后OR值为1.78（95%CI=0.47~6.71,P=0.396）,结果显示绝经前乳腺癌患者中ER、PR的阳性表达与血清睾酮水平呈现出明显的正相关性;而Her2阳性表达与血清睾酮水平在总体、绝经前、绝经后乳腺癌患者中均未表现出明显的负相关性。结论:高血清睾酮水平与乳腺癌ER、PR的阳性表达呈正相关,在绝经前乳腺癌患者中表现尤为显著。血清睾酮水平可以作为预测绝经前激素受体状态的标志物之一。     

RASSF1基因SNP与陕西地区结直肠癌发病风险关系的研究

目的:探讨RASSF1基因第三外显子G133T和第六外显子A315G单核苷酸多态性(SNP)与陕西地区汉族人群结直肠癌(CRC)易感性的关系。方法:采用基于人群的病例对照研究,聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法检测61例CRC和122例健康对照个体RASSF1基因多态位点的基因型频率分布,比较不同基因型与CRC发生风险的关系。结果:RASSF1基因G133T多态的T等位基因频率在CRC患者组为24.6%,显著高于健康对照组的6.1%(P=0.00)。与G/G基因型相比,携带G/T基因型的个体CRC的发病风险显著增加,经性别、年龄、吸烟状况、GIC家族史校正后的OR值为2.33(95%CI=1.05-5.15)。RASSF1基因A315G多态的G等位基因频率在CRC患者组为25.4%,显著高于健康对照组的11.9%(P=0.00)。根据个体吸烟状况进行分层分析发现,与A/A基因型相比,携带A/G基因型和G等位基因(A/G+G/G基因型)可显著增加吸烟个体CRC的发病风险,经性别、年龄、GIC家族史校正后的OR值为4.5(95%CI=1.65-12.28)。根据GIC家族史进行分层分析发现,与A/A基因型相比,携带A/G基因型或G等位基因(A/G+G/G基因型)可显著增加GIC家族史阳性个体CRC的发病风险,经性别、年龄、吸烟状况校正后的OR值为3.78(95%CI=1.39-10.19)。结论:携带RASSF1基因G133T多态的T等位基因(G/T+T/T基因型)可能显著增加陕西地区人群CRC的发病风险。携带RASSF1基因A315G多态的G等位基因(A/G+G/G基因型)可能显著增加陕西地区人群CRC的发病风险。分层分析发现,G等位基因(A/G+G/G基因型)可能显著增加吸烟个体和GIC家族史阳性个体CRC的发病风险。     

定量粪便免疫化学试验筛查阈值对结直肠肿瘤早筛价值的影响

目的:分析定量粪便免疫化学试验（fecal immunochemistry test，FIT）筛查阈值对体检人群结直肠肿瘤早筛价值的影响。方法:以2017年07月至2021年06月在我院接受定量FIT检测并行肠镜检查的1 267例人群为研究对象，比较不同性质肿瘤的定量FIT数值和阳性率。通过Logistic 回归和受试者工作特征（receiver operating characteristic，ROC）曲线分析比较不同性别、年龄和不同阳性阈值下定量FIT对进展期肿瘤的筛检效能。结果:定量 FIT筛查阳性率为4.7%，阳性人群肠镜依从性为22.2%。结直肠癌患者的定量FIT数值高于进展期腺瘤和其他肠镜结果。当定量FIT水平为100~199 μg/L、200~299 μg/L、300~499 μg/L和500 μg/L以上时，患进展期肿瘤的风险分别是<100 μg/L时的4.296倍、4.121倍、6.506倍和10.474倍。不同阳性阈值下，FIT阳性组进展期肿瘤检出率均高于阴性组，且在男性和50~75岁人群中均有统计学差异。在100 μg/L时的比值比（odds ratio，OR）最大（总体OR=6.817，95%CI:2.727~17.040；男性OR=5.570，95%CI:2.198~14.115；50~75岁OR=10.178，95%CI:3.158~32.803）。此时，定量FIT对进展期肿瘤的灵敏度分别为94.7%、93.0%、96.2%，特异度分别为27.6%、29.6%、28.7%。当阳性阈值由100 μg/L升高至500 μg/L时，FIT诊断进展期肿瘤的灵敏度下降，特异度升高，但阳性预测值和阴性预测值变化不大。结论:定量FIT阳性阈值在100 μg/L时筛查进展期结直肠肿瘤的灵敏度较好，但特异度较低，是应用在体检人群伺机性筛查中较好的结直肠肿瘤早筛参考指标。     

结直肠癌发病风险与ABO血型分布的关系

目的:探讨结直肠癌患病风险与ABO血型分布的关系。方法:通过LinkDoc数据库（LinkDoc Data）抽取辽宁省肿瘤医院含有ABO血型信息的结直肠癌住院患者的数据2 333例,与本地区另一家三甲医院的血型样本（36 124例）对照,回顾性分析不同血型患结直肠癌的风险。结果:2 333例结直肠癌患者中,A型患者663例（28.42%）,AB型患者689例（29.53%）,B型患者721例（30.90%）,O型患者260例（11.14%）。与对照组比较,AB型较非AB型结直肠癌患病风险升高（OR=3.54,95%CI=3.219~3.893）,O型较非O型结直肠癌患病风险下降（OR=0.299,95%CI=0.262~0.341）。结论:结直肠癌患者ABO血型分布与对照人群ABO血型分布有明显差别,AB型人群较其它血型人群结直肠癌发生风险升高,而O型结直肠癌发生风险降低,血型可能是结直肠癌发生的危险因素之一,但是有地域差别,在本地区AB血型人群应该是结直肠癌重点筛查对象。     

Food groups and the risk of colorectal carcinoma in an Asian population

BACKGROUND: Singapore Chinese have experienced a rapid transition toward a pattern of disease in which lifestyle-related, chronic, degenerative diseases are major public health concerns. The rates of colorectal carcinoma have increased 2-fold over the last 3 decades. It has long been known that dietary factors play a role in the risk of this disease, although studies in Asian populations, with their unique dietary intake, have been few. METHODS: The authors conducted a population-based case-control study that included 121 Chinese patients with colorectal carcinoma and 222 healthy control participants who provided information on usual intake of major food groups in the preceding 3 years, physical activity, family history of colorectal carcinoma, and demographic variables through an in-person questionnaire. RESULTS: High intake of red meat, but not other meats, indicated a predisposition to risk of colorectal carcinoma (adjusted odds ratio [OR] for the highest tertile vs. the lowest tertile, 2.2; 95% confidence interval [95%CI], 1.1-4.2). A low vegetable intake also was associated with a higher risk, and the combined effect appeared to be additive. Those in the highest tertile of meat intake and the lowest quartile of vegetable intake had an OR of 2.6 (95%CI, 1.0-6.7). The authors observed a slight, albeit nonsignificant, positive association with foods high in refined sugars. There was no association observed with fruit or soy-legume intake in this study. Among nondietary variables, a family history of colorectal carcinoma conferred a significant increase in risk (OR, 6.7; 95% CI 2.4-18.7). CONCLUSIONS: Meat intake and vegetable intake were associated significantly with risk of colorectal carcinoma in this Asian population, and further studies on the effects of changes in these specific types of food may shed light on how best to reduce the rapid increase in rates in similar populations.     

结直肠癌患者CD4+、CD8+T淋巴细胞介导免疫功能的影响因素

目的:探讨结直肠癌患者(colorectal cancer,CRC)CD4+、CD8+T淋巴细胞介导的细胞免疫功能与术前检查肿瘤标记物,患者术前基础疾病和一般情况之间的关系,研究发现影响CRC细胞免疫功能的高危因素。方法:收集2010年02月至2020年06月广西科技大学第二附属医院普通外科218例CRC患者完整的细胞免疫,肿瘤标志物,患者术前基础疾病和一般情况等资料,对数据进行统计描述,临床上界定各检验指标的正常值范围:细胞免疫CD4+和CD4+/CD8+的正常值分别为320~1 250个/μL和0.9~2.0;肿瘤标记物CEA,CA199,CA125,CA153,CA242,CA724的正常值范围分别为0~5 μg/L,0~37 μg/L,0~35 μg/L,0~31.3 μg/L,0~20 μg/L,0~5.7 μg/L。临床上常以患者外周血液检测中的CD4+T淋巴细胞计数或CD4+/CD8+比值低于正常值范围定义为患者的细胞免疫功能低下。对其进行回顾性研究分析,采用统计学SPSS 24.0统计软件,对计量资料用P-P图做正态性检验,对数据先进行单因素分析,有统计学意义的因素进入多因素二元Logistic回归分析的方法,研究发现结直肠癌患者CD4+、CD8+T淋巴细胞介导的细胞免疫功能与各临床参数之间的关系。结果:男性的CD4+水平低于女性,差异有统计学意义（P＜0.05）。血型对细胞免疫功能影响无统计学差异（P＞0.05）。CEA和CA199升高组CD4+水平均低于正常组,差异有统计学意义（P＜0.05）。年龄、T分期、术前心血管病分组、呼吸系统疾病分组的患者细胞免疫功能低下率差异无统计学意义（P＞0.05）。术前患有糖尿病患者细胞免疫功能低下率高于术前未患糖尿病患者,差异有统计学意义（P＜0.01）,术前有吸烟史患者细胞免疫功能低下率高于术前无吸烟史患者,差异有统计学意义（P＜0.01）。CRC细胞免疫功能影响因素的二元Logistic多因素回归分析:术前糖尿病史和术前有吸烟史是导致细胞免疫功能低下的危险因素(OR=5.372,95%CI:2.656~10.865,P＜0.001;OR=4.467,95%CI:2.105~9.476,P＜0.001）。结论:术前有糖尿病史和术前有吸烟史是影响CRC的CD4+、CD8+T淋巴细胞介导的细胞免疫功能低下的独立危险因素,其中术前有吸烟史最显著。患者的性别,术前检查肿瘤标记物CEA和CA199水平对判断CRC细胞免疫功能有一定的参考价值。     

Dietary Factors and Risk of Pancreatic Cancer: a Multi-Centre Case-Control Study in China

Background: Pancreatic cancer is the sixth leading cause of cancer death with an increasing trend in China.Dietary intake is believed to play an important role in pancreatic cancer carcinogenesis. The aim of this paper wasto evaluate associations between some dietary factors and risk of pancreatic cancer in a multi-centre case-controlstudy conducted in China. Materials and Methods: Cases (n=323) were ascertained from four provincial cancerhospitals. Controls (n=323) were randomly selected from the family members of patients without pancreaticcancer in the same hospitals, 1:1 matched to cases by gender, age and study center. Data were collected with aquestionnaire by personal interview. Odds ratios (OR) and 95% confidence intervals (95%CI) were estimatedusing conditional logistic regression. Results: Tea intake (OR =0.49; 95%CI: 0.30-0.80) was associated with a halfreduction in risk of pancreatic cancer. Reduced vegetable consumption (P trend: 0.04) was significant related topancreatic cancer. Although no significant association was found for meat and fruit, ORs were all above or belowthe reference group. A protective effect was found for fruit (OR=1.73 for consumption of 1-2 times/week vs morethan 3 times/week; 95%CI: 1.05-2.86). A high intake of meat was associated to a higher risk of pancreatic cancer(OR=0.59 for consumption of 1-2 times /week vs. more than 3 times /week; 95%CI: 0.35-0.97). Conclusions: Thepresent study supports fruit consumption to reduce pancreatic cancer risk and indicates that high consumptionof meat is related to an elevated risk. Direct inverse relations with tea and vegetable intake were also confirmed.     

Dietary Fibre and the Risk of Colorectal Cancer: a Case-Control Study

Background: Colorectal cancer is one of the most commonly occurring cancers in China. Dietary fibre hasbeen thought to decrease the risk of colorectal cancer in Western countries. However, studies investigatingthe association between dietary fibre (particularly soluble and insoluble fibres) and colorectal cancer havehitherto been lacking in China. Objective: This case-control study examined the effect of dietary fibre intakeon the risk of colorectal cancer, stratified by tumour site. Materials and Methods: The study included 265 cases(colon cancer, 105; rectal cancer, 144; colon and rectal cancer, 16) and 252 controls residing in Qingdao. A foodfrequency questionnaire that included 121 food items was used to collect dietary information. Odds ratio (OR)and 95% confidence intervals (CI) were calculated using unconditional logistic regression analysis. Results:For food groups, controls in the study consumed more vegetables, soy food and total fibre than did colorectalcancer patients (p<0.05). The intakes of fruit, meat and sea-food did not differ significantly between cases andcontrols. However, we did not find any association between soy food intake and colon cancer. We observed inverseassociations between total fibre intake and colorectal, colon and rectal cancer (Q4 vs Q1: OR=0.44, 95%CI, 0.27-0.73; OR=0.40, 95%CI, 0.21-0.76; OR=0.52, 95%CI, 0.29-0.91). Vegetable fibre intake showed similar inverseassociations (Q4 vs Q1: OR=0.51, 95%CI, 0.31-0.85; OR=0.48, 95%CI, 0.25-0.91; OR=0.53, 95%CI, 0.29-0.97). Inaddition, inverse associations were observed between soluble fibre and insoluble fibre and both colorectal cancerand colon cancer. No relationship was found between colorectal cancer and fruit, soy or grain fibre intakewhenthe results were stratified by tumour site. Conclusions: The present study suggests that vegetable fibre and totalfibre play very important roles in protecting against colorectal cancer. Soluble and insoluble fibres were inverselyassociated with only colorectal cancer and colon cancer.     

Meat intake,cooking methods and risk of proximal colon,distal colon and rectal cancer: The Norwegian Women and Cancer (NOWAC) cohort study

Red and processed meat intake is an established risk factor for colorectal cancer (CRC), but epidemiological evidence by subsite and sex is still limited. In the population‐based Norwegian Women and Cancer cohort, we examined associations of meat intake with incident proximal colon, distal colon and rectal cancer, in 84,538 women who completed a validated food frequency questionnaire (FFQ) during 1996–1998 or 2003–2005 (baseline or exposure update) at age 41–70 years, with follow‐up by register linkages through 2009. We also examined the effect of meat cooking methods in a subsample (n = 43,636). Multivariable hazard ratios (HRs) were estimated by Cox regression. There were 459 colon (242 proximal and 167 distal), and 215 rectal cancer cases with follow‐up ≥ 1 (median 11.1) year. Processed meat intake ≥60 vs. <15 g/day was associated with significantly increased cancer risk in all subsites with HRs (95% confidence interval, CI) of 1.69 (1.05–2.72) for proximal colon, 2.13 (1.18–3.83) for distal colon and 1.71 (1.02–2.85) for rectal cancer. Regression calibration of continuous effects based on repeated 24‐hr dietary recalls, indicated attenuation due to measurement errors in FFQ data, but corrected HRs were not statistically significant due to wider CIs. Our study did not support an association between CRC risk and intake of red meat, chicken, or meat cooking methods, but a high processed meat intake was associated with increased risk of proximal colon, distal colon and rectal cancer. The effect of processed meat was mainly driven by the intake of sausages.     

Aberrant promoter methylation of the vimentin gene may contribute to colorectal carcinogenesis: a meta-analysis

This meta-analysis of published cohort studies was conducted to evaluate how closely the promoter methylation of the vimentin gene is correlated with the pathogenesis of colorectal carcinogenesis (CRC). The Web of Science (1945?~?2013), Cochrane Library Database (issue 12, 2013), PubMed (1966?~?2013), EMBASE (1980?~?2013), CINAHL (1982?~?2013), and Chinese Biomedical Database (CBM) (1982?~?2013) were searched without language restrictions. Meta-analyses were conducted using Stata software (Version 12.0, Stata Corporation, College Station, TX, USA). Odds ratios (ORs) and 95 % confidence intervals (95 %CI) were calculated. Seven clinical cohort studies with a total of 467 CRC subjects met our inclusion criteria. Our meta-analysis results demonstrated that the frequency of vimentin promoter methylation in cancer tissues was significantly higher than in normal and benign tissues (cancer tissues vs. normal tissues: OR?=?32.41, 95 %CI?=?21.04?~?49.93, P?<?0.001; cancer tissues vs. benign tissues: OR?=?1.60, 95 %CI 1.05?~?2.42, P?=?0.028). Ethnicity-stratified analysis indicated that the frequency of aberrant vimentin promoter methylation was correlated with the pathogenesis of CRC in both Asians and Caucasians. The findings of our meta-analysis confirm that vimentin methylation may play a crucial role in the pathogenesis of CRC.