肺癌危险因素联合作用的人群归因危险度研究

目的：探讨肺癌危险因素,提高肺癌危险因素评价的实用价值。方法：利用2002年武汉市新发肺癌的病例对照调查资料,分析肺癌的主要危险因素,并在控制其他因素的基础上,分别估计各主要危险因素的调整人群归因危险度和总的联合作用的人群归因危险度以及两因素间交互作用的人群归因危险度。结果：武汉市肺癌主要危险因素为吸烟、人均月收入低、住地附近有污染源、精神压抑和慢性支气管炎病史,其调整的人群归因危险度分别为0．4908、0．1562、0．1559、0．1359和0．1308,五个因素总的人群归因危险度为0．7172;吸烟加精神压抑、吸烟加住地附近有污染源的协同作用表现最为显著,其交互作用指数分别为0．66和0．64;吸烟与精神压抑、住地附近有污染源、人均月收入低、慢性支气管炎病史的协同作用的人群归因危险度分别达到0．5819、0．4975、0．3845、0．2757,其中吸烟与慢性支气管炎病史表现为相加作用,吸烟与人均月收入低、住地附近有污染源及精神压抑之间均表现为相乘作用。结论：同时暴露于吸烟与其他危险因素,特别是吸烟与住地附近有污染源或精神压抑,可明显增加患肺癌的危险度。     

唐山地区农村居民肺癌发病危险因素分析

目的应用1∶1配对病例对照研究的方法,探讨目前唐山地区农民肺癌发病的危险因素,为开展农村肺癌的预防提供科学依据。方法原发性肺癌住院患者中,选取其中长期（10年以上）从事农业生产的农民为病例进行问卷调查。对照来自上述同一医院除外呼吸系统疾病的非肿瘤的同期住院患者,以性别相同、年龄相差不超过5岁、居住地相近（至少同一县区）为条件,按1∶1配对的原则选取一名长期（10年以上）从事农业生产的农民组成对照。结果经过多因素条件Logistic回归分析,发现吸烟、10年前炕冒烟、长期室内燃煤、10年前房屋周围有工厂、累计接触农药剂量大、慢性支气管炎病史、长期生活紧张、过多摄入腌制食物可能为唐山地区农民肺癌发病的危险因素;较多的摄入蔬菜水果可能为唐山地区农民肺癌发病的保护性因素。结论①吸烟、10年前炕冒烟、长期室内燃煤、10年前房屋周围有工厂、累计接触农药剂量大、慢性支气管炎病史、长期生活紧张、过多摄入腌制食物可能为唐山地区农民肺癌发病的危险因素;②较多的摄入蔬菜水果可能为唐山地区农民肺癌发病的保护性因素。     

四川泸州人群DNA修复基因多态性与鼻咽癌风险的关系

目的 研究四川泸州人群X线修复交叉互补基因1(XRCC1)Arg194Trp,Arg280His多态性与鼻咽癌风险的关系.方法 采用病例对照研究方法,PCR-RFLP检测220例鼻咽癌患者及性别、年龄相匹配的250例正常人群XRCC1 Arg194Trp,Arg280His多态性分布及与鼻咽癌风险的关系.结果 病例组和对照组Arg194Trp基因型频率分布差异有显著性(P＜0.05),Arg194Trp多态性可能与个体患鼻咽癌风险相关,等位基因Trp可能增加个体患鼻咽癌的风险(OR=1.628,95%CI为1.194～2.221),Arg280His在两组中分布差异无显著性(P＞0.05).结论 Arg194Trp多态性可能与鼻咽癌风险相关,Arg280His多态性与鼻咽癌易感性无关.     

Early results of urothelial carcinoma screening in a risk population of coke workers: urothelial carcinoma among coke workers

Objective To present the protocol and the early results of a urothelial carcinoma （UC） screening analysis performed in a risk population of coke workers. Methods Between June 2006 and October 2008, 171 male workers （mean age 43 years）, employed in a Ligurian coke plant （Italiana Coke S.r.l） and exposed to polycyclic aromatic hydrocarbons （PAHs） for a median period of 16 years, underwent screening for UC. Urological evaluation included medical history, physical examination, routine laboratory tests, urine analysis, urinary cytology and uCyt＋ assay. In the event of signs and symptoms suggestive of UC or positive urinary tests, the workers were also subjected to urinary ultrasonography and cystoscopy with biopsy of any suspicious lesions. Results Regarding the laboratory tests, 19/171 （11%） uCyt＋ samples were considered inadequate and were excluded from the outcomes assessment. Overall, urine analysis, cytology and uCyt＋ were positive in 18/152 （12%） subjects who showed no evidence of UC at the scheduled check-ups. No significant association was identified between marker positivity and occupational activity. Conclusions Our results fail to show an increased risk of UC among the coke workers evaluated. However, they will need to be confirmed in the future by a larger enrollment and a longer follow-up in order to assess the definitive risk for UC after exposure to coke.     

汉族人群白细胞介素-2基因多态性与鼻咽癌风险的关系

目的研究四川汉族人群白细胞介素-2基因（IL-2）-330T/G及＋114G/T基因多态性与鼻咽癌风险的关系。方法采用病例对照研究方法,PCR-RFLP检测180例汉族人和150例鼻咽癌患者IL-2-330T/G、＋114G/T的多态性分布及与鼻咽癌风险的关系。结果病例组和对照组两多态性位点基因型频率分布无显著性差异（P〉0.05）,两多态性位点未增加个体患鼻咽癌的风险（P〉0.05）。结论 IL-2-330T/G、＋114G/T多态性与鼻咽癌易感性无关。     

高危高龄肺癌患者的外科治疗及围术期处理

目的 总结高危高龄肺癌病人的围手术期处理经验.方法 回顾性分析在2000年1月至2008年12月期间,我科收治的116例高危高龄肺癌患者手术资料.术前测定右心室射血分数,按照所测RVEF值分成<0.4组及≥0.4组,统计各组并发症发生率.结果 全组112例治愈,住院死亡4例,并发症发生率46.4%.结论 高危高龄肺癌患者通过严格的心肺功能评估,选择适当的手术方式,积极防治术后并发症,可以获得相对良好的外科治疗效果.     

Gastric carcinoma in the Kenyan African population

Fifty three consecutive patients with histological evidence of gastric carcinoma were studied between June 1987 and June 1989 at Kenyatta National Hospital (KNH). The male to female ration was 3.4:1 and the peak age of occurrence was in the 7th decade with 62.3% of gastric carcinoma being at the gastric antrum. Poorly differentiated adenocarcinoma was found in 68.2% of patients while well differentiated adenocarcinoma in 4.5% of cases. Intestinal metaplasia was a rare finding. If Lauren's classification of gastric carcinoma is considered then diffuse type of gastric cancer is by far the commoner type in our environment.