Occupational and environmental hazards associated with lung cancer.

In a hospital-based case-control study 194 lung cancer cases, 194 hospital controls, and 194 population controls were interviewed for their smoking, occupational, and residential history by trained interviewers, using a standardized questionnaire. In order to include many different environmental exposures, case ascertainment took place in seven different hospitals with catchment areas ranging from rural to highly industrialized. Lung cancer risk strongly increases with cumulative cigarette dose, reaching an odds ratio (OR) of 16.19 (95% confidence limits (CL): 5.10, 51.33) for male smokers of more than 40 pack-years and an OR of 19.99 (95% CL: 4.98, 80.24) for female smokers of more than 20 pack-years. For the quantification of occupational exposure to known carcinogens of the lung a novel approach was developed which accumulates exposure information obtained by supplemental questionnaires through an automatic procedure. The OR for the highest exposure group in males was 2.7 (95% CL: 1.23, 5.78). Significantly increased risks were observed in the metal industry, particularly in smelter and foundry workers (OR 4.8, 95% CL: 1.15, 20.16) and in turners (OR 2.2, 95% CL: 1.05, 4.75). In the construction industry the risks were particularly high in road construction workers (OR 3.7, 95% CL: 1.06, 13.20) and in unskilled construction workers (OR 2.7, 95% CL: 1.24, 5.76). The risks in these occupational groups increased with duration and with latency. Quantification of air pollution was done on a county basis by time period. An index based on emission data for sulphur dioxide was compared to a semiquantitative index, which included additional information on ambient air pollution. After adjustment for smoking and occupational exposures an OR of 1.01 (95% CL: 0.53, 1.91) for an emission index and of 1.16 (95% CL: 0.64, 2.13) for a semiquantitative index was obtained.     

Four cases of lung cancer associated with idiopathic interstitial pneumonia

It is well known that lung cancer develops frequently in patients with idiopathic interstitial pneumonia (IIP) (9.8-22.8%). We investigated 4 patients who developed lung cancer among the 28 patients with IIP (14.3%) who were admitted to our hospital from June 1981 to March 1989. Many reports have pointed out the clinical features of lung cancer associated with IIP as male sex, old age, heavy smoking, and poor prognosis. Our 4 series were agreed with these clinical features. Lung cancer associated with IIP have been often reported to occur in the lower and peripheral regions of the lung, and honeycomb structures are frequently seen. But we found that lung cancer in IIP could actually occur in both the lower and upper regions of the lung and does not occur only in the honeycomb structures. There was no obvious dominance of any histological type among the tumors. If lung cancer is suspected in a patient with IIP, tumor markers are of some value for diagnosis, but are not sensitive enough to be used alone.     

替考拉宁治疗肺癌合并肺部感染临床观察

目的观察替考拉宁治疗肺癌合并肺部感染患者的临床疗效和安全性。方法对32例确诊为肺癌同时合并肺部感染的患者,根据细菌学检查结果或经验性应用替考拉宁治疗,疗程7~14 d,对其疗效、细菌清除率及不良反应发生率进行统计学分析。结果替考拉宁治疗肺癌合并肺部感染,有效率为84.37%,细菌清除率为88.89%,不良反应发生率为6.25%。结论替考拉宁治疗肺癌合并肺部革兰阳性菌感染疗效确切,安全性高。     

矽肺合并肺癌三维适形放射治疗的临床观察

对41例矽肺合并肺癌患者进行三维适形放射治疗,结果显示,41例患者仅有4例出现放射性肺炎,所有患者肿瘤局部控制率好。治疗后完全缓解85.4%,稳定15.6%,不良反应可以耐受。提示三维适形放射治疗矽肺合并肺癌具有良好临床效果,可提高患者生活质量。     

周围结节型肺癌的CT诊断与病理观察

目的:探讨周围型肺癌影像学特征,提高对该病的认识。方法:收集经手术病理证实为周围性肺癌34例,其中腺癌27例,鳞癌7例,分析其影像学表现。结果:薄层扫描能很好地观察周围结节型肺癌的病灶特征。出现分叶征27例,毛刺征16例,胸膜凹陷征18例,空泡征12例,血管集束征6例。结论:通过对周围结节型肺癌的影像学分析,从而提高了对肺部结节性病变的诊断准确率。     

Evolving routines: preventing fatigue associated with lung and colorectal cancer

Some individuals with cancer develop fatigue whereas others do not. To begin the development of a biobehavioral model that could explain this phenomenon, the authors interviewed 29 individuals with lung and colorectal cancer before, during, and after treatment and obtained evaluable data for 18. Blood samples and body weight were obtained at the time of each interview. A three-stage process, evolving routines, and an adaptive behavioral mode labeled gliding characterized those who reported little or no fatigue, even when hemoglobin levels were low. Three other nonadaptive behavioral modes (inertia, disorganization, and overexertion) characterized those who reported fatigue. Individuals with similar disease and treatment profiles seldom demonstrated the same behavioral or biological response patterns.     

Raised mortality from lung cancer and high sex ratios of births associated with industrial pollution.

Geographical and temporal associations were shown between high mortality from lung cancer and a high sex ratio of births both in the town of Bathgate (Scotland) and in the area of that town which was most exposed to polluted air from a local steel foundry. These findings constituted a replication of a similar association in an adjacent town.     

胃癌伴癌综合征临床新表现1例报告

皮肤瘙痒常常与皮肤病或内分泌等疾病相联系,很少人把胃癌和皮肤瘙痒联系起来,现有1临床病例,以皮肤瘙痒为首发症状的胃癌患者,报道如下,以引起医务人员的注意,以期提高胃癌的早期诊断、早期治疗率.