Efficacy of Lung Cancer Screening; Comparison of Results from a Case-Control Study and a Survival Analysis

A case-control study to evaluate the efficacy of lung cancer screening conducted by us showed that lung cancer screening may reduce the mortality of the disease up to 28%. Assuming this efficacy is unbiased, and that the screening rate is 51.6%, which was observed in the control group in the above study, the number of lung cancer deaths prevented by screening in the study period was calculated to be 47 for males and females combined. In the same study population, screen-detected lung cancer patients (N = 207) in the same study period were followed and the 7-year survival rate (46.9%) was compared to the 5-year survival rate (11.3%) obtained by the Osaka Cancer Registry, in which screen-detected lung cancer patients were only 1.8%. The number of lung cancer deaths prevented by screening, estimated by the difference in the above two survival rates, was 74 (95% confidence interval; 55–93). The number of lung cancer deaths prevented by screening estimated from the case-control study was significantly lower than that estimated from the survival analysis. This indicates that the efficacy of lung cancer screening estimated by the case-control study was within the range that could be explained by the actual long-term survivors among the screen-detected patients in the study population.     

Localized pleural plaques and lung cancer.

In a mass chest radiography survey conducted in 1971 for 7,986 residents of three Finnish communities, 604 subjects (7.6%) with pleural plaques but not other asbestos-related radiographic signs were identified. The same number of referents, each individually matched to each plaque carrier on sex, birth year, and community, was selected from among persons in the same source population with no pleural plaques. The two groups were followed for investigation of incidence of lung cancer during 1972-1989. Twenty-eight of those with plaques and 25 referents contracted lung cancer (crude conditional RR = 1.1; CL95 = 0.7, 1.9). The application of the proportional hazards model, with adjustment for sex, age, and residence, resulted in a hazard ratio of 1.1 (CL = 0.6, 1.8). The risk ratio estimate may be biased; hence, the result is inconclusive in regard to the predictive assessment of lung cancer risk among carriers of pleural plaques.     

因症就诊检出早期大肠癌的临床及病理学特征

目的探讨在就诊的肛肠病人中如何提高早期大肠癌的检出率。方法在１１家医院推广对肛肠病人的四项检查程序——直肠指检，乙结镜检查，大便隐血试验，和Ｘ线气钡灌肠造影。结果在４８２１例有肛肠症状的病人中，检出大肠癌１８８例，检出率为３．９％，其中１８０例有术后病理诊断。４７／１８０例（２６．１％）属早期癌（ＤｕｋｅｓｓｔａｇｅＡ）。４１／４７例由上述四项检查作出初步诊断。初发症状为：（１）便血（２６例，持续１５．２±９．４周后就诊，肿瘤平均直径２．５８ｃｍ）；（２）大便习惯改变（９例，３３．４±１９．７周，３．３９ｃｍ）；（３）腹痛腹块（１０例，１９．２±１１．２周，５．０ｃｍ）；（４）贫血（２例，１７．２±９．９周，４．７５ｃｍ）。８／１２例的Ａ０和Ａ１期病例属便血组，并多位于直肠。４１／４７例以高、中分化腺癌为主，其中１５例伴有腺瘤癌变。术前曾作活检的２７例中，１２例未检出癌变细胞。结论四项检查对检出早期大肠癌是有效的，便血是提示早期癌最有价值的症状，加强大肠癌防治宣教，采用瘤灶多点或全瘤活检技术，高度重视大肠腺瘤和不典型增生等癌前病变，将有助于提高早期大肠癌的检出率     

胃癌患者胃液可溶性白细胞介素-2受体初步研究

应用双抗体夹心ELISA法对87例消化道疾病患者胃液可溶性白细胞介素-2受体(sIL-2R)水平进行测定。结果表明,胃癌患者胃液sIL-2R水平明显高于慢性浅表性胃炎及十二指肠溃疡患者(P相似文献   

大肠癌病人血清胃泌素水平变化及其意义

采用放射免疫方法测定了３１例大肠癌、１３例非肿瘤者血清标本和２０例大肠癌组织、邻近肿瘤（〈３ｃｍ）及远离肿瘤（５ｃｍ）之结肠粘膜组织匀浆标本中的胃泌素浓度。发现：Ｄｕｋｅｓ Ｃ．Ｄ期大肠癌病人血清胃泌素显著高于非肿瘤者（Ｐ〈０．０５）；血清胃泌素浓度与病程进展呈显著正相关（Ｐ〈０．０５）；直肠癌病人血清胃泌素显著高于非肿瘤（Ｐ〈０．０５）；血清胃泌素水平与肿瘤分化程度无关；肿瘤切除后血清胃泌素显著     

Protein kinase C agonist and antagonist effects in normal human epidermal keratinocytes

Abstract Several lines of evidence implicate protein kinase C (PKC) in the development of basal cell and squamous cell carcinomas, tumors which originate from epidermal keratinocytes. To examine PKC in a model relevant to human skin, we exposed normal human epidermal keratinocytes (NHEK) in serum-free media to a variety of PKC agonists and antagonists. NHEK PKC activity increased up to 10-fold within the 1st hour of exposure to tetradecanoyl phorbol acetate (TPA), and gradually returned to control values within 72 h. TPA-induced PKC activity was enhanced by pretreatment of cultures with protein and RNA synthesis inhibitors. TPA-induced growth arrest and differentiation was antagonized by staurosporine. Down-regulation by bryostatin pretreatment blocked TPA-stimulated differentiation. Our overall conclusion is that activation of PKC in cultured human keratinocytes is required for differentiation. These results are crucial to the analysis of compounds suspected of promoting or inhibiting epidermal tumors.     

Streptococcus sanguis bacteremia and colorectal cancer: A case report

Streptococcus sanguis, usually considered a nonpathogen of the oral cavity, was isolated from blood cultures from a patient who was subsequently found to have a cecal adenocarcinoma. Further studies are needed to determine if Streptococcus sanguis infections have diagnostic implications similar to those of Streptococcus bovis. © 1995 Wiley-Liss, Inc.     

Bone mineral density in patients with prostatic cancer treated with orchidectomy and with estrogens

Bone mineral density (BMD) and bone mineral content (BMC) were measured in the femoral neck area, trochanteric area and Wards triangle, and in the distal radius of the left forearm before and after 1 year of endocrine treatment in 27 patients with prostatic cancer. Eleven of the patients were treated with orchidectomy and 16 with combined oral and intramuscular estrogens. The patients were free from metastases during the entire observation period. In the orchidectomized patients, BMD and BMC of the distal radius decreased significantly following treatment, whereas no changes were observed in the estrogen-treated patients. These preliminary results demonstrate that estrogens may protect bone in male subjects also and may merit further investigations on larger groups of patients.     

肝门胆管癌的外科治疗60例临床分析

肝门胆管癌近年有增多趋势,本文报告我院1975年～1985年间肝门胆管癌60例,占全部肝外胆管癌82例之73.1％,占同期全部胆道手术3626例之1.65％。临床表现主要有三型:1)阻塞性黄疸29例,其中25例曾误诊为肝炎;2)急性胆管炎12例;3)长期胆道疾病14例,其他5例。本组行B超检查19例,ERCP10例,PTC39例。最后诊断根据PTC和/或ERCP,剖腹术及病理检查结果。 56例施行了手术治疗,仅6例施行肿瘤连同半肝切除,姑息性肝胆管内引流15例,外引流23例,其他方法12例。平均存活时间:6例切除组24.5月,48例姑息手术组8.7月,未手术的4例为5月。文中强调早期诊断,凡40岁以上出现阻塞性黄疸或“传染性肝炎”均须警惕胆管癌,进行B超,CT,ERCP或PTC检查,文中强调PTC是诊断本病重要手段,可选择进行右左肝管PTC。本病应争取手术切除,不能切除者行肝胆管内引流或外引流,二者疗效无明显差别。