An analysis on the result of early detection and treatment of cancer in Zhejiang urban population / 预防医学

Objective To investigate cancer high - risk rate,screening rate,detection rate in Zhejiang urban area and to provide the further evidence for cancer screening,early detection and treatment programs. Methods Epidemiological investigation and cancer risk evaluation were launched among 40 - 69 years old residents in Hangzhou and Ningbo city. People who were at high risk of lung cancer,liver cancer,upper digestive tract cancer,female breast cancer and colorectal cancer could receive clinical screening for free. Cancer high risk rates,screening rate and clinical detection rates were calculated. Results A total of 41 547 residents finished questionnaires and cancer risk evaluation. Cancer high risk rates of lung,liver,upper digestive,female breast and colorectal were 14. 05% ,12. 58% ,23. 28% ,11. 50% and 11. 82% , respectively. The rates of people who encountered single,couple,three,four and five types of cancer high risk were 29. 64% ,10. 97% ,3. 41% ,1. 16% ,0. 38% ,respectively. Screening rates for the five types of cancer were 50. 91% for lung cancer,49. 16% for liver cancer,19. 55% for upper digestive tract cancer,56. 25% for female breast cancer and 21. 75% for colorectal cancer. Lung cancer/ suspected lung cancer detection rate was 2. 42% . Breast cancer screening BI- RADS Grade 4 - 5 detection rate was 6. 71% . Upper digestive tract cancer detection rate was 0. 32% . Liver cancer detection rate was 0. 04% . Colorectal cancer detection rate was 0. 75% . Conclusion Technical solutions and program management should be improved to enhance the effect of cancer screening,early detection and treatment programs.

An analysis on bladder cancer incidence and mortality in cancer registries of Zhejiang province,2000-2009 / 预防医学

Objective To investigate the bladder cancer incidence and mortality in cancer registries of Zhejiang province during 2000 to 2009.Methods The data were collected from six cancer registries in Zhejiang province.Staff of Zhejiang Provincial Cancer Prevention and Control Office checked the data and calculated crude rate,standardized rate and trend. Results The incidence rate of bladder cancer in Zhejiang cancer registration areas was 6.97 /105 during 2000 to 2009. The incidence of male was higher than female,the ratio was 3.40∶1.The incidence rate increased from 2000(6.36 /105 ) to 2009(7.99 /105 ),with the Annual Percent Change (APC)of 3.69% (95% Confidence Interval:2.49% ~4.90%). The mortality rate of bladder cancer in Zhejiang cancer registration areas was 2.00 /105 during 2000 to 2009.The mortality of male was higher than female,with the ratio 3.27∶1.The mortality of bladder cancer showed ascending trend with a slight fluctuation from 2000 to 2009 (APC =2.28%).The incidence and mortality of bladder cancer showed significantly increasing in above 55 years old age groups.The incidence rate peaked in the 80 -84 age group,while the mortality peaked at age group of over 85 years old.Conclusion The bladder cancer prevention and control work should be focused on the elderly male population in Zhejiang province.

Incidence and mortality of cancer in Zhejiang province in 2009 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the incidence and mortality of cancer registered in Zhejiang province in 2009.</p><p><b>METHODS</b>The statistics of incidence and mortality of cancer were collected from 6 population-based cancer registries in Zhejiang province, including 30 613 new incidence cases and 16 920 death cases reported in 2009. The 6 cancer registries covered population at 9 560 699 in all. The crude rate, age-standardized rate, cumulative rate (0-74 years old), cut rate (35-64 years old), age-specific rate of incidence/mortality as well as the constitution of top 10 common cancers were then calculated and analyzed. The age-standardized rate was calculated and adjusted by the Chinese standard population in 1982 as well as the Segi's world standard population.</p><p><b>RESULTS</b>The crude incidence of cancer was 320.20/100 000. Age-standardized incidence by Chinese standard population and by world standard population were separately 161.99/100 000 and 207.92/100 000, the cumulative rate was 23.83% and the cut rate was 346.87/100 000. Meanwhile, the crude mortality rate was 176.97/100 000, and the age-standardized mortality by Chinese standard population and by world standard population were 79.17/100 000, 107.02/100 000, respectively; and the cumulative mortality rate was 12.23% and cut rate was 139.75/100 000. Age-specific incidence among 0-34 years old population remained low; however, the incidence among 35-39 age group increased obviously (116.46/100 000, 954 cases). The incidence among 45-49 age group elevated even more sharply (272.97/100 000, 2388 cases) and finally reached the peak among 80-84 age group (1564.36/100 000, 2272 cases). Age-specific mortality arose among 40-44 age group (48.06/100 000, 424 cases) and reached its peak among 80-84 age group (1392.23/100 000, 2022 cases) as well. The most common types of cancer were lung cancer, gastric cancer, colorectal cancer, liver cancer, breast cancer, esophageal cancer, thyroid cancer, pancreatic cancer, cervical cancer and lymphoma, which accounted for 74.37% (22 763/30 613) of all new cancer cases.Lung cancer, liver cancer, gastric cancer, colorectal cancer, esophageal cancer, pancreatic cancer, leukemia, lymphoma, brain tumors and breast cancer accounted for 87.75% (14 848/16 920) of all cancer deaths.</p><p><b>CONCLUSION</b>The incidence and mortality of cancer both increased in 2009 according to the statistics from cancer registry in Zhejiang province.Lung cancer, malignant tumor in digestive system and breast cancer were still the key challenges in cancer prevention and control. Meanwhile, the increased incidence of thyroid cancer should also be noticed.</p>

Effect of miRNA-106a expression on the prognosis of patients with esophageal squamous cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the expression of miRNA-106a gene in esophageal squamous cell carcinoma (ESCC) and its association with clinicopathological features and prognosis of ESCC patients.</p><p><b>METHODS</b>Real-time fluorescence quantitative polymerase chain reaction (PCR) assay was used to determine the expression of miRNA-106a gene in esophageal cancer tissue and corresponding normal mucosa of 81 cases. Immunohistochemical technique was applied to detect the expression of p53, human epidermal growth factor receptor 2 (HER-2), DNA topoisomerase II (Topo II) and multidrug resistance-associated protein (MRP). The association of miRNA-106a expression with clinicopathological features, expression of related proteins, and prognosis of the patients was analyzed.</p><p><b>RESULTS</b>Among the 81 cases, under-expression of miRNA-106a gene was found in 48 cases (59.3%), normal expression in 22 cases (27.2%), and overexpression in 11 cases (13.6%). The expression of miRNA-106 gene was significantly associated with lymph node metastasis, pathological stage, and nerve invasion (all P < 0.05), significantly associated with expression of p53 (P = 0.006), and not significantly associated with expressions of HER-2, Topo II and MRP proteins (all P > 0.05). The expression of miRNA-106a gene was also significantly associated with progression-free survival (PFS, P = 0.032), but not significantly with overall survival (OS, P = 0.486). The results of Cox multivariate regression analysis showed that the PFS of ESCC patients was significantly correlated with lymph node metastasis (P = 0.029), but not correlated with the age, gender, tumor length, T stage, degree of differentiation, nerve invasion, and miRNA-106a expression (all P > 0.05).</p><p><b>CONCLUSIONS</b>In esophageal squamous cell carcinomas, the miRNA-106a gene is under-expressed, with tumor suppressor function, and may be regarded as a biological marker to assess the prognosis in patients with esophageal squamous cell carcinoma.</p>

DNA methylation status of RARβ2 and p16(INK4α) in peripheral blood and tumor tissue in patients with esophageal squamous cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the methylation status of retinoic acid receptor β2 (RARβ2) and p16(INK4α) genes in peripheral blood and tumor tissues and the perioperative dynamic changes of free RARβ2 and p16(INK4α) in the peripheral blood, and to investigate the relationship between RARβ2 and p16(INK4α) methylation in peripheral blood and clinicopathological characteristics of esophageal squamous cell carcinoma (ESCC) and their value in evaluating the completeness of surgical resection.</p><p><b>METHODS</b>Real-time methylation specific polymerase chain reaction (real-time MSP) technique was used to detect the methylation status of RARβ2 and p16(INK4α) in tumor tissue, adjacent normal tissue and peripheral blood perioperatively in 76 cases of ESCC. Sixty age-matched healthy volunteers were randomly selected as a control.</p><p><b>RESULTS</b>RARβ2 and p16(INK4α) hypermethylation presented in both tumor tissue [72.4% (55/76) and 86.8% (66/76)] and peripheral blood [63.2% (48/76) and 71.1% (54/76)] in the ESCC patients, showing a good agreement between them. RARβ2 and p16(INK4α) hypermethylation was significantly related with pathological stage, lymph node metastasis, and invasion of nerves and vessels (P < 0.05). The DNA methylation rate in peripheral blood was increasing first and then decreasing in the preoperative, intraoperative and postoperative periods. Moreover, the RARβ2 methylation in peripheral blood was shown to be significantly associated with family history of cancer (P = 0.023).</p><p><b>CONCLUSION</b>RARβ2 and p16(INK4α) methylation in the peripheral blood in ESCC patients may reflect the tumor-bearing status in the body, and may serve as a valuable marker in assessment of the degree of completeness of surgical resection in ESCC patients.</p>

Clinicopathological features and prognostic analysis of esophageal sarcomatoid carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the clinicopathological characteristics and prognosis of a rare histological type of esophageal cancer-sarcomatoid carcinoma.</p><p><b>METHODS</b>Clinicopathological data of 31 patients with esophageal sarcomatoid carcinoma who underwent surgery in the Department of Thoracic Surgery of Zhejiang Cancer Hospital from Jan 2000 to Dec 2009 were collected and analyzed. The survival analysis was performed using Kaplan-Meier method.</p><p><b>RESULTS</b>All the patients underwent surgery. Of the 31 patients, one received preoperative chemoradiotherapy and postoperative chemotherapy, and 8 received postoperative chemotherapy. All the tumors were located in the middle or lower esophagus. Microscopically, the tumors were composed of both carcinomatous and sarcomatous components, and there was a transition between the two components, but no obvious heterogenous elements such as osteosarcoma, chondrosarcoma or rhabdomyosarcoma were found. In the carcinomatous components, positive expression of CK and EMA was found in all the 31 cases, and positive expression of vimentin in 5 of the 31 cases. In the sarcomatous components, positive expression of CK, EMA and vimentin was found in 29, 28 and 23 cases, respectively. The 1-, 3-, and 5-year survival rates were 80.6%, 55.9% and 33.4%, respectively, and the median survival time was 40 months.</p><p><b>CONCLUSIONS</b>Esophageal sarcomatoid carcinoma is a particular type of esophageal malignancy with unique clinicopathological features. The diversity and complexity of the carcinomatous and sarcomatous components and their potential of transformation and differentiation lead to different prognosis from each other.</p>

Incidence and mortality of larynx cancer in China during 2003-2007 / 中华流行病学杂志

Objective To analyze the patterns of incidence and mortality on larynx cancer in China.Methods Data from 32 Cancer Registries in China were examined,sorted,and analyzed by the National Cancer Registry,to obtain the crude,Chinese national and world age- standardized rates (ASR) of incidence and mortality and their trends.Results The crude incidence and mortality rates of larynx cancer wcrc 2.04/105 and 1.06/105 in China during 2003-2007.The rates were higher in males than those in females,and also higher in urban areas than those in rural areas.The highest Chinese ASRs of incidence and mortality of larynx cancer in 32 cancer registries in China were 2.08/105 in Zhongshan city,Guangdong province,and 1.58/105 in She county,Hebei province respectively.The trend of incidence and mortality of larynx cancer was stable from 2003 to 2007.Conclusion Although both the incidence and mortality of larynx cancer in China were still in low level,comprehensive measures should be carried out to prevent the increase on both the incidence and mortality of larynx cancer.

Expression of DNA methylation of APC in peripheral blood and tumor tissue in patients with esophageal squamous cell carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between methylation status of APC gene in both peripheral blood and tumor tissues and clinical-pathology characteristics in patients with esophageal squamous cell carcinoma(ESCC), and to study the dynamic change of APC methylation in peripheral blood in the perioperative period.</p><p><b>METHODS</b>Real-time MSP technique was used to detect methylation status of APC in tumor tissues, adjacent normal tissues and peripheral blood on the day before the surgery, intraoperative, postoperative day 7 in 76 cases with ESCC. Sixty healthy volunteers matched by age and gender were randomly selected as controls.</p><p><b>RESULTS</b>The methylation rate of APC in tumor tissue and peripheral blood was 44.74%(34/76) and 42.11%(32/76), respectively, which were significantly higher than that in adjacent normal tissue and controls [6.58%(5/76) and 1.67%(1/60), P=0.000]. The methylation rates showed good agreement between tumor tissues and peripheral blood, which could be verified by ROC curve(A Zeta=0.849, P=0.000). APC methylation rate was significantly related to pathological staging, lymph node metastasis, depth of invasion, and invasion of nerve and vessel (P<0.05). The results demonstrated that family history of cancer was independently associated with APC methylation in peripheral blood(P<0.05). DNA methylation rates in peripheral blood showed an initial increase and then decreased in the preoperative period, intraoperative and postoperative.</p><p><b>CONCLUSION</b>The methylation rates of APC among free DNA in peripheral blood in patients with ESCC reflect tumor progression, and decrease with the solid tumour resection.</p>

Effect of Yiqi Bufei recipe see text on patients with pulmonary incompetence after pneumonectomy / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the effect of Yiqi Bufei Recipe ([see text], YBR) on surgical tolerability, pulmonary compensatory function and post-operation rehabilitation in patients with pulmonary incompetence (PI) after pneumonectomy.</p><p><b>METHODS</b>YBR intervention was applied to 60 patients with PI after pneumonectomy (as test group), the pulmonary and cardiac functions changes before and after operation, occurrence of postoperative complications, mortality, and the number of hospitalization days and intensive care unit (ICU) confinement period were observed. Meantime, for the negative and positive controls, the same parameters were observed comparatively in 60 patients with normal lung function, and in 60 patients with PI undergoing a similar operation but untreated with Chinese herbs.</p><p><b>RESULTS</b>Lung function in the test group showed insignificant change before and after operation (P >0.05), while significant decrease was seen in the two control groups (P<0.05). Furthermore, the incidences of post-operation complications and mortality as well as the number of hospitalization days and the ICU confinement period in the test group were significantly lower than those in the positive control group respectively (P <0.05).</p><p><b>CONCLUSION</b>YBR could relieve lung injury after pneumonectomy, improve surgical tolerability, reduce the length of postoperative hospitalization days and ICU confinement period, and lower the incidence of postoperative complications and mortality in patients with PI after pneumonectomy.</p>

Analysis of prognostic factors in patients with locoregional recurrence of esophageal carcinoma after curative treatment / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this paper was to evaluate the treatment outcome of multimodal treatment for 196 patients with locoregional recurrent esophageal cancer after curative treatment and to determine the prognostic factors of recurrence.</p><p><b>METHODS</b>One hundred and ninety six patients with locoregional recurrent esophageal cancer curatively treated in our hospital were included in this study. Kaplan-Meier method was used to analyze the survival rate. Log rank test was used to evaluate the difference between the groups. Multivariate survival analysis was conducted using a Cox proportional hazard regression model with a backward stepwise procedure.</p><p><b>RESULTS</b>The overall 1-, 2- and 3-year survival rates were 29.8%, 5.9% and 4.0%, respectively, with a median survival time of 8.0 months. The univariate analysis showed that ECOG PS, the interval between initial treatment and recurrence, the regimens of initial treatment and retreatment were independent prognostic factors. The multivariate analysis showed that the regimens of initial treatment and retreatment were independent prognostic factors. Retreatment methods significantly influenced the survival. The median survival time of chemoradiotherapy, radiation therapy alone, chemotherapy alone, EGFR-TKI and best supportive care were 13.0, 7.0, 6.0, 4.0 and 3.0 months, respectively (P = 0.000).</p><p><b>CONCLUSIONS</b>The prognosis of patients with locoregional recurrent esophageal cancer after curative treatment is poor. The main prognostic factors are the regimens of initial treatment and retreatment. Multimodal treatment including radiotherapy and chemotherapy may improve the long-term survival of the patients.</p>

Related factors of right recurrent nerve nodal involvement in esophageal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the related factors of right recurrent nerve nodal involvement in esophageal cancer.</p><p><b>METHODS</b>280 patients with thoracic esophageal cancer received esophagectomy and right recurrent nerve node dissection. The clinicopathological data were analyzed retrospectively. Univariate data were analyzed by chi-square test, and multivariate data were analyzed by logistic regression.</p><p><b>RESULTS</b>The right recurrent nerve nodal metastasis was found in 76 cases (27.1%, 76/280). In the 979 excised right recurrent nerve nodes, metastases were found in 118 nodes (12.1%). The tumor staging, the total number of involved lymph nodes, vascular invasion, the number of lymph node metastases in the thorax, the number of lymph node metastasis in the abdomen, subcarinal node metastasis, and peri-esophageal lymph node metastasis were independent risk factors of right recurrent nerve node metastasis in esophageal carcinoma.</p><p><b>CONCLUSION</b>Right recurrent nerve lymph nodes should be dissected in those patients with high risk factors of lymph node metastasis in thoracic esophageal carcinoma.</p>

Study on cancer incidence through the Cancer Registry Program in 11 Cities and Counties, China / 中华流行病学杂志

Objective Aim of this paper was to explore the trend and characteristics of cancer incidence in 11 areas (5 cities and 6 counties) in China. Methods Data from cancer registries during 1988 to 2002 collected from the 11 cancer registry points were used to analyze the trends and characteristics of cancer incidence rates. Results There were 695 050 newly developed cancer cases in this study. The crude rate of incidence and the world age-adjusted incidence were 215.50/105 and 170.97/105 respectively. The leading cancer sites were lung, stomach, liver, esophagus, breast, colon, rectum, pancreas, bladder and leukemia. The sixteen key cancers accounted for 85.56% of all the cancer cases. The crude incidence rate of all cancers had been significantly increased from 1988 to 2002. Among them, prostate (185.48%) ranked the fastest growing one followed by cancers of the gallbladder, breast, colon, ovarian, lymphoma, bladder, pancreas, rectum, lung, leukemia and liver. The one that had reduced the most was cervix uteri (17.00%), followed by esophagus, stomach and nasopharynx. Conclusion Crude cancer incidence rate increased in the 11 areas in China from 1988 to 2002. The ranking of pancreas cancer, bladder cancer and leukemia came into the top ten. Even though the incidence rates of prostate and gallbladder cancer were relative low but had a fast increase. The results of this study provided a scientific base for the development of a better strategy on cancer prevention and control in China.

Therapeutic strategies of grade-III open fractures of tibia and fibula / 中国骨伤

<p><b>OBJECTIVE</b>To explore early treatment and technique of grade-III open fracture of tibia and fibula and to summarize the experience of the treatment with external fixation.</p><p><b>METHODS</b>The retrospective analysis were carried out in 168 cases of grade-III open tibial and fibular fractures. One hundred and twenty cases were treated with external fixation,and others were treated with intramedullary nail or amputated. Among 120 patients treated with external fixation in early stage, 86 were male and 34 were female. The age ranged from 18 to 67 years with an average of 36.8 years.</p><p><b>RESULTS</b>One hundred and eleven patients achieved the excellent or good results, some of them underwent later repair of soft tissues. One case was nonunion because of infection and malreduction, and amputation in later stage in 8 cases.</p><p><b>CONCLUSION</b>Treatment with external fixation in early stage is an ideal method for grade-III open fractures of tibia and fibula. Good reduction integrated with simple internal and external fixation is favorable for the repair of soft tissue and union of fracture.</p>

Expression of P-gp, GST-pi and Topo II alpha in gastric and colorectal cancers and their clinical significance / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the expression and clinical significance of P-gp, GST-pi and Topo II alpha in gastric and colorectal cancers.</p><p><b>METHODS</b>The expression of P-gp, GST-pi and Topo II alpha in 83 cases with gastric or colorectal cancer were examined by immunohistochemistry S-P.</p><p><b>RESULTS</b>The positive expression rates of P-gp, GST-pi, Topo II alpha in normal tissue and gastric and colorectal cancers were 69.9%, 65.1%, 50.6% and 83.1%, 85.5%, 45.8%, respectively. The positive rates of P-gp and GST-pi in gastric and colorectal cancer were significantly higher than those in normal gastric and colorectal tissue (P < 0.05). The expression of Topo II alpha in poorly differentiated cancers was significantly higher than that in well-and moderately differentiated cancers. There was no correlation between other items and clinicopathological parameters (P > 0.05).</p><p><b>CONCLUSION</b>P-gp, GST-pi and Topo II alpha play important role in multidrug resistance. Their mechanisms of drug resistance were different. The detection of expression of P-gp, GST-pi and Topo II alpha has an important guiding significance in chemotherapy for gastric and colorectal cancers.</p>