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Objective To investigate the cancer death and distribution characteristics of residents in Cixian County. Methods In accordance with the norms of cancer registration, cancer death data from 2013 to 2017 in Cixian were collected and analyzed, and the crude cancer death rate, age-standardized mortality rates by the Chinese standard population (ASMRC), age-standardized mortality rates by the global standard population (ASMRW). Results From January 1st, 2013, to December 31st, 2017, 6 490 cases of cancer death were recorded. The average annual crude mortality rate was 202.88/100 000, ASMRC was 186.49/100 000, and the ASMRW was 189.02/100 000. The top 10 male mortality cancers were esophageal cancer, stomach cancer, trachea, bronchus and lung cancer, liver cancer, rectal cancer, cerebral nervous system cancer, colon cancer, leukemia, pancreatic cancer, and bladder cancer in order. The top 10 female mortality cancers were esophageal cancer, trachea, bronchus and lung cancer, stomach cancer, liver cancer, breast cancer, cervical cancer, colon cancer, brain, nervous system cancer, rectal cancer, and ovarian cancer. The age of death increased considerably from the age of 40 years. It increased with the increase in age and reached the peak at the age of 85 years. Conclusion Upper gastrointestinal cancer and lung cancer were the main cancers that threatened the residents of Cixian County from 2013 to 2017. Screening and comprehensive prevention of high-risk groups are still the main targets of cancer prevention and control.
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Objective: To analyze the mortality of upper gastrointestinal cancer in Cixian County, Hebei Province, China, over the past 33 years, and provide evidence for the prevention and treatment of such cancer. Methods: According to the cancer registration regulations, changes in the mortality of upper gastrointestinal cancer were collected, sorted and evaluated, and the trends in the mortality of upper gastrointestinal cancer were analyzed using the cancer registration data accumulated by the Cixian cancer Registration Office between January 1, 1983, and December 31, 2015. The percentage changes in crude mortality, standardized mortality in China, and the standardized worldwide mortality were calculated. The annual percent change of mortality was estimated using a linear regression model of the adjustment rate. Results: Over the 33-year period in Cixian County, the average crude mortality of upper gastrointestinal cancer was 119.31/100,000, including 149.21/100,000 for males and 88.40/100,000 for females. The standardized mortality rate in China was 160.85/100,000, including 227.00/100,000 males and 108.07/100,000 females. The worldwide standardized mortality rate was 162.39/100,000, including 228.52/100,000 males and 109.30/100,000 females. Conclusions: The mortality of upper gastrointestinal cancer displayed a decreasing trend, but it still had the highest mortality rate of malignant tumors in Cixian County. Age-specific mortalities were increasing along with the rise of age.
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Objective:To evaluate the safety and efficacy of the technique of minimally invasive separation surgery with small incision and free hand screw placement in patients with spinal metastases.Methods:Retrospectively reviewed the clinical data of 49 consecutive patients from May 2019 to December 2019 who underwent minimally invasive separation surgery with small incision and free hand screw placement for metastatic spinal tumors. Among them, there were 21 males with an average age of 55.62±2.97 years (range: 26-75 years) and 28 females with an average age of 52.50±1.76 years (range: 34-72 years). For patients who have primary tumor history with multiple metastases, routine pre-operative biopsy is not required; but for patients whose primary tumor is unknown and who have no history of tumor, pre-operative biopsy diagnosis is required. Before operation, Karnofsky Performance status (KPS) scoring system was used to evaluate the general condition of patients, Spinal Instability Neoplastic Score (SINS) scoring system was used to evaluate the spine stability, epidural spinal cord compression (ESCC) grading system was performed to access the degree of spinal cord nerve compression, and Frankel grading system was used to evaluate the neurological function. For patients who meet inclusion and exclusion criteria ware performed for decompression and internal fixation by a minimally invasive separation surgery with small incision and free hand screw placement. The demographic, neurological function, complications and perioperative data were collected and analyzed, including pre-operation neurological function, operation time, intraoperative blood loss, postoperative suction drainage, drainage tube extraction time, complications rates, hospital stay, and assessment of neurological recovery at 4 weeks after surgery.Results:Preoperative coil embolization was performed in 1 patient with kidney cancer. The mean intraoperative blood loss was 748.60±79.39 ml. Comparison of intraoperative blood loss of 12 rich blood supply (liver cancer, kidney cancer, thyroid cancer) and 37 poor blood supply spine metastases (970.80 ml vs 676.50 ml) was not statistically significant ( P>0.05). The average operation time was 213.40±9.87 min. The operation involved 1 segment was performed in 41 patients (83.67%) and 8 patients had separation of 2 or more segments. The post-operative drainage before discharge was 494.02±63.30 ml. The average drainage tube retention time was 4.50±0.26 d and the average length of hospital stay was 7.35±0.38 d. The post-operative hospitalization was 5.31±0.29 d. 79.59% of patients had the neurological functions of Frankel grade C and D before surgery and 95.92% of patients exhibited stable and improved function at 4 weeks after surgery which was significantly improved comparing with that before surgery ( P<0.05). The complications occurred were dural rupture (1 case), infection (1 case) and hematoma (1 case). Comparison:The minimally invasive separation surgery with small incision and free hand screw placement could achieve less trauma, low complications rate, rapid postoperative recovery. It is also comparable to the traditional open separation surgery in terms of spinal stability and improvement of neurological functions. It is an excellent alternative for patient with spinal metastases.
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Objective@#To describe the status of non-steroidal anti-inflammatory drugs (NSAIDs) use in areas with a high incidence of upper gastrointestinal cancer in China. @*Methods@#This study was based on the National Key Research and Development Program of "National Precision Medicine Cohort of Esophageal Cancer" and "Study on Identification and Prevention of High-risk Populations of Gastrointestinal Malignancies (Esophageal cancer, Gastric cancer and Colorectal cancer)" . From January 2017 to August 2018, 212 villages or communities with a high incidence of esophageal cancer or gastric cancer were selected from 12 regions in 6 provinces. A total of 35 910 residents aged between 40 and 69 years old who met the inclusion criteria and signed the informed consent were investigated and enrolled in this study. The use of NSAIDs, demographic characteristics, health-related habits, height, weight, and blood pressure were collected by the questionnaire and physical examination. The status of main NSAIDs (aspirin, acetaminophen and ibuprofen) use with the difference varying in genders, age groups and regions were analyzed by using χ2 test and Cochran-Armitage trend analysis method. @*Results@#Of 35 910 subjects, the mean age was (54.6±7.1) years old and males accounted for 43.42% (15 591). The overall prevalence of NSAIDs intake was 4.56% (1 638), but it significantly varied in different provinces (P<0.001). The overall prevalence of NSAIDs intake was 4.87% (1 750) in females, which was significantly higher than that in males 4.24% (1 524) (P<0.001). The prevalence of NSAIDs intake increased with age (P for trend <0.001). As the frequency of NSAIDs intake increased, the incidence of gastrointestinal symptoms, gastrointestinal ulcers and black stools increased (P for trend <0.05 for all). @*Conclusion@#The use of NSAIDs is prevalent in some areas with a high incidence of upper gastrointestinal cancer in China. The increased use of NSAIDs may lead to more adverse effects related to the gastrointestinal tract.
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Objective@#To investigate the overall incidence and age distribution of upper digestive tract cancer in Cixian county, and to provide a reliable basis of prevention and treatment for upper gastrointestinal cancer.@*Methods@#Collected annual incidence rate among 2003-2012 from Cixian cancer registry and abstracted all incidence rate of upper digestive tract cancer. The age-standardized incidence rate by Chinese standard population (ASR China) was calculated using the national population composition of 2000. The age-standardized incidence rate by world standard population (ASR world) was calculated using the world population composition of 1964 of Segi's. The annual average change (APC) was used to estimate the growth rate of the last two years in comparision with the first two years, which was calculated by Joinpoint regression model. The data was divided into two sections (from 2003 to 2007, and from 2008 to 2012), and the rate difference of different age group was calculated.@*Results@#The crude incidence rate of the digestive tract cancer from 2003 to 2012 was 165.36/100 000 (10 309/6 234 346), which dropped from 170.75/10 100 000 (1 029/602 638) of 2003 to 146.02/100 000 of 2012 (936/640 991).The PC and APC of the crude incidence rate of upper gastrointestinal cancer were-12.96%, and-1.54% (95%CI:-3.22%-0.07%), respectively. The PC and APC of ASR China were-10.83%, and-1.30% (95%CI: 2.54%-0.03%), respectively. The PC and APC of ASR world were-9.82%, and-1.13% (95%CI:-2.20%--0.03%), respectively. The incidence of upper gastrointestinal cancer decreased. The incidence rate of 2003-2007 and 2008-2012 were 171.55/100 000 (5 239/3 048 593), and 159.41/10 000 (5 070/3 180 514), respectively and the rate difference was-12.15/100 000. The decrease of rate difference of 70 to 74 years old was the most (-340.32/100 000) and the increase of rate difference over the age of 85 was the most (447.21/100 000).@*Conclusion@#From 2003 to 2012, the crude incidence of upper digestive tract cancer in Cixian showed a decreasing trend, and the 70-74 years old age group shows the most obvious decline
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<p><b>OBJECTIVE</b>To estimate the cost-effectiveness of esophageal cancer endoscopic screening once-in-a-lifetime and to predict the optimal screening age for people in high-risk areas of rural China.</p><p><b>METHODS</b>A Markov model was constructed to predict and compare the effect of four esophageal cancer endoscopic screening modalities which varied with different screening ages. Long-term epidemiological effectiveness and cost-effectiveness were predicted by simulation of the model.</p><p><b>RESULTS</b>Compared with the control group, strategies starting at 40, 45, 50 and 55 year-old had saved life-years of 629.51, 769.88, 738.98 and 533.21 years per 100 000 people, respectively, of which the strategy starting at 45 year-old saved the maximum life years. All strategies were cost-effective and starting at 40 year-old cost the most per life-year saved. Among all alternatives, strategies starting age at 45 year-old and 50 year-old were incremental cost-effective, and the incremental cost-effective ratios were 34 962.87 and 3 346.43 RMB per life year saved, respectively.</p><p><b>CONCLUSIONS</b>The strategy starting at 40 year-old implemented at present and other strategies were cost-effective in high-risk areas of rural China. However, the 45-year-old group is more aligned with the principle of cost-effectiveness. Considering the cost-effectiveness of different strategies and social economic status, 45 year-old is regarded as the optimal starting age of esophageal cancer once-in-a-lifetime endoscopic screening and is recommended in areas lacking health resources. The strategy of starting age at 40 year-old which could obtain better screening effects would be preferable in wealthy regions.</p>
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Adulto , Humanos , Pessoa de Meia-Idade , Fatores Etários , Estudos de Casos e Controles , China , Análise Custo-Benefício , Detecção Precoce de Câncer , Neoplasias Esofágicas , Diagnóstico , Esofagoscopia , Economia , Cadeias de Markov , População RuralRESUMO
Objective:To investigate the distribution of precancerous conditions and lesions of high-risk population in the high-in-cidence area of esophageal cancer in Ci County, Hebei Province. Methods:Esophageal cancer was detected early in 40 to 69 year old patients in Ci Xian through endoscopic screening data and endoscopic screening using iodine staining and indicative biopsy. The pa-tients were classified according to gender, age group, statistical esophageal precancerous condition, and lesion detection rate. Results:The analysis included 11 423 cases by screening queue, and the esophageal biopsy rate was 66.90%. The detection rates of squamous epithelium with mild, moderate, and severe dysplasia were 11.84%, 2.66%, and 1.04%, respectively. DCIS detection rate was 0.40%in patients with squamous cell carcinoma. The detection rate of the patients had been infiltrated by the squamous cell carcinoma was 0.04%.The rate of the squamous cell carcinoma within the mucosa was 0.37%.The rate of the infiltration squamous cell carcinoma was 0.17%. The detection rate of the hyperplasia above average severe dysplasia and cancer was 2.01%. Conclusion: High incidence of esophageal precancerous lesions was found in the Ci County aged 40 to 69. A large number of asymptomatic patients with cancer were detected. Age and sex are closely related to detection rate.
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<p><b>OBJECTIVE</b>To detect the expression of SCUBE3 in human osteosarcoma cell lines and surgical specimens of osteosarcomas and investigate its association with the patients' prognosis.</p><p><b>METHODS</b>The expression of SCUBE3 protein was detected in 5 osteosarcoma cell lines using Western blotting. CCK8 assay was used to assess the effect of SCUBE3 suppression mediated by two specific small interfering RNAs (siRNAs) on the proliferation of U2OS osteosarcoma cells, and the cell cycle changes were detected using flow cytometry. Immunohistochemistry was performed to detect the expression of SCUBE3 in 60 osteosarcoma tissues, and Kaplan-Meier method was performed for survival analysis of the patients.</p><p><b>RESULTS</b>Compared with osteoblast hFOB1.19 cells, the osteosarcoma cell lines all showed significantly higher expressions of SCUBE3. In U2OS cells, suppression of SCUBE3 expression by siRNA significantly inhibited the cell proliferation (P<0.05). Kaplan-Meier survival analysis indicated that patients with high SCUBE3 expression had worse prognosis than those with low SCUBE3 expression (P=0.036).</p><p><b>CONCLUSION</b>SCUBE3 is up-regulated in the 5 osteosarcoma cell lines and in primary osteosarcoma tissues to promote the proliferation of osteosarcoma cells. A high SCUBE3 expression in osteosarcoma tissues is associated with a poor prognosis of the patients, suggesting that SCUBE3 can serve as a potential therapeutic target for osteosarcoma.</p>
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Humanos , Neoplasias Ósseas , Metabolismo , Patologia , Proteínas de Ligação ao Cálcio , Metabolismo , Ciclo Celular , Linhagem Celular Tumoral , Proliferação de Células , Citometria de Fluxo , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Osteossarcoma , Metabolismo , Patologia , Prognóstico , RNA Interferente Pequeno , Regulação para CimaRESUMO
<p><b>OBJECTIVE</b>To detect the expression of CXCL14 in human osteosarcoma cell lines and tissues and investigate its association with the prognosis of the patients.</p><p><b>METHODS</b>RT-PCR, enzyme-linked immunosorbent assay (ELISA) and real-time PCR were used to detect the expression of CXCL14 in 4 osteosarcoma cell lines and in 40 pairs of osteosarcoma tissues and adjacent muscular tissues. CCK8 assay and colony formation assay was used to assess the effect of CXCL14 suppression mediated by two specific siRNAs on the proliferation of U2OS osteosarcoma cells. Immunohistochemistry was performed to detect the expression of CXCL14 in 58 osteosarcoma tissues, and Kaplan-Meier method and log-rank test were performed for survival analysis of the patients.</p><p><b>RESULTS</b>Significant up-regulation of CXCL14 expression was found in the osteosarcoma cell lines and in osteosarcoma tissues compared with the adjacent muscles (P<0.01). In U2OS cell, suppression of CXCL14 expression by siRNA significantly inhibited the cell proliferation (P<0.01) and colony formation rate (P<0.05). Kaplan-Meier survival analysis indicated that patients with high CXCL14 expression had worse prognosis than those with low CXCL14 expression (P=0.02).</p><p><b>CONCLUSION</b>CXCL14 is up-regulated in both osteosarcoma cell lines and primary osteosarcoma tissues to promote the proliferation of osteosarcoma cells. A high CXCL14 expression in osteosarcoma tissues is associated with a poor prognosis, suggesting the that CXCL14 serve as a potential therapeutic target for osteosarcoma.</p>
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Humanos , Neoplasias Ósseas , Metabolismo , Patologia , Linhagem Celular Tumoral , Proliferação de Células , Quimiocinas CXC , Metabolismo , Osteossarcoma , Metabolismo , Patologia , PrognósticoRESUMO
Objective: Epithelial dysplasia of the esophagus and gastric cardia is precancerous lesion, including mild, moderate and severe levels. In 2000 year, WHO recommended to replace dysplasia with intraepithelial neoplasia. Mild and moderate dysplasia were classified as low-grade intraepithelial neoplasia (LIN). Cardia adenocarcinoma was suggested to be called esophageal-gastric junction adenocarcinoma. The risk of cancer development and the rule of time evolution were detected in esophagus and esophageal-gastdc junction LIN in high incidence area of esophageal cancer in Northern China, in an effort to provide scientific data for the prevention of esophageal cancer. Methods: Between October 2001 and October 2002, two townships of Cixian were chosen to carry out endoscopic iodine staining screening cohort study. The total population aged 0-85 was 22,016, of which 6,596 aged 40-69 (3257 males and 3339 females). Except for thoese with contraindications and those who refused to join the study, 3,506 cases were finally recruited in the study, and the screening rate was 53.2%. According to WHO criteria of the pathological diagnosis, the esophageal squamous epithelium with mild and moderate dysplasia and esophageal-gastric junction with mild dysplasia were classified into LIN groups (including 616 cases). The control group contained a total of 2,478 cases without precancerous lesions and free of cancer in endoscopic screening. Results: From June to September in 2008, the cohort was followed up and 174 cases were lost, with a follow-up rate of 95.0%. Follow-up was 3,970.7 person- years in the LIN group and 16,120.0 person-years in the control group.Carcinomous conversion rates were 251.7 and 68.2/per 100,000 person- years respectively in the LIN group and the control group. The median time in the two groups was 38 and 47 months, respectively. Compared with that of the normal population, the relative risk (RR) of LIN was 3.69 (95% CI=1.57-8.69, P=0.001). Conclusion: Population with LIN are at high-risk for esophageal cancer and endoscopic examination every year is absolutely necessary.