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Objective:To investigate the incidence rate of upper digestive tract cancer in Cixian, China, a particular area with high inci-dence of esophageal cancer. Methods:Statistical analysis was performed on the 2003-2012 incidence data of upper digestive tract can-cer in Cixian. The annual incidence rate, Chinese population standardized incidence rate (the bid rate), and structure of world popula-tion standardized incidence rate (referred to as the world standard rate) were calculated. The incidence data were divided into two groups according to period (2003-2007 and 2008-2012), and different age groups were compared. Results:From 2003 to 2012, the in-cidence of upper gastrointestinal cancer was 165.36/10 million. The 2003-2007 crude incidence rate was 171.55/10 million), whereas 2008-2012 crude incidence rate was 151.41/10 million which has reduced over the last five years. Esophageal cancer incidence from 2003 to 2012 had a crude incidence rate of 108.05/10 million during the two periods (from 2003 to 2007, the incidence rate was 116.87/10 million;and from 2008 to 2012, 99.58/10 million), the crude incidence rate of the latter 5-year period has declined obvious-ly. From 2003 to 2012, the overall crude incidence rate of cardia cancer was 31.21/10 million, comparison of two peaiods (from 2003 to 2007 was 29.11/10 million, and 2008-2012, 33.23/10 million) indicated that the level of measurement of the latter period in-creased. At the same period, the overall incidence rate of gastric cancer was 26.10/10 million, comparison of the two periods (2003-2007 the crude incidence rate was 25.57/10 million, 2008-2012 was 26.60/10 million) indicated that the level of the parameter in the latter 5 years increased slightly. Conclusion:The incidence of esophageal cancer in Cixian decreased significantly, but the area remains to have the highest incidence rate of cardiac cancer morbidity. The incidence rate of distal gastric cancer increased significantly in males but decreased slightly in females, which suggests that early diagnosis and treatment of gastric cardia and distal stomach cancer is extremely important.
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Objective To investigate the efficacy of thoracoabdominal mini-incision surgery for the treatment of gastric cardia cancer. Methods Radical resection of gastric cardia cancer was performed on 60 patients from January 2002 to January 2007. Thoracoabdominal mini-incision was used in 30 cases, and posterolateral thoracotomy was carried out in the other 30 patients. The data of the two groups were retrospectively analyzed. Results The operations were accomplished without death or severe complications in all the patients. Compared with the posterolateral thoracotomy group, thoracoabdominal mini-incision group had shorter incisions [(12.4?0.7) cm vs (19.2?2.0) cm, t=-17.577, P=0.000], shorter operation time [(207.3?76.1) min vs (260.0?85.6) min, t=-2.519, P=0.015], earlier postoperative ambulation [(2.3?0.5)d vs (3.4?0.5) d, t=-8.521, P=0.000], less thoracic drainage [(276.7?58.7) ml vs (308.7?59.5) ml, t=-2.097, P=0.040], less analgesic (pethidine) requirement [(66.7?27.3) mg vs (113.3?45.4) mg, t=-4.818, P=0.000], shorter duration of oxygen use [(3.8?2.0) d vs (5.1?2.6) d, t=-2.171, P=0.034], and higher arterial oxygen saturation[(97.6?2.7)% vs (96.1?2.7)%,t=2.152,P=0.036]. No significant difference was observed between the two groups in the number of dissected thoracic lymph nodes (1.87?0.43 vs 1.93?0.37, t=-0.579, P=0.565), number of dissected celiac lymph nodes (4.00?0.45 vs 3.97?0.49, t=0.247, P=0.806), postoperative hospital stay [(11.8?1.0) d vs (12.0?1.2) d, t=-0.701, P=0.486), pulmonary infection (2 vs 5, ?2=0.647, P=0.421), atrial fibrillation (2 vs 4, ?2=0.185, P=0.667) and positive surgical margins (0 vs 1, ?2=0.000, P=1.000). The two groups were followed up for (36.3?13.9) months and (36.3?16.5) months, respectively (t=0.024, P=0.981), no significant difference was detected between them in the 1- and 3-year survival cases (19 vs 22, ?2=0.487, P=0.485; and 10 vs 12, ?2=0.194, P=0.660) and chest pain (2 vs 3, ?2=0.000, P=1.000) during the period. Conclusions By using a thoracoabdominal mini-incision, gastric cardia cancer can be resected completely with less trauma. The approach is ideal for clinical application.
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Objective To explore the clinical significance of MDR1 gene expression inpatients with gastric cardia carcinoma.Methods Using reverse transcription-polymerase chain reaction(RT PCR), the genes expression of MDR1 and MRP, in 4 6 cases of gastric cardia cancer was determined.Results Positive expression of MDR1 and MRP gene were 6:3% and 50% respectively, which was muchhigher than that in tissue adjacent to 1ilo cancer site. In 9 cases of pre-operative chemotherapy , the levels ofMDR 1, and MRP gene expression were higher higher that without chemotherapy (P
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0. 05). More patients in Group A could swallow normal diet than group B (P