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Early upper gastrointestinal cancer screening skills teaching is the vacancy and difficulty of endoscopic teaching and training. In this study, a standardized training program was set up for endoscopic physicians who had mastered the basic gastroscopy techniques. The training period was 12 weeks, including theoretical training, early cancer awareness training, standardized gastroscopy operation technology, endoscopic diagnosis of early esophageal and gastric cancer, and theoretical and skill examination. After passing the examination, trainees can participate in early cancer case competition. According to questionnaire survey, 100%(15/15) of trainees thought that standardized training was necessary for improving the detection rate of early upper gastrointestinal cancer, and it could significantly improve the trainees' diagnosis level. Therefore, the overall setting of the standardized training process for the diagnosis of early upper gastrointestinal cancer in our center is generally reasonable, which is worthy of further promotion.
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Objective:To systematically evaluate the intelligence-assisted endoscopic diagnosis system based on deep learning (DL-IEDS) for early cancer of the upper digestive tract.Methods:Literature on the value of DL-IEDS for diagnosis of early cancer of the upper digestive tract was searched in English (PubMed, Embase, Web of Science and Cochrane Library)and Chinese databases (Sinomed, CNKI, Wanfang and VIP). The quality of literatures was evaluated according to Quality Assessment of Diagnostic Accuracy Studies-2. The Rev Man 5.3, Meta-Disc 1.4 and Stata 15.1 were used for the meta-analysis.Results:Eight studies were included with a total of 9 675 images (including 2 748 images of early cancer). Meta-analysis results showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and comprehensive diagnostic ratio of DL-IEDS in the diagnosis of early cancer of the upper digestive tract were 0.920, 0.874, 6.824, 0.103 and 71.109, respectively. The area under the curve (AUC) of summary receiver operating characteristics was 0.958 7. Five studies reported the results of DL-IEDS in the diagnosis of early gastric cancer, and the combined analysis showed that the pooled sensitivity and specificity were 0.840 and 0.845 respectively, and the AUC was 0.919. Four studies reported the accuracy rate of endoscopic experts and endoscopic novices in diagnosing early upper gastrointestinal cancer, and results showed that the pooled sensitivity, specificity and AUC were 0.693, 0.892 and 0.892 3, and 0.586, 0.860 and 0.754 5, respectively. Compared with endoscopy experts, the AUC of DL-IEDS in diagnosis of early upper gastrointestinal cancer showed no statistically significant difference ( Z=1.510, P=0.131), while compared with endoscopy novices, the difference was statistically significant ( Z=6.841, P<0.001). Conclusion:The DL-IEDS has high diagnostic accuracy for early upper digestive tract cancer, and can significantly improve the diagnostic ability of endoscopy novices.
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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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With the widely application of the metagenomics,the relationship between microbiota and disease has become a hot research topic.Understanding the potential association between upper gastrointestinal cancer or precancerous lesions and microbiota may play an important role in the early detection,clinical diagnosis and treatment,and prognostic evaluation of upper gastrointestinal cancer.Therefore,a literature retrieval was conducted by using PubMed,Embase and wanfang databases to summarize the latest research progress in the microbiota of upper gastrointestinal cancer,including oral,esophageal,gastric cancer and precancerous lesions.Lower microbial diversity or richness in esophageal cancer and precancerous lesions and specific prognostic biomarkers for esophageal cancer were found.Lactobacillus richness showed an increase trend during the process from gastritis to gastric cancer.This paper summarizes the progress in the research of potential biological etiology of upper gastrointestinal cancer from the perspective of metagenomics in order to provide evidence on the,prevention and control of upper gastrointestinal cancer.
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With the widely application of the metagenomics,the relationship between microbiota and disease has become a hot research topic.Understanding the potential association between upper gastrointestinal cancer or precancerous lesions and microbiota may play an important role in the early detection,clinical diagnosis and treatment,and prognostic evaluation of upper gastrointestinal cancer.Therefore,a literature retrieval was conducted by using PubMed,Embase and wanfang databases to summarize the latest research progress in the microbiota of upper gastrointestinal cancer,including oral,esophageal,gastric cancer and precancerous lesions.Lower microbial diversity or richness in esophageal cancer and precancerous lesions and specific prognostic biomarkers for esophageal cancer were found.Lactobacillus richness showed an increase trend during the process from gastritis to gastric cancer.This paper summarizes the progress in the research of potential biological etiology of upper gastrointestinal cancer from the perspective of metagenomics in order to provide evidence on the,prevention and control of upper gastrointestinal cancer.
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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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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 describe the epidemiological characteristics of esophageal cancer, cardiac cancer and non-cardiac gastric cancer in Hua County, Henan Province, and to analyze the patients' choice of hospital by using the data from local NCMS (New Rural Cooperative Medical System) database. Methods: The newly diagnosed cases of esophageal, cardiac and non-cardiac gastric cancers were acquired from the NCMS database of Hua County through a standardized screening procedure. Crude incidence rates, the world's and China's population- standardized incidence rates and truncated incidence rates were calculated. 2-test was used to evaluate the differences of proportions of the patients' choice of hospital. Results: The crude incidence rates of esophageal, cardiac and non-cardiac gastric cancers were 50.52/105, 9.63/105 and 7.00/105, respectively, in rural Hua County, Henan Province, in 2011. Higher incidence rates of these three kinds of cancers were observed in males. The incidence rates of esophageal and non-cardiac gastric cancers in males and females as well as that of cardiac cancer in females increased with age. Although the hospital choice was significantly different among the patients with various cancers (2 = 19.53,P = 0.003), county-level medical facilities were predominant in all three kinds of cancer patients. The hospital choice between the male and female patients was not significantly different (2 = 2.14,P = 0.543). The elderly patients tended to choose lower level of medical facilities while the younger patients chose higher level of medical facilities. Conclusion: Hua County of Henan Province is a high-risk region of esophageal cancer. The policy of NCMS should be further improved to ensure equality of the medical service and resource accessibility for rural elder cancer patients. Copyright © 2013 by TUMOR.
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Photodynamic therapy (PDT) is a promising new modality that utilizes the combination of a photosensitizing chemical and visible light for the management of various solid malignancies, including gastrointestinal (GI) cancer. PDT has some advantages over chemotherapy in terms of its greater safety and lower toxicity in the treatment of malignant lesions. However, PDT has not been used widely for treating upper GI cancer due to its relatively low cost-effectiveness and anatomical characteristics of the GI system. Nevertheless, PDT may be an effective alternative therapy for early upper-GI cancer patients who are at a high risk of curative surgical resection or systemic chemotherapy. In some clinical studies, PDT for various upper GI cancer showed positiveresults. To improve the efficacy of PDT for upper GI cancer, development of photosensitezer and light delivery system is needed.