[Incidence and mortality of thyroid cancer in six cancer registries of Zhejiang province, 2000-2009].

OBJECTIVE: To investigate the incidence and mortality rates of thyroid cancer in Zhejiang province during 2000 to 2009. METHODS: The data of thyroid cancer were collected from six cancer registries in Zhejiang province and the incidence and mortality rates of thyroid cancer were analysed. RESULTS: The mean annual incidence rate of thyroid cancer in Zhejiang cancer registration areas was 6.93/100 000 during 2000 to 2009, and male/female ratio was 1: 3.43. The incidence rate was 3.62/100 000 in 2000 and it increased to 11.42/100 000 in 2009, with the annual percent change (APC) of 16.32% (95% confidence interval: 12.90%-19.85%). The mean annual mortality rate of thyroid cancer was 0.27/100 000 during 2000 to 2009, and male/female ratio was 1: 1.12. The mortality showed a rising trend without a distinct fluctuation from 2000 to 2009, the APC was 2.14% (95% confidence interval: from -7.10% to 12.30%). The incidence showed a rising trend with the increase of ages after 15 years old, and peaked at 55-60 years old. The mortality was low before 54 years old, but showed a rising trend with a distinct fluctuation after 55 years old, and peaked at 85-90 years old. CONCLUSION: The prevention and control of risk factors for thyroid cancer in young and middle-aged people is key to decrease the incidence and mortality of thyroid cancer.

Analysis of cancer incidence in Zhejiang cancer registry in China during 2000 to 2009.

OBJECTIVE: The Zhejiang Provincial Cancer Prevention and Control Office collected cancer registration data during 2000 to 2009 from 6 cancer registries in Zhejiang province of China in order to analyze the cancer incidence. METHODS: Descriptive analysis included cancer incidence stratified by sex, age and cancer site group. The proportions and cumulative rates of 10 common cancers in different groups were also calculated. Chinese population census in 1982 and Segi's population were used for calculating age-standardized incidence rates. The log-linear model was used for fitting to calculate the incidence trends. RESULTS: The 6 cancer registries in Zhejiang province in China covered a total of 60,087,888 person-years during 2000 to 2009 (males 30,445,904, females 29,641,984). The total number of new cancer cases were 163,104 (males 92,982, females 70,122). The morphology verified cases accounted for 69.7%, and the new cases verified only by information from death certification accounted for 1.23%. The crude incidence rate in Zhejiang cancer registration areas was 271.5/105 during 2000 to 2009 (male 305.41/105, female 236.58/105), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 147.1/105 and 188.2/105, the cumulative incidence rate (aged from 0 to 74) being 21.7%. The crude incidence rate was 209.6/105 in 2000, and it increased to 320.20/105 in 2009 (52.8%), with an annual percent change (APC) of 4.51% (95% confidence interval, 3.25%-5.79%). Age-specific incidence rate of 80-84 age group was achieved at the highest point of the incidence curve. Overall with different age groups, the cancer incidences differed, the incidence of liver cancer being highest in 15-44 age group in males; the incidence of breast cancer was the highest in 15-64 age group in females; the incidences of lung cancer were the highest in both males and females over the age of 65 years. CONCLUSIONS: Lung cancer, digestive system malignancies and breast cancer are the most common cancers in Zhejiang province in China requiring an especial focus. The incidences of thyroid cancer, prostate cancer, cervical cancer and lymphoma have increased rapidly. Prevention and control measures should be implemented for these cancers.

[Incidence and mortality of brain tumor in areas with cancer registration of Zhejiang province, from 2000 to 2009].

OBJECTIVE: To investigate the incidence and mortality of brain tumor in Zhejiang cancer registration areas from 2000 to 2009. METHODS: Data from 6 Cancer registration areas of Zhejiang province were collected. Number of cases, crude rates, proportions, age standardized rates, cumulate rates, cut rates, age-specific rates and annual percentage change (APC, 95% CI) of brain tumor incidence and mortality were analyzed. RESULTS: There were 5 123 new diagnosed brain tumor cases in Zhejiang cancer registration areas, accounting for 3.14% of all the new cancer cases. The incidence rate of brain tumor was 8.53/100 000, and the standardized incidence rate by Chinese population was 5.72/100 000, ranking the 7th????? in cancer incidence spectrum of anatomic sites. Agespecific incidence of brain tumor increased along with age, and peaked among 70-74 age groups (24.09/100 000). The annual incidence rate of brain tumor increased from 2000 (6.87/100 000) to 2009(8.35/100 000), with APC as 1.58% (95%CI: -2.17%-5.47%, no statistical significance). A total of 2 357 deaths caused by brain tumor were reported from 2000-2009, accounting for 2.47% of all the cancer death cases. Mortality rate on brain tumor appeared to be 3.92/100 000, with the standardized mortality rate by Chinese population as 2.45/100 000, ranking the 7th????? in cancer mortality spectrum of anatomic sites. The age-specific mortality of brain tumor remained low among 0-39 year-olds, and reached the peak at 80-84 age groups (17.64/100 000). The annual mortality rate of brain tumor decreased from 2000(4.30/100 000)to 2009 (3.83/100 000) with minor fluctuation, and the APC was -0.65% (95%CI: -3.35%-2.12%, no statistical significance). CONCLUSION: Brain tumors incidence and mortality in Zhejiang cancer registration areas were at a relatively high level. People who were at middle-age, especially above 70 years old should be the key targets for protection on this disease. Brain tumor incidence rates increased annually in Zhejiang, which should be called for attention.

[Incidence and mortality of cancer in Zhejiang province in 2009].

OBJECTIVE: To investigate the incidence and mortality of cancer registered in Zhejiang province in 2009. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

Elevated circulating CD19+ lymphocytes predict survival advantage in patients with gastric cancer.

BACKGROUND: Circulating lymphocyte subsets reflect the immunological status and might therefore be a prognostic indicator in cancer patients. Our aim was to evaluate the clinical significance of circulating lymphocyte subset in gastric cancer (GC) cases. METHODS: A retrospective study on a prevalent cohort of 846 GC patients hospitalized at Hospital from Aug 2006 to Jul 2010 was conducted. We calculated the patient's disease free survival (DFS) after first hospital admission, and hazard ratios (HR) from the Cox proportional hazards model. RESULTS: Our findings indicated a significantly decreased percentage of CD3+, and CD8+ cells, a significantly increased proportion of CD4+, CD19+, CD44+, CD25+, NK cells, and an increased CD4+/CD8+ ratio in GC patients as compared with healthy controls (all P<0.05). Alteration of lymphocyte subsets was positively correlated with sex, age, smoking, tumor stage and distant metastasis of GC patients (all P<0.05). Follow-up analysis indicated significantly higher DFS for patients with high circulating CD19+ lymphocytes compared to those with low CD19+ lymphocytes (P=0.037), with CD19+ showing an important cutoff of 7.91± 2.98%. CONCLUSION: Circulating lymphocyte subsets in GC patients are significantly changed, and elevated CD19+ cells may predict a favorable survival.

[Incidence and mortality of larynx cancer in China during 2003-2007].

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 were 2.04/10(5) and 1.06/10(5) 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 2.08/10(5) in Zhongshan city, Guangdong province, and 1.58/10(5) 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 a protein peak(3144 m/z) in serum and its clinical significance in patients with gastric cancer].

OBJECTIVE: To investigate the expression of protein peak (3144 m/z) in serum and of its association with clinical pathological characteristics and prognosis in patients with gastric cancer. METHODS: Three hundred and twenty seven pathologically confirmed gastric cancer patients were recruited from February 2006 to October 2008 in the Zhejiang Cancer Hospital. SELDI-TOF-MS was employed to detect the expression of protein peak (3144 m/z) in preoperative serum. RESULTS: The positive rate of 3144 m/z protein peak was 33.9% (111/327), significantly higher than that of CEA (21.1%,69/327), and the difference was statistically significant (P<0.01). The positive rate of combined detection of protein peak (3144 m/z)and CEA was 45.6% (149/327). The expression of protein peak (3144 m/z) was associated with clinical staging (P<0.01), nervous invasion (P<0.01), tumor size (P<0.01), vascular invasion (P<0.05), lymph node metastasis (P<0.05), expression of CEA (P<0.05), and depth of infiltration (P<0.05). Significant difference was observed in 3-year survival rate between the patients with protein peak and patients without protein peak (44.7% vs. 64.4%, P<0.01). However, 3144 m/z protein peak was not an independent prognostic factor on multivariate Cox regression analysis (P=0.057). CONCLUSION: Protein peak (3144 m/z) may be used as a diagnostic or prognostic marker of gastric cancer.

[Use of serum protein profiling for early diagnosis of gastric cancer].

OBJECTIVES: To identify serum biomarkers associated with early gastric cancer. METHODS: Serum proteins or peptides were purified with weak cation exchange magnetic beads in 433 patients with gastric cancer and 120 healthy subjects. Distinct peaks were selected using Biomarker Wizard software. The area under receiver operating characteristic curve(AUC) was generated to analyze discrimination capability of peaks between gastric cancers and health people. RESULTS: Thirteen distinct peaks were identified between 42 gastric cancer and 42 health people matched by age and gender(P<0.001). There were 5 peaks (2745, 2768, 6629, 3402, and 6436 m/z) with AUC greater than 0.8. Peak of 6629 m/z was identified to be transthyretin. The sensitivity and specificity of 6629 m/z were 65.5% and 92.0%. The sensitivity of 6629 m/z was 59.4% in I(A gastric cancer. CONCLUSION: Transthyretin precursor may be of value in the early diagnosis of gastric cancer.

[Significance of multidrug resistance gene-associated proteins in the postoperative adjuvant chemotherapy for gastric carcinoma and the prognosis].

OBJECTIVE: To investigate the expression of multidrug resistance (MDR) gene-associated proteins (MRP) in gastric carcinoma, and their effects on the postoperative adjuvant chemotherapy and the prognosis of patients. METHODS: The expressions of ToPo II, MRP, GST-pi in 99 patients with gastric carcinoma were detected by immunohistochemistry. The expression and its relationship to the pathological data were analyzed. The positive expression of MRP and GST-pi, and the negative expression of ToPo II were considered as risk factors. Patients were divided into two groups: a high risk drug-resistant group (2-3 risk factors) and the low risk drug-resistant group (0-1 risk factors). Postoperative recurrence, survival rate, and efficacy of adjuvant chemotherapy were compared between two groups. RESULTS: The positive rate of ToPo II was 74.7%, and the expression was associated with types and differentiation of the tumor. The positive rate of GST-pi was 49.5%, and the expression was related to the gender and the differentiation. The positive rate of MRP was 40.4%, and there was no relationship between the MRP expression and the pathological finding. There were no significant differences in the recurrence, time to recurrence, and the 5-year survival rate between the positive and negative group of the three proteins (P>0.05). Recurrence was found in 25 cases(55.6%) in the high risk drug-resistant group and the mean time to recurrence was (15.2+/-8.1) months. The time to recurrence was shorter in the low risk drug-resistant group [(21.3+/-11.1) months, P<0.05] , but there was no significant difference in the recurrence rate between two groups (P>0.05). The 5-year survival rate of the high risk drug-resistant group and the low risk drug-resistant group was 44.4% and 55.6% (P>0.05). The 5-year survival rates of patients with or without chemotherapy in the high risk drug-resistant group were 45.8% and 42.9% (P>0.05). The 5-year survival rates of patients with or without chemotherapy in the low risk drug-resistant group were 70.4% and 40.7%. The survival rate of patients with chemotherapy was higher than that of the patients without chemotherapy (P<0.05). CONCLUSIONS: The expression of ToPo II, MRP and GST-pi is associated with the efficacy of postoperative adjuvant chemotherapy. Chemotherapy appears to be more beneficial to patients with low risk drug-resistance.

[Screening of carcinogenesis associated genes in gastric carcinoma by gene chip].

OBJECTIVE: To screen the carcinogenesis associated genes in gastric carcinoma by gene chip. METHODS: U133A (Affymetrix Santa Clara, CA) gene chip was used to detect differentially expressed genes in tumor tissues, paratumor mucosa and normal mucosa. Bioinformatics was used to analyze the screened results. RESULTS: A total of 150 genes were detected with a difference of expression levels more than 3 times in paratumor mucosa compared with normal gastric mucosa, 130 of which were up-regulated and 20 down-regulated. According to the function classifications of the differentially expressed genes, the most common ones were enzyme and enzyme regulon activity associated genes(28, 18.7% ). The frequencies of nuclei acid binding activity associated genes,signal transduction associated genes and protein binding associated genes were 11.3%, 10%, and 8.7% respectively. Seventy-one differentially expressed genes were detected both in tumor tissues and paratumor mucosa compared with normal mucosa, 61 of which were up-regulated and 10 down-regulated. Among these 71 genes,e leven genes were localized on chromosome 19, 6 on chromosome 1, 2, 16, 17 respectively. No abnormal differentially expressed gene were detected on chromosome 5, 14, 22 and Y. CONCLUSIONS: These 71 genes differentially expressed both in tumor tissues and paratumor mucosa may be associated with carcinogenesis of gastric carcinoma. The four kinds of genes associated with enzyme and enzyme regulon activity, nuclei acid binding activity, signal transduction, and protein binding should be the main genes for the study of carcinogenesis in gastric carcinoma.

Function and chromosome location of differentially expressed genes in gastric cancer.

Using Affymetrix U133A oligonucleotide microarrays, screening was done for genes that were differentially expressed in gastric cancer (T) and normal gastric mucosa (C), and their chromosome location was characterized by bioinformatics. A total of 270 genes were found to have a difference in expression levels of more than eight times. Of them 157 were up-regulated (Signal Log Ratio [SLR] > or = 3), and 113 were down-regulated (SLR< or = -3). Except for, four genes with unknown localization, a vast majority of the genes were sporadically distributed over every chromosome. However, chromosome 1 contained the most differentially expressed genes (26 genes, or 9.8%), followed by chromosomes 11 and 19 (both 24 genes, or 9.1%). These genes were also more likely to be on the short-arm of the chromosome (q), which had 173 (65%). When these genes were classified according to their functions, it was found that most (67 genes, 24.8%) belonged to the enzymes and their regulators groups. The next group was the signal transduction genes group (43 genes, 15.9%). The rest of the top three groups were nucleic acid binding genes (17, 6.3%), transporter genes (15, 5.5%), and protein binding genes (12, 4.4%). These made up 56.9% of all the differentially expressed genes. There were also 50 genes of unknown function (18.5%). Therefore it was concluded that differentially expressed genes in gastric cancer seemed to be sporadically distributed across the genome, but most were found on chromosomes 1, 11 and 19. The five groups associated genes abnormality were important genes for further study on gastric cancer.

[Study on gene expression profile difference in gastric cancer, pericancerous mucosa and normal gastric mucosa from the distant cutting margin by oligonucleotide microarray].

OBJECTIVE: To study the difference of gene expression profiles in gastric cancer (T), pericancerous mucosa (P) and the gastric mucosa from distant cutting margin (C), and to screen an associated novel gene in early gastric carcinogenesis by oligonucleotide microarray. METHODS: U133A (Affymetrix, Santa Clara, CA) gene chip was used to detect the gene expression profile difference in T, P and C, respectively. Bioinformatics was used to analyze the detected results. RESULTS: When gastric cancer was compared with normal gastric mucosa, 766 genes were found,with a difference of more than four times in expression levels, including 530 up-regulated [Signal Log Ratio (SLR) > 2], and 236 down-regulated (SLR< -2). When P was compared with C, 64 genes were found, with a difference of more than four times in expression levels, including 50 up-regulated (SLR > 2), and 14 down-regulated (SLR< -2). Compared with C, a total of 143 genes with a difference of more than four times in expression levels both in T and P tissues. Of the 143 genes, 108 were up-regulated (SLR > 2), and 35 were down-regulated (SLR< -2). CONCLUSIONS: Gene chip can reveal 143 same genes both in pericancerous mucosa and gastric mucosa. These genes may be related to the carcinogenesis and development of early gastric cancer.

Gene expression profile differences in gastric cancer, pericancerous epithelium and normal gastric mucosa by gene chip.

AIM: To study the difference of gene expression in gastric cancer (T), pericancerous epithelium (P) and normal tissue of gastric mucosa (C), and to screen an associated novel gene in early gastric carcinogenesis by oligonucleotide microarray. METHODS: U133A (Affymetrix, Santa Clara, CA) gene chip was used to detect the gene expression profile difference in T, P and C, respectively. Bioinformatics was used to analyze the detected results. RESULTS: When gastric cancer was compared with normal gastric mucosa, 766 genes were found, with a difference of more than four times in expression levels. Of the 766 genes, 530 were up-regulated (Signal Log Ratio (SLR) >2), and 236 were down-regulated (SLR<-2). When pericancerous epithelium was compared with normal gastric mucosa, 64 genes were found, with a difference of more than four times in expression levels. Of the 64 genes, 50 were up-regulated (SLR>2), and 14 were down-regulated (SLR<-2). Compared with normal gastric mucosa, a total of 143 genes with a difference in expression levels (more than four times, either in cancer or in pericancerous epithelium) were found in gastric cancer (T) and pericancerous epithelium (P). Of the 143 genes, 108 were up-regulated (SLR>2), and 35 were down-regulated (SLR<-2). CONCLUSION: To apply a gene chip could find 143 genes associated with the genes of gastric cancer in pericancerous epithelium, although there were no pathological changes in the tissue slices. More interesting, six genes of pericancerous epithelium were up-regulated in comparison with genes of gastric cancer and three genes were down-regulated in comparison with genes of gastric cancer. It is suggested that these genes may be related to the carcinogenesis and development of early gastric cancer.