隐血珠对上消化道疾病诊断价值初步研究

 目的　探讨隐血珠对上消化道疾病诊断价值。方法　对自然人群中24712例志愿者行隐血珠检测,对检测结果为“+++”及“++者作纤维胃镜进一步检查确诊,并进行统计分析。结果　对隐血珠检测阳性者志愿作胃镜检查2568例,发现上消化道各种炎性病变2015例,占75.80%,上消化道癌108例,占4.06%,消化性溃疡、平滑肌瘤、憩室、息肉等病变占3.76%。结论　秦氏隐血珠在上消化道肿瘤高发区高危人群中作为普查初筛手段确有重要实用价值;对临床判断有无上消化道炎性病变亦有重要参考价值,故值得进一步推广应用。     

隐血珠检测上消化道出血病变的价值

目的 评介隐血珠在检测上消化道出血性病变中的意义,为该法用于筛检胃癌及食管癌提供客观的数据资料。方法 对一组因有上消化道症状来医院就诊而需做胃镜检查的患者,在行胃镜检查前先做隐血珠检测,以胃镜和（或）病理学检查结果为金标准,对隐血珠检测的结果用敏感性,特异性,似然比及Ｙｏｕｄｅｎ指数（正确指数）等指标进行评价。结果 ５２１７例患者中,隐血珠阳性者２４０３例（４６．１％）,共发现上消化道恶性肿瘤２０     

莱州市上消化道肿瘤普查报告

目的 :研究上消化道肿瘤普查方法及实施措施。方法 :隐血珠初筛、胃镜精查、病理确诊三级检查法 ,普查上消化道肿瘤高危人群。结果 :隐血珠实查 12 36 46人 ,占普查对象的 4 6 4 2 %。按精查点所辖范围计 ,普查率在 17 6 9%～ 97 97%。隐血珠阳性 32 14 0人 ,占 2 5 99% ,胃镜检查 90 0 2人 ,占隐血珠阳性的 2 8.0 1% ,活检 3374人 ,占胃镜检查的 37 4 8% ,发现癌前病变 14 75人 ,胃癌 12 0人。结论 :普查可发现肿瘤及癌前病变 ,为下步探讨社区人群长期筛查之实施方案、开展成本 -效益分析、组织一、二级预防提供基础     

隐血珠筛检上消化道癌和癌前病变结果报告

目的 :用隐血珠筛检食管癌、胃癌及癌前疾病 ,作为进一步研究的数据源。方法 :用隐血珠对盐城市志愿接受检查的健康人群进行筛选 ,阳性者以胃镜和病理检查结果作为诊断金标准。结果 :3450 0人接受隐血珠筛查 ,阳性 72 35人 ,共发现上消化道癌 2 2 1例 ,其中食管癌 111例 ,胃癌 (含贲门癌 ) 110例。根据隐血珠反应程度的不同 ,在 ( )～ ( )的癌检出度分别为 1 11%、5 0 8%和 6 3% ,35岁以上人群癌检出率 6 4 1/ 10万 ,4 0岁以上年龄组的癌检出率较 39岁以下组呈跳跃性上升 (χ2 =4 72 ,P <0 0 0 5) ,且随年龄的增长 ,癌的检出率增高 ,差异非常显著。癌前病变中 ,食管黏膜鳞状上皮中、重度不典型增生的检出率略低于胃腺上皮中、重度不典型增生 (P >0 0 5)。结论 :在上消化道肿瘤高发地区以“隐血珠初筛→胃镜精查→病理确诊”的三级检查法是筛检早期癌及癌前病变的有效办法。     

秦氏隐血珠在上消化道癌初筛普查中实用价值的调查研究——附31972例初筛人群5、10年随访资料分析

目的：通过对隐血珠初筛人群及癌患5年、10年随访,进一步证实隐血珠对上消化道癌初筛普查的实用价值。方法：空腹时吞入隐血珠,3-5分钟拉出,观察珠内试纸的变化,黄色为阴性（-）,浅蓝色为（ ）,蓝色为（ ）,深蓝色为（ ）,5年、10年后对隐血珠初筛人群及癌患通过三级防癌网络进行全员随访。结果：初筛普查31927人,阳性组3347人做胃镜,经病理确诊为癌患125人,癌检出率3.74%,阴性组645人做胃镜,确诊癌患9人,癌检出率1.4%,两组中早期癌患共78人,占62.4%,性别、年龄、隐血珠反应均是影响癌检出率的因素。经5年及10年两次全员随访资料统计,隐血珠初筛阳性组癌发生率均明显高于阴性组,癌患5年生存率67.2%,10年生存率为55.2%,性别、年龄、隐血珠反应也是影响上消化道癌发病率因素。结论：秦氏隐血珠在上消化道癌初筛普查中有肯定的实用价值。值得推广。     

1600万人群上消化道癌隐血珠筛查报告

目的评价上消化道癌隐血珠筛查结果。方法隐血珠经历研制,临床患者试验;现场验证;全国范围推广应用三个阶段,历时28年,在全国20多个省市,300多个县,30~70岁人群中筛查1600多万人次,胃镜精查近100万人次,检出食管癌和胃癌7766例,2/3是早中期病例。结果最早接受普查的江苏省扬中市医院,隐血珠筛查检出的上消化道早期癌手术治疗103例,5年生存率93.3%,筛查10年后随访,隐血珠阳性组人群食管癌和胃癌发病率仍然比阴性组高出1.08倍,差异有显著性。结论胃液隐血长期不消失,是上消化道癌高危人群,或已是早期癌。经过大量随诊研究,不少当年胃液隐血阳性,胃镜报告为慢性炎症或正常者,观察1~5年后屡有转为早期癌或重度不典型增生者。30~70岁高发区居民,或有胃部疾患者,定期1~2年吞一次隐血珠筛查上消化道疾病不失为良策。     

上消化道早期癌的诊断及手术疗效观察：附143例分析

作者报道1986年4月至1992年3月在上消化道癌高发区扬中县应用隐血珠初筛、胃镜普查和门诊胃镜检查共发现上消化道早期癌143例,占同期切除病例总数的15.4％(143/926)。其中早期食管癌49例,早期胃癌94例。早期胃癌的部位分布中贲门癌57例,占早期胃癌的60.6％。术后随访1、3、5年生存率分别为98.3％、97.5％、和95.2％。作者认为:上消化道早期癌病变发展较慢,病人往往有足够的时间在早期阶段被发现,在上消化道癌高发区对高危人群用隐血珠初筛胃镜普查的方法值得推广。     

隐血珠筛查上消化道癌发病及生存情况调查

目的：C地隐血珠筛查人群发病及癌患者生存的情况调查。进一步探讨在上消化道癌高发区实施早期筛查的重要性。方法：空腹时吞入隐血珠,3至5分钟拉出,观察珠内试纸的变化,黄色为阴性（－）,浅蓝色为（＋）,蓝色为（＋＋）,深蓝色为（＋＋＋）,5年、10年后通过三级防癌网络对隐血珠初筛人群发病及生存情况进行了全员随访。结果：筛查31927人,阳性组3347人做胃镜,经病理确诊癌患者125人,癌检出率3．73％;阴性组645人做胃镜,确诊癌患者9人,癌检出率1．4％,两组早期癌患者共78人,占62．4％,经5年及10年后两次全员随访资料统计,隐血珠初筛阳上组癌发病率均明显高于阴性组,癌患者5年生存率为67．2％,10年生丰为55．2％,性别、年别,年龄、隐血珠反应也是影响初筛人群上消化道癌检出率的因素,结论：在上消化道癌高发区用隐血珠进行早期筛查效果显著。     

应用隐血珠法筛查盐城市上消化道恶性肿瘤结果报告

１９９９年１０月~２０００年１０月,我们应用秦德兴教授发明的隐血珠技术[１],在盐城市５３ ２００例健康人群中,筛选出胃液隐血阳性者１０ ８９３例,经胃镜结合病理确诊为上消化道癌者３８０例。现将结果分析报告如下:     

胃隐血珠加胃镜检查在上消化道体检中应用

[目的]评价健康体检中应用胃隐血珠加胃镜检查法对上消化道癌及癌前病变的意义.[方法]用秦氏胃隐血珠对上消化道系统进行初筛16782人,对阳性及强阳性者再进行胃镜检查,明确诊断.[结果]1561例胃镜检查中566例咬取活检,病理诊断癌68例,其中食管癌26例,胃癌42例.早期癌16例,占23,5%.慢性胃炎伴重度肠化生16例,伴重度异型增生5例;食管重度异型增生4例.[结论]应用秦氏胃隐血珠加胃镜检查法,对健康体检人群进行上消化道肿瘤检查,是一种简便易行的方法,可以提高早期癌及癌前病变的检出率.     

上消化道肿瘤端粒酶活性研究

目的 探讨端粒酶活性与消化道肿瘤发生的关系。方法 采用ＥＬＩＳＡ免疫组化法检测端粒酶的活性,对８７例上消化道癌和２７例癌旁正常粘膜进行对比性研究。结果 食管癌端粒酶检测的阳性率为８１．５％（４４／５５）,癌旁正常粘膜为１７．６％（３／１７）;贲门癌阳性率为１００．０％（１２／１２）;胃癌阳性率为８５．７％（１８／２１）,癌旁正常粘膜为２０．０％（２／１０）。结果表明食管癌及胃癌与其相应的癌旁组织中     

Non-Hodgkin's malignant lymphomas of upper digestive and respiratory tracts

The history of 102 patients with primary Non-Hodgkin's lymphoma of the upper digestive and respiratory tract is reviewed. An analysis is presented of the histopathologic, clinical and prognostic features of these patients, who presented to the Antoni van Leeuwenhoek Hospital in Amsterdam between 1958–1976. The histological slides were reviewed in 91 patients. Ilio-lumbar lymphography and bone marrow examination were performed in 44 and 66 patients respectively:4 lymphograms and 4 bone marrows were found to be abnormal. Of 82 patients with Stage I and II disease, there were 72 remissions with locoregional irradiation. Among these patients 36 suffered a relapse, 27 (75%) during the first year after treatment. The median survival was 14 months for all stages. The survival at 5 years was 28% for Stage I and 12% for Stage II patients. Prognosis was influenced by follicular cb/cc lymphomas, histiocytic poorly differentiated cell type, stage, size of primary tumor, and the radiation dose. We recommend adjuvant chemotherapy in Stage I and II patients after primary radiation treatment because of the high rate of primary relapse in distant sites.     

Multiple primary squamous cell carcinomas in the upper digestive tract

Multiple squamous cell carcinomas are common and patients carry a constant and excessive risk of developing a new cancer at any time (13-21 X the normal). Among 6,203 cases of primary squamous carcinoma of the upper digestive tract, 648 patients (10.4%) developed two or more independent tumors. Altogether, 761 additional malignancies were observed, with up to five cancers being seen in individual patients. There were 279 patients with a prior or synchronous cancer and 409 patients who developed 462 metachronous tumors. There was a substantial risk for developing a second primary cancer in the upper aerodigestive tract. Overall the observed to expected ratio was 2.48, specifically 2.32 for males and 2.89 for females.     

Dose-Response Carcinogenicity in Rats on Low-dose Levels of N-Ethyl-N-nitrosourethane

A dose-response study on the carcinogenicity of N -ethyl- N -nitrosourethane (ENUR) was undertaken to examine its effect at low doses. Six-week-old female F344 rats were divided into 5 groups, each consisting of 40 animals. ENUR was dissolved in distilled water at dose levels of 0 (control), 0.15, 0.6, 2.5 and 10 ppm, and rats were given these solutions ad libitum for 2 years. Significant increase of the total tumor incidences and shortening of the mean survival times were observed in groups given 2.5 and 10 ppm ENUR. In groups given 0.6 ppm or more ENUR, digestive tract tumors were induced dose-dependently. They were restricted to the upper digestive tract from the oral cavity to the forestomach, and were histologically squamous cell papillomas or carcinomas. Dose-related differences in the location and incidence of these tumors were found. The virtually safe doses (VSDs) calculated by using the Weibull, Logit and Probit models were 0.365 × 10^-2, 0.110 × 10^-1 and 0.779 × 10^-1 ppm, respectively. The VSDs estimated in the present study are discussed in comparison with those of other carcinogens.     

上消化道非上皮肿瘤13例报告

报告１３例上消化道非上皮肿瘤。其中良性肿瘤５例（食管平滑肌瘤２例，胃平滑肌瘤３例），恶性肿瘤８例（胃恶性淋巴瘤３例，胃平滑肌肉瘤５例）。主要症状有上腹痛、黑便、呕血、贫血、腹块、吞咽困难等。７例行上消化道钡餐检查，确诊２例。内镜下肿瘤均为腔内型。良性肿瘤多为类圆形，表面光滑，色泽正常、恶性肿瘤表现为结节、糜烂、浸润、溃疡。粘膜活检１１例发现瘤细胞。６例恶性肿瘤手术治疗，随访３例５年仍存活。Ｘ线及胃镜检查是诊断平滑肌瘤的重要方法。     

Reprimo基因在消化道肿瘤中的研究进展

Reprimo基因是一种新型的抑癌基因,定位于人类染色体的2q23,它由X线照射后的细胞分离产生并依赖于p53的表达.2000年之后,对Reprimo基因进行了深入的研究,为寻找肿瘤基因治疗的特异性靶点起到重要作用.但目前对它的认识仍不足,尤其对其在消化道肿瘤中的研究有限.本文就此做一综述,旨在阐述Reprimo基因的结构和功能,以及Reprimo基因在食管癌、胃癌、胰腺癌和结直肠癌等消化道肿瘤中的研究进展.     

循环长链非编码RNA在消化道肿瘤中的研究进展

长链非编码RNA(long non coding RNA,lncRNA),是一类长度超过200个核苷酸,无蛋白质编码功能的RNA分子.越来越多研究证实,lncRNA参与了消化道肿瘤的发生发展.近年来发现消化道肿瘤患者的血液循环中可检测到lncRNA,且这些lncRNA与肿瘤的性质和转归相关.由于取材方便,循环中的IncRNA容易检测,已有相关研究探讨循环中的lncRNA在消化道肿瘤中的价值.本文就消化道肿瘤循环中的lncRNA相关研究报道进行综述,旨在为循环中的lncRNA在消化道肿瘤中的诊断、疗效及预后判断提供线索.     

History of cirrhosis and risk of digestive tract neoplasms.

BACKGROUND: Cirrhosis is strongly related to liver cancer. Data on the possible association between cirrhosis and risk at other cancer sites are scanty. PATIENTS AND METHODS: We analysed data from a network of case-control studies conducted in Italy between 1983 and 1997, including patients with cancers of the oral cavity and pharynx (520), oesophagus (405), stomach (731), colon (943), rectum (613), liver (425), gallbladder (63) and pancreas (395). The controls were 4297 patients admitted to hospitals for acute non-neoplastic conditions. RESULTS: After strict allowance for alcohol drinking, tobacco smoking and history of hepatitis, the multivariate odds ratios for a history of cirrhosis were 4.7 [95% confidence interval (CI) 2.2-9.8] for neoplasms of the oral cavity and pharynx, 2.6 (95% CI 1.2-5.7) for the oesophagus, 1.0 (95% CI 0.4-2.5) for the stomach, 1.0 (95% CI 0.4-2.4) for the colon, 1.7 (95% CI 0.7-4.1) for the rectum, 20.5 (95% CI 12.3-34.2) for the liver, 2.1 (95% CI 0.3-16.8) for the gallbladder and 0.9 (95% CI 0.3-3.0) for the pancreas. CONCLUSIONS: Our study confirms and further quantifies the increased risk of liver cancer in cirrhotic patients and is compatible with an increased risk of oral, pharyngeal and oesophageal cancers.     

Type of cigarettes and cancers of the upper digestive and respiratory tract

The relationship between type of cigarettes smoked and the risk of cancer of upper digestive and respiratory sites was investigated in a case-control study conducted in Northern Italy on 291 males with cancer of the oral cavity or pharynx, 288 with cancer of the esophagus, 162 with cancer of the larynx, and 1,272 control subjects in hospital for acute conditions unrelated to tobacco or alcohol consumption. Using a distinction based on tar-yield or the brand smoked for the longest time (<22 mg, low to medium tar; 22 mg, high tar), the multivariate relative risks among ever-smokers were 8.5 for low/medium and 16.4 for high tar cigarettes for oral and pharyngeal neoplasms, 3.3 and 7.8 for esophageal, and 4.8 and 7.1 for laryngeal cancers. The differences according to type of cigarettes were similar in proportional terms, and hence larger in absolute terms, when analysis was restricted to current smokers only. Thus, these data provide further quantitative evidence on the importance of type of cigarette smoked on the risk of upper-digestive and respiratory tract cancers and have important public health implications.Drs La Vecchia, D'Avanzo and Negri are at the Istituto di Richerche Farmacologiche Mario Negri, Via Eritrea 62, 20157 Milano, Italy. Dr La Vecchia is also at the Institute of Social and Preventive Medicine, University of Lausanne, 1005 Lausanne, Switzerland. Drs Bidoli, Barra, Talamini and Franceschi are in the Aviano Cancer Center, 33081 Aviano, Prodenone, Italy. Reprint requests should be addressed to Dr La Vecchia at the Istituto di Ricerche Farnacologiche. This work was conducted within the framework of the National Research Council (CNR), Applied Projects Oncology (Contract No. 87.01544.44) and Risk Factors for Disease, with contributions from the Italian Association for Cancer Research and the Italian League against Tumours, Milan.