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1.
Anticancer Res ; 40(1): 443-449, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892599

RESUMO

BACKGROUND: We investigated the clinical influence of anastomotic leak (AL) on esophageal cancer survival and recurrence after curative surgery. PATIENTS AND METHODS: This study included 122 patients who underwent curative surgery for esophageal cancer between 2008 and 2018. The patients were classified into those with AL and those without. The risk factors for overall (OS) and recurrence-free (RFS) survival were identified. RESULTS: AL was found in 44 out of the 122 patients (36.1%). The respective OS rates at 3 and 5 years after surgery were 43.9% and 40.2% in the AL group and 63.9% and 53.2% in the non-AL group, which were significantly different (p=0.0049). In contrast, the respective RFS rates at 3 and 5 years after surgery were 44.8% and 29.8%, and 44.9% and 42.4%, which were not significantly different (p=0.2306). A multivariate analysis showed that AL was a significant independent risk factor for both poorer OS and RFS in patients who underwent curative surgery for esophageal cancer. CONCLUSION: To improve survival of patients with esophageal cancer, the surgical procedure, perioperative care and surgical strategy must be carefully planned in order to prevent AL.


Assuntos
Fístula Anastomótica/patologia , Neoplasias Esofágicas/patologia , Recidiva Local de Neoplasia/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Sobrevida
2.
Zhonghua Wai Ke Za Zhi ; 58(1): 61-69, 2020 Jan 01.
Artigo em Chinês | MEDLINE | ID: mdl-31902173

RESUMO

Esophageal cancer surgery originated in the early 20(th) century. However, the true meaning of trans-thoracic esophagectomy and digestive tract reconstruction began in the 1930s. Almost at the same time, Japan and Western countries began the surgical exploration of esophageal cancer. Based on the pathological type of esophageal cancer in Asia, squamous cell carcinoma is the majority, and its biological characteristics and treatment strategies are different from those of European and American patients. After more than eighty years of development, the surgical treatment of esophageal cancer in Japan has been developed from the initial attempt, deep cultivation practice to the pursuit of excellence, and explored a set of more advanced surgical techniques and diagnostic strategies, which is unique in the world. On the basis of the establishment of the Japanese Society of Esophagus, Japanese scholars have developed and irregularly updated the Japanese Classification of Esophageal Cancer and published the professional academic journal Esophagus. The Japanese Clinical Oncology Group organized a number of phase Ⅲ clinical studies on esophageal cancer, providing strong evidence for the diagnosis and treatment of esophageal squamous carcinoma. Focused on the origin, development, current situation and future of esophageal cancer surgery in Japan, this paper summarized the development of esophageal cancer surgery in Japan through literature review, interviews with senior experts and Hot topics of esophageal cancer surgery-questionnaire survey of Japanese experts.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Esofágicas/cirurgia , Esofagectomia/história , Carcinoma de Células Escamosas/história , Neoplasias Esofágicas/história , Esofagectomia/tendências , História do Século XX , História do Século XXI , Humanos , Japão , Estados Unidos
8.
Gastroenterology ; 158(1): 280-281, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31704298
9.
Zhonghua Yi Xue Za Zhi ; 99(47): 3687-3693, 2019 Dec 17.
Artigo em Chinês | MEDLINE | ID: mdl-31874491

RESUMO

Objective: To assess the feasibility, safety, and efficacy of a novel fully covered radioactive stent for the treatment of advanced esophageal and gastric cardia cancer. Methods: Data of 122 patients, who underwent esophageal radioactive stent placement for advanced esophageal or gastric cardia cancer between January 2012 and September 2017 in Zhongda Hospital, were retrospectively analyzed. Patients were divided into the novel stent group (n=59; 45 males, 14 females; mean age 73±10 years old) and the conventional stent group (n=63; 51 males, 12 females; mean age 72±9 years old), according to the types of radioactive stents. No significant difference was found between the two groups in baseline characteristics (all P>0.05). Outcomes were measured in terms of technical success, dysphagia score, stent restenosis, stent migration, major complications, and overall survival. Results: The technical success rate was 98.3% in the novel stent group, and 100.0% in the conventional stent group (P=0.484) . The dysphagia scores 3 days after surgery decreased from 3.27±0.45 and 3.37±0.49 to 1.25±0.66 and 1.32±0.50, respectively (all P<0.01), and the variances were comparable (P=0.709). Compared with conventional stents, novel stents were significantly associated with a decreased in the rate of stent restenosis, 11.9% vs 27.0%; cause-specific hazard ratio 0.387, 95%CI 0.160-0.934 (P=0.035); sub-distributional hazard ratio 0.401, 95%CI 0.167-0.963 (P=0.041), while the stent migration rate was statistically comparable (13.6% vs 6.3%, P=0.181). There was no significant difference between the novel stent group and the conventional stent group in major complications (all P>0.05), including moderate-severe chest pain (22.0% vs 25.4%), hemorrhage (11.9% vs 11.1%), fistula formation (1.7% vs 4.8%), and aspiration pneumonia (5.1% vs 6.3%). The median overall survival was 146(95%CI 115-177) days in the novel stent group, and 147(95%CI 98-196) days in the conventional stent group, and no significant difference was found (P=0.967). Conclusions: In patients with advanced esophageal or gastric cardia cancer,placement of a novel fully covered radioactive stent is safe and effective. This novel stent can relieve dysphagia rapidly and prevent stent restenosis effectively.


Assuntos
Transtornos de Deglutição , Neoplasias Esofágicas , Neoplasias Gástricas , Idoso , Idoso de 80 Anos ou mais , Cárdia , Neoplasias Esofágicas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos , Estudos Retrospectivos , Stents , Neoplasias Gástricas/cirurgia , Resultado do Tratamento
10.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(5): 636-645, 2019 Oct 30.
Artigo em Chinês | MEDLINE | ID: mdl-31699194

RESUMO

Objective To compare the differences in fecal flora among patients with esophageal cancer,gastric cancer,or colorectal cancer and between patients with gastrointestinal tumors and healthy people.Methods The 16S rRNA method was used to analyze the differences in fecal flora among 13 patients with esophageal squamous cell carcinoma,23 patients with gastric cancer,6 patients with colorectal cancer,and 49 healthy persons.Results Bifidobacterium,Faecalibacterium prausnitzii,and Ruminococcus callidus were less abundant in the fecal flora of cancer patients than in those of healthy controls(all P<0.05).Some species of Firmicutes and Actinobacteria were significantly reduced in the feces of patients with esophageal cancer or gastric cancer than in healthy people(P<0.05),whereas others showed consistency with the intestinal cancer group.Anti-tumor treatment,antibiotics,and lactic acid could affect the fecal flora of cancer patients.Conclusion The gut microbiota compositions(mainly Firmicutes and Actinobacteria)and some specific bacteria species in the feces of patients with esophageal cancer and gastric cancer are similar to those in the feces of patients with intestinal cancer,suggesting these bacteria may be involved in the development of upper gastrointestinal tumors.


Assuntos
Bactérias/classificação , Neoplasias Esofágicas/microbiologia , Carcinoma de Células Escamosas do Esôfago/microbiologia , Microbioma Gastrointestinal , Estudos de Casos e Controles , Fezes/microbiologia , Humanos , RNA Ribossômico 16S/genética
11.
Zhonghua Yi Xue Za Zhi ; 99(41): 3260-3265, 2019 Nov 05.
Artigo em Chinês | MEDLINE | ID: mdl-31694123

RESUMO

Objective: To compare the dosimetric parameters of three different modern radiation techniques in radical radiotherapy for esophageal cancer. Methods: A total of 25 patients with pathologically confirmed esophageal squamous cell carcinoma in Zhejiang Cancer Hospital were included from September 2015 to May 2016 and three radiation treatment plans for helical tomotherapy (TOMO), intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) were designed respectively for each patient. Study patients included 24 males and 1 female,aged from 47 to 82 years old, with a median age of 63 years old. All patients received the total prescription dose of 60 Gy in 30 fractions to the planning target volume (PTV). Conformity index (CI), heterogeneity index (HI), D(1), D(2), D(50), D(95), D(98), D(9)9 and V(95), V(100), V(105) of PTV was calculated. The mean dose, V(5), V(10), V(20), V(30), V(40) and V(50) of total lung, heart, and maximum dose (D(max)) to spinal cord were recorded as well. Results: Compared with TOMO and IMRT, VMAT showed higher CI (0.81±0.08) and lower HI (0.10±0.05), and CI was worse in IMRT (0.77±0.05) than TOMO (0.79±0.04) (t=2.604, P=0.016) and VMAT (t=2.817, P=0.010). There was no significant difference in HI among three radiation techniques. The dosimetric parameters of TOMO in normal lung were significantly better than those of VMAT and IMRT, especially in V(20) and V(30). The D(max) of spinal cord (38.24±3.72) Gy in TOMO was significantly lower than that of the VMAT ((39.88±3.27)Gy, t=-3.173, P=0.004) and IMRT plan ((41.09±3.18)Gy, t=-5.559, P=0.000). Subgroup analysis showed that VMAT was superior to TOMO and IMRT in CI and HI, especially HI (0.09±0.01) significantly better than TOMO (0.12±0.03, t=3.024, P=0.029) and IMRT (0.12±0.02, t=-3.800, P=0.013) for patients with cervical and upper thoracic esophageal cancer. TOMO and VMAT were significantly better than IMRT in MLD, lung V(20) and V(30) (all P<0.05). TOMO (38.46±2.15)Gy was significantly superior to VMAT ((41.02±1.28)Gy,t=-2.701, P=0.043) and IMRT ((41.76±1.11)Gy, t=-3.111, P=0.027) at D(max) of the spinal cord. For the patients with middle and lower thoracic esophageal cancer, TOMO, VMAT and IMRT had no statistically significant differences in CI and HI. IMRT was inferior to TOMO and VMAT in MLD, lung V(10), V(20), and V(30) (all P<0.05). TOMO (38.17±4.14) Gy was significantly superior to VMAT ((39.52±3.64)Gy,t=-2.219, P=0.040) and IMRT ((40.87±3.59)Gy,t=-4.528, P=0.000) at D(max) of the spinal cord. Conclusions: The VMAT plan is better than TOMO and IMRT in terms of the conformal degree and dose uniformity of the target volume.TOMO seems significantly better than VMAT and IMRT in protecting normal tissue.


Assuntos
Neoplasias Esofágicas , Radioterapia de Intensidade Modulada , Idoso , Idoso de 80 Anos ou mais , Neoplasias Esofágicas/diagnóstico por imagem , Carcinoma de Células Escamosas do Esôfago , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Órgãos em Risco , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador
12.
Anticancer Res ; 39(11): 5943-5951, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704819

RESUMO

BACKGROUND/AIM: To investigate the function of preferentially expressed antigen of melanoma (PRAME) in esophageal squamous cell carcinoma (ESCC). MATERIALS AND METHODS: mRNA expression levels of PRAME were analyzed in resected esophageal tissues of 150 ESCC patients and correlated with clinicopathological parameters. We also investigated the potential function of PRAME by analyzing coordinately expressed genes in 13 ESCC cell lines. RESULTS: RT-qPCR analysis of clinical samples revealed aberrantly high PRAME expression in tumors compared with normal esophageal tissues. High PRAME expression was significantly associated with shorter disease-specific survival and hematogenous recurrence, but not with overall recurrence. The cumulative incidence of hematogenous recurrence was significantly greater for patients with high compared to those with low PRAME expression. In vitro, PCR array analysis revealed that PRAME was coordinately expressed with EGFR, ITGB, and TCF3. CONCLUSION: PRAME is overexpressed in ESCC tissues and may serve as a novel biomarker for predicting hematogenous recurrence.


Assuntos
Antígenos de Neoplasias/metabolismo , Biomarcadores Tumorais/metabolismo , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/secundário , Recidiva Local de Neoplasia/patologia , RNA Mensageiro/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Neoplasias/genética , Biomarcadores Tumorais/genética , Estudos de Casos e Controles , Estudos de Coortes , Neoplasias Esofágicas/genética , Neoplasias Esofágicas/metabolismo , Carcinoma de Células Escamosas do Esôfago/genética , Carcinoma de Células Escamosas do Esôfago/metabolismo , Feminino , Seguimentos , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Metástase Neoplásica , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/metabolismo , Prognóstico , RNA Mensageiro/genética , Taxa de Sobrevida
13.
Anticancer Res ; 39(11): 6015-6023, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704827

RESUMO

BACKGROUND/AIM: We previously reported that expression of melanoma-associated antigen (MAGE)-D4 mRNA was a prognostic factor for esophageal squamous cell carcinoma (ESCC). The aim of this study was to validate the expression of MAGE-D4 in two additional patient cohorts, and to investigate its biological functions. MATERIALS AND METHODS: The role of MAGE-D4 in cell proliferation, adhesion, and migration was determined by gene knockdown experiments in the KYSE590 cell line. MAGE-D4 protein expression was analyzed in ESCC tissues by immunohistochemistry. A second validation cohort consisted of an ESCC mRNA dataset from The Cancer Genome Atlas. RESULTS: Knockdown of MAGE-D4 significantly decreased cell proliferation and migration. Expression of MAGE-D4 protein was significantly associated with disease-free survival. In the second validation cohort, high MAGE-D4 mRNA expression was associated with significantly shorter overall survival and disease-free survival. CONCLUSION: MAGE-D4 plays an important role in the malignant behavior of ESCC. MAGE-D4 was validated as a prognostic indicator in two independent ESCC patient cohorts.


Assuntos
Antígenos de Neoplasias/metabolismo , Biomarcadores Tumorais/metabolismo , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/secundário , Proteínas de Neoplasias/metabolismo , Idoso , Antígenos de Neoplasias/genética , Apoptose , Biomarcadores Tumorais/genética , Adesão Celular , Proliferação de Células , Estudos de Coortes , Neoplasias Esofágicas/metabolismo , Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago/metabolismo , Carcinoma de Células Escamosas do Esôfago/cirurgia , Feminino , Seguimentos , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Invasividade Neoplásica , Metástase Neoplásica , Proteínas de Neoplasias/antagonistas & inibidores , Proteínas de Neoplasias/genética , Prognóstico , RNA Interferente Pequeno/genética , Taxa de Sobrevida , Células Tumorais Cultivadas
14.
Gan To Kagaku Ryoho ; 46(11): 1753-1755, 2019 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-31748486

RESUMO

A 79-year-old woman had recurrence in the mediastinal lymph node 6 months after curative resection of advanced esophageal cancer(pStage Ⅲ). After radiation therapy and 12 courses of chemotherapy with docetaxel, new recurrent tumors progressed in the mediastinum and apical region of the left lung, and her performance status(PS)deteriorated to grade 3. Alternate-day, low-dose S-1 chemotherapy was started at a dose of 60mg/day. Tumors decreased in size within 6 months, and her PS improved from grade 3 to 0. She had been treated for 33 months without severe adverse events until disease progression. So far, we have experienced in clinical practices that the alternate-day S-1 administration was tolerable for patients who were unfit for the standard daily administration. Alternate-day, low-dose S-1 administration may be a sustainable and effective option in S-1 chemotherapy in patients with recurrent esophageal cancer with impaired PS.


Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Neoplasias Esofágicas , Recidiva Local de Neoplasia , Ácido Oxônico/uso terapêutico , Tegafur/uso terapêutico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica , Docetaxel , Combinação de Medicamentos , Neoplasias Esofágicas/tratamento farmacológico , Feminino , Humanos , Linfonodos , Mediastino
15.
Gan To Kagaku Ryoho ; 46(11): 1757-1759, 2019 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-31748487

RESUMO

Esophageal bypass surgery is a treatment for oral ingestion in cases of unresectable esophageal cancer with esophageal stricture. Esophageal bypass surgery may be necessary especially in cases of advanced esophageal stricture after CRT because of the high risk of bleeding and perforation due to esophageal stent placement. In recent years, as a safe technique with fewer complications, esophageal bypass surgery using a Y-shaped gastric tube has been increasingly performed. Therefore, we will introduce cases that have undergone esophageal bypass surgery after undergoing stent placement for unresectable advanced esophageal cancer stenosed after CRT.


Assuntos
Neoplasias Esofágicas , Estenose Esofágica , Neoplasias Esofágicas/complicações , Estenose Esofágica/etiologia , Estenose Esofágica/terapia , Humanos , Stents
16.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1081-1083, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683390

RESUMO

This article summarizedthe current situation of prevention and control of esophageal cancer in China and briefly introducedthe main measures and challenges of primary prevention and secondary prevention. Suggestions on the prevention and control of esophageal cancer wereproposed in consideration with the core content of this issue including disease burden, risk factors, screening and early diagnosis and treatment.


Assuntos
Detecção Precoce de Câncer , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/prevenção & controle , China , Humanos , Programas de Rastreamento , Fatores de Risco
17.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1084-1087, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683391

RESUMO

The screening, early diagnosis and early treatment project of the upper gastrointestinal cancer had achieved good results since its launch. However, from a national perspective, the endoscopic screening of upper gastrointestinal cancer was still not optimistic, such as the poor rate of the early diagnosis, the low rate of 5-year survival in rural areas, and the disparity of the standardized screening and diagnosis in different areas. Therefore, the situation of upper gastrointestinal cancer prevention and treatment is still severe. Under the guidance of the "Healthy China 2030" plan, based on the international experience and domestic actual circumstance, it is suggested that the screening of high-risk population in high-risk areas should be changed into the opportunistic screening in primary medical institutions. The opportunistic screening could expand the coverage of the screening, early diagnosis and early treatment project of the upper gastrointestinal cancer, and increase the early diagnosis rate in rural areas and primary medical institutions, which could improve the 5-year survival rate of patients with the upper gastrointestinal cancer, and then achieve the sustainable development of the cancer prevention and treatment in China.


Assuntos
Detecção Precoce de Câncer , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/terapia , Programas de Rastreamento/métodos , China , Endoscopia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/etnologia , Humanos , Programas de Rastreamento/tendências , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/etnologia
18.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1094-1097, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683393

RESUMO

Objective: To estimate the incidence and mortality rates of esophageal cancer in China in 2015. Methods: Based on the data quality review and assessment, the esophageal cancer data from 368 cancer registries in 31 provinces (autonomous regions and municipalities) in China were included in this study. According to the national population data in 2015, the nationwide incidence and mortality of the esophageal cancer were estimated. Chinese standard population in 2000 and world Segi's population were used to calculate the age-standardized (ASR) incidence and mortality rates (ASR China and world, respectively). Results: The 368 cancer registries covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. There were 245 651 new esophageal cancer cases estimated in China in 2015, with a crude incidence rate of 17.87/100 000. The ASR China and ASR world were 11.14/100 000 and 11.28/100 000, respectively. The estimated number of esophageal cancer death was 188 044 in China in 2015, with a crude mortality rate of 13.68/100 000; The ASR China and ASR world mortality rates were 8.33/100 000 and 8.36/100 000, respectively. The ASR China incidence and mortality of esophageal cancer in males were higher in males (16.50/100 000 and 12.66/100 000) than those in females (5.92/100 000 and 4.17/100 000), and they were higher in rural areas (15.95/1100 000 and 11.67/100 000) than those in urban areas (7.59/100 000 and 5.87/100 000). Conclusion: The incidence and mortality of esophageal cancer in China are higher than the global average. The disparity of the incidence and mortality rates of esophageal cancer significantly differed in genders and areas.


Assuntos
Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/mortalidade , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , China/epidemiologia , Neoplasias Esofágicas/etnologia , Feminino , Humanos , Incidência , Masculino , Vigilância da População , Sistema de Registros
19.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1104-1109, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683395

RESUMO

Objective: To analyze the related factors of esophageal squamous cell carcinoma and precancerous lesions among residents aged 40-69 years old in rural areas of Shandong Province. Methods: In October 2018, 300 villages in 13 counties of the Shandong upper gastrointestinal cancerearly diagnosis and treatment projectin 2017 were selected as research areas, and 30 400 residents aged 40-69 were recruited in this study. The demographic characteristics, health status and lifestyle information were collected through the questionnaire survey, and endoscope iodine staining and indicative biopsy methods were used for cancer screening among eligible people.The multivariate logistic regression model was used to analyze the risk factors for esophageal cancer and precancerous lesions. Results: The subjects in this study were (56.42±7.24) years old, including 13 193 males (43.40%).There were 936 cases of esophageal cancer and precancerous lesions (3.08%), including 521 males and 415 females.Compared with women, 40-49 years old, high level education, drinking tap water, regular intake of meat, eggs and milk, and family average annual income more than 30 000 RMB, men (OR=1.90, 95%CI: 1.65-2.19), 60-69 years old (OR=5.28, 95%CI: 4.11-7.30), primary school education or below (OR=1.50, 95%CI: 1.20-1.89), drinking groundwater (OR=1.71, 95%CI: 1.38-2.13), never eating meat, eggs and milk (OR=1.48, 95%CI: 1.22-1.80), and family average annual income less than 30 000 RMB (OR=1.41, 95%CI: 1.16-1.70) would increase the risk of esophageal cancer and precancerous lesions. Conclusion: The gender, age, educational level, annual household income, drinking water source, the frequency of eating meat, egg and milk were related to the occurrence of esophageal cancer and precancerous lesions among 40-69 years old residents in rural areas of Shandong Province.


Assuntos
Detecção Precoce de Câncer , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/patologia , Lesões Pré-Cancerosas/patologia , População Rural/estatística & dados numéricos , Adulto , Idoso , Biópsia , China/epidemiologia , Endoscopia , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/epidemiologia , Fatores de Risco
20.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1115-1118, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683397

RESUMO

Objective: To evaluate the effectiveness and benefit of the upper gastrointestinal cancer screening in Yangzhong city, Jiangsu province, from 2009 to 2015. Methods: From 2009 to 2015, 31 natural villages with high-incidence of upper gastrointestinal cancer were selected from Baqiao town, Youfang town and Xinglong sub-district in Yangzhong city. 13 776 residents aged 40 to 69 years old were recruited and screened for upper gastrointestinal cancer by using endoscopic examination and pathological diagnosis. Two economic evaluation methods, cost-effectiveness analysis and cost-benefit analysis, were performed to evaluate the current screening schemes. Results: The mean age of all respondents were (53.60±8.14) years old and the males accounted for 43.64% (6 012). A total of 502 cases of upper gastrointestinal tract lesions were detected, including 100 cases of cancer (62 cases of esophagus, gastric/cardiac early stage cancer, 38 cases of advanced stage cancer), 38 cases of severe esophageal hyperplasia/carcinoma in situ, and 15 cases of high-grade intraepithelial neoplasia in stomach/cardia, the detection rate was 0.73%, 0.28% and 0.11%, respectively; the early diagnosis rate was 75.16% (115/153). The cost of a precancerous lesion, a case diagnosed at the early stage and a positive case identified through the upper gastrointestinal cancer screening in Yangzhong City was 10 037.17, 30 460.64 and 22 895.25 RMB, respectively. The early detection cost index from 2009 to 2015 was 0.52, 0.56, 0.48, 0.48, 0.21, 0.30, and 0.26, respectively. The effectiveness-cost ratio from 2009 to 2015 was 3.41, 2.77, 2.66, 2.58, 4.99, 3.12, and 3.48, respectively. Conclusions: The project of early diagnosis and treatment of upper gastrointestinal tract cancer in Yangzhong city has achieved good results and benefits.


Assuntos
Cárdia/patologia , Detecção Precoce de Câncer/economia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/economia , Programas de Rastreamento/economia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/economia , Adulto , Idoso , China/epidemiologia , Análise Custo-Benefício , Neoplasias Esofágicas/etnologia , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Neoplasias Gástricas/etnologia
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