Search

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.

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.

Objective: To conduct a comprehensive quantitative analysis about the association between genetic polymorphisms of CYP 2E1 and susceptibility to Chinese gastric cancer in order to offer evidence-based evidence for the etiology of gastric cancer., Methods: Using the keywords and entry terms of cytochrom P450 2E1, cytochrome P450, CYP 2E1, stomach neoplasms, individual susceptibility, gene polymorphism, risk factors in English and Chinese, we searched medical literature databases, such as Pub Med, Embase, CBM, VIP, CNKI, China Info, published from January 1 th, 1997 to December 31 th, 2016, the Chines population was selected as the research object. Metaanalysis was performed using Stata 14. 0 in literature that selected quality studies of original literatures of more than 6 stars., Results: There were 10 high-quality original articles covering high, middle and low incidence areas of gastric cancer in our country, with 832 cases and 1018 controls were included, which fit the HWE test. The population with CYP 2E1 C1C2 genotype have a lower risk of developing gastric cancer than the population with CYP 2E1 C1C1 genotype( OR = 0. 650, P < 0. 001, 95% CI 0. 515-0. 821); Subgroup-analysis result reveals that, in smaller sample size population with CYP 2E1 C1C1 genotype have a gastric cancer risk of 2. 02 times the risk of having gastric cancer with CYP 2E1 C1C2 and C2C2 genotypes( P < 0. 001, 95% CI 1. 55-2. 64), in bigger sample size population with CYP 2E1 C1C1 genotype have a gastric cancer risk of0. 93 times the risk of having gastric cancer with CYP 2E1 C1C2 and C2C2 genotypes( P = 0. 586, 95% CI 0. 71-1. 22), in overall sample size population with CYP 2E1 C1C1 genotype have a gastric cancer risk of 1. 50 times the risk of having gastric cancer with CYP 2E1 C1C2 and C2C2 genotypes( P = 0. 006, 95% CI 1. 12-2. 00)., Conclusion: The size of the sample is an important factor affecting the result. The small sample size of the study tends to get positive result. Whether CYP 2E1 C1C1 genotype of the population is a risk factor for gastric cancer remains to be further studied.

Objective: To investigate the trend of esophageal and stomach cancer incidence and mortality in Feicheng during 2000 to 2013, and to evaluate the effects of the national project of screening for upper digestive tract cancers from 2006 to 2015 in Feicheng. Methods: We collected 26 569 cases, which were coded of C15 and C16 in the 10th edition of international classification of diseases (ICD) during the period of 2000-2013. The data came from cancer registration system of Feicheng, Shandong Province, China. These cases already covered 21 679 882 person-year. The annual percent change (APC) of incidence and mortalit were analyzed. The risk factors of upper gastrointestinal cancer were investigated and evaluated for people aging 40-69 in three street offices and eleven townships of Feicheng, and endoscopic screening was conducted among people who was in high risk. The corresponding data were used to analyze the early detection project of upper gastrointestinal cancer screening and early diagnosis, with the index of detection rate, early diagnosis rate, early treatment rate and other indicators. Result: There were 26 569 new cases of esophageal cancer and gastric cancer occurred in Feicheng from 2000 to 2013. The incidence of esophageal cancer gradually increased since 2000 with 76.06 per 100 000 people (575/756 005) and reached the peak in 2010 with incidence rate of 118.76 per 100 000 people (852/717 429), with the annual percent change at about 4.3% (95 %CI: 2.7%-5.9%) and showed a downward trend after then but has no significance, with APC about-7.1% (95 %CI: -15.8%-2.5%). The incidence of gastric cancer was increased from 2000 with an incidence rate of 37.70 per 100 000 people (285/756 005) to 2013 with an incidence rate of 54.59 per 100 000 (538/985 512), with an annual percent change of about 3.3% (95 %CI: 2.1%-4.5%). Esophageal cancer and gastric cancer mortality showed a relatively stable trend during 2000 to 2013, esophageal cancer with APC about 0.1% (95 %CI : -1.3%-1.5%) and stomach cancer with APC about 0.8% (95 %CI : -0.5%-2.0%). From 2006 to 2015, 58 579 residents aged 40-69 years old participated cancer screening project covered 206 105 populations in Feicheng. There were 1 124 invasive cancers and in situ cases from upper digestive tract were detected, with the detective rate at 1.92%. Among those cases, 941 cases were in early stage with the early diagnosis rate of 83.72%, and about 88.97% of detected patients received appropriate treatment after diagnosis. Conclusion: The incidence of esophageal cancer and gastric cancer with a very high level of incidence and mortality, this made the prevention and control situation was still very serious. The project of cancer screening, early diagnosis and treatment on upper digestive tract cancers in Feicheng plays a positive role on cancer control.

Objective: To investigate the combined impact of lifestyle factors on stomach cancer risk. Methods: We analyzed the data from the Shanghai Men's Health Study (SMHS) (2002-2013). The SMHS was conducted in eight neighborhood communities of urban Shanghai. From 2002 through June 2006, 61 480 residents aged 40 to 74 years old with no history of cancer were recruited. Failure time was the date of stomach cancer incidence, death or date of the last follow-up (December 31, 2013). The first two in-person follow-up surveys were conducted in 2004-2008, and 2008-2011, respectively. Using data on lifestyle, the healthy lifestyle index (HLI) was developed. The following lifestyle factors were included: smoking, alcohol consumption, diet habit, overweighted and physical activity. Cox proportional hazard models were used to evaluate the association of stomach cancer risk with lifestyle factors and HLI. Results: Over 9.28 years' follow-up, 477 incident cases of stomach cancer were identified from 59 503 study participants. Participants with zero, one, two, three, four, and five favorable lifestyle behaviors accounted for 3.44% ( n= 2 045), 18.14% ( n= 10 793), 33.68% ( n= 20 041), 29.43% ( n= 17 511), 12.82% ( n= 7 627), and 2.50% ( n= 1 486), respectively. Among all the five lifestyle factors, smoking and alcohol use were significantly related to stomach cancer risk. The relative risk of stomach cancer was 0.71 (95 %CI : 0.57-0.87) for those who never smoked or quitted smoking for no less than 10 years and 0.70 (95 %CI : 0.55-0.90) for those who consumed alcohol no more than 14 drinks per week. For each increment of healthy lifestyle index, the relative risk of stomach cancer was 0.86 (95 %CI : 0.79-0.95). Compared to men with none or one healthy lifestyle factor, the relative risk for those with four or five was 0.62 (95 %CI : 0.46-0.83). When we rebuilt HLI using more categories of each lifestyle factors, the HLI ranged from 0 to 11. For each point increase, the relative risk of stomach cancer was 0.93 (95 %CI : 0.89-0.97). Compared those with 0 to 3 points, the relative risk of those with 8 to 11 points was 0.64 (95 %CI : 0.47-0.87). Conclusion: In the SMHS, only a small proportion of men adhered to all the five healthy lifestyle factors. Compared to those with none or one healthy lifestyle behaviors, those with five may prevent about 1/3 stomach cancer incidence and the HLI was inversely associated with stomach cancer risk.

Malignant tumor has become the top cause of deaths before the average life expectancy in Chinese population. From the variations in the morbidity rate and mortality rate of malignant tumor in the mainland of China between 2000 and 2011, the primary prevention targeting the risk factors/etiological agents significantly reduced the morbidity rates of gastric cancer, esophageal cancer, and primary liver cancer, therefore reduced the mortality rates of these cancers. However, the contribution of clinical treatments to the mortality reduction was not obviously improved during this period. Importantly, it is necessary to conduct research to identify precancerous lesions and early tumors which are prone to progress to aggressive diseases for the active secondary prevention to avoid over-diagnosis and over-treatment. Multi-center, prospective randomized controlled clinical trials and prognosis evaluation independently carried out by third parts are needed to evaluate the longterm effectiveness of some clinical treatment efficiency for cancers with different histological types. On the basis of a series of population-based studies in China, the prevention and clinical treatments for malignant tumor need innovations on technology, management, and even concept; the mechanisms of "forward placement of strategic pass" for the prevention and control of malignant tumor should be established and improved to reduce the increasing disease burden due to malignant tumor in China.

Objective: This study investigated the association between a missense SNP in the codon of ADD1 phosphorylation site and the susceptibility of non-cardia gastric cancer in a Chinese population., Methods: PhosphoSitePlus and dbSNP database were combined to discover missense SNPs in the codon of phosphorylation site. Then, we genotyped the missense SNP in 1, 998 cases with non-cardia gastric cancer and 2, 008 cancer-free controls of Chinese descent. Analysis was conducted by using Logistic model adjusted by gender and age., Results: The rs4963 in the codon of ADD1 phosphorylation site was found. The frequencies of the 3 rs4963 genotypes, CC, CG, GG, among controls were 25.2%, 50.4%, and 24.4%, respectively, among patients were 20.1%, 50.6%, and 29.3%, respectively. Compared with CC genotype, the rs4963 CG genotype and GG genotype significantly increased the risk of non-cardia gastric cancer with the odds ratios being 1.24 (95%CI: 1.06 ∼ 1.46, P = 0.008) and 1.49 (95%CI: 1.25 ∼ 1.78, P < 0.001), respectively., Conclusions: Fnnctional polymorphism in the phosphorylation site of ADD1 (rs4963) may influence the susceptibility of non-cardia gastric cancer.

Objective: To study the distribution of IL-10 gene polymorphisms in patients with gastroduodenal diseases in Hubei Han population and their association with helicobacter pylori (Hp) infection., Methods: Six hundred and five patients with gastroduodenal diseases (220 gastric cancer, 196 chronic gastritis and 189 gastroduodenal ulcer) and 624 healthy controls were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method for IL-10 -1082, -819, -592 gene polymorphisms. Hp infection status was determined by ELISA., Results: (1) There was significant difference of IL-10 -1082 AG+GG genotypes between gastric cancer group and gastric cancer-free and healthy control groups (P<0.05). (2) There was no significant difference of IL-10 -592 and IL-10 -819 gene polymorphisms among gastric cancer, gastric cancer-free and healthy control groups (P>0.05). (3) The frequency of IL-10 -1082 AG+GG genotypes in the Hp positive gastric cancer patients was significantly higher than that of control groups (P<0.05)., Conclusions: (1) Genotypes AG+GG of IL-10 -1082 were associated with gastric cancer in Hubei Han population. (2) The IL-10 -1082 AG+GG genotypes were associated with Hp infection in patients with gastric cancer.

Objective: CDH1, encoding E-cadherin, is an important tumor suppressor gene. The present study aims to investigate the association of -160(C-->A) polymorphism in CDH1 gene with susceptibility to gastric cancer in Fujian province., Methods: One hundred and two patients from independent families and 101 healthy control subjects were analyzed. Genotype analysis was performed through polymerase chain reaction-based denaturing high performance liquid chromatography. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression model., Results: The frequencies of -160(C-->A) polymorphism CC, CA and AA genotype in case group and controls were 58(56.9%), 38(37.3%)ì6(5.9%) and 55(54.5%), 41(40.6%), 5(5%), respectively. AA genotype did not present a significantly increased risk for gastric cancer (OR=1.12; 95% CI:0.32-3.95). No association was found between A allele and clinicopathological characteristics of gastric cancer., Conclusion: -160(C-->A) polymorphism in CDH1 gene promoter region may not be in association with genetic susceptibility to gastric cancer in Chinese population from Fujian.

A total of 650 patients including 452 with esophageal and 198 with cardiac cancers from different nationalities in Xingjiang were treated by surgery in this department from 1978 to January 1990. The total resectability was 85.4% (555/650), with a higher in the esophagus group (83.5%) and a lower in the cardia group (78.3%). Postoperative complications happened in 63 (10.5%) cases, including anastomotic leakage in 29 (5.2%) cases and intrathoracic leakage in 19 (3.4%) cases. Operative mortality was 3.4% (22 cases). Finally the incidence rate of the disease among different nationalities, the criteria of selection of patients for operation and the technique of operation were discussed.