DNA修复酶(MGMT)在人胃肠癌中表达的临床意义

目的探讨MGMT在胃肠癌中表达的临床意义。方法93例胃肠癌(其中胃癌53例,大肠癌40例)利用SABC免疫组织化学方法检测MGMT。结果在胃肠癌中MGMT阳性率为49.46%(46/93),在胃癌和大肠癌中阳性率分别为45.28%(24/53)和55.00%(22/40)。66岁以上老年组MGMT阳性率明显低于其他年龄组(P<0.05),癌组织浸润深度达浆膜组和有淋巴结转移组MGMT阳性率高。MGMT在胃肠癌中的表达与性别和癌组织类型、分化程度相关性不明显(P>0.05)。结论MGMT在胃肠癌中的表达与年龄、浸润深度和淋巴结转移有关。     

ErbB-2、PAK1及VEGF在大肠癌中的关系及其意义研究

目的探讨ErbB-2、PAK1和VEGF在大肠癌中的表达与相关性以及三者与大肠癌临床病理特征之间的关系。方法选取结直肠癌根治术后病理检测确诊为大肠癌的组织标本共48例,分为三组:肠癌组织组(48例)、癌旁组织组(21例)及远癌组织组(12例)。分别采用western blot法和RT-PCR法检测ErbB-2、PAK1及VEGF在各组中的蛋白表达及基因表达,并分析三者表达的相关性。同时收集患者的临床资料,包括组织学分型、病理学分级、Dukes分期、有无淋巴结转移等。结果ErbB-2在肠癌组织的基因表达(53.23±11.25)及蛋白表达(4183232.57±587378.18)比癌旁组织(38.21±6.20,2283766.18±376455.78)均明显增加(P0.05),癌旁组织蛋白表达又高于远癌组织(1394280.24±6562.30)(P0.05),但癌旁组织基因表达(38.21±6.20)与远癌组织(30.29±10.20)无显著差异。PAK1在肠癌组织基因(67.20±19.32)及蛋白表达(3879654.12±256332.02)较癌旁组织(26.50±7.22,1336987.25±98653.20)显著增加(P0.01),远癌组织几乎未见表达。VEGF在肠癌组织的基因(62.30±33.58)及蛋白表达(4219314.65±433587.02)均高于癌旁组织(28.22±7.56,2275653.51±403731.20)及远癌组织(23.33±8.12,1878528.34±387563.71)(P0.05)。三者在肠癌组织的表达呈现两两正相关关系,且与大肠癌的病理学分级、Dukes分期、淋巴结转移密切相关(P0.05),而与组织学分型、肿瘤形态及发生部位无关。结论 ErbB-2、PAK1及VEGF在大肠癌发生发展中具有重要作用。ErbB-2活化后可激活下游分子PAK1及VEGF,后二者又相互促进表达,共同导致了大肠癌的演进侵袭。提示联合检测ErbB-2、PAK1及VEGF比单一检测判定大肠癌恶性行为及评估预后更有意义。     

VEGF—C和VEGFR-3在大肠癌中的表达及与淋巴结转移的关系

目的研究大肠癌患者癌组织中VEGF—C和VEGFR-3的表达及其相互之间的关系,以探讨VEGF—C和VEGFR-33大肠癌发生发展中的作用及与临床预后的关系。方法运用原位杂交方法及免疫组化SP法检测69例大肠癌组织中VEGF—CmRNA和VEGF—C的表达,同时运用免疫组化法分析相同组织中VEGFR-3表达状况。结果VEGF—CmRNA及VEGF—C在大肠癌组织中的表达阳性率分别为52．17％（36／69）和49．27％（34／69）,VEGF—C基因和蛋白表达基本相符合。VEGFR-3表达阳性率为43．48％（30／69）,正常黏膜未见VEGFR-3表达（P〈0．05）;大肠癌组织中VEGF—C与VEGFR-3蛋白表达之间存在显著的相关性（P〈0．01）。在伴有淋巴结转移的大肠腺癌中,VEGF—C与VEGFR～3的阳性表达率分别为67．74％（21／31）和64．52％（20／31）,转移组与非转移组相比较均有显著性差异（P〈0．01）;VEGF—C及VEGFR-3表达与Duke’s分期呈负相关（P〈0．05）,与组织分化、性别、年龄、肿瘤大小等临床病理因素无关（P〉0．05）。结论VEGF—C与VEGFR-3表达可增加大肠癌淋巴道转移和侵袭能力,其检测有助于大肠癌恶性程度评价及预后的判断,两者在大肠癌的发展中起重要作用。     

HSP90 mRNA在胃癌和大肠癌中表达的研究

目的为探讨胃癌和大肠癌细胞HSP90 mRNA表达的特点.方法利用核酸原位杂交技术,对79例胃肠癌组织进行检测.结果表明HSP90 mRNA在胃癌和大肠癌中的阳性率分别为55.56%(15/27)和69.23%(36/52).mRNA表达与病理类型、分化程度和有否淋巴结转移有相关性.结论 HSP90 mRNA在胃肠癌中有较高表达,检测HSP90 mRNA可以作为提示预后的重要临床指标.     

散发性大肠癌血清多肽肿瘤标志物的高通量筛选

目的:以常规体检者和明确诊断的大肠癌患者为研究对象,对其血清进行多肽谱分析,统计分析获得大肠癌特异血清多肽峰,为大肠癌的分子诊断提供理论依据,提高大肠癌的早期诊断水平。方法:1)收集研究对象外周非抗凝血并记录其人口学特征,将非抗凝血进行离心分离血清并保存;2)用Dynabeads RPC18磁珠分离提取血清蛋白质,Bruker UltraFlex TOF/TOF采集信号并用分析软件Clinprot tools 2.2(Bruker)分析筛选出大肠癌血清显著差异峰;3)用SPSS13.0分析大肠癌患者和健康人多肽峰的差异,进行Logistic回归分析差异多肽对形成大肠癌的影响。结果:本次研究共获得111名健康人和94名大肠癌患者的血清多肽峰信息,其中109名健康人和91名大肠癌患者同时具有性别、年龄等人口学信息。筛选出差异多肽峰105个,其中76个多肽在大肠癌患者和健康人间的分布差异有统计学意义(P0.05)。运用Logistic回归分析,进入回归方程(P0.05)的有:年龄,质荷比(m/z)分别为1061.10、1213.09、1607.32、1867.02、1897.95、2011.67和5078.81的七种多肽。结论:液体蛋白芯片飞行时间质谱系统可高效、精确地筛查血清多肽。大肠癌患者与健康人的血清多肽存在差异,筛选得到的质荷比(m/z)分别为1061.10、1213.09、1607.32、1867.02、1897.95、2011.67和5078.81的七种多肽可能作为早期诊断大肠癌的潜在肿瘤标志物。     

左侧大肠癌和右侧大肠癌蛋白质差异表达谱的建立及质谱分析

目的:初步探索左侧大肠癌和右侧大肠癌中蛋白质表达的差异,为左右侧大肠癌生物学特性上的差别提供功能基因组学上的依据。方法:以左右侧大肠癌组织为研究对象,提取组织总蛋白,依次进行二维凝胶电泳,凝胶图象分析,质谱及生物信息学分析。结果:成功建立了左侧大肠癌和右侧大肠癌的二维电泳图谱,进行质谱和生物信息学分析比较得到左侧大肠癌与右侧大肠癌的差异表达蛋白共有16个,其中左侧大肠癌中表达增加的蛋白有10个包括蛋白质二硫化异构酶A1,78 kDa葡萄糖调节蛋白,抑制素,热休克蛋白60,含硫氧还蛋白域的蛋白5,T-复合蛋白1ε亚单位,应急蛋白70,异柠檬酸脱氢酶,蛋白质二硫化异构酶A3,巨噬细胞加帽蛋白;左侧大肠癌表达降低的蛋白6个包括ATP合成酶β亚单位,延伸因子1-delta,热休克蛋白β1,载脂蛋白A-Ⅰ,转甲状腺素蛋白,热休克蛋白β6。结论:左侧大肠癌和右侧大肠癌中存在差异表达蛋白,这些差异表达蛋白可能是左右侧大肠癌生物学性质差异的分子遗传学基础。     

双歧杆菌培养滤液中核酸的提取及对肠癌细胞cAMP,cGMP的影响

实验观察了对数期长双歧杆菌、青春双歧杆菌培养滤液中提取的总核酸对肠癌细胞ｃＡＭＰ、ｃＧＭＰ的影响。结果发现,双歧杆菌培养中滤液中存在大量核酸,将双歧杆菌培养滤中的核提取纯化作用于大肠癌细胞ＣＣＬ１８７,ｃＡＭＰ增高,ＣＧＭＰ没有变化,提示核酸可能作为细胞膜外的第一信使物质腺苷环化酶活性。     

胸苷酸合成酶的表达对原发大肠癌患者预后的影响

目的:研究表明大肠癌组织内胸苷酸合成酶(thymidylate systhase,TS)是独立于分期之外影响大肠癌预后的影响因子,TS高水平表达是预后的不良因素,并且与大肠癌患者应用氟脲嘧啶类或其衍生物类药物化疗疗效有关.本研究是探讨对于接受根治术后应用5-氟脲嘧啶或其衍生物化疗的原发性大肠癌患者,TS表达水平高低对患者预后的判断价值.方法:应用免疫组化法检测了89例大肠癌患者的石腊组织标本的TS表达水平.患者为Dukes'A期、B期、C期原发性大肠癌,均接受大肠癌根治术,术后接受5.氟脲嘧啶或其衍生物的4～6周期的化疗.结果:癌组织中TS表达水平比正常组织中TS表达水平高(67.8%vs 5.1%,P＜0.01).TS低表达患者与TS高表达患者总生存期、无病生存期无差异(P=0.1785,P=0.0798),多因素分析显示分期是唯一与生存期有关因素.结论:癌组织TS表达水平高低不能预测接受大肠癌根治术且术后接受5-氟脲嘧啶或其衍生物化疗的原发性大肠癌患者的预后,但TS表达水平高的患者可能从辅助化疗中获益.     

大肠癌组织中联合检测USP22和BMI-1表达的临床意义

目的:探讨大肠癌组织中联合检测USP22和BMI-1表达的临床意义。方法:应用定量RT-PCR检测82例大肠癌手术切除标本及相应的癌旁组织中USP22及BMI-1 mRNA的表达水平,并分析其表达的差异,研究其表达水平与大肠癌患者临床病理特征及预后的关系。结果:USP22、BMI-1 mRNA在大肠癌及癌旁组织中均可被检出,大肠癌组织中USP22、BMI-1 mRNA的相对表达水平均显著高于癌旁组织(P0.01),且二者之间呈显著正相关(r=0.708,P0.01)。USP22、BMI-1 mRNA的高表达均与大肠癌的美国癌症分期联合委员会(AJCC)分期密切相关(P0.01)。COX回归分析显示USP22及BMI-1的共表达可作为大肠癌患者预后的独立预测因素(P0.01)。结论:USP22和BMI-1的共同激活可促进大肠癌的进展,并预示预后不良。     

大鼠肠癌中Ⅳ型胶原酶及ras P21表达的研究

用二甲肼诱发Ｗｉｓｔａｒ大鼠肠癌,并应用免疫组化双标记方法对肠道良、恶性病变中Ⅳ型胶原酶的表达及基底膜的改变作了研究,同时观察Ｐ２１的表达情况。结果显示,肠道良性病变及良性肿瘤中Ⅳ型胶原酶反应阳性率为２１．７４％,在肠癌中阳性率为７９．４１％,两者差异极显著（Ｐ＜０．０１）。Ⅳ型胶原染色显示,良性病变及良性肿瘤基底膜完整,而肠癌中基底膜出现断裂或缺失。表明Ⅳ型胶原酶对基底膜的破坏及肠癌浸润转移起重要作用。Ｐ２１在肠良性病变及良性肿瘤中阳性率为３０．４３％,而在肠癌中为６７．６５％,两者差异也有极显著意义（Ｐ＜０．０１）。肠癌中Ⅳ型胶原酶的表达与Ｐ２１的表达之间呈正相关（ｒ＝０．８１３,Ｐ＜０．０５）。     

County-level characteristics associated with incidence,late-stage incidence,and mortality from screenable cancers

BackgroundCancer screening differs by rurality and racial residential segregation, but the relationship between these county-level characteristics is understudied. Understanding this relationship and its implications for cancer outcomes could inform interventions to decrease cancer disparities.MethodsWe linked county-level information from national data sources: 2008–2012 cancer incidence, late-stage incidence, and mortality rates (for breast, cervical, and colorectal cancer) from U.S. Cancer Statistics and the National Death Index; metropolitan status from U.S. Department of Agriculture; residential segregation derived from American Community Survey; and prevalence of cancer screening from National Cancer Institute’s Small Area Estimates. We used multivariable, sparse Poisson generalized linear mixed models to assess cancer incidence, late-stage incidence, and mortality rates by county-level characteristics, controlling for density of physicians and median household income.ResultsCancer incidence, late-stage incidence, and mortality rates were 6–18% lower in metropolitan counties for breast and colorectal cancer, and 2–4% lower in more segregated counties for breast and colorectal cancer. Generally, reductions in cancer associated with residential segregation were limited to non-metropolitan counties. Cancer incidence, late-stage incidence, and mortality rates were associated with screening, with rates for corresponding cancers that were 2–9% higher in areas with more breast and colorectal screening, but 2–15% lower in areas with more cervical screening.DiscussionLower cancer burden was observed in counties that were metropolitan and more segregated. Effect modification was observed by metropolitan status and county-level residential segregation, indicating that residential segregation may impact healthcare access differently in different county types. Additional studies are needed to inform interventions to reduce county-level disparities in cancer incidence, late-stage incidence, and mortality.     

Impact of the UK colorectal cancer screening pilot studies on incidence, stage distribution and mortality trends

Objective: To assess the impact of the UK colorectal cancer guaiac faecal occult blood test screening pilot studies on incidence trends, stage distribution and mortality trends. Design: Ecological study. Setting: Scotland and the West Midlands. Data: We extracted anonymised colorectal cancer (ICD-10 C18–C20) registration (1982–2006) and death records (1982–2007), along with corresponding mid-year population estimates. Intervention: Residents of the screening pilot areas, in the age group 50–69 years, were offered biennial guaiac faecal occult blood test screening from 2000 onwards. Screening was not offered routinely in non-pilot areas until the start of the roll-out of the national screening programmes in England and in Scotland in 2006 and 2007, respectively. Main outcome measures: We analysed trends in age-specific incidence and mortality rates, and Dukes’ stage distribution. Within each country/region, we compared the screening pilot areas to non-screening pilot (‘control’) areas using Chi square tests and Poisson regression modelling. Results: Following the start of the screening pilots, as expected in the prevalent round of a new screening programme, in the pilot areas there was a short-lived increase in incidence of colorectal cancer among 50–69 year olds except for females in the West Midlands. A trend towards earlier stage and less advanced disease was also observed, with males showing significant increases in Dukes’ A and corresponding decreases in Dukes’ C in the screening pilot areas (all P < 0.03). With the exception of females in the West Midlands, mortality rates for colorectal cancer decreased significantly and at a faster rate in the populations invited for screening. Conclusion: The existence of a natural control population not yet invited for screening provided a unique opportunity to assess whether the benefits of colorectal cancer screening, beyond the setting of a randomised controlled trial, could be detected using routinely collected statistics. Our analysis suggests that screening will fulfil its aim of reducing mortality from colorectal cancer.     

Local Breast Cancer Spatial Patterning: A Tool for Community Health Resource Allocation to Address Local Disparities in Breast Cancer Mortality

Despite available demographic data on the factors that contribute to breast cancer mortality in large population datasets, local patterns are often overlooked. Such local information could provide a valuable metric by which regional community health resources can be allocated to reduce breast cancer mortality. We used national and statewide datasets to assess geographical distribution of breast cancer mortality rates and known risk factors influencing breast cancer mortality in middle Tennessee. Each county in middle Tennessee, and each ZIP code within metropolitan Davidson County, was scored for risk factor prevalence and assigned quartile scores that were used as a metric to identify geographic areas of need. While breast cancer mortality often correlated with age and incidence, geographic areas were identified in which breast cancer mortality rates did not correlate with age and incidence, but correlated with additional risk factors, such as mammography screening and socioeconomic status. Geographical variability in specific risk factors was evident, demonstrating the utility of this approach to identify local areas of risk. This method revealed local patterns in breast cancer mortality that might otherwise be overlooked in a more broadly based analysis. Our data suggest that understanding the geographic distribution of breast cancer mortality, and the distribution of risk factors that contribute to breast cancer mortality, will not only identify communities with the greatest need of support, but will identify the types of resources that would provide the most benefit to reduce breast cancer mortality in the community.     

Urban-Rural Disparity of Breast Cancer and Socioeconomic Risk Factors in China

Breast cancer is one of the most commonly diagnosed cancers worldwide. The primary aim of this work is the study of breast cancer disparity among Chinese women in urban vs. rural regions and its associations with socioeconomic factors. Data on breast cancer incidence were obtained from the Chinese cancer registry annual report (2005–2009). The ten socioeconomic factors considered in this study were obtained from the national population 2000 census and the Chinese city/county statistical yearbooks. Student’s T test was used to assess disparities of female breast cancer and socioeconomic factors in urban vs. rural regions. Pearson correlation and ordinary least squares (OLS) models were employed to analyze the relationships between socioeconomic factors and cancer incidence. It was found that the breast cancer incidence was significantly higher in urban than in rural regions. Moreover, in urban regions, breast cancer incidence remained relatively stable, whereas in rural regions it displayed an annual percentage change (APC) of 8.55. Among the various socioeconomic factors considered, breast cancer incidence exhibited higher positive correlations with population density, percentage of non-agriculture population, and second industry output. On the other hand, the incidence was negatively correlated with the percentage of population employed in primary industry. Overall, it was observed that higher socioeconomic status would lead to a higher breast cancer incidence in China. When studying breast cancer etiology, special attention should be paid to environmental pollutants, especially endocrine disruptors produced during industrial activities. Lastly, the present work’s findings strongly recommend giving high priority to the development of a systematic nationwide breast cancer screening program for women in China; with sufficient participation, mammography screening can considerably reduce mortality among women.     

腹腔镜结直肠癌根治术与传统开腹手术比较分析

目的:分析腹腔镜结直肠癌根治手术与传统开腹术治疗结直肠癌的临床效果,探讨腹腔镜手术的特点及优势,为临床外科手术提供参考。方法:选择2009年7月至2013年5月在我院进行腹腔镜手术的186例结直肠癌患者的临床资料进行分析,并与择期接受开腹手术的181例结直肠癌患者的临床效果进行对比。比较两组患者的平均手术时间、平均术中出血量、术后肛门排气时间、下床活动时间、平均住院时间及并发症的发生率等。结果:与传统手术组相比,腹腔镜组患者的平均手术时间短、平均术中出血量少、术后肛门排气时间早、平均住院时间短,差异显著且具有统计学意义(P0.05);腹腔镜组患者术后出现下肢静脉血栓1例、皮下气肿9例、高碳酸血症8例,并发症的发生率为7.14%;传统手术组术后出现切口感染10例、消化道出血13例,吻合口漏11例、并发症的发生率为12.90%。腹腔镜根治术患者术后并发症的发生率明显低于传统开腹手术组,差异具有统计学意义(P0.05);腹腔镜组患者的平均住院时间为(8.34±2.12)天,明显短于传统开腹手术组的(11.58±1.98)天,差异具有统计学意义(P0.05)。结论:腹腔镜结直肠癌根治术具有很好的临床效果,术中出血少、术后恢复快,能够减少手术对患者机体造成的损伤,值得临床推广应用。     

Folic acid and sodium butyrate prevent tumorigenesis in a mouse model of colorectal cancer

Colorectal cancer is a leading cause of morbidity and mortality worldwide, and its incidence has been increasing in recent years. The role of epigenetic modifications, including DNA methylation and histone modifications, has only recently been investigated. In this study, the effects of epigenetic agents such as folic acid (FA) and sodium butyrate (NaBu) on the development of colorectal cancer induced by 1,2-dimethylhydrazine (DMH) using ICR mice was examined. Of the mice treated in a chemopreventive manner with epigenetic agents, FA and NaBu, 15–50% developed colorectal cancer at 24 weeks compared with a 95% incidence of colorectal cancer in DMH-treated control mice. Folate deficiency can alter cytosine methylation in DNA leading to inappropriate activation of the proto-oncogene c-myc. We detected lower levels of p21WAF1 gene expression in colorectal cancer samples, as well as significantly lower levels of acetylated histone H3, compared with samples from corresponding normal colorectal mucosa. In contrast, administration of NaBu increased levels of p21WAF1 mRNA and p21WAF1 protein, and was associated with an accumulation of histone acetylation. In summary, our results show that FA and NaBu reduce the incidence of colorectal cancer induced by DMH-induced in ICR mice, and therefore we hypothesize that targeting epigenetic targets should be further investigated for the prevention of colorectal cancer in humans.     

Temporal and geographical variations in colorectal cancer incidence in Northern Iran 2004–2013

Introduction: Colorectal cancer (CRC) is one of the most common cancers in the Golestan province, Northern Iran. The purpose of this study is to describe colorectal cancer incidence patterns and trends in the province 2004–2013.Methods: Data on CRC cases were obtained from the Golestan Population-based Cancer Registry (GPCR). The GPCR is a high-quality cancer registry that collects data on primary cancers according to internationally accepted standard protocols. Age-standardized Incidence rates (ASR) were calculated and the 10-year trend quantified using the average annual percentage change (AAPC) from Joinpoint regressions.Results: The overall ASR of CRC were higher in men (14.8 per 100,000 person-years) and the urban populations (35.4), relative to women (11.5) and the rural populations (17.1), respectively. The overall incidence rate was observed to significantly increase 2004–2013 in men (AAPC = 7.3; 95%CI: 2.9–11.8) and women (AAPC = 6.6; 95%CI: 2.7–10.6). The analysis also showed that urban areas (AAPC = 8.1; 95%CI: 2.4–14.1) had a relatively more rapid increase in rates compared to rural areas (AAPC = 6.9; 95%CI: 2.2–11.7).Conclusions: CRC incidence rates in Golestan have been rising during the most recent decade, with a higher incidence and more rapid increases among men and the urban populations. The underlying risk factors should be assessed in the context of developing CRC prevention interventions in Golestan.     

Cancer in Cumbria and in the vicinity of the Sellafield nuclear installation, 1963-90.

OBJECTIVE--To reappraise the epidemiological findings reported by the Black Advisory Group concerning a possible excess of malignant disease, particularly of childhood acute lymphoid leukaemia and non-Hodgkin lymphomas, in the vicinity of the Sellafield nuclear installation, and to determine whether any excess of malignant disease had occurred among people aged 0-24 years in the area in the years after the Black report--that is, from 1984 to 1990. DESIGN--Calculation of incidence of cancer using data from population based cancer registries and special surveys. SETTING--England and Wales; county of Cumbria; county districts Allerdale and Copeland within Cumbria; Seascale ward within Copeland. SUBJECTS--All residents under the age of 75 years in the above areas, but with particular reference to those aged 0-24 years. MAIN OUTCOME MEASURES--Numbers of cases and incidence particularly of lymphoid leukaemia and non-Hodgkin lymphomas in those aged 0-24 years, but including other cancers and age groups. RESULTS--Previous reports of an increased incidence of cancer, especially of leukaemia, among those aged 0-24 years in Seascale during the period up to and including 1983 are confirmed. During 1984-90 there was an excess of total cancer among those aged 0-24 years. This was based on four cases including two cases of non-Hodgkin lymphoma but none of leukaemia. There was an increased, but nonsignificant, incidence of other cancers, based on two cases (one pinealoma and one Hodgkin''s disease) occurring among those aged 15-24 years during 1984-90. This was not observed in the younger age group or in previous years. For the immediately surrounding area--that is, the county districts of Allerdale and Copeland excluding Seascale and in the remainder of Cumbria--there was no evidence of an increased incidence of cancer among those aged 0-24 years in either period. CONCLUSIONS--During 1963-83 and 1984-90 the incidence of malignant disease, particularly lymphoid leukaemia and non-Hodgkin lymphomas, in young people aged 0-24 in Seascale was higher than would be expected on the basis of either national rates or those for the surrounding areas. Although this increased risk is unlikely to be due to chance, the reasons for it are still unknown.     

Socioeconomic position and incidence of colorectal cancer in the Swedish population

BackgroundThe association between socioeconomic position and incidence of colorectal cancer is inconsistent and differs by global region. We aimed to clarify this association in the Swedish population.MethodsWe conducted a population-based open cohort study using data from Swedish national registers. We included all individuals, aged ≥30 years, residing in Sweden between 1993 and 2010. Socioeconomic position was indicated by (1) highest educational level (five groups), and (2) disposable income (quintiles). We used Poisson regression to estimate incidence rate ratios (IRR) and 95% confidence intervals (95% CI) of colon and rectal cancer, and colon and rectal dysplasia.ResultsIn total, 97,827,817 person-years were accumulated and 82,686 cases of colorectal cancer were diagnosed. Compared to men with ‘higher secondary’ education, the adjusted IRRs (95% CI) of rectal cancer in men with ‘primary or less’, ‘lower secondary’, ‘lower university’ or ‘higher university’ education were: 1.06 (1.00, 1.11), 1.05 (0.99, 1.10), 0.96 (0.89, 1.03), and 0.92 (0.86, 0.98), respectively. In women, the corresponding figures were: 1.04 (0.95, 1.14), 1.03 (0.94, 1.13), 0.92 (0.82, 1.02) and 0.92 (0.82, 1.02). Disposable income was not associated with rectal cancer incidence. Adjusted IRRs of colon cancer did not differ between levels of education or disposable income overall or for specific colon sub-sites. Neither education nor disposable income was consistently associated with incidence of colon or rectal dysplasia.ConclusionsPrevention strategies for colon cancer should be applicable to individuals regardless of their socioeconomic position. However, factors conferred by education, e.g., health awareness, may be important for approaches aiming to reduce inequalities in incidence of rectal cancer. Further evaluation of cancer prevention and health promotion strategies among less educated groups is warranted.     

植物化学提取物对大肠癌作用及其机制的研究进展

大肠癌(colorectal cancer)是胃肠道疾病中常见的恶性肿瘤,其发病率及死亡率均较高。近年来,植物化学提取物指采用适当的溶剂或方法,以植物(整体或部分)为原料提取或加工后所获取的物质,作为肿瘤化学预防治疗的重要组成部分对大肠癌的作用已受到研究者们的广泛关注。研究发现,不同植物化学提取物包括植物多酚类、多肽类、生物碱、皂苷类、多糖类及维生素类等均具有抗大肠癌的作用,作用机制主要与抑制肿瘤细胞增殖、促进肿瘤细胞凋亡、阻断细胞周期、抑制肿瘤血管形成、诱导大肠癌细胞自噬、抑制大肠癌细胞迁移等途径密切相关。本文主要就大肠癌的发生机制、植物化学提取物的种类及其预防和治疗大肠癌的体内外最新研究进展进行了综述,旨在为大肠癌的临床防治提供更多的理论依据。