CONTEXT:Hypophosphatasia (HPP) is a rare inherited metabolic disorder caused by loss-of-function variant(s) of the ALPL gene, which encodes tissue-nonspecific alkaline phosphatase (TNSALP). OBJECTIVE:To enrich the genetic spectrum of HPP and establish a genetic basis for the diagnosis and treatment of the proband. METHODS:A detailed medical history and systematic clinical evaluation were conducted for the proband. Variants in genes relevant to the proband's clinical phenotype were identified through whole-exome sequencing and confirmed by Sanger sequencing. The effect of ALPL gene variants on TNSALP function and their dominant negative effect (DNE) was assessed by transient transfection of recombinant plasmids into HEK293T cells, followed by an analysis of enzyme specific activity (ESA). RESULTS:Two missense variants, c.269A > G and c.787T > C, and 1 intronic variant, c.182-9C > T, were identified in the ALPL gene of the proband. ESA assays revealed that c.269A > G and c.182-9C > T exhibited reduced alkaline phosphatase (ALP) activity, whereas no significant change was observed for c.787T > C. Cotransfection experiments with wild-type and mutant (c.269A > G or c.182-9C > T) TNSALP revealed that both c.269A > G and c.182-9C > T have DNE. CONCLUSION:The compound heterozygous variant comprised of c.269A > G and c.182-9C > T in the ALPL gene may contribute to decreased ALP activity and the disease phenotype of the proband. Moreover, an experienced multidisciplinary team needs to monitor the effect of DNE on carriers and track the relevant clinical symptoms emerging at a later stage.

In this case-control study, the main risk factors for atrophic gastritis (AG) were comprehensively analyzed in a real-world environment to identify potential risk factors associated with garlic intake and its effects on AG. Design Upper gastrointestinal endoscopy and pathological examination were performed as part of a gastric cancer screening and health check-up program. The detailed characteristics of both the case group and healthy control group were recorded and analyzed. All participants were fasted for at least 4 h and a urea breath test13C-UBT) was performed in all participants at rest. Both univariate and multivariate logistic regression analyses were performed and presented as the odds ratio (OR) and 95% confidential interval (CI), with additional subgroup analysis stratified by infectious state based on the presence, eradication or absence of H. pylori. Setting Gansu Province in China. Participants 10,035 people from Gansu Province in China were included. Among 7,058 participants, 4,712 (66.8%) had AG. Garlic intake was a significant risk factor for AG in participants currently (infected state) or previously (eradicated state) infected with H. pylori (OR = 1.39, 95% CI: 1.06–1.83; OR = 1.16, 95% CI = 1.01–1.32). Garlic intake was not significantly associated with AG in participants without H. pylori’ s infection (OR = 1.14, 95% CI: 0.88–1.46). The association between garlic intake and AG differed by H. pylori infectious state. People in the infected or eradicated states are at a higher risk for AG associated with garlic intake. Diet may regulate the pathogenic role of H. pylori and intestinal flora.

Cancer remains a major threat to human health, with the incidence of hepatobiliary tumors consistently high. Treatment methods for hepatobiliary tumors include surgical intervention, ablation, embolization, and pharmacological treatments, with surgery being a critical component of systemic treatment for patients with hepatobiliary tumors. Compared to other methods, surgery is the most effective way to remove tumors and improve survival rates, serving as the cornerstone of various treatment strategies. However, the large patient population sometimes burdens traditional surgical oncology. In recent years, rapidly advancing artificial intelligence (AI) technologies, characterized by efficiency, precision, and personalization, align well with the treatment philosophy of oncologic surgery. Increasing studies have shown that AI-assisted surgical oncology outperforms traditional approaches in many aspects. This review, based on machine learning, neural networks, and other AI techniques, discusses the various applications of AI throughout the entire process of hepatobiliary tumor surgical treatment, including diagnostic assistance, surgical decision-making, intraoperative support, postoperative monitoring, risk assessment, and medical education. It offers new insights and directions for the integration and application of AI in oncologic surgery.

Lung cancer is the most common cause of cancer-related deaths worldwide. Platinum-containing two-drug regimens are the standard first-line chemotherapeutic regimen, but acquired resistance remains a major challenge. Cancer cells can evolve and adapt to therapeutic stress by reprogramming their metabolism and passing on drug resistance to neighboring drug-sensitive cancer cells through cell-to-cell interactions. Here, we have developed a method to study the interactions between cells. Using human lung cancer A549 cells, we constructed a drug-sensitive cell line expressing red fluorescent protein and a cisplatin-resistant cell line. Employing label-free mass cytometry, we acquired metabolites information at the single-cell level. Through pseudotime analysis, we identified two most important clusters of metabolites. We discovered that phosphatidylcholines are strongly associated with drug resistance. Through unsupervised learning, we observed that drug-sensitive cells in co-culture transform into a novel cell state after cisplatin treatment. This method offers a novel tool for investigating the mechanisms underlying the development of cancer cell drug resistance.

Breast cancer liver metastasis (BCLM) presents a critical challenge in breast cancer treatment and has substantial epidemiological and clinical significance. Receptor status is pivotal in managing both primary breast cancer and its liver metastases. Moreover, shifts in these statuses can have a profound impact on patient treatment strategies and prognoses. Research has indicated that there is significant heterogeneity in receptor status between primary breast cancer and liver metastases. This variation may be influenced by a multitude of factors, such as therapeutic pressure, inherent tumor heterogeneity, clonal evolution, and the unique microenvironment of the liver. Changes in the receptor status of BCLM are crucial for adjusting treatment strategies, and liver biopsy plays an important role in the treatment process. Directions for future research targeting changes in receptor status include in-depth study of molecular mechanisms, combined treatment strategies for receptor status reversal, development of artificial intelligence deep learning models to predict receptor status in liver metastases, and clinical research on new drug development and combination therapies. That research will provide more precise treatment strategies for patients with BCLM and improve their prognosis.

Background:The effectiveness of endoscopic screening for upper gastrointestinal (UGI) tract cancers in high-risk areas of China has been well-established. However, the practicality of extending this screening to a wider geographical area remains uncertain. To bridge this gap, we have conducted a hospital-based opportunistic endoscopic screening (OpENS) program for UGI cancers since 2018. Our objectives were to elucidate the implementation process of the OpENS program and assess its effectiveness. Methods:875 hospitals from 710 districts/counties have participated in the OpENS program during 2019-2023. The endoscopic specialists and pathologists participating in the program were mandated to take annual training programs to acquire the fundamentals of screening techniques. Eligible patients who underwent endoscopic examinations were screened for UGI cancers. Patients diagnosed with high-grade intraepithelial neoplasia (HGIN), carcinoma in situ (CIS) and tumors in esophagus or/and stomach were defined as positive cases. Patients with HGIN and CIS were defined as early cases. All hospitals were required to submit screening data via the program's platform, with both the quality of the submitted data and the hospitals' performance being subject to a comprehensive evaluation. The age-standardized incidence rates (ASIRs) for the districts/counties where the participating hospitals were situated were derived from the cancer registry data for the year 2020. Districts/counties with ASIRs for UGI cancers over 22.0/105 were classified as high-risk areas. The positive detection rate (PDR) and early diagnosis rate (EDR) were calculated. Findings:After data cleaning, we included 808 hospitals from 616 districts/counties, with a collective participation of 7,066,892 individuals during 2019-2023. The overall PDR and EDR across all sites were 2.35% and 19.77%. The PDRs and EDRs were 1.02% and 23.18% in esophagus, and were 1.37% and 17.80% in stomach. The PDR was higher among males compared to females (3.59% vs 1.20%), and was increasing with age. The EDR was higher among females compared to males (20.66% vs 19.45%), peaking in the age group of 60-64 years. The PDRs and EDRs were higher in high-risk areas of UGI cancers (p < 0.05). After adjusting for age, sex, province, year of screening, regional UGI cancer incidence level and hospital tier, the hospitals that consecutively participated in the program for five years demonstrated higher PDRs and EDRs when compared to other hospitals (p < 0.05). Among the consecutively participated hospitals, tertiary-level hospitals demonstrated positive associations with the PDRs for both the esophagus and stomach when compared to secondary-level hospitals (p < 0.001). However, the tertiary-level hospitals showed a negative association with the EDR for the esophagus (OR = 0.91, 95% CI: 0.86-0.96, p = 0.001), but exhibited a positive association with the EDR for the stomach (OR = 1.11, 95% CI: 1.05-1.17, p < 0.001). Interpretation:The OpENS program has rapidly expanded across the country. The program has demonstrated high PDRs and EDRs, with hospitals that performed well exhibiting significantly better screening outcomes. Among these well-performed hospitals, secondary-level hospitals can achieve comparable results to tertiary-level hospitals in screening for esophageal lesions, albeit not for stomach lesions. Considering the current hospital capacities in China, the training-guided opportunistic UGI endoscopy screening exhibits significant feasibility and effectiveness across areas with varying level of UGI risks. Funding:CAMS Innovation Fund for Medical Sciences (No. 2021-I2M-1-061, 2021-I2M-1-023).

Background:Gastric cancer is a formidable global heath challenge, especially in China. We aimed to investigate temporal trends and spatial variations of gastric cancer incidence and mortality in Gansu Province, which has the highest incidence rate of gastric cancer in China, and sought to explore the role of various geographic and environmental factors played in the variations of incidence rates of gastric cancer. Methods:We sourced the incidence and mortality data for gastric cancer from the China Cancer Registry Annual Report and environmental data from National Soil Series Survey and Compilation of Soil Series of China and China National Environmental Monitoring Centre. We used joinpoint regression models to examine the temporal trends in age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR) for gastric cancer between 2010 and 2018. We used the Pearson correlation coefficient, robust linear regression, and least-squares regression models to explore the associations between environmental parameters and gastric cancer incidence. Results:The ASIR of gastric cancer per 100 000 population in Gansu Province showed a slightly increasing trend from 2010 (77.75; 95% confidence interval (CI) = 73.98, 81.52) to 2014 (85.20; 95% CI = 80.36, 90.04) and then started to decrease to 51.77 (95% CI = 49.14, 54.40) in 2018. The mortality rate of gastric cancer per 100 000 population remained stable from 2010 (55.69; 95% CI = 52.38, 59.01) to 2017 (51.06; 95% CI = 48.11, 54.01), while the rate showed a noticeable decline in 2018 (33.37; 95% CI = 31.26, 35.48). In 2018, significant variations in the ASIR (more than 5-fold) and ASMR (more than 11-fold) were observed across 15 registries in Gansu Province. Associations between soil properties at different depths and ASIR were calculated for 15 registries in Gansu Province, and statistically significant indicators included soil pH, total nitrogen density (TND), total phosphorus (TP), and soil organic carbon density (SOCD) (P < 0.05). No statistically significant correlation was found between ASIR and ambient air pollutants and surface water properties. The environmental variables explained about 37.9% of the variability in regional level ASIR of gastric cancer (adjusted R2 = 0.379, F = 3.136, P = 0.046). In addition, strong correlations among soil pH, TND, TP, and SOCD. While chemical fertilisers have been documented to induce soil acidification and elevate N, P, and C levels, we thus compared the annual trends in the application of chemical fertilisers with the ASIR of gastric cancer in Gansu Province, revealing consistent patterns. The correlation coefficient between annual quantity of applied chemical fertilisers and ASIR was 0.638. Conclusions:We observed significant geospatial variations in the ASIR and ASMR of gastric cancer in Gansu Province, which has the highest incidence rate of gastric cancer in China, as well as a novel correlation between the usage of chemical fertilisers and the incidence of gastric cancer, highlighting the need for further research in this area.

Colorectal cancer liver metastasis (CRLM) remains the leading cause of mortality among colorectal cancer (CRC) patients, with more than half eventually developing hepatic metastases. Achieving long-term survival in CRLM necessitates early detection, robust stratification, and precision treatment tailored to individual classifications. These processes encompass critical aspects such as tumor staging, predictive modeling of therapeutic responses, and risk stratification for survival outcomes. The rapid evolution of artificial intelligence (AI) has ushered in unprecedented opportunities to address these challenges, offering transformative potential for clinical oncology. This review summarizes the current methodologies for CRLM grading and classification, alongside a detailed discussion of the machine learning models commonly used in oncology and AI-driven applications. It also highlights recent advances in using AI to refine CRLM subtyping and precision medicine approaches, underscoring the indispensable role of interdisciplinary collaboration between clinical oncology and the computational sciences in driving innovation and improving patient outcomes in metastatic colorectal cancer.

Aims The study aims to examine the correlation between alcohol consumption and the risk of gastric cancer in the Wuwei population with different levels of H. pylori infection. Methods The study included 3123 participants aged 40–70 years who had resided in Wuwei City for at least 5 years. Participants completed questionnaires on personal information, diet, alcohol consumption, family and medical history, and H. pylori detection. All participants underwent 13C-UBT testing for H. pylori infection, and upper gastrointestinal endoscopy and pathology were performed. Testing was conducted before diagnosis to avoid recall bias. Results Alcohol increases the risk of gastric cancer, but it decreases the risk in those who are infected. Those aged 50–70 without H. pylori who consume alcohol and smokers who quit with H. pylori infection have a higher risk of gastric cancer. Conclusion Alcohol consumption represents a significant risk factor for the development of gastric cancer. This risk is particularly pronounced with advancing age and following the eradication of H. pylori.

Background and objective Lung cancer is the malignant tumor with the highest incidence rate and the heaviest disease burden in China. In recent years, lung cancer has shown a high incidence trend, seriously affecting the health of the population. In this paper, we analyze the characteristics of lung cancer incidence in 2019 and the trend of incidence rate from 2010-2019 in the tumor registration area of Gansu province, in order to provide a reference basis for the development of lung cancer prevention and control strategies in Gansu province. Methods By analyzing the cases of lung cancer incidence in the tumor registration area of Gansu province in 2019, we calculated the incidence rate, medium incidence rate, world incidence rate and other related indexes; we used Joinpoint to calculate the annual percentage change (APC) for trend analysis. Results In 2019, a total of 3757 new cases of lung cancer were reported in Gansu province, accounting for 14.96% of all new malignant tumors. The incidence rate, medium incidence rate and world incidence rate and world rate of lung cancer were 40.52/105, 25.78/105, 25.86/105; and the cumulative rate of 0-74 years old, and the truncation rate of 35-64 years old were 3.23%, 40.03/105, respectively. The incidence of lung cancer rises with age, and is high in the age group of 40 years and above, and the incidence peaks in the male and female populations in the group of 75 years and above, and the group of 80 years and above, respectively. The crude incidence rate of lung cancer in the tumor registration area of Gansu province from 2010-2019 showed an overall increasing trend, and the rate of increase was relatively fast, with an APC 5.39% (P<0.05); Separately, according to gender, urban and rural areas, the incidence of lung cancer in all populations showed an increasing trend, and the APC of male, female, urban and rural populations were 4.98%, 6.39%, 6.26%, and 4.64%, respectively (all P<0.05). According to the trend analysis of lung cancer incidence rate by age group, only lung cancer incidence in the age group of 65 years and above increased at an annual average rate of 4.15% (P<0.05). Conclusion The incidence rate of lung cancer in the tumor registration area of Gansu province from 2010 to 2019 shows a rising trend year by year, and there are differences in the incidence of lung cancer in people of different genders, regions and age groups, so comprehensive prevention and control work should be carried out for the key populations of lung cancer incidence.

Introduction Altered Immunoglobulin G (IgG) N-glycosylation is associated with aging, inflammation, and diseases status, while its effect on esophageal squamous cell carcinoma (ESCC) remains unknown. As far as we know, this is the first study to explore and validate the association of IgG N-glycosylation and the carcinogenesis progression of ESCC, providing innovative biomarkers for the predictive identification and targeted prevention of ESCC. Methods In total, 496 individuals of ESCC (n=114), precancerosis (n=187) and controls (n=195) from the discovery population (n=348) and validation population (n=148) were recruited in the study. IgG N-glycosylation profile was analyzed and an ESCC-related glycan score was composed by a stepwise ordinal logistic model in the discovery population. The receiver operating characteristic (ROC) curve with the bootstrapping procedure was used to assess the performance of the glycan score. Results In the discovery population, the adjusted OR of GP20 (digalactosylated monosialylated biantennary with core and antennary fucose), IGP33 (the ratio of all fucosylated monosyalilated and disialylated structures), IGP44 (the proportion of high mannose glycan structures in total neutral IgG glycans), IGP58 (the percentage of all fucosylated structures in total neutral IgG glycans), IGP75 (the incidence of bisecting GlcNAc in all fucosylated digalactosylated structures in total neutral IgG glycans), and the glycan score are 4.03 (95% CI: 3.03-5.36, P<0.001), 0.69 (95% CI: 0.55-0.87, P<0.001), 0.56 (95% CI: 0.45-0.69, P<0.001), 0.52 (95% CI: 0.41-0.65, P<0.001), 7.17 (95% CI: 4.77-10.79, P<0.001), and 2.86 (95% CI: 2.33-3.53, P<0.001), respectively. Individuals in the highest tertile of the glycan score own an increased risk (OR: 11.41), compared with those in the lowest. The average multi-class AUC are 0.822 (95% CI: 0.786-0.849). Findings are verified in the validation population, with an average AUC of 0.807 (95% CI: 0.758-0.864). Discussion Our study demonstrated that IgG N-glycans and the proposed glycan score appear to be promising predictive markers for ESCC, contributing to the early prevention of esophageal cancer. From the perspective of biological mechanism, IgG fucosylation and mannosylation might involve in the carcinogenesis progression of ESCC, and provide potential therapeutic targets for personalized interventions of cancer progression.

[目的]分析2018年甘肃省肿瘤登记地区肺癌流行现状及变化趋势.[方法]按性别、城乡和年龄组分层计算肺癌发病(死亡)率、中国人口标化率(中标率)、世界人口标化率(世标率)及年龄别率等指标,描述2018年肺癌流行特征;利用Joinpoint线性回归模型计算年度变化百分比(APC),分析2010-2018年肺癌年度变化趋势.[结果]2018年甘肃省肿瘤登记地区肺癌新发病例数为640例,发病率为30.10/10万,中标率为22.03/10万,世标率为24.87/10万,0～74岁累积率为2.74％;肺癌死亡病例数为515例,死亡率为24.22/10万,中标率为18.18/10万,世标率为21.03/10万,0～74岁累积率为2.18％;农村发病率为城市的1.61倍,死亡率是城市的1.91倍;肺癌男性年龄别发病率和死亡率分别在80～84岁和75～79岁年龄组达到最高峰,女性在75～79岁和85岁及以上年龄组达到最高峰;肺癌发病和死亡情况地区分布情况显示,景泰县发病率和死亡率均为最高,武威市凉州区均为最低.2010-2018年甘肃省肿瘤登记地区肺癌中标发病率APC为0.60％(95％CI:-1.31％～2.55％),中标死亡率APC为4.80％(95％CI:-2.23％～12.35％),变化趋势差异均无统计学意义(P＞0.05).[结论]甘肃省肺癌发病及死亡率虽低于全国平均水平,但仍属于甘肃省高发癌种,已严重威胁居民生命健康,应积极推进肺癌高危人群评估及筛查早诊早治工作,有效遏制肺癌的高发态势.

BACKGROUND:Effective noninvasive biomarkers of gastric cancer (GC) are critical for early detection and improvement of prognosis. We performed genome-wide long non-coding RNA (lncRNA) microarray analysis to identify and validate novel GC biomarkers depending on a high-risk population cohort. METHODS:LncRNA profiles were described using the Human LncRNA Microarray between GC and control plasma samples. The differential candidate lncRNAs were validated in two stages by quantitative reverse transcription polymerase chain reaction (qRT-PCR). We further evaluated the joint effect between the GC-associated lncRNA and Helicobacter pylori (H. pylori) infection on the risk of cardia and non-cardia GC, respectively. RESULTS:Different lncRNA expression profiles were identified between GC and control plasma with a total of 1206 differential lncRNAs including 470 upregulated and 736 downregulated in GC compared with the control group. The eight significantly upregulated lncRNAs (RP11-521D12.1, AC011995.3, RP11-5P4.3, RP11-244 K5.6, RP11-422 J15.1, CTD-2306 M5.1, CTC-428G20.2, and AC009133.20) in GC cases both in the present study and a similar microarray screening study by our collaborative team were selected for a two-stage validation. After the large sample size validation, the subjects with higher expression of RP11-244 K5.6 showed a significantly increased risk of GC with an adjusted odds ratio (OR) as 2.68 and 95% confidence interval (CI) as 1.15-6.24. Joint effects between RP11-244 K5.6 expression and H. pylori infection on the risk of GC were evaluated with no statistical significance. CONCLUSIONS:Our study found different lncRNA expression profiles between GC and control plasma and preliminarily identified RP11-244 K5.6 as a potential noninvasive biomarker for GC screening.

目的 分析2018年甘肃省白银市恶性肿瘤发病与死亡情况.方法 根据2018年甘肃省白银市恶性肿瘤发病和死亡资料,分析其发病率、死亡率、发病死亡顺位和构成比等指标,中标率和世标率分别采用2000年全国普查标准人口年龄构成和Segi′s世界标准人口年龄构成计算.结果 2018年白银市恶性肿瘤发病率为272.67/10万,中标率178.33/10万,世标率为172.91/10万,0～74岁累积发病率为18.93％;恶性肿瘤发病率最高的是胃癌,其次为肺癌、肝癌、结直肠癌和乳腺癌,前10位占新发恶性肿瘤的74.73％.恶性肿瘤死亡率为146.55/10万,中标率86.39/10万,世标率为84.57/10万,0～74岁累积死亡率为9.29％;恶性肿瘤死亡率最高的是胃癌,其次为肺癌、肝癌、结直肠癌和胰腺癌,前10位占全部死亡恶性肿瘤的84.34％.中标发病率和中标死亡率均为男性高于女性,农村地区高于城市地区;发病率和死亡率均在80～84岁年龄组达到高峰.白银市各区县发病率中标和死亡率中标最高的分别为平川区和景泰县,最低的为白银区.结论 胃癌、肺癌、肝癌、结直肠癌、乳腺癌和胰腺癌等的发病率和死亡率较高,是需要重点防控的恶性肿瘤;女性乳腺癌和宫颈癌排在女性发病率、死亡率的前五位,应作为女性重点防控的恶性肿瘤.

Disability weights are crucial for quantifying health loss associated with non-fatal outcomes and were not well assessed in different countries, especially for specific cancer. Therefore, this study aimed to identify disability weights with a focus on specific cancer in a large Chinese population. Two types of web surveys were conducted, and 254 health states, including 30 new states for specific cancer, were investigated using paired comparison methods. The years lived with disability (YLDs) of cancer were calculated as the sum of the prevalence of each sequela of cancer multiplied by its relative disability weight. In total, 44,069 participants were eligible for the disability weights study. The disability weights of 254 health states were estimated. Among those, the disability weights of 18 specific cancer types varied greatly at diagnosis and primary treatment stage, with the value ranging from 0.619 (95% uncertainty interval (UI) 0.606-0.632) for brain cancer to 0.167 (95% UI 0.158-0.176) for oropharyngeal cancer. The discrepancy in YLDs calculated by different disability weights was high, and the largest gap for all cancer combined was approximately 30.14%. When calculated using the cancer-specific disability weights, a total of 1,967,830 (95% UI 1,928,880-2,008,060) YLDs of cancer were recorded in China. The disability weights of cancer varied greatly among cancer types and populations, which had considerable influence on the estimation of the disease burden. Cancer-specific disability weights could provide a more accurate evaluation of the cancer burden.

[目的]分析2018年武威市恶性肿瘤发病与死亡特征及2010-2018年恶性肿瘤发病与死亡变化趋势.[方法]按照国家癌症中心制定的数据质量审核评价标准,对武威市符合质量控制标准要求的肿瘤登记点上报的恶性肿瘤发病、死亡和人口数据进行汇总分析.按性别和年龄组分层计算发病(死亡)率、标化发病(死亡)率、0～74岁累积率等统计指标.利用Joinpoint线性回归模型计算2010-2018年武威市恶性肿瘤发病率、死亡率的年度变化百分比(APC),分析恶性肿瘤发病和死亡趋势.中标率和世标率分别采用2000年全国普查标准人口年龄构成和Segi世界标准人口年龄构成计算.[结果]2018年武威市恶性肿瘤发病率为267.89/10万,中标率为192.21/10万,世标率为208.31/10万,累积发病率(0～74岁)为24.30％;恶性肿瘤死亡率为131.38/10万,中标率为93.71/10万,世标率为105.02/10万,累积死亡率(0～74岁)为11.51％.男性中标发病率和中标死亡率均高于女性.恶性肿瘤发病率在70～74岁年龄组达到发病高峰,死亡率在75～79岁年龄组达到高峰.2018年武威市恶性肿瘤发病前10位依次为胃癌、女性乳腺癌、肺癌、食管癌、肝癌、结直肠癌、宫颈癌、子宫体癌、卵巢癌、前列腺癌,占全部新发恶性肿瘤的79.38％;恶性肿瘤死亡前10位依次为胃癌、肝癌、肺癌、食管癌、结直肠癌、胰腺癌、女性乳腺癌、宫颈癌、脑及中枢神经系统肿瘤、胆囊癌,占全部死亡恶性肿瘤的90.35％.2010-2018年武威市恶性肿瘤中标发病率呈下降趋势(APC=-7.3％,95％CI:-17.6％～4.3％),中标死亡率呈下降趋势(APC=-1.2％,95％CI:-7.5％～5.5％),差异均无统计学意义(P均＞0.05).[结论]武威市恶性肿瘤发病和死亡水平呈平稳趋势,发病率和死亡率依旧相对偏高,防控形势严峻.胃癌、食管癌、肺癌、肝癌、乳腺癌等病种是武威市癌症防控工作的重点.

Objective:To evaluate the performance of rural practitioners of endoscopic cleaning and disinfection participating in the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers and to analyze the influencing factors.Methods:The questionnaires for skill assessment were designed based on the skill scheme and clinical practice of the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China, and the App Early diagnosis, Early treatment was used as the examination platform. The practitioners in 539 county hospitals from 25 provinces participating in the program in 2019 were assessed for techniques and skills for endoscopic cleaning and disinfection and the excellence rate was calculated. Multivariate logistic regression model was used to analyze the influencing factors for the examination. Results:A total of 1 671 endoscopic cleaning and disinfection practitioners participated in the assessment with the score of 73.41±16.60. The passing rate was 85.82%, and the excellence rate was 44.94%. Among all questions, the correct rate of "opportunistic screening flow chart" was the highest (98.21%), and that of "the evaluation index for mass screening" was the lowest (57.89%). The multivariate logistic regression analysis showed that the excellence rate was high in practitioners who had a bachelor degree or above ( OR=1.627,95% CI:1.319-2.007, P<0.001), the career for 5 to <15 years (5 to <10 years: OR=1.329,95% CI:1.045-1.689, P=0.020; 10 to <15 years: OR=1.384,95% CI:1.026-1.867, P=0.033), working in eastern and central regions (eastern regions: OR=3.476,95% CI:2.368-5.103, P<0.001;central regions: OR=4.028,95% CI:2.679-6.057, P<0.001) and with full understanding of the screening scheme ( OR=1.547,95% CI:1.246-1.921, P<0.001) . Conclusion:Practitioners on the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China have mastered the basic screening scheme and skills for endoscopic cleaning and disinfection. The education background, duration of the career, area and understanding of screening scheme are influencing factors for the excellence rate of endoscopic cleaning and disinfection.

Abstract Background Dietary patterns and symptoms research among Chinese with esophageal squamous cell carcinoma (ESCC) and its precursor lesions is limited, especially as it relates to multiple food consumption and multiple co-occurring symptoms. The aim of our study was to identify the dietary patterns and severity of symptom classes with the risk of esophageal squamous cell carcinoma and its histological precursor lesions, and develop a risk prediction model for different stages of esophageal disease. Methods We analyzed data from a multicenter cross-sectional study carried out in ESCC high incidence areas between 2017 and 2018, which included 34,707 individuals aged 40–69 years. Dietary patterns and severity of symptom classes were derived by applying a latent class analysis (LCA). A multiple logistic regression model was used to derive the odds ratio (ORs) and corresponding 95% confidence intervals (CIs) for ESCC and the different stages of esophageal disease according to the dietary patterns and severity of symptom classes identified. We built the risk prediction model by using a nomogram. Results We identified five dietary patterns and three severity of symptom classes. The dietary patterns were classified as follows: “Healthy”, “Western”, “Lower consumers-combination”, “Medium consumers-combination” and “Higher consumers-combination” patterns based on the intake of foods such as red meat, vegetables and fruits. The severity of symptoms was categorized into “Asymptomatic”, “Mild symptoms” and “Overt symptoms” classes based on health-related symptoms reported by the participants. Compared to the “Healthy” pattern, the other four patterns were all associated with an increased risk of esophageal disease. Similarly, the other two symptom classes present different degrees of increased risk of esophageal disease compared to the “Asymptomatic”. The nomograms reflect the good predictive ability of the model. Conclusion Among individuals aged 40–69 years in high incidence regions of upper gastrointestinal cancer, the results supplied that subjects with diets rich in livestock and poultry meat and low in fruits and vegetables and subjects with typical symptoms were at increased ESCC risk. The findings highlight the importance of considering food and symptom combinations in cancer risk evaluation.

目的:通过分析某三级甲等医院肺癌患者住院费用构成及主要影响因素,为减轻患者经济负担及合理控制住院费用提供相关科学依据.方法:选取某三甲肿瘤专科医院2015～2019年住院肺癌患者的病案数据资料,分析住院费用的构成和住院费用的影响因素.结果:本研究共纳入肺癌患者10087例,平均年龄59岁,平均住院天数14天.次均住院费用15771.59元,且2015～2019年次均住院费用呈上升趋势,年均增长速度为16.37％.住院费用构成主要是西药费、诊断费用、非手术治疗费.影响住院费用的因素包括:住院天数、出院年份、是否手术、年龄、病理学类型等.结论:肺癌患者住院费用增长迅速,建议在提升医院精细化管理、提高肺癌早诊早治覆盖范围的同时,针对费用影响因素全面深化医药卫生体制改革,探索更长效的住院费用控费措施,减轻肺癌患者疾病经济负担.

[目的]分析甘肃省2018年肿瘤登记地区食管癌流行特征及2010-2018年变化趋势.[方法]按照国家癌症中心制定的数据质量审核评价标准,收集整理甘肃省经质量控制合格的15个肿瘤登记点上报的食管癌发病、死亡和人口数据进行汇总分析.按性别、城乡和年龄组分层计算食管癌发病(死亡)率、年龄别发病(死亡)率、标化发病(死亡)率、0～74岁累积发病(死亡)率等.利用Joinpoint线性回归模型分析计算2010-2018年甘肃省肿瘤登记地区食管癌发病(死亡)率的年度变化百分比(APC).中标率和世标率分别采用2000年中国人口普查标准人口年龄构成和Segi's世界标准人口年龄构成进行标化.[结果]甘肃省肿瘤登记地区2018年新发食管癌病例975例,占全部恶性肿瘤新发病例的7.17％,发病率为18.15/10万,发病中标率为13.12/10万,发病世标率为14.93/10万,累积发病率(0～74岁)为1.81％;肿瘤登记地区食管癌死亡病例608例,占全部恶性肿瘤死亡病例的8.03％,死亡率为11.32/10万,死亡中标率为8.16/10万,死亡世标率为9.57/10万,累积死亡率(0～74岁)为0.95％.2010-2018年甘肃省肿瘤登记地区食管癌发病和死亡呈明显下降趋势,发病中标率APC为-8.60％(P＜0.05),死亡中标率APC为-10.2％(P＜0.05).[结论]甘肃省食管癌的整体发病和死亡水平呈下降趋势,但仍为甘肃省负担较重的恶性肿瘤之一,在现有的防控措施基础上应更加针对性地做好高危人群的预防工作,以降低甘肃省食管癌的疾病负担.