Correlated Analysis of Esophageal and Gastric Cardiac Cancer with Family History
|Keywords||Esophageal / gastric cardia Family history Familial esophageal / gastric cardia Familial predisposition|
Background Esophageal Cancer (Esophageal cancer, EC) one six common malignancy in the world. The junction of Henan, Hebei, Shanxi provinces Taihang Mountains China is also the world's esophageal cancer incidence and mortality in areas with the highest, and for the center to the provinces at the junction concentric circles outward incidence gradually reduce. Major epidemiological characteristics of esophageal cancer is a significant regional distribution differences, a difference of up to 500 times the incidence of high and low incidence areas. Cardia (Gastric cardia adenocarcinoma, GCA) is also in northern China, one of the most common malignant tumor in the past, often cardia classified in esophageal cancer research in recent years has gradually to be treated as a separate disease. The cardia significant epidemiological characteristics of the consistency with the esophageal regional distribution and distal stomach tumor inconsistency is also a high incidence of high incidence areas in esophageal cardia. Other epidemiological characteristics of the esophagus / responsibility doors cancer prominent obvious familial aggregation phenomenon, the laboratory in recent years, the study found that: Linzhou positive family history of esophageal cancer was significantly higher than that outside the state forest Henan and Henan Province outside the forest after the state resident immigrants epidemiological survey found that immigrants 100 years, similar to the esophagus / cardia cancer and precancerous lesion detection rate out of the ground. This esophagus / cardia geographical distribution differences and obvious familial aggregation phenomenon, especially immigrants epidemiological investigation prompted environmental and genetic factors may play an important role in the esophageal / gastric cardia occurred. However, environmental and genetic factors, the exact molecular mechanisms and the proportion of esophageal / gastric cardia occurred is not clear, especially with regard to cardia cancer genetic predisposition (family history) reported rarely. Esophageal carcinoma the critical susceptibility genes remains uncertain, mainly due to the esophageal pedigree data collection difficulties, limiting research progress screening susceptible candidate genes. The research group in the Henan high incidence of esophageal cancer in the population census process and found that in the region there are more obvious familial patients with esophageal cancer (positive family history of esophageal cancer) and \at least two or more members suffered from esophageal cancer; same generation first-degree relatives of members of the family should have at least two patients with esophageal cancer). The characteristics of these groups are: family members are concentrated in the rural areas of high incidence of esophageal several generations for a long time living in the same village, little mobility, similar to environmental factors, genetic background is clear, stable, more members of the family, is very conducive to clarify esophageal cancer the key genetic related gene molecular mechanism (candidate susceptibility genes). Therefore, to explore esophageal / cardia family, susceptible gene has become the focus of attention, about esophageal the / responsibility doors cancer crowd of family history of cancer clinical and pathological features, esophageal / gastric cardia familial predisposition, risk factors, and prognosis The study reported at home and abroad, especially the cardia cancer research is very rare. Obviously, the system to collect, collate these familial esophageal / gastric cardia cancer clinical background information and genetic background information is an important basis for the screening of esophageal cancer genetic key genes. In this study, it is on the basis of the above-mentioned research by households to the high incidence of residents survey of patients with esophageal cancer pathology and clinical data collection and analysis, and genetic epidemiological risk factors of esophageal cancer in the risk factors and so on, so as to clarify the the esophageal genetic key candidate susceptibility gene lay an important foundation. Materials and Methods 2.1 study surveyed a positive family history of esophageal / gastric cardia 1000 cases, including esophageal cancer 500 cases (male 296, female 204), the youngest 17 years old, maximum 93 years, with an average of 58 ± 9 years; cardia 500 cases (male 274, female 226), the youngest 24 years old, 86 years old, an average of 54 ± 7 years. Negative family history of esophageal / gastric cardia 1000 cases, including esophageal cancer 500 patients (male 289, female 211), the youngest 40 years old, maximum 83 years, an average of 53 ± 6 years; the gastric cardia 500 cases (male 218, female 282), The youngest was 24 years old, 86 years old, an average of 55 ± 4 years old. Were histologically proven primary esophageal squamous cell carcinoma and gastric cardia adenocarcinoma. The statistics are from a number of hospitals in Anyang, Henan Province, Linzhou. The 2.2 tumors positive family history of esophageal / gastric cardia standard family history of cancer-positive esophageal / gastric cardia (EC / GCA FH) ≥ 2 cases of esophageal / gastric cardia (or other tumors) family in three successive generations. Family history of cancer negative esophageal / gastric cardia (EC / GCA FH-) ≤ 1 cases of esophageal / gastric cardia in three successive generations also patients with other malignancies. 2.3 epidemiological investigation esophageal / gastric cardia significant characteristics of the regional distribution of select Anyang Linzhou hospital representative survey of hospitalized patients from 2009 to 2010, the survey include: general ( age, gender, and communication), a family history of the case, the relationship between family members, and other projects. A retrospective survey of previous hospitalization medical records, supplemented been discharged esophageal / gastric cardia in patients with clinical and pathological data (including medical record number, pathological number, name, age, place of origin, prevalence, types, family history, Contact exact pathological diagnosis and pathology type). All findings are used EXCEL software for data entry processing, in accordance with the the tumors positive family history of esophageal / gastric cardia standard screened 1000 patients with a positive family history of esophageal / gastric cardia patients for epidemiological comparative analysis with 1000 patients with a family history of negative patients. 2.4 Statistical analysis of the data from the application of the above findings the following statistical methods to analyze the test, All calculations were performed using the statistical soft even SPSS13.0 conducted. (1) The chi-square test (x2 test): sample rate used to test the two (or more) or constitutes the difference between the ratio of significant significance. If P lt; 0.05, the difference was statistically significant. (2) the odds ratio (odds ratio, OR): case-control study, said the strength of the indicators of the link between the exposure and the disease. OR, GT; 1 Description disease risk due to exposure increases, between exposure and disease is the \OR = 1 illustrates the risk of disease and exposure. 3 Results 3.1 family history positive / negative esophageal / gastric cardia tumors general comparative analysis of tumor positive family history of male patients with esophageal cancer was 59.2% (296/500), family history of cancer negative male patients with esophageal cancer was 57.8% (289/500 ), was not significantly different, P gt; 0.05. The tumor positive family history of female patients with esophageal cancer was 40.8% (204/500), family history of cancer-negative female patients with esophageal cancer was 42.2% (211/500), no significant difference, P gt; 0.05. In the 40-50 year-old group of patients with esophageal cancer, positive family history of cancer was 4.2% (21/500), 38.4% (192/500) in the 50-60 year-old group of patients with esophageal cancer, family history of cancer positive in 60 -70 year-old group of patients with esophageal cancer, family history of cancer positive for 44% (220/500), and ≥ 70 years of age group of patients with esophageal cancer, a positive family history of cancer was 12.8% (64/500), with the same ages tumor There were no significant differences in family history negative esophageal cancer patients (6%, 30/500; 34.6%, 173/500; 44.4%, 222/500; 14%, 70/500), P gt; 0.05. Family history of cancer-positive male patients with cardiac cancer, 54.8% (274/500), family history of cancer-negative men cardia cancer patients was 43.6% (218/500), no significant difference, P gt; 0.05. Family history of cancer-positive women cardia cancer patients was 45.2% (226/500) and 56.4% (282/500), family history of cancer-negative female patients with cardiac cancer was not significantly different, P gt; 0.05. In the 40-50 year-old group of patients with cardiac cancer, positive family history of cancer was 3.2% (16/500) in the 50-60 year-old group of patients with cardiac cancer, family history of cancer positive for 34.2% (171/500) at 60 -70 year-old group of patients with cardiac cancer, family history of cancer positive for 45% (225/500), and ≥ 70 years cardia group of patients, a positive family history of cancer was 11.9% (59/500), with the same ages tumor was no significant difference in family history negative cardia cancer patients (5%, 25/500; 35.9%, 179/500; 41.5%, 207/500; 16%, 80/500), P gt; 0.05. 3.2 positive family history / the negative esophageal / gastric cardia tumor clinicopathological data comparative analysis of positive family history of esophageal cancer patients with a family history of negative comparison, advanced esophageal cancer (OR = 1.19,95% CI :0.53-2 .69), poorly differentiated esophageal cancer (OR = 3.695, OR 95% CI :1.231-11 .09), the middle of esophageal cancer (OR = 1.725, OR.95% CI :1.120-2 .656), clinical IV esophageal cancer (OR = 1.548, OR 95% CI :1.138-2 .105), on esophageal cancer family history positive people higher cancer susceptibility. Cardia in patients with a positive family history and family history of negative comparison, mid-cardia cancer (OR = 1.895,95% CI :1.244-2 .885), moderately differentiated gastric cardia (OR = 1.497, OR 95% CI :1.137-1 .970), junction at the cardia (O = 1.907, OR 95% CI :1.264-2 .878), clinical stage Ⅲ esophageal cancer (OR = 1.292, OR 95% CI :1.006-1 .659), family history positive population cancer susceptibility Description responsible doors cancer than family history negative susceptibility. 4 Conclusion 4.1 esophageal / cardia susceptibility of different family, a different genetic and / or environmental susceptibility factors, genetic factors are important risk factors. 4.2 positive family history of esophageal / gastric cardia cancer more likely to vicious degrees higher.