课件：癌症三级预防苏州大学.ppt

* * * Countries with the highest prevalence of gastric cancer are highlighted in yellow based on age-standardised rate (ASR) in men 20/100000 by region. Regions highlighted in green represent countries with ASR for gastric cancer in men ≥10 and ?20/100000. Regions highlighted in light blue represent countries with a low incidence of gastric cancer (ASR in men 10/100000). Approximately two-thirds of gastric cancer cases occur in less developed countries, with the highest incidence rates in the Asia-Pacific region [1–3]. Areas with the highest incidence of gastric cancer include Japan, China, Korea, Central and South America, Eastern Europe and the Middle East. There is a low incidence rate in North America, Northern Europe, Australia/New Zealand and India. In the US, there are approximately 22000 new cases of gastric cancer diagnosed per year [3]. Worldwide: 900000 new cases and 700000 deaths per year due to gastric cancer 5-year survival-rate for gastric cancer is ?20% gastric cancer is the second leading cause of cancer death in the world. 1. Parkin DM et al. CA Cancer J Clin 2005;55:74–108 2. Yang L. World J Gastroenterol 2006;12:17–20 3. * 我国每年有近20多万新发胃癌病例，占全部恶性肿瘤的17.2%，居所有恶性肿瘤发病率的首位。胃癌死亡率占所有恶性肿瘤死亡的23.02%，也居各类癌症死亡的首位，每年约16万人死于胃癌。 * 早期胃癌患者，无论有无淋巴结转移，手术治疗后的5年生存率超过90%，其中始发阶段小胃癌及微小胃癌的10年生存率可达100%。因此，胃癌的早期、及时、准确检出，对于降低胃癌死亡率具有十分重要的意义。 * 但目前尚无设计完善、大样本、随机对照的研究工作证明胃癌筛查可显著降低胃癌死亡率 WHO尚不推荐大规模地开展胃镜普查 * Surgery and radiation remove or kill the bulk of locoregional cancer; however, small local tumor deposits and occult metastases may escape these treatments and result in subsequent recurrence or relapse. Cytotoxic chemotherapy agents work by a variety of mechanisms, but they share in common the property of affecting rapidly dividing cells more than they affect nondividing or slowly replicating cells. Antimetabolites interfere with DNA elongation37 Topoisomerase inhibitors and anthracyclines block a key enzyme in DNA replication38,39 Anthracyclines are also DNA interc