大肠肿瘤的预防现状与进展 2012-11-23submitted.pptVIP

Ma YL, et al. JCO, 2011;29:3775-82 维生素D的摄入与CRC发生危险呈负相关 Ma YL, et al. JCO, 2011;29:3775-82 血中25-hydroxyvitamin D [25(OH)D] 水平与 CRC发生的危险性呈负相关 谢 谢！ * 食用木酚素（木脂体）和原菌幕（初生外菌幕） 均属于多酚类物质，高木酚素的摄入可能增加CRA的再发。 As you know, NSAID are ulcerogenic to the stomach and duodenum and lead to a three fold to 10-fold increase in ulcer complications, hospitalisation, and death from ulcer disease. Such ulcer complications are estimated to cause up to 16 500 deaths each year in the United States and 2000 deaths a year in Britain. Hospitalisations due to complications associated with NSAID use are a problem in elderly patients. Followed along with the increasing the dose of cox2 inhibitors, although prevention effect increased, while the serious cardiovascular events was increased. Because of the serious cardiovascular events, Refecoxib has been withdrawn from the market. The size of each square is proportional to the weight of the study (inverse of variance). The range is the difference in the midpoint between the highest and lowest categories of exposure. The size of each square is proportional to the weight of the study (inverse of variance). The range is the difference in the midpoint between the highest and lowest categories of exposure. 大肠肿瘤的预防:现状与进展 上海交通大学医学院附属仁济医院消化科 上海市消化疾病研究所 房 静 远 大肠癌: 家族性(遗传性) 散发性:发生途径 经典的腺瘤-腺癌途径、 “锯齿状途径” de Novo 途径 大肠息肉 肿瘤性息肉(腺瘤) 非肿瘤性息肉 增生性息肉(I型可癌变) 锯齿状腺瘤(样息肉)(介于HPS与CRA间) 幼年性息肉 淋巴样息肉 炎症性息肉 大肠腺瘤 息肉样病变 平坦型 凹陷样 具有上皮内瘤变 WHO Fact sheet , Feb 2011 全球肿瘤病死情况 全部癌死亡760万 (占因病而亡人数的 13% ) lung (1400,000 deaths/year) stomach (740,000 deaths) liver (700,000 deaths) colorectal (610 000 deaths) breast (460 000 deaths) 2008年 全部癌死亡740万 (占因病而亡人数的 13% ) lung (1.3 million deaths/year) stomach (803 000 deaths) colorectal (639 000 deaths) liver (610 000 deaths) breast (519 000 deaths) 2004年 WHO Fact sheet , Feb 2009 预 防 策 略 确定高危人群