Table CDR62880 Esophageal Cancer Prevention/食管癌预防
ID Type Description_en Description_zh
p1 Phrase Gastroesophageal reflux/Barrett esophagus 胃食管返流症/Barrett食管
p2 Phrase Esophageal Cancer Screening 食管癌的筛查
p3 Phrase Esophageal Cancer Prevention 食管癌的预防
p4 Phrase Squamous Cell Carcinoma 食管鳞状细胞癌
p5 Phrase Esophageal Cancer (PDQ®): Prevention 食管癌(PDQ®):预防
p6 Phrase Internal Validity : Fair 内部效度:一般
p7 Phrase Consistency : Large study 一致性:大型研究
p8 Phrase Consistency : Multiple studies 一致性:多项研究
p9 Phrase Consistency : Single study 一致性:单项研究
p10 Phrase Aspirin and nonsteroidal anti-inflammatory drugs 阿司匹林和非甾体类抗炎药
p11 Phrase Tobacco, Alcohol, and Dietary Factors 吸烟,饮酒与饮食因素
p12 Phrase Avoidance of tobacco and alcohol 远离吸烟与饮酒
p13 Phrase Consistency : Good; multiple studies 一致性:佳,多项研究
p14 Phrase Radiofrequency Ablation in Dysplastic Barrett Esophagus 对有不典型增生的Barrett食管行射频消融术
p15 Phrase Aspirin and nonsteroidal anti-inflammatory drug use 阿司匹林和非甾体类抗炎药(NSAID)
p16 Phrase The risk declines with smoking cessation 戒烟后食管鳞癌发生风险降低
p17 Phrase Ablation of Barrett Esophagus With Dysplasia 不典型增生的Barrett食管消融术
p18 Phrase Helicobacter pylori infection and gastric atrophy 幽门螺杆菌与胃粘膜萎缩
p19 Phrase The epidemiology of these types varies markedly 不同类型的食管肿瘤,其流行病学特征迥异
p20 Phrase Study Design : Ecologic and descriptive studies 研究设计:生态学与描述性研究
s1 Sentence Direction and Magnitude of Effect : Small positive 效应方向与强度:少量收益
s2 Sentence Magnitude of Effects on Health Outcomes : Unknown 对健康结局的效应强度:不明
s3 Sentence Magnitude of Effects on Health Outcomes : Unknown magnitude 对健康结局的效应强度:强度不明
s4 Sentence Study Design : Evidence obtained from randomized controlled trials 研究设计:来自病例对照研究的证据
s5 Sentence Magnitude of Effects on Health Outcomes : Large positive 对健康结局的效应强度:获益较大
s6 Sentence Magnitude of Effects on Health Outcomes : Positive; unknown magnitude 对健康结局的效应强度:正面,强度不明
s7 Sentence The second report of this study presented micronuclei frequency results 该项研究发表的第二份报告展现了细胞微核频率数据
s8 Sentence Both were conducted in a high-risk area of China (Linxian) 这2项试验均在中国高危地区(林县)进行
s9 Sentence Study Design : Evidence obtained from cohort or case-control studies 研究设计:来自队列或病例对照研究的证据
s10 Sentence Magnitude of Effects on Health Outcomes : Large positive benefit 对健康结局的效应强度:较大收益
s11 Sentence Similar studies have not been conducted in the United States 在美国尚未进行过类似研究
s12 Sentence Magnitude of Effects on Health Outcomes : Increased risk, small magnitude 对健康结局的效应强度:风险增加,强度较小
s13 Sentence In the 1960s, squamous cell cancers comprised over 90% of all esophageal tumors 20世纪60年代,鳞状细胞癌占所有食管肿瘤的90%以上
s14 Sentence Magnitude of Effects on Health Outcomes : Impact on cancer mortality not known 对健康结局的效应强度:对癌症死亡率的影响不明
s15 Sentence Based on fair evidence, an association exists between gastroesophageal reflux disease (GERD) and adenocarcinoma 证据一般:食管腺癌与胃食管返流症(GERD)间存在相关性
s16 Sentence Two histological types account for the majority of malignant esophageal neoplasms: adenocarcinoma and squamous carcinoma 绝大多数食管恶性肿瘤为两大组织类型:腺癌和鳞癌
s17 Sentence The intestinal-type epithelium of Barrett esophagus has a characteristic endoscopic appearance that differs from squamous epithelium Barrett食管的肠上皮与鳞状上皮在内镜下的形态学截然不同
s18 Sentence There are also many other places to get materials and information about cancer treatment and services 您还有其他途径获取癌症治疗与服务的材料和信息
s19 Sentence The frequency, severity, and duration of reflux symptoms were positively associated with increased risk of esophageal adenocarcinoma 食管腺癌发生风险与返流症状的发生频率、严重程度、持续时间呈正相关
s20 Sentence Updated statistics with estimated new cases and deaths for 2013 (cited American Cancer Society as reference 1) 更新2013年新发病例与死亡病例的统计学数据(引用美国癌症研究所参考文献1)
s21 Sentence Two National Cancer Institute-sponsored phase III trials of combinations of multiple vitamins and minerals have been reported 美国国家癌症研究所赞助的2项III期临床试验比较了多种维生素与矿物质联合使用的效果
s22 Sentence Based on solid evidence, avoidance of tobacco and alcohol would decrease the risk of squamous cell cancer 充分证据显示,远离吸烟与饮酒可降低食管鳞状细胞癌的发生风险
s23 Sentence Dysplasia in Barrett epithelium represents a neoplastic alteration of the columnar epithelium that may progress to invasive adenocarcinoma Barrett食管上皮的不典型增生表现为柱状上皮癌变,可进展为侵袭性腺癌
s24 Sentence Reports have suggested that gastric infection with H. pylori may protect the esophagus from GERD and its complications 研究发现,胃感染幽门螺旋杆菌后可能会减少发生GERD及其并发症,从而减轻对食管的损害
s25 Sentence Case-control studies have also suggested a significantly increased risk of cancer of the esophagus associated with alcohol abuse 一些病例对照研究结果也显示酒精滥用会导致食管癌发生风险显著增加
s26 Sentence In the United States, squamous cell carcinoma of the esophagus is strongly associated with tobacco and alcohol abuse 在美国,食管鳞癌与吸烟及酒精滥用存在显著相关性
s27 Sentence Serum levels of vitamin A, beta carotene, riboflavin, and zinc were obtained at 0, 2, and 13.5 months 在第0个月、第2个月及第13.5个月分别采集血标本测定维生素A、β-胡萝卜素、维生素B2和锌的血清浓度
s28 Sentence This 6-year intervention was associated with a nonsignificant change: a 16% reduction in the esophageal cancer mortality rate 该研究持续6年,观察到试验组食管癌死亡率降低16%,也无统计学差异
s29 Sentence The results of a population-based case-controlled study suggest that symptomatic gastroesophageal reflux is a risk factor for esophageal adenocarcinoma 一项基于人群的病例对照研究结果明确提示,症状性胃食管返流病是食管腺癌的高危因素
s30 Sentence Of the new cases, it is estimated that 14,440 will occur in men and 3,550 will occur in women 新发病例中,预计有14,440例男性,3,550例女性
s31 Sentence It is unknown whether elimination of gastroesophageal reflux by surgical or medical means will reduce the risk of esophageal adenocarcinoma 利用手术或内科治疗以消除胃食管返流能否降低食管腺癌的发生风险尚不明确
s32 Sentence Additionally, 77.4% of persons in the ablation group had complete eradication of intestinal metaplasia, compared to 2.3% in the control group 此外,消融组77.4%的患者肠上皮化生完全根治,而对照组仅有2.3%完全根治
s33 Sentence In 2013, it is estimated that 17,990 Americans will be diagnosed with esophageal cancer and 15,210 will die of this malignancy 据估测,2013年美国将有17,990例新发食管癌,有15,210例死于食管癌
s34 Sentence Patients whose duodenal ulcers were treated successfully with antibiotics developed reflux esophagitis twice as often as those in whom infection persisted 十二指肠溃疡患者使用抗生素完全治愈后发生返流性食管炎的几率是持续溃疡者的2倍
s35 Sentence The relative risk associated with tobacco use is 2.4, and the population attributable risk is 54.2% (95% confidence interval [CI], 3.0–76.2) 吸烟对食管细胞癌的相对危险度为2.4,人群归因危险度为54.2%(95%置信区间[CI],3.0-76.2)
s36 Sentence It is possible that overdiagnosis and overtreatment of Barrett esophagus, particularly without severe dysplasia, could lead to a substantial number of harms 对Barrett食管的过度诊断和过度治疗,尤其对未发生重度不典型增生的食管,可能会导致显著伤害
s37 Sentence The combination of beta carotene, alpha-tocopherol, and selenium was associated with a nonstatistically significant 4% reduction in the esophageal cancer mortality rate β-胡萝卜素、α-维生素E和硒联合组的食管癌死亡率降低4%,但无统计学差异
s38 Sentence Pooled results show a protective association between aspirin/NSAID use and esophageal cancer (odds ratio [OR] = 0.57; 95% confidence interval [CI], 0.47–0.71) 汇总数据显示,应用阿司匹林/NSAID对食管癌的发生有保护性作用(比值比[OR],0.57;95%CI,0.47-0.71)
s39 Sentence According to this theory, H. pylori infections that cause pangastritis also cause a decrease in gastric acid production that protects against GERD 这一假说认为幽门螺旋杆菌导致全胃炎的同时,也引起胃酸分泌减少,从而降低GERD的发生及危害
s40 Sentence The complication rate was relatively low; among 84 treated persons, there was one upper gastrointestinal hemorrhage and five strictures that were easily treated 在84例接受治疗的患者中,仅出现1例上消化道出血和5例食管狭窄,这些情况均易于治疗
s41 Sentence The most important epidemiological difference between squamous cell cancer and adenocarcinoma, however, is the strong association between gastroesophageal reflux disease (GERD) and adenocarcinoma 腺癌和鳞癌在流行病学特征的最主要差别在于腺癌与胃食管返流病(GERD)存在密切相关性
s42 Sentence Based on solid evidence, harms of radiofrequency ablation include esophageal stricture and requirement for dilatation, and upper gastrointestinal hemorrhage, but at low rates 证据可靠:射频消融副作用包括食管狭窄需扩张治疗和上消化道出血,但发生率较低
s43 Sentence An interesting hypothesis relates the rise in the incidence of esophageal adenocarcinoma to a declining prevalence of Helicobacter pylori infection in Western countries 在西方国家,有一个经典的假说:食管腺癌的发生与幽门螺旋杆菌的患病率呈负相关
s44 Sentence Expert-reviewed information summary about factors that may influence the risk of developing esophageal cancer and about research aimed at the prevention of this disease 经专家审核后的食管癌危险因素及其预防相关研究汇总
s45 Sentence In black women, aged 55 to 69 years, the incidence rate is slightly higher than that of white women aged 70 years and older 而55-69岁黑人女性中发病率稍高于70岁以上白人女性
s46 Sentence In black men, however, the incidence rate for those aged 55 to 69 years is close to that of whites aged 70 years and older 实际上,鳞癌在55-69岁黑人男性中的发病率与70岁以上白人男性中的发病率基本相近
s47 Sentence The potential for overdiagnosis and overtreatment may be considerable, if physicians used results of this study to treat persons with Barrett esophagus and no dysplasia 如果临床医师仅仅根据该试验结果对有Barrett食管但无不典型增生的患者进行治疗,则可能出现很多过度诊断和过度治疗病例
s48 Sentence Association with aspirin use was statistically significant (OR = 0.50; 95% CI, 0.38–0.66); association with NSAIDs was of borderline significance (OR = 0.75; 95% CI, 0.54–1.0) 阿司匹林对食管癌保护性效应具有统计学差异(OR,0.50;95%CI,0.38-0.66),而NSAID对食管癌的保护性效应为没有显著性(OR,0.75;95%CI,0.54-1.0)
s49 Sentence Aspirin/NSAID use was associated with lower risk of both adenocarcinoma (OR = 0.67; 95% CI, 0.51–0.87) and squamous cell carcinoma (OR = 0.58; 95% CI, 0.43–0.78) 阿司匹林/NSAID既与食管腺癌的发生风险降低有关(OR,0.67;95%CI,0.51-0.87),也与食管鳞状细胞癌的发生风险降低有关(OR,0.58;95%CI,0.43-0.78)
s50 Sentence Note: Separate PDQ summaries on Esophageal Cancer Screening , Esophageal Cancer Treatment , and Levels of Evidence for Cancer Screening and Prevention Studies are also available 注:其他食管癌的相关总结,可参照食管癌的筛查、食管癌的治疗以及癌症筛查与预防研究的证据等级等PDQ总结
s51 Sentence Based on solid evidence, harms of NSAID use include upper gastrointestinal bleeding and serious cardiovascular events such as myocardial infarction, heart failure, hemorrhagic stroke, and renal impairment 证据可靠:使用NSAID的副作用包括上消化道出血及严重的心血管事件,如心肌梗死、心衰、出血性休克和肾功能损害
s52 Sentence Based on fair evidence, diets high in cruciferous (cabbage, broccoli, cauliflower) and green and yellow vegetables and fruits are associated with a decreased risk of esophageal cancer 一般性证据表明,富含十字花科蔬菜(卷心菜、西兰花、花椰菜)与绿色、黄色蔬菜、水果的饮食与食管癌风险降低相关
s53 Sentence Retrospective cohort studies adjusted for tobacco use have shown a twofold to sevenfold increase in risk of esophageal cancer in alcoholics compared with rates for the general population 一些回顾性队列研究在调整吸烟因素后,发现酗酒者食管癌的发病风险是普通人群的2至7倍
s54 Sentence Evidence from the study suggests that ablation does not simply coagulate and hide dangerous cells under the surface of the esophagus (those cells could later evolve to cancer) 但该研究提供的消融治疗可减少食管癌发生风险的证据较为薄弱(实际上,研究设计并未旨在解答这一问题)
s55 Sentence Long-standing GERD is associated with the development of Barrett esophagus, a condition in which an abnormal intestinal type epithelium replaces the stratified squamous epithelium that normally lines the distal esophagus 长期GERD可引起Barrett食管,后者源于远段食管正常复层鳞状上皮发生肠上皮化生
s56 Sentence A systematic review and meta-analysis of the association of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) with esophageal cancer identified two cohort and seven case-control studies published between 1980 and 2001 一项关于阿司匹林和非甾体类抗炎药(NSAID)与食管癌相关性的系统性综述和荟萃分析共检索了自1980年到2001年间发表的2项队列研究和7项病例对照研究
s57 Sentence A randomized controlled trial assessed whether, among persons with Barrett esophagus and dysplasia, radiofrequency ablation (vs. sham ablation) could eradicate dysplastic Barrett esophagus and decrease the rate of neoplastic progression 一项随机对照临床试验评估了射频消融(与模拟消融术对比)是否达到根治Barrett食管、食管不典型增生及减少其进展为肿瘤的发生率的效果
s58 Sentence Although the overall incidence of squamous cell carcinoma of the esophagus is declining, this histologic type remains six times more likely to occur in black males than in white males 虽然鳞癌的总发病率有所下降,但是黑人男性的鳞癌发病率是白人男性的6倍以上
s59 Sentence Based on fair evidence, epidemiologic studies have found that aspirin or NSAID use is associated with decreased risk of developing or dying from esophageal cancer (OR = 0.57; 95% CI, 0.47–0.71) 证据一般:流行病学研究发现应用阿司匹林或甾体类抗炎药与食管癌的发生风险及死亡风险降低有关(OR,0.57;95%CI,0.47-0.71)
s60 Sentence In China, esophageal cancer is associated with deficiencies of nutrients such as retinol, riboflavin, alpha-carotene and beta carotene, alpha-tocopherol, ascorbate, and zinc, and with exposure to specific carcinogens (e.g., N-nitroso compounds) 在中国,食管癌与一些营养元素缺乏相关,包括视黄醇、核黄素、α-胡萝卜素和β-胡萝卜素、抗坏血酸、锌,以及暴露特殊致癌原相关(例如N-亚硝基化合物)
s61 Sentence A randomized controlled trial has found that radiofrequency ablation of Barrett esophagus with severe dysplasia may lead to eradication of both dysplasia and intestinal metaplasia, and a reduced risk of disease progression 一项随机对照临床试验发现,对重度不典型增生的Barrett食管行射频消融术可能会根治不典型增生和肠上皮化生,并降低疾病进展风险
s62 Sentence Among persons with low-grade dysplasia, eradication of dysplasia occurred in 90.5% of the treatment group compared to 22.7% in the control group; in the high-grade dysplasia group, rates were 81.0% compared to 19.0% 研究提示,在低级别不典型增生的患者中,治疗组不典型增生的根治率达到了90.5%,对照组为22.7%;在高级别不典型增生的患者中,治疗组和对照组的不典型增生根治率分别为81.0%和19.0%
s63 Sentence External Validity : Patients representative of a subset of people with dysplasia, particularly severe dysplasia; physicians may not be representative of practicing physicians since this is a new technology and requires specialized knowledge 外部效度:研究人群具有不典型增生,特别是重度不典型增生,具有代表性;参与研究的医生不具有实际代表性,因为射频消融尚属一项新兴治疗技术,需要经过特殊训练
s64 Sentence Other factors that have been suggested to explain the increased risk of esophageal adenocarcinoma include obesity and use of medications, such as anticholinergics that can predispose to GERD by relaxing the lower esophageal sphincter 其他可能解释食管腺癌风险增高的因素包括肥胖和抗胆碱能药等药物应用,这些药物可能通过松弛食管下括约肌从而增加GERD风险
s65 Sentence In one, a complex modified factorial design was used to study four different vitamin/mineral combinations administered for 5 years at doses one to two times the U.S. recommended daily allowances (RDA) to 29,584 subjects 第一项试验使用了改良复杂因素设计,共29,584例受试者分别服用4种不同的维生素/矿物质组合,持续服用5年,剂量为美国每日推荐剂量(RDA)的1-2倍
s66 Sentence A statistically significant reduction occurred in the mean percentage of micronucleated esophageal cells in the active-treatment group compared with the placebo group. The pattern of cell proliferation, another potential intermediate endpoint marker, also improved 研究人员比较了含微核的食管细胞所占比例,发现积极治疗组的微核细胞比例显著低于安慰剂组,积极治疗组的另一间接终点标志,即细胞增生情况亦有改善
s67 Sentence A question entirely separate from this study is whether patients should or should not be screened for Barrett esophagus (this study focused on treatment of persons with Barrett who had been identified as having dysplasia) 本研究完全未涉及的另一个问题是,患者是否应接受Barrett食管筛查(本研究主要关注有不典型增生的Barrett食管患者的治疗)
s68 Sentence Based on fair evidence, serum CagA antibodies and gastric atrophy are associated with an increased risk of esophageal squamous cell carcinoma (OR = 2.1; 95% CI, 1.1–4.0 and OR = 4.3; 95% CI, 1.9–9.6, respectively) 证据充分:血清细胞毒素相关基因A(CagA)抗体及胃粘膜萎缩与食管鳞状细胞癌发生风险增加有关(分别OR=2.1,95%CI,1.1-4.0;OR=4.3,95%CI,1.9-9.6)
s69 Sentence GERD is a risk factor for esophageal adenocarcinoma because long-standing GERD is associated with Barrett esophagus, the condition in which an abnormal intestinal epithelium replaces the stratified squamous epithelium that normally lines the distal esophagus GERD是食管腺癌的危险因素,因为长期GERD可引起Barrett食管,后者源于远段食管的正常复层鳞状上皮发生肠上皮化生
s70 Sentence While risk factors for squamous cell carcinoma of the esophagus have been identified (such as tobacco use, alcoholism, malnutrition, and infection with human papillomavirus), the risk factors associated with esophageal adenocarcinoma are less well defined 虽然食管鳞癌的多项危险因素已被证实(包括烟草、酒精、营养不良及人乳头瘤病毒感染),,但腺癌相关危险因素很少被证实
s71 Sentence Persons in the ablation group had less disease progression, and although cancer was not a primary outcome because expected numbers were small, there were fewer cancers in the ablation group (1.2% vs. 9.3%; P = .045) 消融组患者疾病进展率较低,因为预期患癌人数较少,故未将癌症发生设为主要终点,但消融组的癌症发生率更低(分别1.2%和9.3%;P=0.45),并发症发生率也相对较低
s72 Sentence Based on fair evidence, epidemiologic studies have found that aspirin or nonsteroidal anti-inflammatory drug (NSAID) use is associated with decreased risk of developing or dying from esophageal cancer (odds ratio [OR] = 0.57; 95% CI, 0.47–0.71) 一般性证据显示:流行病学研究发现应用阿司匹林或非甾体类抗炎药与食管癌的发生风险及死亡风险降低有关(比值比[OR],0.57;95%CI,0.47-0.71)
s73 Sentence Furthermore, the study does not discuss the net benefits and harms of an overall program of screening (e.g., of screening persons with gastroesophageal reflux disease (GERD) or certain GERD symptoms) and the surveillance of persons with Barrett 此外,本研究并未讨论到整体筛查计划(例如,筛查有胃食管返流病(GERD)的患者或有GERD症状的患者)和Barrett食管监测的获益和危害
s74 Sentence Magnitude of Effects on Health Outcomes : The low rates of esophageal stricture and requirement for dilatation and upper gastrointestinal hemorrhage may be an understatement of the risks if this practice is widely adopted by less experienced physicians 对健康结局的效应强度:虽然食管狭窄需扩张治疗及上消化道出血的发生率较低,但由于部分临床医师的经验不足,上述情况发生可能被低估
s75 Sentence The incidence of esophageal adenocarcinomas has risen markedly for the past 2 decades, such that it is now more prevalent than squamous cell cancer in the United States and Western Europe, with most tumors located in the distal esophagus 近20年来,美国和西欧食管腺癌的发病率显著升高,导致腺癌取代鳞癌位列食管癌首位,而腺癌好发于食管远段
s76 Sentence The other trial included only higher-risk subjects with esophageal dysplasia and had a two-arm design (26 vitamins and minerals, including beta carotene, alpha-tocopherol, and selenium, at two to three times the U.S. RDA in one arm versus placebo in the other) 第二项试验仅招募有食管不典型增生的高危受试者,试验分为2组(一组服用26种维生素和矿物质,其中包括β-胡萝卜素、α-维生素E和硒,剂量为美国每日推荐剂量的2-3倍,另一组服用安慰剂)