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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 賴美淑(Mei-Shu Lai) | |
dc.contributor.author | Shih-Tsang Lin | en |
dc.contributor.author | 林世倉 | zh_TW |
dc.date.accessioned | 2021-05-20T20:18:05Z | - |
dc.date.available | 2011-10-03 | |
dc.date.available | 2021-05-20T20:18:05Z | - |
dc.date.copyright | 2011-10-03 | |
dc.date.issued | 2011 | |
dc.date.submitted | 2011-08-11 | |
dc.identifier.citation | 參考文獻
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Winn DM, Blot WJ. Second cancer following cancers of the buccal cavity and pharynx in Connecticut, 1935-1982. Natl Cancer Inst Monogr 1985;68:25-48. 24. Boysen M, Loven JO. Second malignant neoplasms in patients with head and neck squamous cell carcinomas. Acta Oncol 1993;32:283-8. 25. Day GL, Blot WJ, Shore RE, et al. Second cancers following oral and pharyngeal cancers: role of tobacco and alcohol. J Natl Cancer Inst 1994;86:131-7. 26. Day GL, Blot WJ, Shore RE, et al. Second cancers following oral and pharyngeal cancer: patients' characteristics and survival patterns. Eur J Cancer B Oral Oncol 1994;30B:381-6. 27. Kinoshita N, Koyama Y, Yoshino K, et al. Second primary cancers occurring in patients with cancers of the mouth and meso-hypo pharynx in Japan. Nippon Koshu Eisei Zasshi 1997;44:201-6. 28. Sood S, Bradley PJ, Quraishi MS. Second primary tumors in squamous cell carcinoma of the head and neck-incidence, site, location, and prevention. Current Opinion in Otolaryngology & Head and Neck Surgery 2000;8:87-90. 29. Slaughter DP, Southwick HW, Smejkal W. Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin. Cancer 1953;6:963-8. 30. Kohmura T, Hasegawa Y, Matsuura H, Terada A, Takahashi M, Nakashima T. Clinical analysis of multiple primary malignancies of the hypopharynx and esophagus. Am J Otolaryngol 2001;22:107-10. 31. Chuang SC, Hashibe M, Scelo G, et al. Risk of second primary cancer among esophageal cancer patients: a pooled analysis of 13 cancer registries. Cancer Epidemiol Biomarkers Prev 2008;17:1543-9. 32. Lee KD, Lu CH, Chen PT, et al. The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma: a population-based study in Taiwan over a 25 year period. BMC Cancer 2009;9:373. 33. Warren S, Gates, O. Multiple primary malignant tumors. A survey of the literature and a statistical study. Am J Cancer 1932; 16:1358. 34. http://surveillance.cancer.gov/joinpoint/. (accessed on 2011.5.22) 35. http://globocan.iarc.fr/factsheets/cancers/oesophagus.asp. (accessed on 2011.5.22) 36. Lee CT, Chang CY, Lee YC, et al. Narrow-band imaging with magnifying endoscopy for the screening of esophageal cancer in patients with primary head and neck cancers. Endoscopy 2010;42:613-9. 37. Wang A. Betel nut culture turns over a new leaf. Taiwan review 2008 Feb. 1. 38. Chen MC, Huang WC, Chan CH, Chen PT, Lee KD. Impact of second primary esophageal or lung cancer on survival of patients with head and neck cancer. Oral Oncol 2010;46:249-54. 39. Chen MC, Chen PT, Chan CH, et al. Second primary esophageal or lung cancer in patients with head and neck carcinoma in Taiwan: incidence and risk in relation to primary index tumor site. J Cancer Res Clin Oncol 2010. 40. Goetz M, Kiesslich R. Advanced imaging of the gastrointestinal tract: research vs. clinical tools? Curr Opin Gastroenterol 2009;25:412-21. 41. Yoshida T, Inoue H, Usui S, Satodate H, Fukami N, Kudo SE. Narrow-band imaging system with magnifying endoscopy for superficial esophageal lesions. Gastrointest Endosc 2004;59:288-95. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/9336 | - |
dc.description.abstract | 背景
在台灣下咽癌和食道癌的發生率近二十年來有明顯上升的趨勢。抽菸、喝酒、嚼檳榔是主要的危險因子,這些與生活習慣相關的危險因子在年齡-年代-世代模型中大部分被歸類為世代效應。最近幾年,以全人口為基礎的研究顯示,下咽癌在口腔及咽癌中得到第二原發食道癌的風險最高。本研究主要目的在針對鱗狀細胞癌探討下咽癌和食道癌間的關係,並對於下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌的發生率趨勢加以分析。 材料與方法 以台灣癌症登記資料,取得西元1983到2007年間下咽鱗狀細胞癌和食道鱗狀細胞癌的個案,計算不同性別的年齡標準化發生率。將男性下咽鱗狀細胞癌和食道鱗狀細胞癌的發生率趨勢利用自我廻歸年齡-年代-世代模型,分別得到年齡效應、年代效應以及世代效應,來進行分析。並對男性下咽鱗狀細胞癌併發'同時性'第二原發食道鱗狀細胞癌(與第一原發癌同時診斷或診斷後六個月內發生的第二原發癌)及'異時性'第二原發食道鱗狀細胞癌(第一原發癌診斷後六個月後發生的第二原發癌)的發生率趨勢變化加以分析。 結果 在年齡-年代-世代的分析,下咽鱗狀細胞癌和食道鱗狀細胞癌有相同年齡、年代及世代效應的趨勢。世代效應是一個先降後升的趨勢,從中世代1903年開始逐漸下降,到中世代1948年才開始逐漸上升。年代效應則是從年代組1983-1987年開始就持續上升。年齡效應從一開始上升到60-64歲年齡群才有些許的下降。三者效應強弱依次為年齡效應,世代效應,最後才是年代效應。下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌的發生率同樣有持續增加的趨勢。另外,下咽鱗狀細胞癌併發同時性和異時性第二原發食道鱗狀細胞癌的發生率在西元2003-2007年間呈現相反的趨勢變化。其中,同時性第二原發食道鱗狀細胞癌的發生率呈現較之前年代增加更快的趨勢,而異時性第二原發食道鱗狀細胞癌的發生率則呈現下降的趨勢。 結論 下咽鱗狀細胞癌和食道鱗狀細胞癌的年齡-年代-世代分析結果呈現相同的趨勢,顯示兩者之間有相似的 病因,並推論有相同機轉的致癌過程。而下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌的分析呈現兩者的診斷差異日在西元2003至2007年間有明顯縮短的現象。 | zh_TW |
dc.description.abstract | Background and Objectives
The incidence of hypopharyngeal cancer and esophageal cancer has been reported to increase in recent two decades in Taiwan. Alcohol intake, betel quid chewing, and smoking were considered to be associated to the increased trends and such lifestyle factors was regarded mostly as cohort effect in age-period cohort model. In recent population-based study in Taiwan, the risk of developing second primary esophageal cancer was showed to be highest in hypophayngeal cancer among oral and pharyngeal cancer. This study aimed to exam the relationship of incidence trends of hypopharyngeal and esophageal cancer, which focused on squamous cell carcinoma and to demonstrate the incidence trends of hypopharyngeal squamous cell carcinoma with second primary esophageal squamous cell carcinoma. Materials and Methods A population-based study was conducted using the database from Taiwan Cancer Registry between 1983 and 2007. Patients with hypopharyngeal and esophageal squamous cell carcinoma were identified and gender-specific age-standardized incidence rates of that were calculated. The incidence trends of hypopharyngeal and esophageal squamous cell carcinoma of men were analyzed with autoregressive age-period-cohort model. Age effect, period effect, and cohort effect were obtained respectively. The incidence trends of hypopharyngeal squamous cell carcinoma with ‘synchronous’ second primary esophageal squamous cell carcinoma (difference of diagnostic time between primary and second primary cancer is simultaneous or less than 6 months) and ‘metachronous’ second primary esophageal squamous cell carcinoma (difference of diagnostic time between primary and second primary cancer is more than 6 months) of men were also analyzed. Results The result showed the same pattern of age-period-cohort model in both hypopharyngeal and esophageal squamous cell carcinoma. The cohort effect decreased from mid-cohort 1903 gradually and increased from mid-cohort 1948 to mid-cohort 1973. Period effect increased persistently since time period 1983-1987. Age effect increased until age group 60-64 and then decreased slightly. Age effect was strongest, followed by cohort effect. The incidence trend of hypopharyngeal squamous cell carcinoma with second primary esophageal squamous cell carcinoma also increased. Interestingly, during time period 2003-2007, there were inverse incidence trends of hypopharyngeal squamous cell carcinoma with synchronous and metachronous second primary esophageal squamous cell carcinoma. The incidence trend of synchronous second primary esophageal squamous cell carcinoma increased more rapidly than previous periods and that of metachronous second primary esophageal squamous cell carcinoma decreased. Conclusions The same pattern of age-period-cohort model in both hypopharygneal and esophageal squamous cell carcinoma implies similar etiology and even mechanism of carcinogenesis. There is obvious shortening of difference of diagnostic time in hypopharyngeal squamous cell carcinoma with second primary esophageal squamous cell carcinoma during time period 2003-2007. | en |
dc.description.provenance | Made available in DSpace on 2021-05-20T20:18:05Z (GMT). No. of bitstreams: 1 ntu-100-R98846014-1.pdf: 1211845 bytes, checksum: a256602ba2a1a9ff8eee580f08e9524d (MD5) Previous issue date: 2011 | en |
dc.description.tableofcontents | 目錄
誌謝 ii 中文摘要 iii Abstract v 第一章 背景 - 1 - 第二章 文獻回顧 - 3 - 第一節 各國發生率趨勢 - 3 - 第二節 年齡-年代-世代模型 - 4 - 第三節 各國年齡別發生率曲線 (年齡效應) - 5 - 第四節 台灣癌症登記系統進展 (年代效應) - 6 - 第五節 危險因子 (世代效應) - 6 - 第六節 下咽癌併發第二原發食道癌 - 8 - 研究目的 - 20 - 第三章 研究材料與研究方法: - 21 - 第一節 研究資料收集 - 21 - 第二節 研究方法 - 21 - 第三節 統計分析 - 22 - 第四章 結果 - 25 - 第一節 下咽鱗狀細胞癌及食道鱗狀細胞癌發生率趨勢分析 - 25 - 1.1 年齡標準化發生率趨勢 - 25 - 1.2 Joinpoint Regression Program分析 - 26 - 1.3 年齡與年代及年齡與世代雙因子模型分析 - 26 - 第二節 年齡-年代-世代模型分析 - 27 - 2.1 自我廻歸年齡-年代-世代模型 - 27 - 2.2 年齡、年代及世代效應強弱比較 - 28 - 2.3 敏感度分析(sensitivity analysis) - 28 - 第三節 下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌發生率趨勢分析 - 29 - 3.1 同時性及異時性第二原發食道鱗狀細胞癌發生率趨勢 - 29 - 3.2 調整診斷差異日發生率趨勢變化 - 30 - 第五章 討論 - 31 - 第一節 下咽及食道鱗狀細胞癌在台灣的特殊性 - 31 - 第二節 年齡、年代及世代效應探討 - 32 - 2.1 年齡效應 - 32 - 2.2 年代效應 - 32 - 2.3 世代效應 - 33 - 2.4 由年齡-年代-世代模型推論 - 34 - 第三節 下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌發生率探討 - 34 - 3.1 發生率上升趨勢之探討 - 34 - 3.2 同時性和異時性第二原發食道鱗狀細胞癌發生率趨勢相反之探討 - 35 - 第四節 與其他研究的比較 - 36 - 4.1 年齡-年代-世代模型比較 - 36 - 4.2 下咽癌併發第二原發食道癌的排除條件 - 37 - 第五節 研究限制 - 38 - 第六章 結論 - 39 - 圖目錄: - 40 - Figure 1. 台灣男性下咽及食道鱗狀細胞癌年齡標準化發生率趨勢圖(年) - 40 - Figure 2. 台灣男性下咽及食道鱗狀細胞癌年齡標準化發生率趨勢圖(年代組) - 41 - Figure 3. 台灣女性下咽及食道鱗狀細胞癌年齡標準化發生率趨勢圖(年) - 42 - Figure 4. 台灣女性下咽及食道鱗狀細胞癌年齡標準化發生率趨勢圖(年代組) - 43 - Figure 5. 台灣男性下咽及食道鱗狀細胞癌發生率趨勢廻歸線分析 - 44 - Figure 6. 男性下咽鱗狀細胞癌年齡-年代模型 (年齡為橫軸) - 45 - Figure 7. 男性食道鱗狀細胞癌年齡-年代模型 (年齡為橫軸) - 45 - Figure 8. 男性下咽鱗狀細胞癌年齡-年代模型 (年代為橫軸) - 46 - Figure 9. 男性食道鱗狀細胞癌年齡-年代模型 (年代為橫軸) - 46 - Figure 10. 男性下咽鱗狀細胞癌年齡-世代模型 - 47 - Figure 11. 男性食道鱗狀細胞癌年齡-世代模型 - 47 - Figure 12. 男性下咽及食道鱗狀細胞癌自我廻歸年齡-年代-世代模型 - 48 - Figure 13.男性下咽及中下食道鱗狀細胞癌自我廻歸年齡-年代-世代模型- 48 - Figure 14. 下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌個數年齡分佈圖,1987-2007 - 49 - Figure 15. 男性下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌發生率趨勢 ….- 50 - Figure 16. 男性下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌發生率趨勢 (年代組) - 50 - Figure 17. 男性下咽鱗狀細胞癌併發同時性第二原發食道鱗狀細胞癌發生率趨勢 - 51 - Figure 18. 男性下咽鱗狀細胞癌併發同時性第二原發食道鱗狀細胞癌發生率趨勢 (年代組) - 51 - Figure 19. 男性下咽鱗狀細胞癌併發異時性第二原發食道鱗狀細胞癌發生率趨勢 - 52 - Figure 20. 男性下咽鱗狀細胞癌併發異時性第二原發食道鱗狀細胞癌發生率趨勢 (年代組) - 52 - Figure 21. 男性下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌發生率趨勢,診斷差異日>30 - 53 - Figure 22. 男性下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌發生率趨勢,診斷差異日>30 (年代組) - 53 - Figure 23. 男性下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌發生率趨勢,診斷差異日>14 - 54 - Figure 24. 男性下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌發生率趨勢,診斷差異日>14 (年代組) - 54 - Figure 25. 男性下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌發生率趨勢,診斷差異日>7 - 55 - Figure 26. 男性下咽鱗狀細胞癌併發第二原發食道鱗狀細胞癌發生率趨勢,診斷差異日>7 (年代組) - 55 - 表目錄: - 56 - Table 1. 西元1983-2007年台灣下咽癌及食道癌組織學分佈情形 - 56 - Table 2. 下咽鱗狀細胞癌與食道鱗狀細胞癌年齡標準化發生率(年) - 57 - Table 3. 下咽鱗狀細胞癌與食道鱗狀細胞癌年齡標準化發生率(年代) - 58 - Table 4. 下咽鱗狀細胞癌和食道鱗狀細胞癌診斷平均年齡及中位數年齡 - 59 - Table 5. 男性下咽鱗狀細胞癌年齡-年代年齡標準化發生率 - 59 - Table 6. 男性食道鱗狀細胞癌年齡-年代年齡標準化發生率 - 60 - Table 7. 男性下咽鱗狀細胞癌年齡-世代年齡標準化發生率 - 61 - Table 8. 男性食道鱗狀細胞癌年齡-世代年齡標準化發生率 - 62 - Table 9. 自我廻歸年齡-年代-世代模型係數對數表 - 64 - Table 10. 波以松廻歸分析和概似比檢定結果 - 65 - 參考文獻 - 66 - | |
dc.language.iso | zh-TW | |
dc.title | 台灣下咽鱗狀細胞癌及食道鱗狀細胞癌發生率趨勢分析 | zh_TW |
dc.title | Analysis of incidence trends of hypopharyngeal and esophageal squamous cell carcinoma in Taiwan | en |
dc.type | Thesis | |
dc.date.schoolyear | 99-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 柯政郁,李文宗 | |
dc.subject.keyword | 下咽,食道,鱗狀細胞癌,發生率,年齡-年代-世代模型,第二原發癌,同時性,異時性, | zh_TW |
dc.subject.keyword | hypopharynx,esophagus,squamous cell carcinoma,incidence,age-period-cohort model,second primary cancer,synchronous,metachronous, | en |
dc.relation.page | 68 | |
dc.rights.note | 同意授權(全球公開) | |
dc.date.accepted | 2011-08-12 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 流行病學與預防醫學研究所 | zh_TW |
顯示於系所單位: | 流行病學與預防醫學研究所 |
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