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中華民國泌尿科醫學會雜誌

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篇名 烏腳病流行區與非流行區膀胱癌病患的預後追蹤
卷期 4:2
並列篇名 Further Investigation of Bladder Tumors in Areas Endemic and Non-Endemic for Blackfoot Disease
作者 陳黎明江金培黃俊雄周以和王起杰
頁次 1051-1055
關鍵字 膀胱癌烏腳病流行區預後TSCI
出刊日期 199306

中文摘要

為了進一步探討台灣烏腳病流行區內膀胱癌及非烏腳病流行區膀胱癌的情形,我們比較了此二區域膀胱癌患者腫瘤發生的特性包括年齡、性別、癌細胞分化的程度、癌細胞對於周邊組織侵犯的程度及癌細胞在操受手術治療後發生浸潤性再發的情形;結果我們發現烏腳病流行區內的患者(共119名)無論在年齡、性別、癌細胞分化的程度、癌細胞對於周邊組織的浸潤在統計學上與非烏腳病區內的患者(共208名)並無顯著的差異(P>0.05);但是,在接受手術後癌細胞發生浸潤性再發的情形烏腳病地區36%,而非烏腳病地區為17.2%,此在統計學上具有顯著的差異(P<0.05)。我們同時也發現嘉義縣布袋鎮及義竹鄉、台南宗學甲鎮及北門鄉是烏腳病流行區膀胱癌病例最多的地方,而這些地區正是井水中有高螢光物質存在的地區,因此,我們建議住在此一地區的居民應定期接受尿液細胞學的篩檢以發現早期癌病人。

英文摘要

To further investigate the prevalence of tumors of the bladder in areas where blackfoot disease is endemic or non-endemic, 327 diagnosed tumor cases were followed up. Resulting data were analysed and compared by age of onset, sex, tumor differentiation and stage, invasive tumor recurrence post-operatively and prognosis for patients from areas endemic (n=119) and non-endemic (n:108) for blackfoot disease. This study demonstrated that age at tumor onset, sex, tumor differentiation and tumor stage showed no statistically significant differences between the two groups (P>0.05). However, 36% of the patients in the blackfoot endemic areas developed invasive recurrent tumors; 17.2% of those in the non-endemic areas also developed such tumors. This is a statistically significant difference (P<0.05). The high-risk villages on Taiwan were the districts of Putai, Ichu, Hsuehchia and Peimen districts. A high content of arsenic in the Artesian well water used there may be an important cancer determinant in these areas. It is suggested that periodic, but regular, follow-up be done for residents of the blackfoot disease area, with screening of urinary cytology as well. Further, the Artesian well water should be replaced with a piped water supply as the most effective disease prevention method.