The influence of cigarette smoking, alcohol, and green tea consumption on the risk of carcinoma of the cardia and distal stomach in Shanghai, China

BACKGROUND

The divergent incidence patterns of gastric cardia and distal stomach cancer may suggest different etiologies. This study examined the role of cigarette smoking, alcohol drinking, and green tea consumption as risk factors for carcinoma by anatomic subsite of stomach.

METHODS

Newly-diagnosed stomach carcinoma patients (n = 1124) and frequency-matched population controls (n = 1451) were interviewed in person. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models.

RESULTS

Excess risks associated with cigarette smoking and alcohol consumption were observed largely among men. The adjusted ORs for all stomach cancer combined were 1.35 (CI: 1.06-1.71) for current smokers, and 1.26 (CI: 0.86-1.84) for ex-smokers. For tumors of the distal stomach, statistically significant positive dose-response trends were found for the number of cigarettes smoked per day, the duration and pack-years of smoking, and inverse trends for years of stopped smoking. For tumors of the gastric cardia, however, a monotonic association was found only for the number of cigarettes smoked per day (P=0.06). Alcohol consumption was not related to the risk of cardia cancer, while a moderate excess risk of distal stomach cancer (OR: 1.55; CI: 1.07-2.26) was observed among heavy alcohol drinkers. Green tea drinking was inversely associated with risk of stomach cancer arising from either subsite, with ORs of 0.77 (CI: 0.52-1.13) among female heavy drinkers, and 0.76 (CI: 0.55-1.27) among male heavy drinkers.

CONCLUSIONS

Our findings provide further evidence that cigarette smoking and, possibly, alcohol consumption increase the risk of stomach carcinoma, notably of the distal segment. An inverse association with green tea drinking was also observed.

p53 overexpression and bcl-2 persistence in endometrial carcinoma: comparison of papillary serous and endometrioid subtypes

Forty-two cases, including 21 uterine papillary serous carcinomas (UPSC) and 21 age-, nuclear-grade-, and clinical-stage-matched uterine endometrioid carcinomas (UEC), were studied immunohistochemically for p53 and bcl-2 in archival paraffin-embedded tissue. Compared to UEC (28.6% positive), UPSC (71.4% positive) had a significantly higher frequency of p53 overexpression (P = 0.005); furthermore, in a clinical-stage-matched fashion, a higher frequency of p53 overexpression was found in early-stage cases (P = 0.032), but not in late-stage cases. In a nuclear-grade-matched comparison, no statistical difference in p53 overexpression was identified between the two subtypes, although UPSC had stronger p53 immunoreactivity than UEC. Of UPSC, no difference in p53 overexpression was detected between tumors of early and late stages; additionally, in 5 cases, there was an abrupt transition from nonstaining morphologically benign glands to uniformly positive p53 nuclear staining in regions of intraepithelial carcinoma. Conversely, in UEC, there was a significant difference in p53 immunostaining between tumors of early and late stages (P = 0.01); no case had an abrupt transition for p53 immunostaining. For bcl-2 immunostaining, UEC had a significantly higher immunohistochemical staining score than did UPSC (P = 0.0002). In general, the staining intensity of bcl-2 diminished progressively from proliferative phase and hyperplastic endometrium to UEC and then to UPSC, with 3 of 21 (14.3%) UPSC being negative. These results suggest that p53 alteration may be an early event in the development of UPSC and may be related to its clinical aggressiveness, while it is a late event in UEC. Early detection of p53 nuclear accumulation may help to identify precursor lesions of UPSC. bcl-2 persistence is frequently associated with endometrial carcinoma, and failure to inactivate bcl-2 expression probably is related to the development of endometrial carcinoma.

Diet and risk of non-Hodgkin lymphoma in older women

OBJECTIVE

To test whether high dietary intakes of fat, protein, and milk are associated with the development of non-Hodgkin lymphoma in older women.

DESIGN

Prospective cohort study with a 7-year follow-up period.

SETTING

General community.

PARTICIPANTS

Sample of 35 156 Iowa women aged 55 to 69 years with no prior history of cancer who returned the 1986 baseline questionnaire.

MAIN OUTCOME MEASURE

Non-Hodgkin lymphoma (104 incident cases).

MAIN RESULTS

After controlling for age, marital status, residence, total energy intake, and transfusion history, the relative risks (RRs) for the highest tertile of intake compared with the lowest were 2.00 (95% confidence interval [CI], 1.21-3.30; P for trend = .01) for animal fat, 1.69 (95% CI, 1.07-2.67; P for trend = .02) for saturated fat, and 1.90 (95% CI, 1.18-3.04; P for trend = .01) for monounsaturated fat, and there was no association with vegetable fat or polyunsaturated fat. Greater intake of animal protein (RR = 1.52; 95% CI, 0.94-2.44; P for trend = .08), but not vegetable protein, was associated with elevated risk, and this was mainly explained by greater consumption of red meat (RR = 1.98; 95% CI, 1.13-3.47; P for trend = .02) and hamburger in particular (RR = 2.35; 95% CI, 1.23-4.48; P for trend = .02). Milk and dairy product consumption were not associated with elevated risk. There was also a decreased risk of non-Hodgkin lymphoma with greater consumption of fruits (RR = 0.64; 95% CI, 0.40-1.05; P for trend = .07).

CONCLUSIONS

A high-meat diet and a high intake of fat from animal sources is associated with an increased risk of non-Hodgkin lymphoma in older women.

[Alteration of mRNA transcripts of rat Sertoli cell secreted proteins and Leydig cell LH/CG-R protein following glycosides of Tripterigium Wilfordii Hook administration]

Our studies were undertaken to assess the male antifertility mechanism of the total glycosides extracted from Tripterigium Wilfordii Hook. f. (GTW). In experimental group I, GTW was given by gastric gavage at a dose of 30 mg/kg per day for 35 days. In experimental group I, GTW was given in the same way at a dose of 10 mg/kg per day for 49 days. The transcripts level analysis indicated that in all the experimental groups ABP, SGP-2 and LH/CG-R mRNA were increased. Two ABP and two LH/CG-R mRNA transcripts with respective molecular sizes of 1.7 kb, 2.3 kb and 1.2 kb, 4.4 kb were identified. ABP and LH/ CG-R mRNA with 1.7 kb and 1.2 kb increased, while those with 2.3 and 4.4 kb remained unchanged. In addition, the changes of different proteins at the mRNA level were shown to be GTW dose-dependent. The morphological features of germ cell degeneration and appearance of germ cells in tubular lumen suggest that the increases in transcripts level of three proteins in testis may not be directly associated with the effect of GTW. The question whether GTW interfere with the function of sertoli cells and leydig cells would be study.

[The postnatal changes of follicle-stimulating hormone receptor mRNA level in rat testis]

It was found in this study that the follicle-stimulating hormone receptor (FSHR) mRNA levels varied between days 2 and 60. The FSHR mRNA rised slightly in the neonatal rat testis and then declined. In the prepuberty the content of FSHR mRNA remained at a Constant level. During the puberty the FSHR mRNA increased to its highest level on days 25 and finally it rised again after days 40.

[Assignment of differentiation-relevant cDNA RA538 on human chromosomes by fluorescence in situ hybridization]

OBJECTIVE

To localize the differentiation-relevant cDNA RA538 (3.8kb) onto the human chromosome 8q2.

METHODS

A modified non-isotopic labeling technique was used.

RESULTS

The cDNA RA538 was obtained by subtraction hybridization from human esophageal cancer cell line EC8712 induced by retinoic acid. Fluorescence in situ hybridization (FISH) using double-labeled probes showed clear and paired hybridization signals at the corresponding regions of both two chromatids in 18 out of 60 metaphases examined. While by single-labeling, only 7 were positive in 60 metaphases observed and the fluorescent spots were seen only at one chromatid.

CONCLUSION

The modified FISH protocol is useful for mapping cDNA sequences of a few kilobases.

Value of systematic transition zone biopsies in the early detection of prostate cancer

PURPOSE

A prospective study was done to determine the value of performing 2 systematic transition zone biopsies in addition to systematic sextant peripheral zone biopsies for early detection of prostate cancer.

MATERIALS AND METHODS

From January 1 to August 31, 1994 we evaluated 847 consecutive patients referred to us for a suspicious lesion on digital rectal examination or an elevated serum prostate specific antigen level. All patients underwent 2 systematic transition zone biopsies in addition to systematic sextant biopsies of the peripheral zone.

RESULTS

Of the transition zone biopsies 68 (24.4%) contained malignancy, including only 8 (2.9%) with cancer found exclusively in the transition zone. The remaining 271 cases (97.1%) had 1 or more positive peripheral zone biopsies and would have been detected with or without additional systematic transition zone biopsies. The same analysis of 552 patients with a negative digital rectal examination yielded 6 (4.1%) exclusively transition zone tumors among 145 cancers detected in this group.

CONCLUSIONS

The low additional yield of transition zone biopsies (2.9 to 4.1%) does not warrant their systematic use for the early detection of prostate cancer.

Follicle-stimulating hormone receptor is expressed in human ovarian surface epithelium and fallopian tube

The cellular expression of pituitary gonadotropin receptors in gonadal tissues is poorly defined because of the lack of suitable reagents. In this study, we developed in situ hybridization and reverse transcription polymerase chain reaction techniques for the evaluation of follicle-stimulating hormone receptor (FSHR) expression in the ovary and fallopian tube. Using a single-strand RNA probe, we demonstrated that FSHR mRNA expression is strongest in Graafian follicles. Within these developing follicles, granulosa cells showed the greatest expression, although both theca interna and theca externa were also positive, interna greater than externa. Granulosa cells in both primary and primordial follicles were positive, with primordial follicles showing only weak focal positivity. Ovarian surface epithelium and fallopian tube epithelium, not previously recognized to express FSHR, were both strongly positive. The FSHR expression in the ovary and fallopian tube was confirmed by reverse transcription polymerase chain reaction. Our results indicated that the FSHR is expressed in a cell-specific fashion at different stages of follicular development and is also expressed in ovarian surface and fallopian tube epithelia. The presence of FSHR in ovarian surface epithelium and of gonadotropin-binding sites in ovarian neoplasms provide additional evidence supporting the derivation of epithelial ovarian tumors from the surface epithelium and should promote heightened interest in the gonadotropin theory of ovarian tumorigenesis. More importantly, this study shows the feasibility of evaluating FSHR expression by both in situ hybridization and reverse transcription polymerase chain reaction. Application of these techniques to tumor specimens will help to elucidate the role of gonadotropins and their receptors in the carcinogenesis of gynecological tumors.

Borderline papillary serous tumour of the fallopian tube

We report a case of borderline papillary serous tumor of the fallopian tube in a 31-year-old woman. The tumor was characterized by the formation of papillary projections with focally prominent epithelial stratification and atypia. The histologic features of the tumor were largely similar to a borderline serous tumor of the ovary. Two years after initial presentation, the patient underwent in vitro fertilization and carried the ensuing pregnancy to term. There is no evidence of disease nearly 6 years after presentation, which suggests that these extremely uncommon tumors can be managed conservatively.

Segregation analysis of breast cancer: a comparison of type-dependent age-at-onset versus type-dependent susceptibility models

Most segregation analyses of breast cancer susceptibility have modeled the effect of the major gene on the age-at-onset distribution. However, in families linked to BRCA1 or BRCA2, there is wide variation in the age-at-onset among gene carriers. We performed a segregation analysis of 544 Minnesota breast cancer families using models which parameterized the putative major gene effect in two ways: earlier age-at-onset, with a common level of susceptibility (model I), and greater susceptibility, with a common mean age-at-onset (model II). Five hypothetical modes of transmission and an unrestricted general hypothesis were fitted to the data. Twice the difference between the log(e) likelihood for the data under the specified hypothesis (recessive, no major gene, etc.) and the log(e) likelihood under the general hypothesis is distributed asymptotically as a chi-square statistic with the degrees of freedom equal to the difference in the number of parameters estimated. This difference was compared to the critical value for the chi-square distribution to assess goodness-of-fit. Under model I, both Mendelian and non-Mendelian hypotheses were rejected. When model II was used, the non-Mendelian hypotheses were rejected whereas all Mendelian hypotheses were not. Mendelian recessive inheritance of a common allele (qA = 0.11) with a high penetrance (87%) provided the best fit to the data. We then stratified the families into two subsets based on the age at diagnosis of the proband [< or = 55 years (n = 265) versus > 55 years (n = 279)]; there was no evidence of heterogeneity under either model (I or II). These data suggest that, in some breast cancer families, the effect of the putative susceptibility gene is better represented as increasing overall susceptibility to breast cancer rather than as a shift in the age-at-onset distribution.

Mucinous adenocarcinoma of the endometrium with intestinal differentiation: a case report

Mucinous differentiation of endocervical type has been well documented in endometrial carcinoma. However, we describe an unusual case of adenocarcinoma of the endometrium showing diffuse histological, immunohistochemical, and ultrastructural evidence of intestinal differentiation. Although intestinal differentiation has been described in mesodermally derived tissues including endocervix, ovary, and urinary tract, it has not been reported in normal endometrium. One previous case has been reported showing this pattern in endometrial carcinoma. Possible histogenetic mechanisms of this pattern are discussed.

Differentiation of epidemic-associated strains of Listeria monocytogenes by restriction fragment length polymorphism in a gene region essential for growth at low temperatures (4 degrees C)

The growth of Listeria monocytogenes in food stored in the cold has often been implicated in outbreaks of listeriosis. Many subtyping schemes have suggested that epidemic-associated strains belong to a unique genetic group. It has not yet been possible, however, to identify molecular or bacteriologic markers unique to epidemic-associated strains. Recently we cloned three genes of L. monocytogenes, ltrA, ltrB, and ltrC, which are essential for growth at low temperatures (4 degrees C). The use of a 1.2-kb PstI fragment derived from ltrB as a probe in Southern blots of HindIII-digested DNA revealed three hybridization patterns: the first (a 5.0-kb band) was observed in strains of serotypes 4b, 1/2b, and 3b; the second (a 3.1-kb band) was seen in strains of serotypes 1/2a, 3a, 1/2c, and 3c; and the third (a 9.5-kb band) was characteristic of epidemic-associated serotype 4b strains. These and other data suggest that probes derived from this gene region that is essential for growth at low temperatures can be useful molecular tools for the subtyping of strains implicated in food-borne listeriosis.

Retinol, antioxidant vitamins, and cancers of the upper digestive tract in a prospective cohort study of postmenopausal women

Very few prospective studies have reported previously on the association of micronutrient intake and the risk of cancers of the upper digestive tract (mouth, pharynx, esophagus, and stomach) in western populations. During 7 years of follow-up in the Iowa Women's Health Study, from 1986-1992, 59 of the 34,691 at-risk cohort members developed cancers of the upper digestive tract. The association of retinol and antioxidant vitamins (carotene and vitamins C and E) were evaluated separately for cancers of the mouth/pharynx/esophagus (n = 33) and stomach (n = 26). After adjustment for age, smoking, and total energy intake, higher intakes of carotene and vitamins C and E were related to lower risks of both oral/pharyngeal/esophageal and gastric cancers, while retinol was associated with lower risk of gastric cancer only. The dose-response relation between gastric cancer risk and intake of carotene was clear and statistically significant, with relative risks of 0.6 and 0.3, respectively, observed among women in the upper two versus the lowest tertiles of intake. This study provides further evidence that higher intake of antioxidant vitamins may be important in the prevention of cancers of the upper digestive organs.

Prior immunity-related medical conditions and pancreatic-cancer risk in Shanghai

To investigate the role of immunity-related medical conditions in the etiology of pancreatic cancer, we analyzed data from a population-based case-control study of pancreatic cancer conducted in Shanghai during 1992 and 1993. Information on prior histories of selected auto-immune diseases and allergic conditions was obtained from 108 incident pancreatic-cancer cases and 275 age- and gender-frequency matched controls by face-to-face interviews using a structured questionnaire. A prior history of auto-immune diseases was associated with a 2-fold elevated risk of pancreatic cancer (95% CI = 1.0-4.2), with an indication of a dose-response relation for the number of reported diseases. In contrast, a prior history of allergic condition was related to reduced risk (OR = 0.6, 95% CI = 0.4-1.1). With the possible exception of drug allergy, such an inverse association was seen for virtually all allergic conditions., although none of the OR was statistically significant. This study suggests that host immune function may be involved in the etiology of pancreatic cancer. Further investigations into the mechanism of these observed associations are warranted.

Acquired neuromyotonia: evidence for autoantibodies directed against K+ channels of peripheral nerves

Acquired neuromyotonia is characterized by hyperexcitability of motor nerves leading to muscle twitching, cramps, and weakness. The symptoms may improve following plasma exchange, and injection of immunoglobulin G (IgG) from 1 neuromyotonia patient into mice increased the resistance of neuromuscular transmission to d-tubocurarine. Here we examine nerves and muscle in vitro from mice injected with plasma or purified IgG from 6 neuromyotonia patients or pooled control subjects, and cultured dorsal root ganglion cells after treatment with IgG. Three of the patients had antibodies against human voltage-gated potassium channels labeled with 125I-alpha-dendrotoxin. The quantal release of acetylcholine (quantal content) at end-plates in diaphragms from mice treated with neuromyotonia IgG preparations was increased by 21% relative to control values (p = 0.0053). With one IgG preparation, the duration of the superficial peroneal nerve compound action currents was increased by 93%. The dorsal root ganglion cells treated with this IgG showed a marked increase in repetitive firing of action potentials. All effects were similar to those obtained with aminopyridines. We conclude that at least some patients with acquired neuromyotonia have antibodies directed against aminopyridine- or alpha-dendrotoxin-sensitive K+ channels in motor and sensory neurons, and they are likely to be implicated in the disease process.

Retinol, antioxidant vitamins, and cancers of the upper digestive tract in a prospective cohort study of postmenopausal women

Very few prospective studies have reported previously on the association of micronutrient intake and the risk of cancers of the upper digestive tract (mouth, pharynx, esophagus, and stomach) in western populations. During 7 years of follow-up in the Iowa Women's Health Study, from 1986-1992, 59 of the 34,691 at-risk cohort members developed cancers of the upper digestive tract. The association of retinol and antioxidant vitamins (carotene and vitamins C and E) were evaluated separately for cancers of the mouth/pharynx/esophagus (n = 33) and stomach (n = 26). After adjustment for age, smoking, and total energy intake, higher intakes of carotene and vitamins C and E were related to lower risks of both oral/pharyngeal/esophageal and gastric cancers, while retinol was associated with lower risk of gastric cancer only. The dose-response relation between gastric cancer risk and intake of carotene was clear and statistically significant, with relative risks of 0.6 and 0.3, respectively, observed among women in the upper two versus the lowest tertiles of intake. This study provides further evidence that higher intake of antioxidant vitamins may be important in the prevention of cancers of the upper digestive organs.

[Posterior chamber intraocular lens implantation in the absence of posterior capsular support]

The authors retrospectively studied the clinical records of 15 eyes without posterior capsular support receiving transscleral ciliary sulcus fixation of posterior chamber intraocular lenses. Postoperative followup period range from 2 weeks to 8 months, an average of 2.2 months. Postoperative visual acuity improved in all patients, 20% of which had 0.6 or better and 40%-between 0.2 and 0.5. Lens rotation was the primary complication and accounted for poor acuity in some cases. The results indicate that ciliary sulcus fixation in the absence of posterior capsular support appears to be safe and effective and may represent a significant advance in anterior segment surgery.

Genetic transfer of a nonpeptide antagonist binding site to a previously unresponsive angiotensin receptor

Mutational analysis based on the pharmacological differences between mammalian and amphibian angiotensin II receptors (AT receptors) previously identified 7 aa residues located in transmembrane domains (TMs) III (Val-108), IV (Ala-163), V (Pro-192, Thr-198), VI (Ser-252), and VII (Leu-300, Phe-301) of the rat AT receptor type 1b (rAT1b receptor) that significantly influenced binding of the nonpeptide antagonist Losartan. Further studies have shown that an additional 6 residues in the rAT1b receptor TMs II (Ala-73), III (Ser-109, Ala-114, Ser-115), VI (Phe-248), and VII (Asn-295) are important in Losartan binding. The 13 residues required for Losartan binding in the mammalian receptor were exchanged for the corresponding amino acids in the Xenopus AT receptor type a (xATa receptor) to generate a mutant amphibian receptor that bound Losartan with the same affinity as the rAT1b receptor (Losartan IC50 values: rAT1b, 2.2 +/- 0.2 nM: xATa, > 50 microM; mutant, 2.0 +/- 0.1 nM). To our knowledge, this is the first report of a gain-of-function mutant in which the residues crucial to formation of a ligand binding site in a mammalian peptide hormone receptor were transferred to a previously unresponsive receptor by site-directed mutagenesis. Ala substitutions and comparison of mammalian and amphibian combinatorial mutants indicated that TM III in the rAT1b receptor plays a key role in Losartan binding. Identification of residues involved in nonpeptide ligand binding will facilitate studies aimed at elucidating the chemical basis for ligand recognition in the AT receptor and peptide hormone receptors in general.

Association of body mass index and body fat distribution with risk of lung cancer in older women

Obesity has been associated with an increased risk of cancer at a number of sites. A notable exception appears to be lung cancer, for which several studies suggest a modest inverse association. However, cigarette smoking is directly associated with lung cancer and inversely associated with body mass index. To investigate the hypothesis that body mass index is associated with lung cancer independent of cigarette smoking, the authors analyzed data from a prospective cohort study of 41,837 Iowa women aged 55-69 years at baseline in 1986. In addition, they examined whether central adiposity (high waist/hip ratio) was associated with lung cancer incidence. Through 1992 (6 years of follow-up), 233 cases of lung cancer were identified through the State Health Registry of Iowa. The body mass index at several ages was calculated from self-reports of height at baseline and weights at ages 18, 30, 40, and 50 years and at baseline. Current and former smokers generally had lower mean body mass indices than did nonsmokers at all ages except 18 years. Cases generally had lower body mass indices than did noncases at all ages except 18 and 30 years but, among current smokers, cases had higher mean body mass indices than did noncases at all ages except baseline, although the differences were not statistically significant. An apparent positive association of a high waist/hip ratio with lung cancer in the total cohort was found to be primarily accounted for by a higher waist/hip ratio in current and former smokers. When stratified by smoking status and adjusted for other risk factors, including age and pack-years of smoking, the body mass index at baseline, body mass index at age 50 years, and waist/hip ratio were not associated with lung cancer. The results of multivariate analyses suggest that the inverse association of body mass index with lung cancer can be explained by smoking status and that the positive association of waist/hip ratio with lung cancer can be explained by pack-years of smoking.

Dietary intake of energy and animal foods and endometrial cancer incidence. The Iowa women's health study

To assess the relations of dietary intake of energy and animal foods to endometrial cancer risk, dietary analyses were performed using data from a prospective cohort study of over 23,000 postmenopausal Iowa women who responded to a mailed questionnaire in 1986 and were followed through the end of 1992 for cancer incidence and total mortality. Usual intakes of 127 food items were measured by a semiquantitative food frequency questionnaire. After 7 years of follow-up, 216 incident endometrial cancer cases had been ascertained. There was no statistically significant association of dietary intake of energy and most animal foods with endometrial cancer incidence over the 7-year follow-up period. Stratified analyses, however, suggested that intake of energy from plant foods may be inversely associated with endometrial cancer risk in the latter years of follow-up (trend test, p = 0.03), while high intake of energy and foods from animal sources related to slightly, but not statistically significantly, elevated risks of this cancer in the earlier years of follow-up. The only significant dose-response relation observed in food group analyses was for processed meat and fish, for which a significant 50% excess risk of endometrial cancer was found among women in the highest versus the lowest tertile of intake. This study suggests that dietary intake of energy and most animal foods is not related to or is only weakly related to the risk of endometrial cancer among postmenopausal US women.

Hormonal replacement therapy and morbidity and mortality in a prospective study of postmenopausal women

We assessed the association of hormonal replacement therapy with mortality and incidence of multiple diseases in over 40,000 postmenopausal women followed for 6 years as part of the Iowa Women's Health Study. Compared with women who never used hormone replacement therapy, current users had multivariate adjusted relative risks (RR) as follows: total mortality (RR = 0.78; 95% confidence interval [CI] = 0.65, 0.94), coronary heart disease mortality (RR = 0.74; 95% CI = 0.48, 1.12), endometrial cancer incidence (RR = 4.3; 95% CI = 2.7, 6.9), breast cancer incidence (RR = 1.23; 95% CI = 0.99, 1.55), colon cancer incidence (RR = 0.72; 95% CI = 0.46, 1.12), and hip fracture incidence (RR = 0.53; 95% CI = 0.31, 0.91).

Excimer laser photorefractive keratectomy for myopia in China. A report of 750 eyes with a 6-month follow-up

A total of 750 six-month follow-up records of myopia treated with excimer laser photorefractive keratectomy (PRK) were analyzed. By 6 months, in group 1 (up to -6.00D, 587 eyes), uncorrected visual acuity was improved to 20/20 or better in 86.7% of treated eyes and 95.4% fell into the range of refraction of +/- 1.00D. In group 2 (-6.25D to -11.00D, 163 eyes), 74.5% of treated eyes had uncorrected visual acuity of 20/20 or better and 89.4% of the eyes were within +/- 1.00D. The designed predictability of the two groups was the same (P > 0.1). The refractive stability from 3 to 6 months between the two groups was not statistically different, and no severe complications were observed in these two groups. The excimer laser PRK for correcting myopia up to -11.00D appears to be effective, predictable, stable and safe in this study. The ideal outcome may result from the precise ablation quality of excimer laser, its computerized surgical manipulation and an appropriate postoperative management including detection of refractive indices by corneal topography and modulation by steroid.