Newsletter No. 538

姑「瘜」足以養癌？ Polyps, the Root of Colorectal Cancer 讓時尚女王神魂顛倒的屏風 Coromandel Screen Defines Space and Beauty 雅 共 賞 / ART iculation 醫 醫 筆 寫 / D octors ’ N otes 款彩壽慶人物六曲漆屏風 | 清康熙．十七世紀晚期 | 高257、廣615厘米 | 文物館館友會惠贈 其中填上混合了漆或油的彩料。是以款彩又 稱「刻灰」或「大雕填」。屏風之外，這種工 藝也多應用於插屏、箱匣等大型家具。 克羅曼多其實是個位於印度東南沿岸的貿易 港的地名。十六世紀正值明代漆器工藝自由 貿易的黃金時代，在供應本土所需之外更大 量出口。克羅曼多是歐洲和遠東之間海事貿 易的中轉站，就成為了外國人認識這種華美 漆器的途徑，也變成了他們常用的稱呼。 文物館所藏的這件款彩壽慶人物六曲漆屏 風共十二牒，以鉸鏈扣連，正背兩面分別刻 男女壽慶場景，四周圍以博古、花鳥、瑞獸圖 案。屏風以黑色為底色，賦色的油彩有藍、 時尚界傳奇人物Coco Chanel 的傳記中有這 樣的記述： 「我十八歲就迷上了中國屏風……當我走進 一間中國商店，第一次看到克羅曼多屏風的 時候，我興奮得幾乎昏倒。」 「克羅曼多」一詞無疑充滿異域風情，到 底它為甚麼會出現在中國商店？又是怎樣 的藝術品，可以深深迷住二十世紀的時尚  女王呢？ 所謂克羅曼多（Coromandel）漆器，其實就 是十六世紀盛行於中國的款彩漆雕，其造法 是以磚粉、灰、混和豬血等塗於木板上成漆 胎，再於表面罩黑漆，繼而在黑漆地上刻花 紋，但只保留輪廓線，剔去輪廓內的漆，再於 綠、紅、淡紅、淺藍和白色。其構圖繁密，黑漆 輪廓刻劃細勻，填色富麗，為清初康熙時期 款彩漆器的典型特色。首尾兩牒兩面本均有 題識，但原有的年款被改動為乾隆年款，推 斷此屏於乾隆時期再次用作賀壽禮品，款識 遭塗改，以致未能考證確切製造年月。 這類型的大屏風原常竪於大堂入口，或作為 房間的間隔，亦用作庭園或涼臺的擋風屏。 不過，香港寸金尺土，要在家放一套六米多 寬、兩米多高的屏風相信並不容易。如果大 家想近觀這種讓時尚女王「興奮得幾乎昏 倒」的工藝品，不妨多留意文物館的展覽  消息！ Heidi Wong 大腸癌是本港最常見的癌症。2016年，每十 萬標準人口計算的年齡標準化發病率為男性 的50.6和女性的31.4，不下於西方國家。 大腸癌可於結腸或直腸發生。目前腸癌病人 確診，大多數病情已到第二、第三期。這些病 人切除腫瘤後，還要接受輔助化療，以減低 復發機會，但病人承受的創傷亦較大。有見 及此，中大醫學院早年積極研究大腸癌篩查 的成效，冀及早治療甚至預防腸癌，促成政 府推行計劃。現在計劃已實施至第二階段， 五十六歲至七十五歲市民可獲政府資助進行 大便隱血測試，若結果呈陽性，便要進行大 腸鏡檢查。 瘜肉是腸癌的元兇，當中腺性 瘜肉的致癌風險最高。外科學 系結直腸外科教授 吳兆文 說： 「若腸道有三粒或以上腺性 瘜肉，或其中一粒達一厘米， 都屬高危。腺性瘜肉也有不同 種類，若是絨毛狀結構，演變 為腸癌的風險更高。」醫生一 般會寧枉毋縱，進行大腸鏡檢 查時，若發現瘜肉，不分種類 即時切除。瘜肉轉癌，需時五 至十年，若腸鏡檢查沒有發現瘜肉，可於十 年後才再作檢查。 年齡、煙酒、低纖多紅肉的飲食習慣和肥胖 等，都是可引發腸癌的因素。家族中曾有人患 上大腸癌或遺傳性腸病者，亦會增加風險。 近年，另一致癌因素浮現，便是潰瘍性結腸 炎。「患者因自身免疫系統問題，腸道持續發 炎，若不處理，可能演變為腸癌，潰瘍性結腸 炎的發病率在過去三十年急升六倍。」 中大研發出大腸癌風險評估指數，只要填寫 問卷，便可就上述因素計算自己患有高危瘜 肉的機會。「經評估高風險人士可考慮直接 進行腸鏡檢查，一般人只要接受大便隱血測 試便足夠。」 實施大腸癌篩查計劃，短期內可能發現更多 腸癌個案，但病人能及早發現，去除瘜肉，便 可杜絕日後患癌的機會。吳教授預言：「十年 後，腸癌的發病率會遞減。」 Colorectal cancer is the most common cancer in Hong Kong. In 2016, the age-standardized incidence rates were 50.6 for male and 31.4 for female per 100,000 standard population. These figures are comparable to those in Western countries. Colorectal cancer may occur in the colon or rectum. Most colorectal cancer cases are diagnosed at stage two or three. To reduce the chance of relapse, these patients are required to receive chemotherapy after having their tumours removed. The Faculty of Medicine of CUHK conducted researches on colorectal cancer screening which aims at early detection and treatment, leading to the initiation of the Government’s Pilot Programme. The second phase of the programme has been rolled out; Hong Kong residents aged 56 to 75 are subsidized to take a faecal occult blood test. If blood is found, colonoscopic check-ups will be arranged for further assessment. Polyps are the culprit of colorectal cancer. The risk of developing into cancer for the adenomatous polyp is the highest. ‘If three or more polyps are found, or one is 1cm or larger, the person is considered at high risk. Among different types of adenomatous polyp, the villous adenoma has even higher risk of progression to cancer,’ said Prof. Simon Ng of the Department of Surgery. It takes five to 10 years for a polyp to turn into cancer. If no polyps are found in the colonoscopic check- up, patients are advised to have the check-up again after 10 years. Age, smoking and alcohol consumption, low fibre intake, high consumption of red meat and obesity are risk factors for colorectal cancer. Family history of bowel cancer or hereditary bowel diseases also lead to higher risk. In recent years, another risk factor, ulcerative colitis, has been spotted. ‘Due to immune system dysfunction, patients who suffer from continuous bowel inflammation have a higher risk of progressing to colorectal cancer. The incidence rate of ulcerative colitis has increased six-fold in the past 30 years.’ Based on the above factors, CUHK developed the Colorectal-polyp Prediction Index, which allows the public to assess their chances of developing a high-risk polyp by completing a questionnaire. ‘Those classified as high-risk may consider having a colonoscopic check-up while others may simply have a faecal occult blood test.’ Thanks to the implementation of the Colorectal Cancer Screening Programme, a larger number of colorectal cancer cases can be detected early. Timely detection and removal of polyps could minimize the risk of developing cancer. ‘After 10 years, the incidence rate of the cancer will drop gradually,’ Professor Ng explained. M. Mak 07 # 5 3 8 | 1 9 . 0 5 . 2 0 1 9