• 主题
高级搜索  >
历史搜索 清空历史
您现在的位置：首页> 中文期刊>肿瘤学>医药卫生>肿瘤研究与临床

肿瘤研究与临床

肿瘤研究与临床

CSTPCD

Cancer Research and Clinic
中华医学会、山西省肿瘤研究所、山西省肿瘤医院主办。本刊是肿瘤学专业学术期刊。办刊宗旨：开展学术交流，推广科技成果，反映发展动态，引导研究方向。基础与临床并举，普及与提高兼顾，努力推动我国恶性肿瘤防治事业的发展。服务对象：从事肿瘤研究及临床工作的中高级医务人员及其他关注本领域发展动态的相关人员。主要栏目：专论、专家讲坛、论著、短篇论著、调查报告、讲座、会议速递、综述、短篇及个案报告等。编委会由国内外100多位著名肿瘤学专家组成。为中国科技论文统计源期刊（中国科技核心期刊）、中国生物医学核心期刊、中国肿瘤学类核心期刊。被美国《化学文摘》（CA）等国际著名检索期刊及国内各大检索数据库收录。
更多
  • 发文量：6345
  • 被引量：1444
  • H指数：1
  • 开始收录时间：1994,6(1)
  • CNKI综合因子：0.824
  • 维普期刊影响因子： 1.180
  • 万方期刊影响因子：1.29
  • 创刊时间：1986
  • 国内刊号/CN：11-5355/R
    国际刊号/ISSN：1006-9801
  • 发行周期：月刊
    邮发代号：22-137
  • 主管单位：中华人民共和国卫生部
    主办单位：中华医学会；山西省肿瘤研究所；山西省肿瘤医院
肿瘤研究与临床-联系信息
  • 主编：-
  • 电话：0351-4650389 4650386 4651416
  • 邮箱：crc@cmaph.org
  • 地址：太原市职工新街3号
  • 邮编：030013
肿瘤研究与临床-获奖情况
  • 暂无获奖信息
  • 收录汇总
  • 刊内文献检索
  • 投稿信息

刊期浏览

相关中文期刊

相关中文会议

相关外文期刊

相关外文会议

最新期刊

热门期刊

肿瘤研究与临床 >2021年第11期

学科

年度

全选（0）
排序：
共4384条结果
  • 摘要：Objective To evaluate the efficacy of prosthetic replacement for bone tumors and devitalization and replantation after resection of tumor segment for the treatment of patients with extremity osteosarcoma. Methods A total of 54 patients with Enneking stage Ⅱ extremity osteosarcoma who underwent limb-salvaging surgery in the Second Hospital of Shanxi Medical University from December 2010 to June 2017 were analyzed. Kaplan-Meier survival analysis was performed on the prosthetic replacement for bone tumors group and devitalization and replantation after resection of tumor segment group, the 5-year survival rate and distant metastasis rate between the two groups were compared. The χ 2 test and t test were used to compare the local recurrence rate, occurrence of local infection, and postoperative functional recovery between the two groups. Results Forty-six patients were followed up with the period ranging from 3 to 84 months. The prosthetic replacement for bone tumors group had 35 cases and the devitalization and replantation after resection of tumor segment group had 11 cases. The postoperative 5-year survival rate and 5-year distant metastasis rate were compared between the prosthetic replacement for bone tumors group and devitalization and replantation after resection of tumor segment group by using the Kaplan-Meier method (52.5％ vs. 59.4％, 38.5％ vs. 35.7％), and the differences were not statistically significant (χ 2 values were 0.084 and 0.013, both P > 0.05). For local recurrence rate and the risk of postoperative infection, the patients in devitalization and replantation after resection of tumor segment group showed higher results than those in prostheticreplacement for bone tumors group [36.4％ (4/11) vs. 8.6％ (3/35), 36.4％ (4/11) vs. 11.4％ (4/35)], and the differences were statistically significant (χ 2 values were 4.181 and 5.020, both P < 0.05). For 6 months postoperative functional reconstruction score, the patients in devitalization and replantation after resection of tumor segment group showed worse result than that in prosthetic replacement for bone tumors group [(17.4± 2.5) points vs. (24.3±4.8) points], and the difference was statistically significant (t = -4.911, P < 0.05); but this index tended to show better result at 18 months after surgery as compared with prosthetic replacement for bone tumors group [(27.3±2.7) points vs.(24.8±4.6) points], but the difference was not statistically significant (t= 1.811, P > 0.05). Conclusion The efficacy of prosthetic replacement for bone tumors is considered better than that of devitalization and replantation after resection of tumor segment, and it could be used as the preferred surgical option for limb-salvaging treatment in patients with extremity osteosarcoma at present.%目的 评价保肢手术肿瘤假体置换术与瘤段灭活再植术治疗四肢骨肉瘤患者的效果.方法 以2010年12月至2017年6月于山西医科大学第二医院行保肢手术治疗的54例EnnekingⅡ期四肢骨肉瘤患者为研究对象.采用Kaplan-Meier法对肿瘤假体置换术组与瘤段灭活再植术组患者进行生存分析,比较两组患者的5年生存率及远处转移率.采用 χ2检验和t检验对两组患者局部复发率以及局部感染发生率、术后功能恢复情况进行比较.结果 46例骨肉瘤患者获得随访,随访时间3～84个月.肿瘤假体置换术组35例,瘤段灭活再植术组11例.Kaplan-Meier生存分析显示,肿瘤假体置换术组与瘤段灭活再植术组患者5年生存率及远处转移率比较(52.5％比59.4％,38.5％比35.7％),差异均无统计学意义(χ2值分别为0.084、0.013,均P>0.05).瘤段灭活再植术组局部复发率、患肢局部感染率均高于肿瘤假体置换术组[36.4％(4/11)比8.6％(3/35),36.4％(4/11)比11.4％(4/35)],差异均有统计学意义(χ2值分别为4.181、5.020,均P<0.05).两组患者术后6个月功能评分比较显示,瘤段灭活再植术组功能恢复差于肿瘤假体置换术组[(17.4±2.5)分比(24.3±4.8)分],差异有统计学意义(t=-4.911,P<0.05);术后18个月功能评分比较显示,瘤段灭活再植术组功能评分有所上升,高于肿瘤假体置换术组[(27.3±2.7)分比(24.8±4.6)分],但差异无统计学意义(t=1.811,P>0.05).结论 肿瘤假体置换术疗效优于瘤段灭活再植术,可作为现阶段四肢骨肉瘤患者保肢治疗时的首选手术方式.
  • 摘要：目的 探讨成年人肺母细胞瘤(ATPB)的临床特征及18F-FDG PET-CT表现.方法 回顾性分析南京医科大学第一附属医院1例ATPB患者的临床资料及18F-FDG PET-CT显像资料,分析其18F-FDG PET-CT显像特点,并复习相关文献.结果 患者,女性,61岁,因刺激性咳嗽2个月余来院就诊,查胸部CT示右肺中叶近肺门软组织结节,边缘光滑,不均匀性轻度强化,CT诊断为错构瘤,未予治疗.4个月后复查CT提示病灶明显增大;18F-FDG PET-CT检查示:右肺中叶外侧段支气管阻断,右肺门见大小约10.0 cm×7.7 cm×8.5 cm类圆形软组织肿块,边缘光滑,内见低密度坏死灶,放射性摄取不均匀性增高,最大标准摄取值22.2,PET-CT诊断为右肺中央型肺癌.之后行右肺中叶肿块切除术,病理确诊为肺母细胞瘤.术后未予放化疗,随访22个月,患者疾病无进展.结论 ATPB是一种罕见、恶性度较高的肺原发肿瘤,18F-FDG PET-CT显像表现为18F-FDG高摄取,PET-CT检查有助于疾病的早期发现.
  • 摘要：Multidrug resistance is a major cause of clinical failure of tumor chemotherapy, study on the mechanisms of tumor multidrug resistance has been becoming a fascinating area in the field of tumor chemotherapy. The tumor multidrug resistance is generally considered to be due to the gene mutation, amplification or epigenetic changes that affect the uptake , metabolism or excretion of tumor drugs . P-glycoprotein is a transmembrane glycoprotein encoded by multidrug resistance gene MDR1, which leads to the principal contributor to tumor multidrug resistance. Research suggests that P-glycoprotein can metastasize through the tumor cells, thereby affecting tumor resistance. This article reviews the role of intercellular transfer of P-glycoprotein in tumor drug resistance.%肿瘤多药耐药是临床上肿瘤化疗失败的主要原因,有关肿瘤多药耐药的机制研究已成为肿瘤化学药物治疗领域的热点.肿瘤多药耐药一般认为是由于基因突变、扩增或表观遗传改变影响了肿瘤细胞药物的摄取、代谢或外排.P糖蛋白是由多药耐药基因MDR1编码的一种跨膜糖蛋白,是引起肿瘤多药耐药的主要原因.研究表明,多药耐药基因产物P糖蛋白能够在肿瘤细胞间发生转移,从而影响肿瘤的耐药.文章对P糖蛋白转移在肿瘤耐药中的作用进行综述.
  • 摘要：目的 探讨初治晚期非小细胞肺癌(NSCLC)患者外周血血小板与淋巴细胞比值(PLR)、肺癌组织细胞增殖抗原Ki-67在化疗效果及预后判断中的价值.方法 回顾性分析2015年1月至2016年1月于山西省肿瘤医院经病理及免疫组织化学确诊的132例晚期NSCLC患者的临床资料.采集患者化疗前外周静脉血,应用血细胞分析仪检测血小板、淋巴细胞数,计算PLR;免疫组织化学SP法检测组织切片Ki-67表达情况.一线化疗采用含铂双药方案治疗至少4个周期.计数资料比较采用 χ2检验;有效率影响因素采用logistic回归模型进行分析;应用Kaplan-Meier法进行生存分析,并行log-rank检验;Cox风险比例模型进行预后多因素分析.结果 一线化疗有效率41.7％(55/132).患者1、2年总生存(OS)率分别为26.1％、10.4％,中位无进展生存(PFS)时间5.7个月(95％CI 3.2～10.9个月),中位OS时间14.1个月(95％CI 6.8～18.4个月).中位PLR为172.0.PLR<172.0组有效率高于PLR≥172.0组[60.6％(40/66)比22.7％(15/66),χ2=19.481,P<0.05],中位OS时间较PLR≥172.0组长(17.6个月比15.0个月,χ2=4.976,P<0.05),两组中位PFS时间差异无统计学意义(8.6个月比6.5个月,χ2=0.078,P>0.05).Ki-67阴性组与阳性组间有效率差异无统计学意义[40.0％(28/70)比43.5％(27/62),χ2=0.170,P>0.05],阴性组中位PFS时间、OS时间均较阳性组长(7.6个月比6.5个月,χ2=7.170,P<0.05;18.3个月比14.5个月,χ2=15.870,P<0.05).多因素分析显示,PLR是有效率的独立影响因素(P<0.05),Ki-67是PFS的独立影响因素(P<0.05),PLR、Ki-67是OS的独立影响因素(P<0.05).结论 PLR和Ki-67可以作为预测晚期NSCLC化疗效果和预后评估的有意义指标.%Objective To investigate the value of platelet-to-lymphocyte ratio (PLR) and cell proliferation antigen Ki-67 in judging the chemotherapy efficacy and prognosis of patients with advanced non-small cell lung cancer (NSCLC). Methods The clinical data of 132 patients with advanced NSCLC diagnosed by pathology and immunohistochemistry from January 2015 to January 2016 in Shanxi Provincial Cancer Hospital were retrospectively analyzed. Peripheral venous blood cells were collected before chemotherapy, the platelet and lymphocyte counts were detected by using blood cell analyzer to calculate PLR. Immunohistochemical SP method was used to detect the expression of Ki-67 in tissue sections. The platinum-containing dual-drug regimen was used in the first-line chemotherapy for at least 4 cycles. The χ2 test was used to compare the count data, and the logistic regression model was used to analyze the factors affecting the effective rate. The Kaplan-Meier method and log-rank test were used for survival analysis, and the Cox proportional hazards regression model was used for multivariate analysis of prognosis. Results The total effective rate of the first-line chemotherapy was 41.7％ (55/132). The 1-year and 2-year overall survival (OS) rates were 26.1％ and10.4％, respectively. and the mean progression-free survival (PFS) time was 5.7 months (95％ CI 3.2-10.9 months) and the median OS time was 14.05 months (95％ CI 6.8-18.4 months). The median PLR was 172.0. The effective rate in PLR < 172.0 group was higher than that in PLR≥172.0 group [60.6％ (40/66) vs. 22.7％(15/66), χ 2 = 19.481, P < 0.05], and the median OS time in PLR < 172.0 group was longer than that in PLR≥172.0 group (17.6 months vs. 15.0 months, χ 2 = 4.976, P < 0.05), and there was no significant difference in the median PFS time between the two groups (8.6 months vs. 6.5 months, χ 2 = 0.078, P > 0.05). There was no significant difference in the effective rate between Ki-67 negative group and positive group [40.0％ (28/70) vs. 43.5％ (27/62), χ 2 = 0.170, P > 0.05]. The median PFS time and OS time in Ki-67 negative group were longer than those in positive group (7.6 months vs. 6.5 months, χ 2 = 7.170, P < 0.05; 18.3 months vs. 14.5 months,χ 2 = 15.870, P < 0.05). According to the results of multivariate analysis, PLR was an effective independent factor for effective rate (P < 0.05), Ki-67 was an independent influencing factor for PFS (P < 0.05), and PLR and Ki-67 were independent influencing factors for OS (P < 0.05). Conclusion PLR and Ki-67 can be used as meaningful indicators for predicting the chemotherapy efficacy and prognosis of advanced NSCLC.
  • 摘要：Objective To investigate the expressions of Wnt3a and Wnt5a in papillary thyroid carcinoma (PTC) and their clinical significances. Methods Immunohistochemical SABC method was used to detect the expressions of Wnt3a and Wnt5a proteins in PTC tissues and their paracancerous tissues collected from 79 patients in Dandong First Hospital from January 2014 to June 2018, and the relationships between the expressions of Wnt3a and Wnt5a proteins and clinicopathological features of PTC patients were analyzed. The expressions of Wnt3a and Wnt5a proteins in 10 pairs of fresh PTC tissues and paracancerous tissues were detected by Western blot. Results The results of immunohistochemistry showed that the positive expression rates of Wnt3a and Wnt5a proteins in PTC tissues were significantly higher than those in paracancerous tissues [69.6％ (55/79) vs. 25.3％ (20/79), 60.8％ (48/79) vs. 20.2％ (16/79)], and the differences were statistically significant (χ 2 values were 31.092 and 26.894, both P < 0.01). The results of Western blot showed that the expressions of Wnt3a and Wnt5a proteins in 10 pairs of fresh PTC tissues was significantly higher than those in paracancerous tissues(1.61±0.40 vs. 0.43±0.14, 1.38±0.291 vs. 0.36±0.13), and the differences were statistically significant (t values were 16.234 and 13.493, both P < 0.01). The expressions of Wnt3a and Wnt5a in PTC tissues were correlated with TNM stage, differentiation, extramembranous invasion and lymph node metastasis (Wnt3a: χ2 values were 6.645, 15.945, 8.783 and 11.220; Wnt5a: χ2 values were 21.525, 7.611, 17.880 and 12.581, all P < 0.05), but not with patients'age, sex and tumor diameter (all P > 0.05). There was a positive correlation between Wnt3a and Wnt5a proteins expressions in PTC (r = 0.597, P < 0.01).Conclusion The abnormal expressions of Wnt3a and Wnt5a proteins in PTC may be related to the development of PTC.%目的 探讨Wnt3a和Wnt5a在甲状腺乳头状癌(PTC)中的表达及其临床意义.方法 选取2014年1月至2018年6月丹东市第一医院收治的79例PTC患者,采用免疫组织化学SABC法检测PTC组织和相应癌旁组织中Wnt3a、Wnt5a蛋白的表达,并探讨其与PTC患者临床病理特征的关系.应用蛋白质印迹法检测10对新鲜PTC组织及癌旁组织中Wnt3a和Wnt5a蛋白的表达.结果 免疫组织化学结果显示,Wnt3a和Wnt5a在PTC组织中的阳性表达率均高于癌旁组织[69.6％(55/79)比25.3％(20/79),60.8％(48/79)比20.2％(16/79)],差异均有统计学意义(χ2值分别为31.092、26.894,均P<0.01).蛋白质印迹法结果显示,10对新鲜PTC组织中Wnt3a、Wnt5a蛋白的相对表达量较癌旁组织中升高(1.61±0.40比0.43±0.14,1.38±0.291比0.36±0.13),差异均有统计学意义(t值分别为16.234、13.493,均P<0.01).PTC组织中Wnt3a和Wnt5a的表达与TNM分期、肿瘤分化程度、被膜外侵犯和淋巴结转移均有关(Wnt3a:χ2值分别为6.645、15.945、8.783、11.220,均P<0.05;Wnt5a:χ2值分别为21.525、7.611、17.880、12.581,均P<0.05),与患者年龄、性别、肿瘤直径均无关(均P>0.05).Wnt3a和Wnt5a蛋白在PTC中的表达呈正相关(r=0.597,P<0.01).结论 Wnt3a和Wnt5a蛋白在PTC中异常表达,可能与PTC的发生、发展有关.
  • 摘要：目的 探讨肺原发恶性黑色素瘤的病理特征、诊断及鉴别诊断.方法 分析苏北人民医院收治的1例肺原发恶性黑色素瘤患者的病理特征,并结合相关文献进行复习.结果 患者,男性,56岁,以肺占位性病变就诊,肿瘤位于右肺上叶后段,直径约0.6 cm,免疫组织化学检查示,瘤细胞HMB45、S-100蛋白、Melan-A弥漫表达;LCA、CgA、CD56、Syn、TTF-1、CD138均不表达,Ki-67(约10％+),结合病理学形态、影像学结果及临床查体情况,诊断为肺原发恶性黑色素瘤.结论 肺原发性恶性黑色素瘤较为罕见,诊断时需结合临床及其他检查综合考虑.
  • 摘要：Objective To analysis the expression of thyroid transcription factor 1 (TTF-1) in patients with lung adenocarcinoma, and discuss the relationship between TTF-1 expression and prognosis of patients with advanced lung adenocarcinoma. Methods A total of 786 cases of lung adenocarcinoma who were admitted to Xi'an Chest Hospital from January 2012 to June 2016 were selected. The expression of TTF-1 was detected by immunohistochemistry. The relationship between TTF-1 expression and patients ' clinicopathological features, treatment and survival were analyzed. Cox proportional hazard model was used to analyze the relationship between TTF-1 and prognosis of patients with advanced lung adenocarcinoma. Results Among 786 patients, 559 patients (71.12％) had positive TTF-1 expression, 227 patients (28.88％) had negative TTF-1 expression. The expression rates of TTF-1 in patients with well-differentiated, early stage, no lymph node metastasis, and no distant metastasis [77.26％ (197/255), 78.89％ (269/341), 78.95％ (225/285), and 75.61％(372/492)] were higher than those in patients with poorly differentiated, late stage, lymph node metastasis and distant metastasis 68.17％ (362/531), 65.17％ (290/445), 66.67％ (334/501), 63.60％ (187/294), the differenceswere statistically significant (χ 2 values were 6.917, 25.261, 13.339, and 12.911, all P < 0.05). The expressions of TTF-1 in primary lesions and metastatic lesions were consistent (κ = 0.894, P < 0.01). Among 385 patients with advanced lung adenocarcinoma who were unable to perform the operation, the proportion of epidermal growth factor receptor (EGFR) mutation in TTF-1 positive expression patients (45.60％, 109/239) was significantly higher than that in TTF-1 negative expression patients (26.02％, 38/146), and the difference was statistically significant (χ 2 = 14.721, P < 0.01). The median progression free survival (PFS) time of TTF-1 positive expression patients was significantly longer than that of TTF -1 negative expression patients (6.00 months vs. 4.20 months, P < 0.01), whether EGFR was mutation or not, the median PFS time of TTF-1 positive expression patients was significantly longer than that of TTF-1 negative expression patients (P =0.003; P < 0.01). TTF-1 expression (HR = 0.793, 95％ CI 0.639-0.984, P = 0.011) and EGFR gene status (HR =0.694, 95％ CI 0.432-0.864, P = 0.004) were independent influencing factors affecting the PFS of patients with advanced lung adenocarcinoma. Conclusions TTF-1 is widely expressed in lung adenocarcinoma and is associated with tumor differentiation, staging, lymph metastasis and distant metastasis. TTF-1 is a prognostic influencing factor in patients with advanced lung adenocarcinoma and can be used as a predictor of treatment for patients with advanced lung adenocarcinoma.%目的 分析甲状腺转录因子1(TTF-1)在肺腺癌患者中的表达情况,并探讨TTF-1表达与晚期肺腺癌患者预后的相关性.方法 选取2012年1月至2016年6月西安市胸科医院786例确诊的肺腺癌患者,免疫组织化学法检测TTF-1的表达情况.分析TTF-1表达与患者临床病理特征及治疗、生存情况的关系,Cox风险比例模型分析TTF-1及临床病理特征与晚期肺腺癌患者预后的相关性.结果 786例患者中,559例(71.12％)TTF-1阳性表达,227例(28.88％)TTF-1阴性表达.肿瘤分化程度高、 分期早、 无淋巴结和远处转移的患者TTF-1呈高表达,表达率分别为77.26％(197/255)、78.89％(269/341)、78.95％(225/285)、75.61％(372/492),与分化程度低、分期晚、有淋巴结和远处转移者的68.17％(362/531)、65.17％(290/445)、66.67％(334/501)、63.60％(187/294)比较,差异均有统计学意义(χ2值分别为6.917、25.261、13.339、12.911,均P<0.05);TTF-1在原发病灶及转移病灶中的表达一致(κ=0.894,P<0.01).385例无法手术的晚期肺腺癌患者中,TTF-1表达阳性患者的表皮生长因子受体(EGFR)突变比例(45.60％,109/239)高于阴性患者(26.02％,38/146),差异有统计学意义(χ2=14.721,P<0.01);TTF-1表达阳性患者的中位无进展生存(PFS)时间较TTF-1表达阴性患者延长(6.00个月比4.20个月,P<0.01),无论EGFR是否突变TTF表达阳性患者中位PFS时间均较TTF-1表达阴性患者延长(P=0.003;P<0.01).TTF-1表达(HR=0.793,95％CI 0.639～0.984,P=0.011)及EGFR基因状态(HR=0.694,95％CI 0.432～0.864,P=0.004)是晚期肺腺癌患者PFS的独立影响因素.结论 TTF-1在肺腺癌中广泛表达,与肿瘤分化、分期、淋巴结转移及远处转移相关.TTF-1是晚期肺腺癌患者预后影响因素,可作为晚期肺腺癌患者预后的预测因子.
  • 摘要：Objective To systematically evaluate the efficacy of the lienal polypeptide injection combined with chemotherapy or radiotherapy on the short-term efficacy, Karnofsky score, immune function and adverse reactions in treatment of various cancers. Methods The databases of PubMed, Embase, Cochrane Library, CNKI, Wanfang and VIP were retrieved from database establishing time to January 2017, and the randomized controlled trials (RCT) about lienal polypeptide injection combined with radiotherapy or chemotherapy in the treatment of advanced cancer were collected. The quality assessment was conducted and eligible trials were included in the Meta-analysis. Results A total of 23 articles were included, involving 1658 patients. The patients were divided into treatment group (lienal polypeptide injection combined with chemotherapy or radiotherapy, 842 cases) and control group (chemotherapy or radiotherapy alone, 816 cases). Results of Meta-analysis showed that the short-term effective rate (RR = 1.20, 95％ CI 1.07-1.33, P = 0.001), the improvement rate of Karnofsky score (RR = 1.77, 95％ CI 1.43-2.19, P < 0.05) and immune function related indicators: CD3+ (MD = 9.48, 95％ CI 6.76-12.20, P < 0.01), CD4+ (MD = 7.54, 95％ CI 5.38-9.71, P < 0.01), NK cells (MD = 4.47, 95％CI 3.45-5.48, P < 0.01) and CD4 +/CD8 + (MD = 0.33, 95％ CI 0.25-0.42, P < 0.01) in the treatment group were significantly higher than those in the control group, and the differences were statistically significant. The incidence of nausea and vomiting (RR = 0.51, 95％ CI 0.35-0.73, P = 0.0002) and bone marrow suppression (RR = 0.41, 95％ CI 0.25, 0.68, P = 0.0006) in the treatment group were significantly lower than those in the control group, and the differences were statisticallysignificant. There was no statistical difference in CD8+ level and the incidence of neurotoxicity, diarrhea, oral mucositis and hepatic injury between the two groups (all P > 0.05). Conclusion Lienal polypeptide injection combined with radiotherapy or chemotherapy is superior to conventional radiotherapy or chemotherapy alone in the treatment of cancer, which can improve the quality of life of patients with tumors, reduce the incidence of nausea and vomiting and bone marrow suppression induced by the treatment.%目的 系统评价脾多肽注射液联合放化疗对各型肿瘤的近期有效率、Karnofsky评分、免疫功能及不良反应的影响.方法 在PubMed、Embase、Cochrane图书馆、中国知网、万方数据库、维普数据库中检索截至2017年1月11日所有关于脾多肽注射液用于肿瘤辅助放化疗的临床随机对照试验(RCT)的文献,对其进行质量评估,并对符合要求的所有文献研究结果进行Meta分析.结果 最终纳入文献23篇,涉及1658例患者.将纳入的患者分为治疗组(脾多肽注射液+放化疗)842例,对照组(单纯放化疗)816例.Meta分析结果显示治疗组近期有效率(RR=1.20,95％CI 1.07～1.33,P=0.001)、Karnofsky评分改善水平(RR=1.77,95％CI 1.43～2.19,P<0.05)、免疫功能相关指标:CD3+(MD=9.48,95％CI 6.76～12.20,P<0.01)、CD4+(MD=7.54,95％CI 5.38～9.71,P<0.01)、NK细胞(MD=4.47,95％CI 3.45～5.48,P<0.01)以及CD4+/CD8+(MD=0.33,95％CI 0.25～0.42,P<0.01)水平均高于对照组,差异均有统计学意义;治疗组恶心、呕吐发生率(RR=0.51,95％CI 0.35～0.73,P=0.0002)、骨髓抑制发生率(RR=0.41,95％CI 0.25～0.68,P=0.0006)均低于对照组,差异均有统计学意义;治疗组免疫功能指标CD8+及不良反应中神经系统不良反应、腹泻、口腔黏膜炎、肝损伤与对照组比较差异均无统计学意义(均P>0.05).结论 脾多肽注射液联合放化疗疗效优于单纯放化疗,可提高肿瘤患者生命质量,降低放化疗引起的恶心、呕吐和骨髓抑制的发生率.
  • 摘要：The location of the skull base neoplasms are very deep, and the operation is unpredictable. The advent of skull base endoscopic technology has opened up a new surgical path for skull base neoplasms, but it also puts forward higher requirements for preoperative real-time images and detailed pathological anatomy. Obviously, traditional imaging techniques cannot keep up with it. 3D printing is a new stereoscopic rendering technology developed in recent years and applied to the medical field. It can seamlessly integrate, transform and reconstruct multi-modal imaging data such as CT/CT angiography/magnetic resonance imaging of patients into a three-dimensional model. The three-dimensional model is not only stereoscopic, intuitive, but also can display the complex anatomy of the skull base neoplasms and its surroundings point-to-point, and it can also be operated under the preoperative simulated endoscopic operation, so that the endoscopic surgery plan of the skull base neoplasms is more personalized and precise. It will undoubtedly further improve the total tumor resection rate and reduce the surgical side injury. This article reviews the application and progress of current 3D printing technologies in the field of endoscopic surgery of skull base neoplasms.%颅底肿瘤位置隐险,手术难度高.颅底内镜技术的问世,为颅底肿瘤开辟了一条全新的手术通路,但同时也对术前实时影像、细致的病理解剖把握提出了更高的要求.显然,传统的影像技术不能与时俱进地满足这一点.3D打印是近几年发展并应用到医学领域的一项新的立体呈现技术,它能将患者实时的CT/CT血管成像/磁共振成像等多模态影像学数据无缝融合、转化重建、仿真打印成三维立体模型,不仅立体、直观,甚至能点对点地展现出颅底肿瘤及其周围的复杂解剖结构,而且还能在术前模拟内镜下操作,从而使颅底肿瘤内镜手术预案更个性化、精准化,无疑将进一步提高肿瘤全切除率.文章总结了目前3D打印技术在颅底肿瘤内镜手术领域中的应用与进展.
  • 摘要：Humic acids, a complex macromolecular organic carbon resources, contain different functional groups such as quinones, phenols, carboxylic acids, hydroxyl, and aromatic structures. The various functions and pharmacological activities are mainly attributable to the different functional groups of humic acids. In recent years, studies show that antitumor effect of humic acids can be analyzed from activation of immune system, induction of cell injury and apoptosis, photothermal reaction, or binding with other materials. This paper reviews the progress of antitumor mechanisms of humic acids.%腐植酸是一类天然大分子有机弱酸混合物,包含有较多活性基团如醌基、酚基、羧基、羟基、芳环等结构.不同的芳香结构和活性基团对生物体可能存在不同的反应及药理作用.近年来的研究表明,腐植酸类物质可能从激活免疫系统、诱导细胞损伤及细胞凋亡、发挥光热转换或络合其他材料来发挥抗肿瘤作用.现就腐植酸类物质抗肿瘤作用机制的研究进行综述.
  • 摘要：目的 探讨非小细胞肺癌(NSCLC)组织中叉头框转录因子O1(FOXO1)与Kruppel样转录因子9(KLF9)的表达及其临床意义.方法 收集2012年9月至2015年6月榆林市第一医院手术切除的102例NSCLC肿瘤组织标本,另选取距癌组织边缘≥5 cm的癌旁组织作为对照组.采用实时定量聚合酶链反应(qRT-PCR)检测NSCLC组织及癌旁组织中FOXO1与KLF9 mRNA相对表达量,免疫组织化学法检测NSCLC组织及癌旁组织中FOXO1、KLF9蛋白表达.根据癌组织mRNA检测结果的均值将FOXO1、KLF9分为高表达组与低表达组,分析二者与患者临床病理参数的关系.采用Pearson法对FOXO1、KLF9的表达进行相关性分析,采用Kaplan-Meier法对患者生存情况进行分析,对影响NSCLC预后的相关因素进行logistic回归分析.结果 与癌旁组织相比,NSCLC组织FOXO1 mRNA相对表达量升高(2.82±0.15比1.28±0.47,t=31.525,P<0.05),KLF9 mRNA相对表达量降低(0.34±0.07比1.04±0.11,t=54.222,P<0.05).FOXO1在有淋巴结转移、分化程度高、TNM分期为Ⅲ～Ⅳ期患者癌组织中的表达水平较高,差异均有统计学意义(均P<0.05);KLF9在有淋巴结转移、 分化程度高、TNM分期为Ⅲ～Ⅳ期患者癌组织中的表达水平较低,差异均有统计学意义(均P<0.05).Pearson相关分析法显示FOXO1与KLF9表达无相关性(r=0.154,P=0.156).Kaplan-Meier法分析结果显示FOXO1高表达组3年总生存率低于FOXO1低表达组(10.81％比60.71％,χ2=27.341,P<0.01),KLF9低表达组3年总生存率低于KLF9高表达组(26.32％比61.54％,χ2=8.526,P=0.003).logistic回归分析结果显示FOXO1高表达是影响NSCLC预后的危险因素(OR=2.682,P=0.003),KLF9高表达是NSCLC预后的保护因素(OR=0.446,P=0.012).结论 NSCLC组织中FOXO1高表达与KLF9低表达可作为预测NSCLC进展情况的有效指标,二者均与患者预后不良密切相关.%Objective To investigate the expressions of forkhead transcription factor O1 (FOXO1) and Kruppel like transcription factor 9 (KLF9) in non-small cell lung cancer (NSCLC) and their clinical significances. Methods A total of 102 patients with NSCLC who underwent surgical resection in the First Hospital of Yulin from September 2012 to June 2015 were selected as NSCLC group, and the paracancerous tissues more than 5 cm far from the edge of the cancer tissues were selected as the control group. The relative expressions of FOXO1 and KLF9 mRNA in NSCLC tissues and paracancerous tissues were detected by real-time quantitative polymerase chain reaction (qRT-PCR), and the immunohistochemistry was used to detect the expressions of FOXO1 and KLF9 in NSCLC tissues and paracancerous tissues. According to the mean mRNA expression in NSCLC tissues, FOXO1 and KLF9 were divided into high expression group and low expression group, their relationships with clinicopathological parameters were observed. The correlation of FOXO1 and KLF9 expressions was analyzed by Pearson method, and the survival of patients was analyzed by Kaplan-Meier method, logistic regression analysis was performed on the related factors affecting the prognosis of NSCLC. Results Compared with the control group, the expression level of FOXO1 in NSCLC group increased (1.28±0.47 vs. 2.82±0.15, t = 31.525, P < 0.05), while the expression level of KLF9 decreased (1.04±0.11 vs. 0.34± 0.07, t = 54.222, P < 0.05). The expressions of FOXO1 were lower in NSCLC tissues of patients with lymph node metastasis, high differentiation, and TNM stage Ⅲ-Ⅳ than those in NSCLC tissues of patients without lymph node metastasis, middle and low differentiation, and TNM stage Ⅰ-Ⅱ, and the differences were statistically significant (all P < 0.05). The expressions of KLF9 were higher in NSCLC tissues of patients with lymph node metastasis, high differentiation, and TNM stage Ⅲ-Ⅳ than those in NSCLC tissues of patients without lymph node metastasis, middle and low differentiation and TNM stage Ⅰ-Ⅱ, and the differences were statistically significant (all P < 0.05). Pearson correlation analysis showed that there was no significant correlation between FOXO1 and KLF9 expression (r = 0.154, P = 0.156). Kaplan-Meier analysis showed that the 3-year overall survival rate of FOXO1 high expression group was lower than that of FOXO1 low expression group (10.81％ vs. 60.71％, χ 2 = 27.341, P < 0.01). The 3-year overall survival rate of KLF9 low expression group was lower than that of KLF9 high expression group (26.32％ vs. 61.54％, χ 2 = 8.526, P = 0.003). Logistic regression analysis showed that FOXO1 was a risk factor for the prognosis of NSCLC (OR = 2.682, P = 0.003), and KLF9 was a protective factor for the prognosis of NSCLC (OR = 0.446, P = 0.012). Conclusions The high expression of FOXO1 and the low expression of KLF9 in NSCLC tissues can be used as effective indexes to predict the progression of NSCLC. The expressions of FOXO1 and KLF9 are closely related to the poor prognosis of patients.
  • 摘要：目的 分析一线、二线使用吉非替尼治疗表皮生长因子受体(EGFR)不同位点突变的晚期非小细胞肺癌(NSCLC)患者的疗效.方法 回顾性分析2013年1月至2014年12月山西省肿瘤医院接受吉非替尼治疗的EGFR不同位点突变的70例晚期NSCLC患者临床资料,按治疗方式分为一线治疗组(36例)和二线治疗组(34例);按基因突变类型可分为19号外显子缺失组(EGFR基因19号外显子LREA缺失,46例)和21号突变组(21号外显子L858R突变,24例).观察各组无进展生存(PFS)时间、有效率(ORR)、疾病控制率(DCR).结果 70例可评估患者中,19号外显子LREA缺失患者中位PFS时间8.88个月(95％CI 7.72～10.04),21号外显子L858R突变患者中位PFS时间8.67个月(95％CI 7.17～10.17),差异无统计学意义(P=0.959);19号外显子LREA缺失患者ORR为69.6％(32/46),21号外显子L858R突变患者ORR为54.2％(13/24),差异无统计学意义(χ2=1.629,P=0.202);19号外显子LREA缺失患者DCR为84.8％(39/46),21号外显子L858R突变患者DCR为91.7％(22/24),差异无统计学意义(χ2=0.194,P=0.659).一线治疗组中位PFS时间9.22个月(95％CI 7.92～10.52),二线治疗组中位PFS时间8.37个月(95％CI 7.08～9.65),差异无统计学意义(P=0.507);一线治疗组ORR为63.9％(23/36),二线治疗组ORR为58.8％(20/34),差异无统计学意义(χ2=1.460,P=0.227);一线治疗DCR为88.9％(32/36),二线治疗DCR为88.2％(30/34),差异无统计学意义(χ2=0.060,P=0.940).结论 NSCLC患者EGFR不同位点突变及一线、二线使用吉非替尼治疗近期疗效和无进展生存情况相近.%Objective To analyze the efficacy of gefitinib in the first-line and the second-line treatment of advanced non-small cell lung cancer (NSCLC) with different mutations of epidermal growth factor receptor (EGFR). Methods The clinical data of 70 patients with advanced NSCLC harboring different EGFR mutations and taking gefitinib as the first-line or the second-line treatment in Shanxi Provincial Cancer Hospital from January 2013 to December 2014 was analyzed retrospectively. According to the treatment method, the patients were divided into the first-line treatment group (36 cases) and the second-line treatment group (34 cases); according to the type of gene mutations, the patients were divided into exon 19 deletion group (EGFR gene exon 19 LREA deletion, 46 cases) and exon 21 mutation group (exon 21 L858R mutation, 24 cases). Progression-free survival (PFS), effective rate (ORR), and disease control rate (DCR) were observed in each group. Results Of the 70 evaluable patients, the median PFS time in patients with exon 19 LREA deletion was 8.88 months (95％ CI 7.72-10.04), and the median PFS time in patients with exon 21 L858R mutation was 8.67 months (95％ CI 7.17-10.17), the difference between the two groups was not statistically significant (P = 0.959). The ORR in patients with exon 19 LREA deletion was 69.6％ (32/46), and the ORR inpatients with exon 21 L858R mutation was 54.2％ (13/24), the difference was not statistically significant (χ 2= 1.629, P = 0.202). The DCR in patients with exon 19 LREA deletion was 84.8％ (39/46), and the DCR in patients with exon 21 L858R mutation was 91.7％ (22/24), the difference was not statistically significant (χ 2= 0.194, P = 0.659). The median PFS time in patients with the first-line treatment was 9.22 months (95％ CI 7.92-10.52), and the median PFS time in patients with the second-line treatment was 8.37 months (95％ CI 7.08-9.65), the difference was not statistically significant (P = 0.507). The ORR in patients with the first-line treatment was 63.9％ (23/36), and the ORR in patients with the second-line treatment was 58.8％ (20/34), the difference was not statistically significant (χ 2 = 1.460, P = 0.227). The DCR in patients with the first-line treatment was 88.9％ (32/36), and the DCR in patients with the second-line treatment was 88.2％ (30/34), the difference was not statistical significant (χ 2 = 0.060, P = 0.940). Conclusion The short-term efficacy and PFS are similar between NSCLC patients with different mutations of EGFR or with the first-line and the second-line treatment with gefitinib.
  • 摘要：Objective To investigate the expression of programmed death ligand 1 (PD-L1) in lung adenocarcinoma tissues and its correlation with clinicopathological features of patients. Methods A total of 141 paraffin-embedded specimens of patients with newly diagnosed lung adenocarcinoma by pathology from January to August 2018 in the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School were collected. The expression of PD-L1 in the tumor cells (TC) and tumor-infiltrating immune cells (IC) were detected by immunohistochemistry EnVision staining. Based on the percentage of expression, PD-L1 in TC and IC were divided into TC3 (≥50％), TC2 (≥5％ and <50％), TC1 (≥1％ and <5％), and TC0 (<1％); IC3 (≥10％), IC2 (≥5％ and <10％), IC1 (≥1％ and <5％), and IC0 (<1％). Results PD-L1 expression was positive in 90 cases, and the positive rate was 63.8％ (90/141) at a TC1 or IC1 threshold. When a TC3 or IC3 threshold was applied, PD-L1 expression was positive in 17 cases, and the positive rate was 12.1％ (17/141). In the TC1 or IC1 threshold group, PD-L1 expressions were different in patients with different sex, nerve invasion and pleural invasion, and the differences were statistically significant (all P < 0.05). While in the TC3 or IC3 threshold group, PD-L1 expressions were different in patients with different cell differentiation, clinical stage, lymphocyte infiltration, vascular invasion and nerve invasion, and the differences were statistically significant (all P < 0.05). In both TC1 or IC1 threshold group and TC3 or IC3 threshold group, PD-L1 expression was associated with nerve invasion (both P < 0.05). Conclusions PD-L1 expression is associated with nerve invasion. PD-L1 inhibitors expect to be used as a potential treatment strategy for recurrent and progressive lung adenocarcinoma patients with high level expression of PD-L1.%目的 探讨程序性死亡受体配体1(PD-L1)在肺腺癌组织中的表达及其与患者临床病理特征的关系.方法 收集南京大学医学院附属鼓楼医院2018年1月至8月病理确诊的141例初治肺腺癌患者石蜡包埋标本,应用免疫组织化学EnVision法检测PD-L1蛋白在肺腺癌组织肿瘤细胞(TC)及肿瘤间质浸润淋巴细胞(IC)中的表达情况,根据TC和IC中PD-L1的表达百分比进行计分.PD-L1在TC中按表达百分比分为TC3(≥50％)、TC2(≥5％且<50％)、TC1(≥1％且<5％)、TC0(<1％);PD-L1在IC中按表达百分比分为IC3(≥10％)、IC2(≥5％且<10％)、IC1(≥1％且<5％)、IC0(<1％).结果 PD-L1在肺腺癌中的表达以TC1或IC1为阈值,阳性表达90例,阳性率63.8％(90/141);以TC3或IC3为阳性阈值,阳性表达17例,阳性率12.1％(17/141).若以TC1或IC1为阳性阈值,PD-L1表达在不同性别、神经是否侵犯、胸膜是否侵犯患者间差异均有统计学意义(均P<0.05);若以TC3或IC3为阳性阈值,PD-L1在不同分化程度、临床分期、淋巴结转移有无、脉管是否侵犯、神经是否侵犯患者间差异均有统计学意义(均P<0.05);以TC1或IC1、TC3或IC3为阳性阈值,PD-L1表达均与神经侵犯相关(均P<0.05).结论 PD-L1表达与神经受侵相关,PD-L1抑制剂有望用于PD-L1高表达复发进展肺腺癌患者的治疗.
  • 摘要：目的 探讨锌指蛋白217(ZNF217)在非小细胞肺癌(NSCLC)中的表达及其与患者预后的关系.方法 选择2012年1月至2013年10月重庆三峡中心医院收治的120例NSCLC患者.采用免疫组织化学方法检测ZNF217在NSCLC组织及癌旁组织中的表达,分析ZNF217的表达与患者临床病理特征的相关性;采用Kaplan-Meier法及Cox回归模型多因素分析法,探讨影响NSCLC根治术预后的因素.结果 ZNF217主要表达于肿瘤细胞核内,肿瘤组织的ZNF217阳性率高于癌旁组织[52.5％(63/120)比20.1％(25/120);χ2=25.909,P<0.05].随着肿瘤T分期(χ2=7.333,P=0.026)、N分期(χ2=7.782,P=0.020)、TNM分期(χ2=11.557,P=0.003)的升高,ZNF217阳性率增高.ZNF217阳性患者术后总生存(P=0.007)及无进展生存(P=0.004)较阴性患者差.Cox多因素分析显示,ZNF217是影响NSCLC预后的独立危险因素.结论 ZNF217是影响NSCLC预后的独立危险因素,可能成为NSCLC精准治疗的潜在靶点.%Objective To explore the expression of zinc finger protein 217 (ZNF217) in non-small cell lung cancer (NSCLC) and its correlation with prognosis of patients. Methods A total of 120 NSCLC patients in Chongqing Three Gorges Central Hospital from January 2012 to October 2013 were selected. Immunohistochemical method was used to test the expression of ZNF217 in NSCLC tissues and paracancerous tissues. The correlation of ZNF217 expression with patient's clinicopathological features was analyzed. At the same time, the Kaplan-Meier method and Cox regression model multiple factor analysis method were used to explore the factors affecting the prognosis of patients after NSCLC radical operations. Results ZNF217 mainly existed in cell nucleus of NSCLC. The positive expression rate of ZNF217 in the cancer tissues was higher than that in the paracancerous tissues [52.5％ (63/120) vs. 20.1％ (25/120), χ 2 = 25.909, P < 0.05]. The positive expression rate of ZNF217 increased with the increase of tumor T stage (χ 2 = 7.333, P = 0.026), N stage (χ 2 = 7.782, P = 0.020) and TNM stage (χ 2 = 11.557, P = 0.003). The overall survival (P = 0.007) and progression-free survival (P = 0.004) of patients with positive ZNF217 were poorer than those of patients with negative ZNF217. Cox multiple factor analysis showed that ZNF217 was an independent risk factor affecting the prognosis of NSCLC. Conclusion ZNF217 is an independent risk factor affecting the prognosis of NSCLC, and it may be a potential target for accurate treatment of NSCLC.
  • 摘要：目的 观察大分割调强放疗联合阿帕替尼治疗合并上腔静脉综合征老年非小细胞肺癌(NSCLC)患者的临床疗效.方法 回顾性分析江苏大学附属徐州医院2015年2月至2017年12月收治的合并上腔静脉综合征的老年NSCLC患者46例,分为观察组与对照组(各23例).对照组行单纯大分割放疗,观察组放疗第1天开始同步口服阿帕替尼,比较两组疗效及不良反应.结果 观察组治疗1周完全缓解率为78.3％(18/23),高于对照组的43.3％(10/23)(χ2=4.60,P<0.05).观察组有效率为86.9％(21/23),高于对照组的65.2％(15/23)(χ2=4.294,P<0.05).两组主要不良反应为放射性食管炎、放射性肺炎、白细胞下降,多数为Ⅰ～Ⅱ级,两组不良反应发生率差异均无统计学意义(均P>0.05).观察组1年总生存率为56％,对照组为40％,两组差异有统计学意义(P=0.009).结论 大分割调强放疗联合阿帕替尼治疗合并上腔静脉综合征老年NSCLC患者有效,且治疗耐受性良好.%Objective To observe the clinical efficacy of large fraction intensity modulated radiation therapy combined with apatinib in the treatment of elderly patients with non-small cell lung cancer and superior vena cava syndrome. Methods A retrospective analysis was made on 46 elderly patients with non-small cell lung cancer and superior vena cava syndrome who were admitted to Xuzhou Cancer Hospital Affiliated to Jiangsu University from February 2015 to December 2017. The patients were divided into observation group and control group with 23 cases in each group. The control group received radiation therapy only. Apatinib was enrolled in the observation group on the first day synchronously. The remission time of symptoms, short-term efficacy, occurrence of adverse reactions and 1-year overall survival rate were observed and compared between the two groups. Results The complete remission rate was 78.3％ (18/23) in the observation group and 43.3％ (10/23) in the control group, and the difference between the two groups was statistically significant (χ 2 = 4.60, P < 0.05). The effective response rate was 86.9％ (21/23) in the observation group and 65.2％ (15/23) in the control group, and the difference between the two groups was statistically significant (χ 2 = 4.294, P < 0.05). The main adverse reactions in the two groups were radioactive esophagitis, radiation pneumonitis and leukopenia, and most of them were grade Ⅰ-Ⅱ, there was no significant difference between the two groups (all P > 0.05). The 1-year overall survival rate was 56％ in the observation group and 40％ in the control group, and the difference between the two groups was statistically significant (P = 0.009). Conclusion Large fraction intensity modulated radiation therapy combined with apatinib is effective in the treatment of elderly patients with non-small cell lung cancer and superior vena cava syndrome, and theadverse reactions are well tolerated.
  • 摘要：Objective To discuss the correlation between family history of malignant neoplasms (MN-FH) and the clinicopathological features of patients with non-small cell lung cancer (NSCLC). Methods The clinicopathological data of 326 patients with NSCLC in Yangzhou University Affiliated Hospital from June 2016 to June 2018 were analyzed retrospectively. The patients were divided into two groups based on with or without MN-FH, and the clinicopathological features of the two groups were analyzed by χ 2 test. Results Of the 326 patients with NSCLC, 41 (12.6％) were in the MN-FH group and 285 (87.4％) in the MN-FH group. There were no significant differences in sex, age, smoking, location of tumors and histological classification between patients with or without MN-FH (χ 2 values were 0.031, 0.769, 0.546, 0.117, and 0.945, all P > 0.05), but in patients with MN-FH, the proportion of tumor diameter < 5 cm [65.9％ (27/41) vs. 42.5％(121/285), χ 2 = 14.173, P < 0.05], undifferentiation and low differentiation [70.7％ (29/41) vs. 53.7％(153/285), χ 2 = 4.224, P < 0.05], TNM stage Ⅲ+Ⅳ [65.9％ (27/41) vs. 46.7％ (133/285), χ 2 = 5.280, P <0.05], lymph node metastasis [78.0％ (32/41) vs. 60.0％ (171/285), χ 2 = 4.970, P < 0.05], distant metastasis [75.6％ (31/41) vs. 53.3％ (152/285), χ 2 = 7.224, P < 0.05], high degree of malignancy [70.7％ (29/41) vs. 51.6％ (147/285), χ 2 = 5.293, P < 0.05] and combination of other tumors [29.3％ (12/41) vs. 7.7％ (22/285),χ 2 = 17.817, P < 0.05] were significantly higher than those in patients without MN-FH. Conclusions NSCLC patients with MN-FH have a higher degree of malignancy. For people with MN-FH, physical examination is very important.%目的 探讨恶性肿瘤家族史(MN-FH)与非小细胞肺癌(NSCLC)患者临床病理特征之间的关系.方法 回顾性分析扬州大学附属医院2016年6月至2018年6月收治的326例NSCLC患者的临床病理资料,根据有无MN-FH分成两组.采用 χ2检验分析两组临床病理特征之间的关系.结果 326例NSCLC患者中,有MN-FH 41例(12.6％),无MN-FH 285例(87.4％).有无MN-FH两组NSCLC患者间性别、年龄、吸烟、肿瘤发生部位、组织学分型的构成差异均无统计学意义(χ2值分别为0.031、0.769、0.546、0.117、0.945,均P>0.05),但有MN-FH组肿瘤直径<5 cm[65.9％(27/41)比42.5％(121/285),χ2=14.173,P<0.05]、未分化+低分化[70.7％(29/41)比53.7％(153/285),χ2=4.224,P<0.05]、TNM分期Ⅲ+Ⅳ期[65.9％(27/41)比46.7％(133/285),χ2=5.280,P<0.05]、淋巴结转移[78.0％(32/41)比60.0％(171/285),χ2=4.970,P<0.05]、远处转移[75.6％(31/41)比53.3％(152/285),χ2=7.224,P<0.05]、高恶性程度[70.7％(29/41)比51.6％(147/285),χ2=5.293,P<0.05]、合并其他肿瘤[29.3％(12/41)比7.7％(22/285),χ2=17.817,P<0.05]比例均高于无MN-FH组.结论 有MN-FH的NSCLC患者肿瘤恶性程度较高.对于有MN-FH的人群体检十分重要.
  • 摘要：肿瘤免疫治疗中,程序性死亡受体1(PD-1)及程序性死亡受体配体1(PD-L1)的研究为晚期肺癌的综合治疗提供了新的途径.肺癌免疫治疗中约有20％的非小细胞肺癌患者能从中获益,而PD-L1高表达的肺癌患者生存获益更多.目前国内外有关PD-1表达的相关研究还较少,对于PD-1/PD-L1表达含量的检测也多集中在肿瘤组织.随着液体活组织检查技术的研究进展,外周血检测的便捷性和准确性也日趋受到重视,但对于肿瘤免疫治疗疗效预测的生物学指标还较少,检测的统一标准及准确性还需要更多的临床实践及探索.文章就PD-1与PD-L1在肺癌患者组织及外周血中表达的研究情况进行综述,旨在为肺癌免疫检查点阻断剂的治疗提供参考.%In tumor immunotherapy, the study of programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) provides a new approach for the comprehensive treatment of advanced lung cancer. About 20％ of patients with non-small cell lung cancer could benefit from lung cancer immunotherapy, while those with high PD-L1 expression will benefit more. At present, there are few related studies on PD-1 expression at home and abroad, and the detection of PD-1/PD-L1 expressions is mostly concentrated in tumor tissues. With the research progress of liquid biopsy technology, the convenience and accuracy of peripheral blood testing are also receiving more and more attention. However, there are still few biological indicators for predicting the efficacy of tumor immunotherapy, and the uniform standard and accuracy of testing still need more clinical practice and exploration. This article reviews the research on the expressions of PD-1 and PD-L1 in tissues and peripheral blood of patients with lung cancer, aiming to provide reference for the treatment of lung cancer with immune checkpoint blockers.
  • 摘要：目的 探讨预后营养指数(PNI)与结直肠癌患者辅助化疗后粒细胞减少的关系.方法 回顾性分析2014年12月至2018年1月就诊于北京市顺义区医院的44例结直肠癌辅助化疗患者的临床资料,按粒细胞减少程度分为A组(0～2级粒细胞减少)和B组(3～4级粒细胞减少).收集患者化疗前1周内血清清蛋白、外周淋巴细胞计数、中性粒细胞计数,并计算PNI.采用χ2检验和秩和检验比较两组患者的临床资料、体质量指数(BMI)、基线中性粒细胞计数及PNI,采用logistic回归分析化疗后粒细胞减少的危险因素.结果 A组基线中位中性粒细胞计数和中位PNI分别为3.17×109/L[(1.38～7.79)×109/L]和50.40(37.40～57.05),高于B组的2.54×109/L[(1.22～3.87)×109/L]和45.50(37.95～50.95),两组间差异均有统计学意义(Z=-2.085,P=0.037;Z=-2.615,P=0.009).logistic回归分析提示PNI为影响化疗后粒细胞减少的独立危险因素(HR=0.803,95％CI 0.646～0.998,P=0.048).结论 PNI对预测结直肠癌患者辅助化疗后粒细胞减少有一定提示作用.%Objective To investigate the relationship between prognostic nutritional index (PNI) and neutropenia after adjuvant chemotherapy in patients with colorectal cancer. Methods The clinical data of 44 patients with colorectal cancer performed adjuvant chemotherapy in Shunyi District Hospital from December 2014 to January 2018 were retrospectively analyzed, and the patients were divided into group A (grade 0-2 neutropenia) and group B (grade3-4 neutropenia) according to the degree of neutropenia. The serum albumin, peripheral lymphocyte counts, and neutrophil counts within 1 week before chemotherapy were collected, and the PNI was calculated. The chi-square test and rank sum test were used to compare the clinical data, body mass index (BMI), baseline neutrophil count, and PNI between the two groups. Logistic regression analysis was used to analyze the risk factors for neutropenia after chemotherapy. Results The baseline median neutrophil counts and median PNI in group A were 3.17×109/L [(1.38-7.79)×109/L] and 50.40 (37.40-57.05), and in group B were 2.54 ×109/L [(1.22-3.87) ×109/L] and 45.50 (37.95-50.95). The baseline neutrophil counts and PNI in group A were significantly higher than those in group B, the differences between the two groups were statistically significant (Z= -2.085, P= 0.037; Z= -2.615, P= 0.009). Logistic regression analysis showed that PNI was an independent risk factor for neutropenia after chemotherapy (HR=0.803, 95％CI 0.646-0.998, P= 0.048). Conclusion PNI has a certain role in predicting neutropenia after adjuvant chemotherapy in patients with colorectal cancer.
  • 摘要：从风险管理角度出发,探讨药物临床试验机构的管理.根据风险管理风险评估技术,并以立项审核为例,按照风险识别、风险评估和风险控制的基本程序,将8项风险因素纳入至临床试验项目立项审核风险管理表中,初步建立药物临床试验机构风险管理模式,以此改进药物临床试验项目的管理质量,有效降低后期临床试验过程中风险发生率.%The management of drug clinical trial institutions from the risk management point of view is investigated. According to the technology of risk assessment in risk management, taking the project audit as an example, basing on the basic procedures of risk identification, risk assessment and risk control, making 8 risk factors into the table of risk management for project approval of clinical trial in order to initially establish a risk management of drug clinical trial institutions. In this way, the management quality of project for drug clinical trials will be probably improved, so that the risk incidence rate will be effectively reduced in the later phase of clinical trial.
  • 摘要：The pathogenesis of colorectal cancer is related to genetic and environmental factors. Chronic inflammation of the intestinal mucosa is one of the most important factors in environmental factors. In inflammation factors, Intestinal flora plays a role in bridging and inducing intervention. Environmental changes disrupt the homeostasis of intestinal flora, intestinal flora maladjustment occurred, bacteria induces intestinal mucosal inflammation. The pathogenic bacterium adheres to the surface of the intestinal mucosa, it produces cytotoxic and genotoxic products, intestinal epithelial cells undergo genetic damage. The synthesis and metabolites of bacteria also control the occurrence of colorectal tumor process. This process leads to the progression of inflammation to cancer. This article reviews the process of intestinal flora mediated from inflammation to carcinogenesis, and the latest progress in related pathogenic bacteria, and proposes that the intestinal flora can be adjusted and targeted removal of the conditional pathogenic bacteria, and achieve the goal of cancer prevention. The relationship between intestinal flora, intestinal inflammation and colorectal cancer is reviewed.%结直肠癌的发病机制与遗传和环境等综合因素有关.在环境因素中,肠黏膜的慢性炎症又是重要的癌变因素之一.在炎症相关因素中,肠道菌群起到桥梁和诱导介入的作用.环境改变破坏肠道菌群稳态,发生肠道菌群失调,诱导肠黏膜炎症,致病菌依附聚集在肠黏膜表面,产生细胞毒素与基因毒性产物,肠道上皮细胞发生遗传损伤,细菌的合成和代谢产物亦调控结直肠肿瘤的发生进程,这一过程导致炎症向癌变进展.文章综述了肠道菌群介导的从炎症到癌变的过程,以及相关条件致病菌的最新相关进展,并提出了可以调节肠道菌群,针对性的清除条件致病菌,并达到预防癌变的目的.文章就肠道菌群、肠道炎症和结直肠癌的关系进行综述.
  • 摘要：Objective To investigate the expression of Notch receptors and its relationship with clinicopathological features and prognosis in gastric cancer tissues. Methods Immunohistochemical SP method was used to detect the expression levels of Notch1, Notch2, Notch3 and Notch4 corresponding receptors in 45 patients with gastric cancer from January 2014 to May 2015 in the Third Affiliated Hospital of Hunan University of Traditional Chinese Medicine. The correlation between expression levels of Notch receptors and lymph node metastasis, TNM staging, disease-free survival (DFS) and overall survival (OS) were analyzed. Results Notch1, Notch2, Notch3 and Notch4 corresponding receptors were mainly distributed in the cytoplasm, and the positive expression rates in gastric cancer tissues were 93.3％ (42/45), 86.7％ (39/45), 80.0％ (36/45), and 77.8％ (35/45), which were higher than those in adjacent tissues [31.1％ (14/45), 24.4％(11/45), 40.0％ (18/45), and 46.7％ (21/45)], and the differences were statistically significant (all P< 0.05). There was no correlation between the expression of Notch1, Notch2, Notch3 and Notch4 corresponding receptors and lymph node metastasis, TNM staging, DFS and OS in gastric cancer tissues (all P> 0.05). Conclusion Notch receptors are highly expressed in gastric cancer tissues, and have no correlation with lymph node metastasis, TNM staging, DFS and OS of patients after surgery.%目的 探讨胃癌组织中Notch受体的表达及其与临床病理特征及预后的关系.方法 采用免疫组织化学SP法检测湖南中医药大学第三附属医院2014年1月至2015年5月45例手术治疗的胃癌患者标本中Notch1、Notch2、Notch3、Notch4相应受体表达情况,分析Notch受体表达与淋巴结转移、TNM分期及无病生存(DFS)、总生存(OS)的关系.结果 Notch1、Notch2、Notch3、Notch4相应受体主要分布在细胞质中,在胃癌组织中的阳性表达率分别为93.3％(42/45)、86.7％(39/45)、80.0％(36/45)、77.8％(35/45),均高于癌旁组织[31.1％(14/45)、24.4％(11/45)、40.0％(18/45)、46.7％(21/45)],差异均有统计学意义(均P<0.05).胃癌组织Notch1、Notch2、Notch3、Notch4相应受体表达与患者淋巴结转移状态、TNM分期、DFS、OS均无相关性(均P>0.05).结论 Notch受体在胃癌组织中高表达,与患者淋巴结转移、TNM分期及术后患者DFS、OS均无相关性.
  • 摘要：Objective To observe the clinical efficacy of irinotecan combined with capecitabine or tegafur-gimeracil-oteracil potassium in the second-line treatment of advanced colorectal cancer. Methods The clinical data of 19 patients with advanced colorectal cancer who were admitted to the Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College from October 2014 to December 2017 were retrospectively analyzed, and these patients failed the first-line chemotherapy regimen. All patients were treated with irinotecan plus capecitabine or tegafur-gimeracil-oteracil potassium. The patient's short-term efficacy, adverse reactions, progression-free survival, and overall survival were analyzed. Results After treatment, the efficacy in 18 of the 19 patients with advanced colorectal cancer was evaluable, including partial remission in 3 patients, stable disease in 13 patients, and disease progression in 2 patients. The objective remission rate was 16.7％ (3/18), the disease control rate was 88.9％ (16/18), the median progression-free survival time was 7.6 months, and the median overall survival time was 23.3 months. All of the patients were well tolerated , and the grade 4 adverse reaction was presented as grade 4 neutropenia (1 case), grade 3 leukopenia (2 cases) and thrombocytopenia (1 case), grade 2 diarrhea (1 case), and grade 1 diarrhea (3 cases), and grade 1-2 liver injury (3 cases) and nephrotoxicity (2 cases). Conclusion Irinotecan combined with capecitabine or tegafur-gimeracil-oteracil potassium in the treatment of advanced colorectal cancer is effective and safe, which is worthy of clinical promotion.%目的 观察伊立替康联合卡培他滨或替吉奥二线治疗晚期结直肠癌的临床效果.方法 回顾性分析中国医学科学院北京协和医学院肿瘤医院2014年10月至2017年12月收治的19例经一线化疗方案失败的晚期结直肠癌患者临床资料,所有患者均采用伊立替康联合卡培他滨或替吉奥方案治疗,分析患者近期疗效、不良反应、无进展生存及总生存情况.结果 19例患者治疗后,18例可评估疗效,其中部分缓解3例,稳定13例,进展2例,客观缓解率为16.7％(3/18),疾病控制率为88.9％(16/18),中位无进展生存时间7.6个月,中位总生存时间23.3个月.全组患者治疗耐受良好,不良反应表现为4级中性粒细胞减少1例,3级白细胞减少2例,3级血小板减少1例,2级腹泻1例,1级腹泻3例,1～2级肝损伤3例,1～2级肾毒性2例.结论 伊立替康联合卡培他滨或替吉奥治疗晚期结直肠癌效果确切且安全性良好,值得临床推广.
  • 摘要：目的 对比食管癌术后颈部吻合口瘘采用颈部切口完全敞开与半敞开引流的疗效.方法 回顾性分析2015年6月至2017年7月在郑州大学人民医院行食管癌根治术颈部胃-食管吻合术后发生吻合口瘘的53例患者的临床资料,其中颈部切口半敞开引流29例(A组),颈部切口完全敞开引流24例(B组).比较两组术前、术后1个月患者体质量指数(BMI)和血清清蛋白水平及瘘口愈合时间、治疗费用、吻合口狭窄发生率、肺部感染发生率.结果 A组与B组在术前1个月的BMI[(23.87±1.27)kg/m2和(23.34±1.76)kg/m2]、术后1个月BMI[(23.83±1.15)kg/m2和(23.28±1.61)kg/m2]、术前血清清蛋白水平[(38.40±3.61)g/L和(38.36±3.07)g/L]、 吻合口狭窄的发生率[31.03％(9/29)和33.33％(8/24)]、肺部感染发生率[58.63％(17/29)和54.17％(13/24)]方面比较,差异均无统计意义(均P>0.05).A组和B组患者住院时间[(19.62±2.39)d和(26.71±5.45)d]、治疗费用[(11.64±2.39)万元和(13.35±2.92)万元]、术后1个月血清清蛋白水平[(42.49±3.71)g/L和(38.00±3.71)g/L]比较,差异均有统计学意义(均P<0.05).53例患者的颈部瘘口经保守治疗均愈合.结论 对于食管癌术后发生吻合口瘘的患者,通过半敞开引流处理瘘口时,暴露切口小,切口愈合时间短,治疗费用低,还可快速改善患者营养情况,值得推广.
  • 摘要：Colorectal cancer is one of the most common malignant tumors of the digestive system. The incidence of colorectal cancer in China is increasing year by year. Screening for adenomas, precancerous lesions and early cancers can effectively reduce the incidence and mortality of colorectal cancer. Therefore, colorectal cancer screening is particularly important. At present, the colorectal cancer examination is mainly divided into fecal examination and colon structural examination. The fecal examination includes fecal occult blood test, fecal exfoliated cell test and fecal genetic analysis. The colon structural examination includes barium enema, colonoscopy and computed tomography colonography. Colonoscopy is considered as the gold standard for the diagnosis of colorectal cancer. It has the advantage of high accuracy, and can be used to find precancerous lesions and remove them at the same time. However, the screening should be greatly restricted because of its invasive examination, the need for intestinal preparation, obvious discomfort and the high cost of medical treatment. Comparatively, fecal occult blood test is simple, easy, non-invasive, saving manpower and material resources, and is suitable for large population screening. Some scholars in China have begun to pay attention to colorectal cancer screening, and fecal occult blood test is widely used in these screenings.%大肠癌是常见的消化道恶性肿瘤之一,近年来我国大肠癌发病率呈上升趋势,通过筛查可以诊断出腺瘤、癌前病变和早期癌症,从而降低其发病率和死亡率,因此筛查对于大肠癌显得尤为重要.目前大肠癌检查主要分为粪便检查和结肠结构性检查,其中粪便检查包括粪便隐血试验、粪便脱落细胞检查及粪便基因学检查等,结肠结构性检查包括钡灌肠、 结肠镜检查及计算机断层扫描结肠造影等.结肠镜检查被认为是大肠癌诊断的金标准,具有精准度高、可于发现癌前病变同时将其切除的优点,但因其为侵入性检查、需要肠道准备、检查时多引起被检查者明显不适和诊疗费用较高,其在筛查应用中受到了很大限制.相对而言,粪便隐血试验简单、易行、无创、节省人力物力,适合大规模人群筛查.我国部分学者已经开始重视大肠癌筛查,而粪便隐血试验在这些筛查中已被广泛应用.
  • 摘要：目的 探讨依他硝唑和紫杉醇对肝癌H22荷瘤小鼠的协同放射增敏作用.方法 在BALB/c小鼠背部接种肝癌H22细胞,构建移植瘤动物模型.其中40只荷瘤小鼠按随机数字表法分为4组,每组10只,各组经尾静脉分别注射磷酸盐缓冲液(PBS)、依他硝唑(200 mg/kg)、紫杉醇(1 mg/kg)及二药联合,给药2 h后,脱臼处死小鼠,采用高效液相色谱法分析小鼠血液和肿瘤组织内药物含量.取65只荷瘤小鼠按随机数字表法分为PBS无照射组、PBS照射组、依他硝唑照射组、紫杉醇照射组及联合给药照射组,每组13只,依据分组情况给药,照射组小鼠于给药2 h后接受60Co源照射;各组取10只,于不同时间点观察小鼠存活情况,测量并计算肿瘤体积,照射后第180天脱臼处死仍存活小鼠;各组另外3只于照射2 d后处死,取肿瘤组织,采用免疫组织化学法检测肿瘤组织乏氧诱导因子1(HIF-1)的表达情况.计量资料组间比较采用方差分析和t检验,应用Kaplan-Meier法进行生存分析.结果 给药2 h后,单独给药组和联合给药组间小鼠血液和肿瘤组织内依他硝唑和紫杉醇含量差异均无统计学意义[血液依他硝唑:(55.5±4.7)μg/ml比(50.7±5.2)μg/ml;肿瘤内依他硝唑:(31.2±3.5)μg/g比(33.6±5.4)μg/g;血液紫杉醇:(316.9±9.6)μg/ml比(289.5±10.3)μg/ml;肿瘤内紫杉醇:(161.7±7.2)μg/g比(181.3±11.6)μg/g;均P>0.05].自接受照射后第10天开始的40 d内,各时间点照射组较未照射组小鼠体质量下降明显(均P<0.05),给药组之间体质量差异无统计学意义(均P>0.05).照射后第40天,PBS照射组、 依他硝唑照射组、 紫杉醇照射组和联合给药照射组的肿瘤抑制率分别为19.2％、33.9％、48.7％和61.6％,照射后第180天,PBS无照射组、PBS照射组、依他硝唑照射组、紫杉醇照射组及联合给药照射组小鼠存活率分别为0、0、0、12.5％和25.0％,中位存活时间分别为30.2、54.7、55.6、83.4、102.8 d.照射2 d后,PBS照射组、依他硝唑照射组、紫杉醇照射组及联合给药照射组肿瘤组织HIF-1阳性表达率均较PBS无照射组低,差异均有统计学意义[(45.7±4.8)％、(40.6±5.9)％、(24.5±5.6)％、(17.2±3.7％)％比(63.1±7.2)％,均P<0.05],紫杉醇照射组和联合给药照射组HIF-1阳性表达率均较PBS照射组和依他硝唑照射组低(均P<0.05).结论 依他硝唑和紫杉醇联合对肝癌H22荷瘤小鼠具有协同放射增敏作用,同时HIF-1的表达水平降低,反映出乏氧细胞减少.%Objective To investigate the synergistic effect of etanidazole and paclitaxel on hepatocellular carcinoma H22 cells in mice. Methods To establish the murine xenografts, H22 cells was inoculated subcutaneously into the back of BALB/c mice. Among them, 40 tumor-bearing mice were divided into 4 groups by random number table method, 10 mice in each group, and each group injected with phosphate buffered saline (PBS), etanidazole (200 mg/kg), paclitaxel (1 mg/kg) and two drugs combination. Two hours after the administration, the mice were sacrificed by dislocation, and the drugs content in blood and tumor tissues of mice was measured by high-performance liquid chromatography. Sixty-five tumor-bearing mice were selected and divided into PBS non-irradiation group, PBS irradiation group, etanidazole irradiation group, paclitaxel irradiation group and two drugs combination irradiation group by random number table method, 13 mice/group. According to the grouping, the irradiated mice received 60Co source irradiation 2 hours after administration; the survival of 10 mice was observed at different time points, and the tumor volume was measured and calculated. The survival mice were killed by cervical dislocation 180 days after radiation. The other 3 mice in each group were killed after 2 days of irradiation, the tumor tissues were taken, and the expression of hypoxia inducible factor 1 (HIF-1) in these tumor tissues was detected by using immunohistochemistry. Statistical analysis of measurement data between groups was performed by using the one-way ANOVA and t test, and the survival analysis was made by Kaplan-Meier method. Results There was no significant difference of etanidazole and paclitaxel content in blood and tumor tissues between alone and combination administration groups at 2 hours after administration [etanidazole in blood: (55.5 ±4.7) μg/ml vs. (50.7±5.2) μg/ml; etanidazole in tumor: (31.2±3.5) μg/g vs. (33.6±5.4) μg/g; paclitaxel in blood: (316.9± 9.6)μg/ml vs. (289.5±10.3)μg/ml;paclitaxel in tumor: (161.7±7.2) μg/g vs. (181.3±11.6) μg/g; all P>0.05]. Within 40 days from the 10th day after the irradiation, the body weight of the irradiated group at each time point was significantly lower than that of the unirradiated group (all P< 0.05), but there was no significant difference in the body weight among the administration groups (all P>0.05). On the 40th day after irradiation, the tumor inhibition rates of the PBS irradiation group, etanidazole irradiation group, paclitaxel irradiation group, and two drugs combination irradiation group were 19.2％, 33.9％, 48.7％, and 61.6％, respectively. On the 180th day after irradiation, the survival rates of the PBS non-irradiation group, PBS irradiation group, etanidazole irradiation group, paclitaxel irradiation group, and two drugs combination irradiation group were 0, 0, 0, 12.5％, and 25.0％, respectively, and the median survival interval was 30.2, 54.7, 55.6, 83.4, and 102.8 d. After 2 days of irradiation, the positive expression rate of HIF-1 in the tumors tissues of PBS irradiation group, etanidazole irradiation group, paclitaxel irradiation group and two drugs combination irradiation group was lower than that in the PBS non-irradiation group, the differences were statistically significant [(45.7 ±4.8)％, (40.6 ±5.9)％, (24.5±5.6)％, (17.2±3.7％)％vs. (63.1±7.2)％, all P<0.05]. The positive expression rate of HIF-1 in the paclitaxel irradiation group and two drugs combination irradiation group was lower than that in the PBS irradiation group and etanidazole irradiation group (all P<0.05). Conclusion The combination of etanidazole and paclitaxel has synergistic radiation sensitization effect on hepatocellular carcinoma H22 cells in mice, and the expression level of HIF-1 is decreased, reflecting the decrease of hypoxic cells.
  • 摘要：目的 探讨结直肠癌错配修复(MMR)蛋白表达和微卫星不稳定(MSI)与肿瘤TNM分期的相关性.方法 回顾性分析2008年1月至2017年12月在空军军医大学西京消化病医院行结直肠癌根治术的1351例患者的临床资料.分析不同性别、年龄及TNM分期患者MMR蛋白表达和MSI情况.结果 1351例中,291例(22％)MMR蛋白表达缺失.单因素分析结果显示,年龄≥60岁与<60岁患者间MSH2、MSH6、PMS2缺失率比较,差异均有统计学意义(均P<0.05);T3期亚组MSH2缺失率与其他T分期亚组比较,差异有统计学意义(P<0.05);各N分期亚组间MLH1、PMS2缺失率比较,差异均有统计学意义(均P<0.05);N0和N1期亚组MSH2、MSH6缺失率与其他N分期亚组比较,差异均有统计学意义(均P<0.05);各M分期亚组间PMS2缺失率比较,差异有统计学意义(均P<0.05);各TNM分期亚组间PMS2缺失率比较,差异均有统计学意义(均P<0.05);TNM分期Ⅱ期、 Ⅲ期亚组MLH1、MSH2、MSH6缺失率与其他TNM分期亚组比较,差异均有统计学意义(均P<0.05).年龄≥60岁与<60岁患者MSI阳性率比较,差异有统计学意义(P<0.05);T3期亚组、T4期亚组、各N分期亚组间、各M分期亚组间及TNM分期Ⅱ期、Ⅲ期和Ⅳ期亚组MSI阳性率比较,差异均有统计学意义(均P<0.05).结论 结直肠癌患者MMR蛋白表达和MSI与肿瘤TNM分期密切相关,检测结直肠癌患者MMR蛋白表达和MSI对判断结直肠癌TNM分期有一定的参考价值,并可能指导结直肠癌患者的诊疗及判断预后.%Objective To investigate the relationship between mismatch repair (MMR) protein expression and microsatellite instability (MSI) and tumor TNM staging in colorectal cancer. Methods The clinical data of 1351 patients who underwent radical resection of colorectal cancer at the Xijing Digestive Hospital of Air Force Military Medical University from January 2008 to December 2017 were retrospectively analyzed. The MMR and MSI status in patients with different gender, age and TNM staging were analyzed. Results Of the 1351 specimens, 291 (22％) didn't express MMR protein. Univariate analysis showed that there were significant differences in the deletion rates of MSH2, MSH6 and PMS2 between patients ≥60 years old and<60 years old (all P<0.05);there were significant differences in the deletion rates of MSH2 between stage T3 and the other stages (P<0.05); the deletion rates of MLH1, PMS2 among different N stages, and the deletion rates of MSH2 and MSH6 between stage N0 or N1 and the other N stages were significantly different (all P< 0.05); the deletion rates of PMS2 among different M stages were significantly different (P< 0.05). There were significant differences in PMS2 deletion rates among different TNM stages and MLH1, MSH2 and MSH6 deletion rates between stage Ⅱ or Ⅲ and the other stages (all P< 0.05). There was significant difference in MSI positive rates between patients ≥60 years old and<60 years old (P<0.05); there were significant differences in MSI positive rates between stage T3 or T4 and the other T stages, among different N or M stages, and between TNM stage Ⅱ, ⅢorⅣand the other TNM stages (all P<0.05). Conclusions The MMR protein expression and MSI in colorectal cancer patients are closely related to tumor TNM staging. Detection of MMR protein expression and MSI in colorectal cancer patients has certain reference value for judging TNM staging of colorectal cancer. To a certain extent, it can guide the diagnosis and treatment of patients with colorectal cancer and judge the prognosis.
  • 摘要：目的 探讨股骨远端恶性骨肿瘤患者保肢术后的肿瘤学预后、假体的生存率及相关影响因素.方法 回顾性分析山西医科大学第二医院2008年1月至2013年12月收治的42例股骨远端恶性骨肿瘤行瘤段切除、膝关节肿瘤假体置换术患者的临床资料.对患者的肿瘤学预后、假体生存率及相关影响因素进行分析.结果 随访时间18～97个月.42例恶性骨肿瘤患者中,无瘤生存21例(50％),带瘤生存7例(16％),5年总生存率为66％.其中EnnekingⅡB期患者的5年总生存率为55.4％,ⅡA期患者的5年总生存率为75.0％,两者差异有统计学意义(χ2=4.350,P=0.037).人工假体生存率为78.6％(22/28),不同的截骨长度影响假体的生存率(χ2=4.248,P=0.039),不同的假体种类不影响假体的生存率(χ2=2.177,P=0.140).结论 股骨远端恶性骨肿瘤患者保肢术后具有较好的肿瘤学预后,影响肿瘤预后的重要因素是肿瘤Enneking分期.股骨远端不同的截骨长度影响假体的生存率,截骨的长度越长假体的生存率越低.%Objective To investigate the oncological prognosis, prosthesis survival rate and other related factors after limb salvage surgery for distal femoral malignant bone tumors. Methods A total of 42 patients who received the surgery of resection of malignant bone tumor of distal femur and prosthesis replacement of knee joint tumor in the Second Hospital of Shanxi Medical University from January 2008 to December 2013 were retrospectively analyzed. The patient's oncological prognosis, prosthesis survival rate and related influencing factors were analyzed. Results The follow-up period was 18-97 months. Of 42 patients with malignant bone tumors, 21 cases (50％) survived without tumor, 7 cases (16％) survived with tumor, and the 5-year overall survival rate was 66％. The overall survival rate of patients with Enneking stage ⅡB tumor was 55.4％, and that of patients with stage ⅡA tumor was 75.0％, and the difference was statistically significant (χ2= 4.350, P= 0.037). The survival rate of artificial prosthesis was 78.6％ (22/28), the different length of osteotomy affected the survival rate of prosthesis (χ2= 4.248, P= 0.039), but the different types of prosthesis did not affect the survival rate of prosthesis (χ2= 2.177, P= 0.140). Conclusions The distal femoral malignant bone tumor has a good oncological prognosis after limb salvage surgery, Enneking staging is an important factor affecting the oncological prognosis. The different length of osteotomy at the distal femur affects the survival rate of the prosthesis, the longer the prosthesis, the lower the survival rate of the prosthesis.
  • 摘要：目的 探讨肾脏原始神经外胚层肿瘤(PNET)的临床病理特征.方法 回顾性分析山西大医院收治的1例肾脏PNET患者的临床病理资料,并进行文献复习.结果 该患者临床表现和影像学检查无特异性,行根治性肾切除术,过程顺利.肉眼可见肿瘤切面呈灰红色,可区别于肾脏透明细胞癌;术后免疫组织化学提示为PNET、Vimentin(+)、CD99(+)、NSE(部分+)、CD117(部分+)、CD56(+)、Syn(+)、Fli-1(+)、Ki-67(30％+).术后21个月患者无复发及转移征象.结论 肾脏PNET临床罕见,预后相对较好,诊断依赖于组织病理学,早期手术治疗对改善预后有重要意义.

    肿瘤研究与临床的期刊信息

    • 曾用名：山西肿瘤防治通讯
    • 创刊时间：1986
    • 地区：CN
    • 语言：中文
    • 热门主题：中华医学会;山西省肿瘤研究所;山西省肿瘤医院
    • 学科分类：

      Biochemistry, Genetics and Molecular Biology:Cancer Research;Medicine:Oncology;

    肿瘤研究与临床的获奖情况

    肿瘤研究与临床的收录情况

    • • 农业与生物科学研究中心文摘
    • • 化学文摘（网络版）
    • • 医学文摘
    • • 哥白尼索引
    • • 日本科学技术振兴机构数据库
    • • 文摘与引文数据库
    • • 中国科技核心期刊

    肿瘤研究与临床的投稿信息

    • 投稿方式：在线投稿
    • 投稿须知：点击查看
    • 期刊官方网站：点击前往
    • 通讯地址：太原市职工新街3号
    • 邮编：030013
    • 联系电话：0351-4650389 4650386 4651416
    • 邮箱：crc@cmaph.org
    • 期刊栏目：论著；临床实验研究；短篇论著；综述；读者·作者·编者
    免费订阅本刊

    客服邮箱：kefu@zhangqiaokeyan.com

    京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有 出版物经营许可证

    • 客服微信

    • 服务号