宫腺肌病恶变3例临床病理分析

目的：探讨子宫腺肌病恶变病例的临床病理特点。方法：回顾性分析我院2001年1月至2010年12月收治的3例子宫腺肌病恶变患者的临床病理资料。结果：3例患者就诊年龄为45、56及58岁,临床表现主要为经量增多、经期延长、绝经后阴道流血及盆腔痛,3者血清CA125浓度分别为34.98U/ml、196.6U/ml、22.4U/ml,超声检查无特异性,均依靠术后石蜡病理确诊,3例患者均行手术治疗,术后酌情辅以放化疗。结论：子宫腺肌病恶变罕见,术后病理为唯一确诊依据,术前诊断困难,易误诊、漏诊,为治疗方式的选择及实施造成一定局限性,应提高对该病的认识,重视早期诊断,正确治疗,改善预后。     

血清CA125结合超声造影检查对子宫肌瘤与子宫腺肌症的鉴别诊断价值

[目的]探讨血清CA125结合超声造影检查对子宫肌瘤与子宫腺肌症的鉴别诊断价值.[方法]对73例临床诊断为子宫局灶性病变的患者进行血清CA125检测、常规腔内超声及超声造影检查,并与术后组织病理结果比较.[结果] 73例患者中27例(37.0％)为子宫腺肌症,46例(63.0％)为子宫肌瘤;CA125阳性24例(32.9％).血清CA125阳性患者中,79.2％ (19/24)经术后病理确诊为子宫腺肌症;血清CA125阴性患者中,83.7％(41/49)经术后病理确诊为子宫肌瘤,两者差异有统计学意义(P＜0.01).27例子宫腺肌症超声造影表现为绝大多数病灶内部呈不均匀增强,占74.1％(20/27);46例子宫肌瘤超声造影表现为绝大多数病灶区环状不均匀强化,占87.0％(40/46),两者差异有统计学意义(P＜0.01).[结论]血清CA125结合超声造影检查,可为子宫肌瘤与子宫腺肌症的鉴别诊断提供更准确的信息,具有重要的临床应用价值.     

子宫腺肉瘤的临床病理分析

目的探讨子宫腺肉瘤的临床病理学特征、诊断、治疗及预后。方法回顾性分析中国医学科学院肿瘤医院自2001年～2013年收治的13例子宫腺肉瘤患者的临床病理资料及随访结果。结果患者年龄36～71岁,平均54岁。主要表现为异常阴道出血,特征性病理表现为肿瘤间质＂套袖样＂或息肉样突入腺腔内。13例患者均接受手术治疗,9例术后行辅助化疗,3例行放疗。随诊期间1例Ⅳ期患者因化疗无效于术后1个月死亡;3例患者于初始治疗后数月内死于肿瘤复发、转移,另外9例患者随访至今无复发。结论子宫腺肉瘤临床罕见,无特异性临床表现,确诊依赖于术后病理学检查;临床呈低度恶性,治疗应采用手术为主的综合治疗,晚期及存在高危因素的患者预后不良。疾病易复发,应长期随诊。     

子宫内膜异位症恶变3例报告

目的探讨子宫内膜异位症恶变的临床特点。方法回顾性分析1995年1月至2006年4月收治的3例子宫内膜异位症恶变病例的临床、病理资料并结合复习文献。结果子宫内膜异位症恶变3例占同期盆腔子宫内膜异位病例的1.82%;常见症候为盆腔包块、腹部不适或疼痛和痛经;手术切除病灶经病理检查才能确诊;3例中1例失访、1例已生存42个月、另1例已生存55个月。结论子宫内膜异位症恶变罕见;术前难以诊断、切除病检才能确诊;治疗以手术切除为主综合化疗、放疗及激素治疗;早期病例预后较好。     

16例子宫静脉内平滑肌瘤临床分析

目的:分析子宫静脉平滑肌瘤的临床病理特征,探讨其诊断与治疗方法。方法:回顾性分析自2004年4 月至2009年10月我院确诊的子宫静脉平滑肌瘤患者的临床特征及病理资料。结果:子宫静脉平滑肌瘤的临床表现与子宫肌瘤或子宫肌腺症相似,术前超声诊断率很低,术中绝大部分子宫静脉平滑肌瘤可以诊断,子宫静脉平滑肌瘤可以发生在宫体、宫颈及阔韧带内。手术方式有子宫肌瘤剔除术、全子宫切除术、全子宫+双附件切除术。术后随访有1 例复发。结论:子宫静脉平滑肌瘤是一种具有生长转移特征的的良性肿瘤,术前诊断困难,术中应仔细探查,切除全部肿瘤,且术后要严密随访。      

子宫肌腺病临床误诊为子宫肌瘤47例分析

子宫肌腺病是子宫内膜异位于肌壁内的良性病变，多缺少典型的症状及特异性检查方法，临床上较易误诊。现将1989年1月至1996年12月临床误诊为子宫肌瘤，术后病理确诊为子宫肌腺病47例报告如下。临床资料年龄：30－54岁，中位42岁。30－40岁19例，41－50岁月例，sl－54岁7例。主诉：月经紊乱或经量增多37例，痛经4例，腹痛3例，体检发现3例。妇科检查：45例行妇科检查，子宫均不同程度增大。B超检查：46例行B超检查，43例报告为子宫肌瘤，2例报告为子宫占位病变，l例报告为子宫内膜病变。术式：全子宫切除术引例，次全子宫切除术16例。病理结…     

子宫腺肌病与子宫内膜癌相关性的研究进展

子宫内膜癌是女性生殖系统中常见的恶性肿瘤,在接受手术治疗的子宫内膜癌患者的术后病理标本中常常发现合并子宫腺肌病,二者虽然是两个不同的妇科疾病,但它们之间却存在潜在的联系。子宫腺肌病可能是促进子宫内膜癌发生发展的高危因素,但同时也可能是抑制子宫内膜癌进展的保护因素。在研究子宫腺肌病与子宫内膜癌的相关性时,很难明确恶性肿瘤的来源,恶性肿瘤可从子宫内膜扩散到子宫腺肌病病灶中,反之亦然。子宫肌层连接区的破坏是判断肿瘤是否侵犯子宫肌层的重要解剖标志,而子宫腺肌病主要表现为病灶连接区异常增厚,并伴有组织侵袭、快速增殖、血管生成以及远处转移等生物学行为,从而对子宫内膜癌的诊治及术后分期造成一定的影响。阐明二者之间潜在的联系及其相互作用机制,有助于子宫内膜癌和子宫腺肌病的早期诊断,从而提高患者的生存率及生活质量。本文根据相关研究报道,通过分析子宫腺肌病对子宫内膜癌发生发展、诊断和预后的影响,探讨子宫腺肌病与子宫内膜癌的相关性,为子宫内膜癌和子宫腺肌病的精准诊疗以及相关研究找到新的思路和方向。     

利用卵巢肿瘤的新标志CA_(125)鉴别子宫平滑肌瘤和子宫肌腺病

根据免疫组织化学检查,人卵巢癌相关抗原CA_(125)存在于上皮性卵巢肿瘤的腺腔上皮细胞膜上。临床上,以卵巢非粘液性单纯性原发癌患者血清中出现率高且浓度亦高,并与治疗效果密切相关,为卵巢癌血清标志被重视。作者术前测定良性子宫肿瘤患者血清的 CA_(125)水平,对鉴别有困难的子宫平滑肌瘤和子宫肌腺病进行鉴别,获得有意义的结果。研究对象及方法:64例正常者均系无症状并经妇科检查及超声检查排除子宫、卵巢肿瘤和妊娠的21～91岁妇女,19例良性子宫肿瘤均为术后摘除子宫病理检查确诊者,其中子宫平滑肌瘤11例、子宫肌腺病7例、两病同存者1例,各在术前、后取血清,置-20℃保存。用 CA_(125)RIA 箱(CENTOCOR,Inc,Ma-     

子宫苗勒管腺肉瘤临床病理分析

目的 探讨子宫苗勒管腺肉瘤的临床病理特点、诊治方法及预后.方法 回顾性分析北京协和医院2003年1月至2009年2月收治的9例子宫苗勒管腺肉瘤患者的临床病理资料,并进行随访.结果 9例患者中,子宫内膜腺肉瘤6例,宫颈腺肉瘤3例.主要表现为异常阴道出血和盆腔疼痛.妇科检查见宫颈或阴道肿物,可扪及子宫增大和盆腔包块.肿瘤间质以腺周套袖样及息肉样突入腺腔结构为特征性病理表现.子宫苗勒管腺肉瘤术前正确诊断率为66.7%,以临床Ⅰ期为主(7/9).9例患者均行手术治疗,术后辅以化疗7例,辅以放疗1例,高效孕激素治疗3例.有5例患者保留单侧或双侧卵巢,3例行病灶局部切除术.2例子宫内膜腺肉瘤复发,其中1例临床Ⅲ期患者合并肉瘤成分过度生长,术后13个月死于肿瘤复发;另1例患者行宫腔病灶切除术后2年复发,切除子宫后随访正常.另7例患者随访至今无复发.结论 子宫苗勒管腺肉瘤临床罕见,患者症状、体征无特异性,其诊断依赖病理形态学检察.子宫苗勒管腺肉瘤呈低度恶性,临床以早期病例为主.治疗应采用手术为主的综合疗法,临床早期且完整切除病灶者的预后较好,临床晚期且合并肉瘤成分过度生长者的预后差.子宫苗勒管腺肉瘤的复发率较高,应长期密切随诊.     

快速冰冻病理检查在子宫内膜癌术中的诊断价值

目的:探讨快速冰冻病理检查在子宫内膜癌术中诊断的价值,为术中手术治疗方案的制定提供客观依据。方法:对2006年1月-2010年12月我院妇科诊断及手术治疗的182例子宫内膜癌患者的临床病理资料进行回顾性分析。所有患者术前均采用分段诊断性刮宫诊断方法诊断为子宫内膜癌,接受手术治疗并常规术中行快速冷冻病理切片检查。以术后石蜡病理检查结果为标准,比较患者术中快速冰冻病理检查结果在判断肿瘤分级和肌层浸润方面与其的符合率。结果:182例子宫癌患者浆液性癌、透明细胞癌、子宫内膜样腺癌所占比例分别为10.44%、2.74%、87.36%;术前肿瘤细胞分级确诊为G1级,依据FIGO分期,Ⅰa期、Ⅰb期、Ⅰc期、Ⅱa期、Ⅱb期、Ⅲc期所占比例分别为57.69%、13.19%、10.44%、7.69%、5.49%、5.49%。182例子宫内膜癌患者肿瘤细胞分级诊断,差异有统计学意义(P<0.05)。快速冰冻病理检查和石蜡切片病理检查,差异有统计学意义(P<0.05)。结论:快速冰冻病理检查在子宫内膜癌术中对组织学分级的诊断准确率不高,但对肌层浸润深度尤其≥1/2肌层浸润深度的诊断较为准确。在子宫内膜癌术中应用快速冰冻病理检查具有一定的指导意义,可作为肌层浸润深度评估的常规检查之一,为术中制定手术范围及淋巴结切除提供客观依据。     

两种慢性髓系白血病细胞株对干扰素-α的敏感性

背景和目的：临床研究表明干扰素-α(interferon-alpha,IFN-α)是造血系统恶性肿瘤和淋巴瘤的有效治疗剂之一。然而,IFN-α仅可使约70％～80％的慢性髓系白血病(chronic myeloid leukemia,CML)患者获得血液学缓解。不同的CML患者对IFN-α反应性不同的机制尚未阐明。本研究旨在比较两种CML细胞株KA-1／A3、K562对IFN-α的不同敏感性。方法：(1)采用MTT、半固体集落形成和台盼蓝染色液体培养细胞检测,不同浓度IFN-α(100、500、1000、5000和10000u／ml)对KT-1／A3及K562细胞生长的影响;(2)IFN-α(1000u／ml)诱导KT-1／A3、K562细胞48h后,采用流式细胞分析(flow cytometry,FCM)、荧光染色和DNA片段检测细胞凋亡;(3)加入IFN-α(1000u／m1)培养KT-1／A3、K562细胞48h后采用相对定量RT-PCR分析细胞bcr／abl基因表达水平。结果：(1)IFN-α呈剂量依赖性(从100u／ml到10000u／ml)抑制KT-1／A3细胞生长;(2)IFN-α(1000u／m1)诱导48h后使KT-1／A3细胞凋亡率从3．3％升到11．8％,并使KT-1／A3细胞中bcr／abl嵌合基因的表达水平降至对照组的66．7％;(3)IFN-α对K562细胞的生长、凋亡及bcr／abl嵌合基因表达无明显调节效应。结论：不同类型的CML细胞对IFN-α的反应性不同。     

Significance of CA19-9 in Predicting the Prognosis of Urothelial Carcinoma: A Hospital Based Study from Nepal

Background: The present study was undertaken to establish any correlation of elevated levels of CA19-9 withtumor stage or grade of urothelial carcinoma. Materials and Methods: This hospital based study was carriedout in the Department of Biochemistry of Nepalese Army Institute of Health Sciences between 1st July 2012 and31st December 2012. Approval for the study was obtained from the institutional research ethical committee.CA19-9 was assayed with an ELISA reader for all cases and expressed in U/ml with 37U/ml taken as the cut-offupper value for normal. Results: Out of 20 cases enrolled, 15 were of urothelial carcinoma and the remaining5 were controls. There was marked difference between the mean values of CA19-9 in cases 40.2±19.3U/ml ofurothelial carcinoma and controls 7.98±7.34U/ml. The number of cases in Ta, TI, T2, T3, T4 stages of urothelialcarcinoma were 2, 6, 3, 3, 1 respectively. The percentage rise in CA19-9 was less with low grade tumors (22.2%)when compared with high grade tumors (66.6%) (p value 0.001*). The percentage of rise in CA19-9 for muscleinvasive tumors was very high when compared to superficial tumors. Similarly, the percentage of rise in CA19-9 for metastatic disease was very high when compared to non-metastatic disease and it was found statisticallysignificant (p value 0.001*). Conclusion: Serum CA19-9 levels predicts the prognosis of urothelial carcinoma asit is almost invariably raised in tumors having metastatic spread.     

Enhancement of cytotoxicity of cisplatin in vitro by recombinant human tumor necrosis factor and/or recombinant human interferon-alpha, -beta and -gamma

This study was conducted to investigate the modulatory effects of recombinant human tumor necrosis factor (rH-TNF) and recombinant human interferon (rH-IFN)-alpha, -beta and -gamma, either alone or in combination, on the cytotoxicity of cisplatin, using MTT assay, against MKN-45 (human stomach adenocarcinoma). MKN-45 was resistant to rH-TNF even at doses up to 10(3) U/ml. rH-IFN-gamma inhibited the survival of MKN-45 dose-dependently, while rH-IFN-alpha and -beta did not inhibit the survival of MKN-45 even at the highest concentrations tested (10(4) U/ml). Combination of rH-TNF with rH-IFN-alpha, -beta or -gamma did not significantly inhibit the survival of MKN-45, except for a combination of 10 U/ml of rH-TNF and 10(3) U/ml of rH-IFN-gamma (P less than 0.05). Cisplatin inhibited the survival of MKN-45 dose-dependently. By the simultaneous combination of cisplatin with rH-TNF and/or rH-IFN-alpha, -beta or -gamma, cytotoxicity of cisplatin was enhanced and the combination effects were additive. The effects of rH-TNF and rH-IFN-alpha, -beta and -gamma on the modification of cytotoxicity of cisplatin were evaluated in terms of modification index (MI), demonstrating that rH-TNF, rH-IFN-alpha, -beta and -gamma all augmented the cytotoxicity of cisplatin: MI values at 10(3) U/ml of rH-IFN-alpha, -beta and -gamma were 1.4, 1.4 and 2.3, respectively; those at the same concentrations of rH-IFN-alpha, -beta and -gamma in the presence of 10 U/ml of rH-TNF were 3.6, 2.5 and 5.1, respectively. These results demonstrating that the cytotoxicity of cisplatin was enhanced by rH-TNF and/or rH-IFN-alpha, -beta or -gamma suggest that cancer may be more effectively treated with the combination of cisplatin with these biological response modifiers than with cisplatin alone.     

Significance of Suppressor of Cytokine Signaling-3 Expression in Bladder Urothelial Carcinoma in Relation to Proinflammatory Cytokines and Tumor Histopathological Grading

Background: Bladder cancer is among the five most common malignancies worldwide. Altered expression ofsuppressor of cytokine signaling -3 (SOCS-3) has been implicated in various types of human cancers; however, itsrole in bladder cancer is not well established. Aim: The present study was undertaken to investigate the mRNAexpression of SOCS-3 in normal and cancerous bladder tissue and to explore its correlation with urinary levelsof some proinflammatory cytokines, cytokeratin-18 (CK -18) and with tumor histopathological grading, in orderto evaluate their role as potential diagnostic markers. Materials and Methods: SOCS3 mRNA expression levelswere evaluated using quantitative real time PCR. Urinary levels of interleukins 6 and 8 were estimated by enzymelinked immunosorbent assay (ELISA). Cytokeratin-18 expression was analyzed by immuunohistochemistry thenvalidated by ELISA. Results: SOC3 m RNA expression levels were significantly lower in high grade urothelialcarcinoma (0.36±0.12) compared to low grade carcinoma (1.22±0.38) and controls (4.08±0.88), (p<0.001). However,in high grade urothelial carcinoma the urinary levels of IL-6, IL-8, total CK-18(221.33±22.84 pg/ml, 325.2±53.6 pg/ml, 466.7±57.40 U/L respectively) were significantly higher than their levels in low grade carcinoma (58.6±18.6 pg/ml, 58.3±50.2 pg/ml, 185.5±60.3 U/L respectively) and controls (50.9±23.0 pg/ml, 7.12±2.74 pg/ml, 106.7±47.3U/Lrespectively), (p<0.001). Conclusions: Advanced grade of urothelial bladder carcinoma is significantly associatedwith lowered mRNA expression of SOC3 as well as elevated urinary levels of proinflammatory cytokines andCK-18. Furthermore, our results suggested that urinary IL-8, IL-6 and CK-18 may benefit as noninvasivebiomarkers for early detection as well as histopathological subtyping of urothelial carcinoma.     

Absence of chemotherapy-induced alopecia with paclitaxel in a case of hypothyroidism: case report.

A 69-year-old woman presented in October 1998 with abdominalpain and distension. On physical examination, ascites and tenderness on palpating the lower abdominal area were found.An abdominal computed tomography (CT) scan revealed a 4.5 cmmass in the left ovary with multiple peritoneal implants andascites. The serum tumor marker CA 125 was 190 U/ml (normal,<32), whereas thyroid hormones were within normal limits:thyroid-stimulating hormone (TSH) 5.1 U/ml, thyroxine 7.2 U/ml,tri-iodothyronine 1.2 U/ml. She underwent a staging laparotomy     

卵巢透明细胞癌血液学检验的临床意义

目的探讨卵巢透明细胞癌（OCCA）血液学检验结果的临床意义及其与预后的关系。方法回顾性分析1999年2月至2009年9月间我院收治的121例卵巢透明细胞癌患者的临床资料。结果中位发病年龄48岁（24～73岁）。FIGO分期：Ⅰ期57.0%（69/121）,Ⅱ期9.9%（12/121）,Ⅲ期30.6%（37/121）,Ⅳ期2.6%（3/121）。总的5年生存率（49.8%）：Ⅰ期68.7%,Ⅱ期76.4%,Ⅲ期13.9%,Ⅳ期0。初次治疗前、术后1周、化疗3程后及复发时CA125均值分别为（433.9±1051.3）U/ml、（162.9±327.0）U/ml、（20.3±40.5）U/ml和（317.0±1023.8）U/ml。初次治疗前CA125水平高于正常参考值者占87.2%（75/86）。初次治疗前CA19-9均值为（90.6±152.8）U/ml,高于正常参考值者占50.7%（34/67）;CEA均值为（3.6±9.4）ng/ml,高于正常参考值者占6.9%（2/29）;乳酸脱氢酶（LDH）均值（259.3±168.8）U/L,高于正常参考值者占35.9%（14/39）;血清钙均值（2.4±0.2）mmol/L,高于正常参考值者占9.8%（4/41）;血清铁均值（10.3±6.4）μmol/L,低于正常参考值者占35.1%（13/37）;血红蛋白（HGB）均值（123.7±17.4）g/L,低于正常参考值者占17.4%（4/23）。初次治疗前CA125水平≤1000U/ml组和〉1000U/ml组中位生存时间比较,差异有显著性（P=0.019）。化疗3程后CA125水平≤20U/ml组和〉20U/ml组中位生存时间比较,差异有显著性（P=0.002）。结论 OCCA血液学检验特点包括CA125及CA19-9升高、乳酸脱氢酶（LDH）升高、血钙升高、血清铁降低和血红蛋白（HGB）降低,初次治疗前和化疗3程后CA125水平可能与OC-CA的预后相关。     

Netrin-4对胶质母细胞瘤细胞ERK/MAPK信号通路的影响

目的:通过免疫印迹方法检测不同浓度的Netrin-4(NTN4)重组蛋白对GBM细胞中磷酸化ERK水平的影响,初步探讨NTN4对GBM细胞ERK/MAPK信号通路的调控作用.方法:体外培养野生型GBM细胞:U251 MG细胞及U87MG细胞,加入两种不同浓度的NTN4重组蛋白(5ng/ml,50ng/ml),裂解细胞提取目的蛋白,在不同时间点(0,10min/20min,30min,1h,2h,3h)通过免疫印迹方法检测磷酸化ERK水平变化情况.结果:加入NTN4后,U251 MG细胞和U87MG细胞中的磷酸化ERK水平都有所增加;在U251 MG细胞中,5ng/ml的NTN4作用后1h,磷酸化ERK水平最高,50ng/ml的NTN4作用后10分钟,磷酸化ERK水平最高;在U87MG细胞中,不同浓度的NTN4都在作用10分钟时,磷酸化ERK水平最高.结论:Netrin-4激活胶质母细胞瘤细胞内ERK/MAPK信号通路,是其抑制GBM细胞衰老的可能机制.     

宫颈癌患者血清CYFRA21-1、TPS、CA125和CEA表达的临床分析

目的:探讨宫颈癌患者血清CYFRA21-1、TPS、CA125、CEA表达和临床的相关性。方法:随机选取28例宫颈癌患者和同时期的宫颈上皮内瘤样病变患者31例,健康对照人群35例。化学发光分析法检测血清CYFRA21-1、TPS、CA125和CEA水平,观察其和宫颈癌临床分型、分期的关系。结果:宫颈癌组CYFRA21-1、TPS、CA125、CEA检出水平最高,分别为:（5.15±36.35）ng/ml、（129.45±74.73）U/L、（58.35±17.47）U/ml、（15.86±9.35）ng/ml;宫颈上皮内瘤样病变检出水平其次,分别为:（0.96±0.45）ng/ml、（53.12±21.56）U/L、（36.24±14.23）U/ml、（3.28±1.74）ng/ml;健康人群最低,分别为:（0.61±0.32）ng/ml、（36.71±17.35）U/L、（12.69±4.51）U/ml、（1.26±0.86）ng/ml,以上两两比较差异均有显著性差异(P<0.05)。宫颈癌Ⅰ-Ⅱ期和宫颈癌Ⅲ-Ⅳ期在CYFRA21-1、TPS、CA125、CEA水平上比较差异也有统计学意义（P<0.05）。结论:血清CYFRA21-1、TPS、CA125、CEA在宫颈癌患者中的表达明显高于宫颈上皮内瘤样病变和健康受试者,为临床诊治研究提供了新的思路和方向。其在宫颈癌诊断中是否具有较好的特异性,需做进一步的临床研究。     

Carbohydrate antigen 15-3 and mucinous carbohydrate antigen immunoreactivities in human seminal plasma

Carbohydrate antigen 15-3 (CA 15-3) and mucinous carbohydrate antigen (MCA) immunoreactivities were detected in human seminal plasma. Mean values for CA 15-3 (8.2 +/- 3.7 U/ml, range 2.6 - 18.4 U/ml) and MCA (13.8 +/- 8.2 U/ml, range 2.1-31.9 U/ml) in the seminal plasma were of the same magnitude as that found in serum. No correlation was obtained between seminal plasma, either CA 15-3 or MCA immunoreactivities, and volume of seminal plasma, sperm count or percent of motile spermatozoa. Seminal plasma CA 15-3 and MCA levels were significantly (p less than 0.001) correlated (r = 0.55). The nature and origin of CA 15-3 and MCA immunoreactivities in human plasma are unknown.