进展期不同部位胃癌HER-2蛋白的表达

背景:HER-2基因为人表皮生长因子受体(EGFR)家族成员之一,在多种肿瘤中过表达。研究发现针对HER-2基因的靶向治疗可显著延长进展期胃癌/食管胃交界部腺癌患者的生存期。目的:研究HER-2蛋白在进展期不同部位胃癌中的表达情况。方法:应用免疫组化SP法对2012年2月-2013年8月安阳市肿瘤医院783例进展期胃癌行HER-2蛋白表达的检测,比较不同部位胃癌中HER-2蛋白阳性表达率。结果:食管胃交界部腺癌中的HER-2蛋白阳性表达率显著高于胃体腺癌和胃窦/幽门部腺癌(12.7%对6.7%和8.3%,P0.05),而胃体腺癌与胃窦/幽门部腺癌之间HER-2蛋白阳性表达率无明显差异(P0.05)。结论:HER-2蛋白阳性表达率可能与胃癌发生部位有关。     

青年人与老年人胃癌临床病理及预后对比分析

目的探讨青年与老年胃癌的临床、内镜、术后病理特点及预后。方法回顾性总结我院2003年12月～2012年12月经胃镜检查,手术确诊的青年人(≤35岁)胃癌51例及老年人(≥65岁)胃癌284例,进行临床表现、内镜表现、术后病理分型及预后等对比分析。结果近年来,胃癌患病总人数下降,同期内老年人胃癌总人数多于青年人;青年组胃癌以女性多,老年组以男性多;青年组多在胃下1/3,老年组多在胃上1/3;内镜下青年组多表现为Borrmann Ⅲ、Borrmann Ⅳ,术后病理以低分化腺癌、黏液腺癌、印戒细胞癌为主;老年组以Borrmann Ⅰ、Borrmann Ⅲ为主,术后以高-中分化腺癌居多;两组胃癌手术方式无差异性;老年组1年、3年生存率高于青年组。结论青年人胃癌临床症状隐匿,病理分化差,预后差。早期胃镜检查、定期复查、幽门螺杆菌根除、手术是青年人胃癌治疗的关键。     

延安地区胃癌发生部位的流行病学特征分析

目的了解近年来陕西省延安地区居民胃癌发生部位的流行病学特征,为胃癌防治提供依据。方法收集2010年1月至2014年12月陕西省延安市3家医院中经胃镜和病理检查确诊并且居住在延安地区的1 689例胃癌患者,统计分析患者的一般资料及肿瘤发生部位的流行病学特征。结果1 689例患者的胃癌发生部位:胃体(34.3%)、胃大部或全胃(27.3%)、胃窦(22.3%)、贲门(11.1%)、胃角(3.4%)、胃底(1.2%)、幽门(0.4%);男性1 308例(77.4%),女性381例(22.6%);胃窦和胃角部位胃癌患者的年龄以40~59岁居多(47.1%和46.6%),其余部位胃癌患者年龄均以60~79岁居多;各部位胃癌发病的主要人群为农民,农民占胃癌患者总数的55.4%;胃癌患者多来自宝塔区(35.8%)、安塞(12.7%);早期胃癌检出率较低,仅为2.2%;进展期胃癌临床分型以溃疡浸润型(BorrmannⅢ型)为主;各部位胃癌均以低分化腺癌为主。结论延安地区胃癌的好发部位是胃体、胃窦、贲门;各部位胃癌患者均以男性、农民为主要人群,好发年龄主要集中在中老年人(40~79岁);各部位胃癌患者主要分布在延安北部地区,而东南部地区较少;早期胃癌检出率较低,且主要集中在贲门、胃体部;进展期各部位胃癌在临床分型上均以BorrmannⅢ型为主,均以低分化腺癌为主。     

凹陷型胃癌抑酸治疗后假性愈合2例

正近年来,我国胃癌的发病率和死亡率居高不下,早诊断、早治疗是改善胃癌预后的根本方法。然而,胃癌早期多表现为非特异性消化不良症状,患者就诊时常被经验性给予抑酸治疗(质子泵抑制剂或H_2受体阻滞剂),而未行胃镜检查,从而延误诊断。本文就2例凹陷型胃癌抑酸治疗后假性愈合患者进行讨论。病例1:患者男,65岁,2012年2月20日于我院诊断为"肝硬化、肝左叶小肝癌",2012年3月2日行肝癌切除术,术后病理示:中分化肝细胞癌,切缘未见癌细胞。2015年4     

胃类癌引起上消化道大出血一例

患者男,68岁,半年前因反复解黑便于当地基层医院诊断为胃体腺癌,1个月前无明显诱因下呕吐鲜血约1000 ml,伴头晕、乏力、心悸、冷汗,在当地医院胃镜检查示胃体溃疡伴出血,病理检查提示胃体腺癌,予常规抑酸、止血、补液等对症支持治疗,出血控制后出院.为求进一步诊治来我院就诊,以胃癌收治入院.     

质子泵抑制剂治疗对胃食管反流病患者胃黏膜组织学变化的影响

背景:长期质子泵抑制剂(PPI)治疗对胃食管反流病(GERD)胃黏膜组织病理学特征(如萎缩、肠化生,甚至异型增生等)的影响少见针对性研究。目的:观察长期PPI治疗对不同幽门螺杆菌(Hp)感染状态GERD患者胃黏膜损伤和病理改变的影响。方法:采用前瞻性、随机和对照设计,纳入100例胃镜检查诊断为反流性食管炎(RE)的患者。给予埃索美拉唑20 mg bid初始治疗8周,之后按需维持治疗10个月。评估Hp感染的状态,治疗前后分别行GERDQ评分、胃镜检查以及胃黏膜组织学检查。结果:PPI治疗后,GERDQ评分较治疗前显著降低(P=0.000),食管炎愈合率为81.0%。Hp阳性组食管炎愈合率与Hp阴性组无明显差异(P=0.323)。胃体、胃窦黏膜慢性炎症较治疗前明显减轻(P0.05),活动性炎症基本消失,萎缩、肠化生均无加重,异型增生无增加趋势。Hp阳性组PPI治疗后胃窦黏膜活动性炎症(P=0.021)、异型增生(P=0.028)与Hp阴性组相比差异均有统计学意义。Hp阳性组胃窦慢性炎症的改善幅度低于胃体(P=0.041)。结论:长期大剂量PPI治疗可有效缓解GERD患者的临床症状,促进食管黏膜愈合,明显减轻患者胃体、胃窦的炎症。     

质子泵抑制剂与酸反跳

酸反跳(rebound acid hypersecretion)指停用抑酸药物后胃酸分泌增加超过治疗前水平.质子泵抑制剂(proton pump inhibitors,PPIs)作为一代抑酸药物,比H2受体阻滞剂(histamine-2receptor antagonists,H2RA)具有更强的抑酸效果,是治疗酸相关疾病的主要药物.目前研究已经证实,PPIs可致酸反跳发生.PPIs的酸反跳可以再次诱发酸相关症状出现,不仅增加医疗预算,也给PPIs治疗的终止带来问题.高胃泌素血症是导致酸反跳现象的重要机制.正确使用PPIs,严格掌握适应证,探讨在有效治疗酸相关疾病的同时减少酸反跳发生的措施.     

短程兰索拉唑、克拉霉素和阿莫西林三联疗法根除幽门螺杆菌在东南亚患者中的疗效——5日一日三次疗法和7日一日两次疗法

目的:测定和比较含兰索拉唑、克拉霉素和阿莫西林的5日tid疗法和7日bid疗法根除幽门螺杆菌(H.pylori)的疗效.方法:本研究为随机、双盲、对照研究.胃窦和胃体部活检经组织学检查和快速尿素酶试验确诊为H.pylori感染的患者纳入研究.患者分别接受克拉霉素500 mg tid、阿莫西林500 mg tid和兰索拉唑每日30 mg治疗5天(LAC5组)或克抗雷素500 mg bid、阿莫西林500 mg bid和兰索拉唑每日30 mg治疗7天(LAC7组).治疗结束至少4周后,用组织字检应查和快速尿素酶试验评估H.Pylori是否成功根除,胃窦和胃体部活检H.Pylori阴性定义为H.Pylori根除.结果:108例患者纳入研究.LAC5组有4例患者失访;LAC7组2例患者失访,2例患者对药物不能依从.按意图治疗分析,LAC5组的根除率为85.2%[46/54,95%可信区间(CI):72.9%,93.4%],LAC7组的根除率为87.0%(47/54,95%CI:75.1%,94.6%);按方案分析,LAC5组的根除率为92.0%(46/50,95%CI:80.8%,97.8%),LAC7组的根除率为94.0%(47/50,95%CI:83.5%,98.7%).两种疗法对患者均很适宜,除LAC7组2例外,其余患者均服完规定的药物.两种疗法的副作用均较轻微,没有患者因对药物不耐受而中断治疗.最常见的副作用是味觉改变(LAC5组:64.7%,LAC7组:78.8%).少数患者有腹泻、恶心和厌食.结论:LAC5 tid疗法和LAC7 bid疗法均为具有良好耐受性的治疗方案,根除H.Pylori的疗效高.     

抑酸治疗时幽门螺旋菌相关胃体胃炎加重:抑酸治疗的长期安全性

幽门螺旋菌(HP)引起以胃窦为主的慢性活动性胃炎,使易于发生粘膜萎缩及肠化,最终可导致胃癌。目前已知低酸分泌患者萎缩性胃炎迅速发生,为此作者研究抑酸治疗前后胃窦与胃体组织学变化,以阐明幽门螺旋菌相关胃炎变化。经内镜证实的十二指肠球部溃疡20例,良性胃溃疡6例,返流性食管炎21例和糜烂性胃炎3例。年龄20至79岁。在内镜检查前一月内未用抑酸、抗菌和铋剂治疗,且无严重基础疾病。所有病例给予奥美拉唑40mg/d连用8周。治疗前后经内镜在距幽门口2cm内取胃窦粘膜3块和距门齿50cm胃体大小弯侧粘膜6块,分别作HP培养和病理组织学检查。     

15075例基层医院胃镜检查结果分析

目的 总结基层医院胃癌及早期胃癌筛查水平.方法 回顾分析上海市金山区中心医院枫泾分院自1992年1月～2007年12月接受电子胃镜检查患者的胃癌筛查结果.结果 16年间因症状共行胃镜检查15 075例,经活检病理或手术巨体病理共检出胃癌273例,胃癌检出率1.81%.检出早期胃癌14例,早期胃癌检出率5.13%.首次胃镜病理阴性而漏诊胃癌43例,其中进展期胃癌39例,漏诊率15.06%,早期胃癌4例,漏诊率28.57%.结论基层医院也能检出早期胃癌,并有望今后能进一步提高早期胃癌检出率.加强胃镜阴性者复查,对胃癌前病变患者追踪随诊,清洁可疑病灶,减少创面渗血,靶向活检,多点多块活检,是减少胃癌漏诊率、提高早期胃癌检出率的关键手段.     

胃及胃食管连接部腺癌单纯手术治疗与术后联合放化疗的疗效比较

目的比较胃及胃食管连接部腺癌患者单纯手术治疗与术后联合放化疗的疗效。方法将156例胃及胃食管连接部腺癌患者随机分成单纯手术组和手术后联合放化疗组。所有患者均行胃及扩大的淋巴结切除（D2）。其中联合放化疗组患者联合氟尿嘧啶加亚叶酸的化疗及放疗。结果单纯手术组患者平均生存时间为27个月,联合放化疗组患者平均生存时间为36个月。单纯手术组死亡的危险度（HR）与联合放化疗组之比为1．35（22．3：16．5）（95％的可信区间：1．09—1．66,P=0．05）;单纯手术组癌症复发的危险度（rm）与联合放化疗组之比为1．52（37．2：24．5）（95％的可信区间：1．23～1．86,P〈0．01）。联合放化疗组患者无复发平均生存30个月,单纯手术组平均为19个月（P〈0．05）;联合放化疗组3年无复发生存率为48％,单纯手术组为31％（P〈0．05）。结论胃及胃食管连接部腺癌有复发的可能,高危患者均应在术后进行放化疗。     

腺病毒介导的肿瘤生长抑制因子4和白细胞介素-24双基因共表达对肺腺癌放疗增敏的体内外实验研究

目的 研究肿瘤生长抑制因子4 (ING4)和白细胞介素-24 (IL-24) 双基因共表达腺病毒载体对肺腺癌细胞SPC-A-1的体内外放疗增敏作用及其潜在的作用机制.方法 用Western blot法检测ING4和IL-24在SPC-A-1细胞中的表达;四甲基偶氮唑盐比色(MTT)法和流式细胞仪分别检测Ad-ING4-IL-24联合放疗对SPC-A-1肺腺癌细胞的生长抑制作用和促凋亡作用.应用抽签法将25只裸鼠随机均分为5组:PBS组、腺病毒(Ad)组、双基因组、放疗组及联合组,除放疗组外其余各组均采用瘤体内注射干预用药,隔日1次,共注射6次.第1次治疗前及开始治疗后隔日测量各组瘤体的长径(L)和短径(W),计算瘤体体积(V=L×W2/2),绘制瘤体体积-时间变化曲线.采用 SPC-A-1细胞株建立肺腺癌裸鼠模型,观察Ad-ING4-IL-24联合放疗对移植瘤的抑制作用.免疫组织化学法检测天冬氨酸特异性半胱氨酸蛋白酶-3(Caspase-3)、B细胞淋巴瘤/白血病-2 (Bcl-2)、Bcl-2相关X蛋白(Bax)及血管内皮细胞生长因子(VEGF)基因的表达.采用金正均法计算q值并判断其放疗增敏作用.结果 Western blot法检测结果显示,目的 基因在SPC-A-1细胞中成功表达;MTT和流式细胞仪检测结果显示,Ad-ING4-IL-24联合放疗组对SPC-A-1细胞的生长抑制和促细胞凋亡作用[(86.2±0.8)%、(60.9±1.0)%]明显高于Ad-ING4-IL-24双基因组[(49.8±0.3)%、(26.3±1.3)%]和放疗组[(44.4±2.2)%、(33.3±0.8)%](生长抑制率比较,F=550.88,P＜0.01;凋亡率比较,F=614.08,P＜0.01),Ad-ING4-IL-24联合放疗具有放疗增敏协同作用(q=1.20);裸鼠体内瘤重抑瘤率Ad-ING4-IL-24组、放疗组及Ad-ING4-IL-24联合放疗组分别为49.5%(样本5只)、35.4%(样本5只)和79.8%(样本5只),Ad-ING4-IL-24联合放疗能明显抑制移植瘤生长,具有放疗增敏协同作用(q=1.18);免疫组织化学法检测结果显示,Ad-ING4-IL-24联合放疗可明显上调Bax和Caspase-3基因表达,下调Bcl-2及VEGF基因表达.结论 Ad-ING4-IL-24具有放疗增敏作用,是理想的放疗增敏剂,其作用机制可能与诱导肿瘤细胞凋亡和抑制血管形成有关.

Abstract：

Objective To study the radiosensitivity of the recombinant adenoviral vector (called Ad-ING4-IL-24) carrying and co-expressing inhibitor of growth 4 (ING4) and interleukin-24 (IL-24) to human lung adenocarcinoma and the underlying mechanisms. Methods The expression levels of ING4 and IL-24 were detected by Western blot. The growth-suppressing and apoptosis-inducing effect of Ad-ING4-IL-24 combined with radiotherapy on SPC-A-1 lung carcinoma cells were assessed by MTT assay and FCM respectively. The 25 nude mice were randomly divided into 5 groups of 5 mice ecah: PBS group,Ad group,Ad-ING4-IL-24 group,radiotherapy group and joint group (Ad-ING4-IL-24 combined radiotherapy). Mice in all groups except radiotherapy group were intratumorally injected every other day for 6 cycles. The short and long axes of the tumor were measured dynamically, tumor volume was calculated as: V=L×W2/2, changes in tumor volume were graphed. The human lung carcinoma model was established with SPC-A-1 cells in nude mice. The ratios of tumor-suppression and q were calculated. The expression of Caspase-3, Bcl-2, Bax, VEGF in tumor samples were detected by immunohistochemistry. Results The expressions of ING4 and IL-24 were successfully expressed in SPC-A-1 cells. MTT assay and FCM showed that the levels of cell-growth inhibition and apoptosis induction in Ad-ING4-IL-24 combined with radiotherapy group [(86.2±0.8)%,(60.9±1.0)%] were higher than in Ad-ING4-IL-24 group [(49.8±0.3)%,(26.3±1.3)%] and in radiotherapy group [(44.4±2.2)%,(33.3±0.8)%] (ratio of cell-growth inhibition, F=550.88,P＜0.01; ratio of induced apoptosis F=614.08,P＜0.01). Ad-ING4-IL-24 combined with radiotherapy showed an enhanced radiosensitivity effect on human lung adenocarcinoma(q=1.20). In Ad-ING4-IL-24 group, radiotherapy group and Ad-ING4-IL-24 combined with radiotherapy group, the weight inhibition ratio was 49.5% (5 nude mice), 35.4%(5 nude mice), 79.8%(5 nude mice) respectively. Ad-ING4-IL-24 combined with radiotherapy had a synergetic and enhanced radiosensitivity effect on inhibiting the growth of transplanted tumor(q=1.18). According to immunohistochemistry, Ad-ING4-IL-24 was shown to up-regulate the expression of Bax and Caspase-3 but down-regulate the expression of Bcl-2 and VEGF. Conclusion Ad-ING4-IL-24 had an enhanced radiosensitivity effect on human lung adenocarcinoma, and therefore acted as a radiotherapy sensitizer, which may be related to its effect on apoptosis-induction and antiangiogenesis.     

Sutured Perineal Omentoplasty After Abdominoperineal Resection for Adenocarcinoma of the Lower Rectum

PURPOSE This study was designed to describe and evaluate the efficacy of sutured perineal omentoplasty on perineal wound healing after abdominoperineal resection for adenocarcinoma of the lower rectum.METHODS Charts of patients who underwent abdominoperineal resection for adenocarcinoma of the rectum from June 1995 to December 2001 were reviewed for mortality, morbidity, and perineal healing. Abdominoperineal resection was accomplished according to Miles combined with total mesorectal excision. The omentum was pediculized on the left gastroepiploic artery and tightly sewn to the subcutaneous fatty tissue. The perineal skin was then closed primarily.RESULTS A total of 104 patients were included in the study. The mean age at surgery was 65 (range, 13–91) years. The distance of the tumor from the anal sphincters was 0.45 ± 0.9 mm (range, 0–50). During the study period, 92 patients (88 percent) had sutured perineal omentoplasty. The rate of primary perineal wound healing was 80 percent. Postoperative perineal wound complications consisted of perineal abscess in seven patients. Six of these patients had a sutured perineal omentoplasty (6 percent). Only four patients required a surgical drainage. Minor perineal suppuration occurred in four patients (4 percent), whereas partial perineal wound dehiscence occurred in eight patients (8 percent). All wounds healed completely at three months. Intestinal obstruction occurred in three patients (3 percent). No complication of the pedicled omentoplasty was observed.CONCLUSIONS This study demonstrated that sutured perineal omentoplasty is possible in the majority of patients after abdominoperineal resection for adenocarcinoma of the lower rectum with excellent primary perineal wound healing.Poster presentation at the meeting of The American Society of Colon and Rectal Sergeons, New Orleans, Louisiana, June 21 to 26, 2003.Published online: 31 January 2005     

Radioimmunolocalization using the radiolabeled monoclonal anti-cea antibody 11-285-14 lacks diagnostic utility for the differentiation of pancreatic and bile duct cancer from chronic pancreatitis and sclerosing cholangitis

CEA expression was determined by immunohistochemistry in paraffin sections from cases of pancreatic cancer(n = 30), chronic pancreatitis(n = 10), cholangiocarcinoma(n = 12), and sclerosing cholangitis (n-4) using a new anti-CEA monoclonal antibody (11-285-14). CEA was expressed in 77% of pancreatic cancers and 80% of cholangiocarcinomas, but was not detected in any of the cases of sclerosing cholangitis. Although 60% of chronic pancreatitic tissues were positive, staining intensity was markedly reduced compared to cancers. Twenty-five patients with these conditions were therefore studied using radioimmunolocalization. Eleven of 12 pancreatic cancers were positively imaged, as were all three biliary tumors. However, positive scans were also obtained in 50% of the cases of chronic pancreatitis and sclerosing cholangitis. The overall sensitivity (68%) and specificity (63%) of radioimmunolocalization using the 11-285-14 antibody were not high enough to justify its use for diagnosis. Aspects of this paper were presented at the International Symposium on Cancer of the Exocrine Pancreas (New Horizons), Toledo, Ohio, June 15–17, 1989.     

Prolonged survival of a patient with advanced colonic cancer

A 39-year-old man who survived 14 years following the diagnosis of advanced colonic carcinoma is reported. The presence of metastatic lesions had been well documented at the time of abdominal surgery on three different occasions and at autopsy. The possible mechanism for his unusually prolonged survival time is discussed.     

Synchronous Adenocarcinoma and Gastrointestinal Stromal Tumor in the Stomach

In recent years, the synchronous occurrence of tumors of different histotypes arising in the same organ has been reported more frequently in the literature. In the stomach, adenocarcinoma has been described with coexisting primary rhabdomyosarcoma, carcinoid, and low-grade B-cell lymphoma of mucosa-associated lymphoid tissue. The simultaneous development of adenocarcinoma and gastric mesenchymal tumor has been documented rarely. We report one such case. A 65-year-old male was diagnosed with a proximal gastric adenocarcinoma and underwent subtotal gastrectomy. Subsequent histopathological examination revealed the presence of another tumor at the gastric antrum. This was a gastrointestinal stromal tumor of low risk category (GIST). The literature has only a few previous reports of this very rare association. It is not known whether this synchronicity is incidental or there is a causative factor inducing the development of tumors of different histotypes in the same organ. Pathologists, oncologists and surgeons should be aware of this interesting condition.     

Metallothionein concentration in the liver of patients with Wilson''s disease, primary biliary cirrhosis, and liver metastasis of colorectal cancer

In patients with primary biliary cirrhosis and Wilson's disease liver copper concentrations become elevated during the evolution of the disorder. The accumulated copper is thought to be detoxified by metallothionein, a protein which binds copper and zinc. In liver metastasis of colorectal cancer, copper and zinc concentrations are usually decreased compared to normal liver tissue, but little is known about the concomitant metallothionein levels. In the present study metallothionein concentrations were determined in archival liver samples from patients with primary biliary cirrhosis and Wilson's disease, and in both normal and malignancy-containing liver samples from patients with metastasis from a colorectal adenocarcinoma. Twenty-seven control liver samples contained 3.98 +/- 1.55 mg metallothionein/g protein. From the 21 liver samples of patients with primary biliary cirrhosis, which had a mean metallothionein concentration of 6.06 +/- 5.03 mg/g protein, 6 were above the highest control level. Liver metallothionein concentrations for the 8 patients with Wilson's disease were significantly elevated (10.98 +/- 6.93 mg/g protein, p < 0.005 vs. controls and p < 0.05 vs. primary biliary cirrhosis). In the 11 liver metastases from colorectal adenocarcinomas metallothionein concentrations (1.17 +/- 0.90 mg/g protein) were significantly (p < 0.005) lower than surrounding normal liver tissue (4.25 +/- 1.75 mg/g protein). We conclude that in primary biliary cirrhosis and Wilson's disease increased liver metallothionein concentrations may detoxify the accumulated copper. Furthermore, liver metastasis of colorectal cancer contains less metallothionein than the surrounding normal liver tissue.     

Barrett食管和食管腺癌的基因表达谱研究

目的:研究Barrett食管(BE)和食管腺癌的基因表达谱,筛查与食管腺癌相关的基因.方法:使用Dchip软件对已经在GEO数据库中公开的BE和食管腺癌Affymetrix芯片表达谱数据进行分析.还原扫描图像进行独立核验,并对基因和组织进行双向聚类,最后用配对t检验筛查出在BE和食管腺癌中表达水平都发生变化的基因,并进一步分析其功能.结果:24张Affymetrix芯片的杂交质量稳定,被污染和发生交叉杂交的探针簇都少于5%.对基因和样本的双向聚类表明,大部分组织分类正确.只有N8和A5位于错误的组织类型中.对其余22张芯片再次分别进行配对t检验,得到24个基因.其中表达水平呈进行性上升的5个,呈进行性下降的19个.新检出的PITX1已在稍前不久的另一项研究中得到证实.结论:用新的分析方法研究已公开的表达谱芯片资料为研究肿瘤的发病机制提供了新的手段.     

Radical external beam radiation therapy for adenocarcinoma of the rectum

External beam megavoltage radiation therapy was used as primary treatment for 123 patients with rectal adenocarcinoma. Surgery was undertaken for some patients who had residual tumor. The overall five-year survival rate was 21 per cent. When patients were separated into those who presented with clinically mobile and those with clinically fixed rectal tumor masses, the survival rates were 38 per cent and 2 per cent, respectively. The primary tumor was controlled by radiation alone in 21 of 56 (38 per cent) patients who had mobile tumors but in only six of 67 (9 per cent) patients who had fixed tumors. Further investigation of high-dose primary radiation, with surgery reserved for patients with residual rectal carcinoma, may allow reduction of the number of patients who require abdominoperineal resection. Secretarial and statistical service support was provided by a grant from the Ontario Cancer Treatment and Research Foundation.     

食管胃交界腺癌的研究进展

食管胃交界腺癌（AEG）发生于食管和胃交界区域,目前尚无统一的分类标准,以解剖学为基础的Siewert分类法逐渐被临床认可。Barrett’s食管通路和胃通路是AEG的主要发病机制。手术切除是AEG的主要治疗方法,新辅助疗法的应用可在一定程度上改善患者预后,基因靶向疗法是治疗AEG的新方向。目前,东西方国家对AEG的研究结果存在争议,其病因、临床病理特点、分子生物学特点以及治疗方法等仍有待进一步研究。本文就AEG的研究进展作一综述。