大肠恶性肿瘤血液流变学及血脂代谢改变的临床意义

目的 探索大肠恶性肿瘤血液流变学及血脂水平变化的规律,评价其临床意义。方法 对６４例大肠恶性肿瘤、２６例大肠息肉、３６例普通病人检测了血液流变学指标、血甘油三酯、胆固醇、高密度脂蛋白、低密度脂蛋白、极低密度脂蛋白。结果 大肠息肉组与正常级各项指标间无明显差异,大肠癌有淋巴结转移及远处转移时全血中、低切粘度、血浆粘度、全血还原粘度、红细胞聚集指数、红细胞变形指数、血沉方程Ｋ值均明显增高,血甘油三酯、低密度脂蛋白也增高。结论 随着大肠癌病情的发展,血脂代谢出现异常,血液流变学出现明显变化,动态观察血液流变学和血脂改变,对大肠癌诊治及监测有重要意义。     

血液流变学在胃癌TNM分期中的意义

目的检测胃癌患者血粘度的变化，寻找早期发现胃癌的简易指标。方法：检测４４例胃癌患者血液流变学（血粘度）的有关指标，并按国际ＴＮＭ法分组，分析各血液流变学指标在胃癌不同分期中的意义。结果：（１）胃癌患者的全血低切粘度比正常人增高３０％，血浆高切粘度增高１１０．８％，红细胞凝聚指数增加４８．１８％，红细胞刚性指数增加５２．９４％；而红细胞变形指数明显低于正常人４８．９４％。各项比较均有显著性差异（Ｐ＜０．０５）。（２）按国际ＴＮＭ分期将各患者分组后表明：在Ⅰａ－Ⅱ期间，随着胃癌分期的增加，全血低切粘度、全血高切粘度、血浆高切粘度、红细胞凝集指数、红细胞刚性指数、全血还原粘度指标逐渐增加；红细胞变形指数逐渐降低；Ⅲ－Ⅵ期患者表现为红细胞刚性指数增加和红细胞变形指数下降，而其它指标却接近正常。结论：当机体的血液流变学指标发生改变时，应引起高度重视。     

不同分期肺癌患者血液流变性变化的临床意义

目的探讨不同分期肺癌患者血液流变性变化的临床意义.方法采用国产血液粘度计,在37℃条件下,测定全血粘度、血浆粘度、红细胞压积、红细胞聚集指数、纤维蛋白原,并观察各期肺癌患者的血液流变学特性及它们之间的差异.结果Ⅱ、Ⅲ期肺癌的血液流变学各参数,包括全血各粘度,血浆粘度等指标均显著高于正常人,其各个切变率全血粘度和血浆粘度等指标均明显高于正常人,Ⅰ、Ⅳ期肺癌各个血液流变学指标接近甚至低于正常.结论肺癌患者在病程的不同阶段,血液流变性有不同的变化,这种变化可能有其特定的临床意义.     

血液流变性在肺癌发展过程中的变化规律

目的 探讨血液流变性在肺癌发展过程中的变化规律。方法 采用国产血液粘度计，在37℃条件下，测定全血粘度、血浆粘度、红细胞压积、红细胞聚集指数、纤维蛋白原，并观察各期肺癌患者的血液流变学特性及它们之间的差异。结果 Ⅱ、Ⅲ期肺癌的血液流变学各参数，包括全血各粘度，血浆粘度等指标均显著高于正常人，其各个切变率全血粘度和血浆粘度等指标均明显高于正常人，Ⅰ、Ⅳ期肺癌各个血液流变学指标接近正常。结论 肺癌患者在病程的不同阶段，血液流变性有不同的变化，这种变化可能有其特定的临床意义。     

恶性肿瘤,高血压病患者及健康人血液流变学观察

目的　探讨恶性肿瘤与血液流变学的关系。方法　对恶性肿瘤患者４４ 例与高血压病患者４２ 例及健康人４２例的血液流变学进行观察分析。结果　恶性肿瘤患者的红细胞沉降率、血浆粘度、血栓长度、血小板粘附率均高于高血压组及正常组（Ｐ＜ ０．０５ 和Ｐ＜ ０．０１）;红细胞压积低于高血压组及正常对照组（Ｐ＜ ０．０１）;血栓湿重明显高于正常组（Ｐ＜ ０．０１）;全血高切粘度平均值低于高血压组（Ｐ＜ ０．０５）,有显著性差异,晚期转移组的红细胞沉降率,血浆粘度高于非转移组（Ｐ＜ ０．０５）;血球压积低于非转移组（Ｐ＜ ０．０１）。结论　恶性肿瘤患者存在着明显的血液流变学异常,晚期患者尤其明显,提示恶性肿瘤患者处于高粘高凝状态,检测血液流变学对判断病情预测预后有一定意义,改善血液粘滞状态可以延缓病情,防止转移,预防血栓并发症发生。     

45例肝癌患者血液流变指标的检测分析

目的了解肝癌病人血流变状态,探讨肝癌与血瘀症的关系.方法对45例肝癌病人及40例健康者血液流变学相关指标进行比较.结果肝癌病人全血低切还原粘度、全切高切还原粘度、红细胞电泳指数、血沉、红细胞压积明显高于正常对照组(P＜0.01).全血高切粘度、全血低切粘度差异显著(P＜0.05).结论提示肝癌病人呈高粘滞状态,血液流变学检测对指导治疗具有重要价值.     

消化系统恶性肿瘤患者血液流变学指标检测的临床价值

目的 探讨消化系统恶性肿瘤患者血液流变学相关指标的检测价值.方法 收取消化系统恶性肿瘤患者119例作为观察组,对其临床资料进行回顾性分析,同时收取同期健康体检的人群82例作为对照组,对2组的血液流变学指标检测结果进行观察与比较.结果 恶性肿瘤患者全血粘度以及纤维蛋白原含量与健康体检人群无统计学差异(P＞0.05),但血浆黏度、红细胞沉降率及血小板粘附率均远高于健康体检人群,血细胞比容远低于健康体检人群,差异均具有统计学意义(P＜0.05).转移组患者血浆粘度及红细胞沉降率均明显高于非转移组患者,差异有统计学意义(P＜0.05),而在其他血液流变学指标方面,2组差异无统计学意义(P＞0.05).治疗后,恶性肿瘤患者的血浆黏度明显降低,血细胞比容明显升高,与治疗前相比差异均具有统计学意义(P＜0.05);而在其他血液流变学指标比较方面,治疗前后尚无统计学差异(P＞0.05).结论 消化系统恶性肿瘤患者血液存在明显高凝状态,因此血液流变学指标对于评价肿瘤发生发展具有十分重要的意义.     

血液流变学在原发性肺癌和转移性肺癌的变化特性探讨

目的:探讨原发性肺癌与转移性肺癌患者血液流变学值变化的特性。方法:选择我院住院肺癌患者55例,并分为原发性肺癌组26例;转移性肺癌组29例;健康对照组50例。采用国产血液粘度计分别测定各组全血粘度、血浆粘度、红细胞压积、红细胞聚集指数、纤维蛋白元。结果:肺癌组血液流变学各参数明显高于健康对照组,差异具统计学意义,t=2.903-13.593,P<0.001,P<0.01;而原发性肺癌组血液流变学各参数,除血浆粘度外均明显高于转移性肺癌组,差异具统计学意义P<0.001,P<0.01;且上两组血液流变学各指标较之健康对照组均明显增高,差异具统计学意义P<0.001,P<0.01。结论:血液流变学值的检测对肺癌的诊断、治疗、预后的评估具有一定的临床价值。     

血液流变学在原发性肺癌和转移性肺癌的变化特性探讨

目的:探讨原发性肺癌与转移性肺癌患者血液流变学值变化的特性.方法:选择我院住院肺癌患者55例,并分为原发性肺癌组26例;转移性肺癌组29例;健康对照组50例.采用国产血液粘度计分别测定各组全血粘度、血浆粘度、红细胞压积、红细胞聚集指数,纤维蛋白元.结果:肺癌组血液流变学各参数明显高于健康对照组,差异具统计学意义,t=2.903-13.593, P＜0.001, P＜0.01;而原发性肺癌组血液流变学各参数,除血浆粘度外均明显高于转移性肺癌组,差异具统计学意义P＜0.001,P＜0.01;且上两组血液流变学各指标较之健康对照组均明显增高,差异具统计学意义P＜0.001, P＜0.01.结论:血液流变学值的检测对肺癌的诊断、治疗、预后的评估具有一定的临床价值.     

肺癌各期的血液流变学特点及藻酸双酯钠的治疗作用

为探讨不同ＴＮＭ分期肺癌的血液流变学特点及藻酸双酯钠（ＰＳＳ）的治疗作用，检测了５８例肺癌血液流变学指标，并观察了１５例Ⅲ期以上肺癌用ＰＳＳ静脉滴注后血液流变学的变化。结果显示：各期肺癌全血比粘度、血浆比粘度、纤维蛋白原、红细胞聚集指标（血沉和方程Ｋ值）、红细胞变形指数均高于正常对照值，血球压积却低于正常对照值。不同分期肺癌的血球压积、全血粘度、血浆粘度、血浆纤维蛋白原、血沉、血沉方程Ｋ值、红细胞变形指数相比较均无显著性差异，但Ⅰ～Ⅱ期红细胞电泳时间短于正常对照值（Ｐ＜０．０５），Ⅲ期短于Ⅰ～Ⅱ期（Ｐ＜０．０５），Ⅳ期短于Ⅲ期（Ｐ＜０．０５）。１５例Ⅲ期以上肺癌病人藻酸双酯钠治疗后血球压积、血浆比粘度、血浆纤维蛋白原均有所下降，红细胞变形指数升高，而与肺癌病情轻重有明显关系的红细胞电泳时间却无明显改变，血沉反而略有上升（Ｐ＜０．０５）。结果表明：肺癌血液流变学具有不同与其它疾病的特点；红细胞电泳时间与肺癌病情轻重有关；ＰＳＳ对肺癌血液流变学指标有一定的改善作用。     

Incidence and familial occurrence of colorectal cancer and polyps in a health-care district of northern Italy

The first year of registration of colorectal tumors in a predominantly urban population (263,546 inhabitants) of northern Italy gave us the opportunity to investigate: (a) the incidence (crude, age-specific, age-standardized) of both colorectal cancer and polyps and their localization; (b) the familial occurrence of these neoplasms; and (c) if the data could fit into the "Adenoma-Carcinoma Sequence." Crude incidence of cancer was 52.8 new cases/100,000 in 1984, with 53.4 cases in men and 52.2 cases in women. The corresponding figures for polyps were 59.6 new cases, with 83.4 in men and 37.3 cases in women. The incidence increased with age for both cancer and polyps, although the latter were more frequent until patients were in their sixties and the peak of incidence of polyps anticipated that of cancer by a 5 year period. Both cancer and polyps had a similar distribution in the large bowel, more than 60% being located in the left distal portion. There were 72 cases of colorectal cancer among the first-degree relatives of the registered patients compared with 16 in the controls (RR = 4.26, chi 2 = 27.2 p less than 0.001). An increased frequency of cases of colorectal cancer in the families was found in both the cancer group and the polyp group. In conclusion, the observed incidence of large bowel tumors was similar to that of other well-developed countries. The earlier rise and peak of age-specific incidence of polyps as compared to cancer, the similar distribution of benign and malignant neoplasms in the various intestinal tracts, and the similar familial aggregation observed both in the cancer and in the polyp groups further support the "polyp-cancer sequence" and provide us with a promising strategy for the prevention of colorectal malignancies.     

Labeling index in colonic cancer, polyps and polyposis and nonspecific colitis

Thymidine historadiography was employed to study labelling index in tumors and grossly-unaltered mucosa of large bowel in 34 cases of colorectal cancer and 67 patients with single polyps, polyposis and villous tumors of large bowel and suffering from nonspecific colitis. Mean labelling index in tumor tissue was established at 5.49, in normal mucosa of large bowel of healthy subjects--1.19, and in colitis, polyps and villous tumors--2.32, 4.24 and 5.84%, respectively. Labelling index increased with the degree of pathologic changes in mucosal epithelium of large bowel. Thymidine historadiography should be used in formation of groups at risk for large bowel cancer.     

Predictors of metachronous colorectal neoplasms in sporadic adenoma patients

Our objective was to assess the overall risk of subsequent colorectal neoplasms (cancer or adenoma) in relation with the various characteristics of the index lesion in a cohort of patients who underwent endoscopic polypectomies of colorectal adenomas. A total of 1086 patients with adenomas of the large bowel were reported between 1979 and 1999 at the National Cancer Institute of Milan during a screening program for colorectal carcinoma. Data on patients who had colonoscopic examinations and treatments were collected prospectively. The relation between colorectal cancer (CRC) and adenoma features was assessed by computing the hazard ratio (HR) values and corresponding confidence intervals (95% CI) according to Cox proportional hazard models. Of the 1086 eligible patients (487 females, 579 males), 736 had single adenomas (67.7%) and 350 had multiple adenomas (32.3%). Histologic examination revealed 772 cases of tubular adenoma (73%), 205 cases of tubulovillous adenoma and 80 cases of villous adenoma (7.5%). Severe dysplasia was found in 3.3% of the cases. During the 11393 person-years of follow-up, with an average time of surveillance of 10.5 years, colorectal carcinomas developed in 10 patients (0.8%) and a new adenoma in 323 patients (29%). Multivariate analysis showed that male gender (HR 1.6; 95% CI 1.3-2.0), multiple polyps (HR 1.6; 95% CI 1.3-2.0), polyps larger than 2 cm (HR 1.5; 95% CI 1.1-2.1), tubulovillous and villous histology (HR 1.3; 95% CI 1.0-1.6 and HR 1.8; 95% CI 1.2-2.6, respectively) at index polypectomy were statistically significant risk factors for developing metachronous adenomatous polyps. The standardized incidence rates (SIR) for CRC was 0.52 (95% CI 0.25-0.95). The SIR was increased in subjects with severe dysplasia (2.8; 95% CI 0.34-1.02). Some features of large bowel adenomas are strongly correlated with an increased risk of metachronous adenomas and colorectal cancer. However, the endoscopic polypectomy is able to reduce by 50% the incidence of CRC in patients with large bowel adenomas.     

Hemorheology study during invasion and metastasis after the subcutaneous transplantation of mouse uterine cervix carcinoma U14

The hemorheological changes during invasion and metastasis in mice injected with uterine cervix carcinoma U14 were studied. The tumor cells were transplanted subcutaneously into 615-strain inbred mice. Animals were sacrificed at days 5, 9, 15 and 19. Every mouse was examined histologically and viscosity tests were performed, including determination of plasma viscosity, blood viscosity, hemotocrit and aggregation of red cells. The results of the histological examination showed that tumor invasion is slightly apparent 5 days after transplantation (grades I–III). The invasive behavior of the tumor cells increased 9 days after inoculotion, when interstitial edema and new capillary formation occurred adjacent to the solid tumor. At 15 days, invasive tumor behavior was exhibited, with extensive interstitial edema, new capillary formation (10090 cases) adjacent to the solid tumor, and lymphatic metastasis (71% cases). Nineteen days after transplantation the invasive behavior of the tumor cells was of grade III and lymphatic metastasis was present in 100% of cases. The hemorheological investigation showed no change after 5 days. After 9 days, however, plasma viscosity, aggregation of red cells and blood viscosity increased significantly. At 15 and 19 days after transplantation, all four hemorheological values showed a significant decrease. The results are discussed.     

全结肠镜检出大肠息肉及大肠癌患者的结果分析

目的回顾性分析大肠息肉癌变的相关影响因素及探讨全结肠镜检查对大肠癌及腺瘤患者诊断治疗的重要性。方法 对电子肠镜检查中检出的大肠息肉及大肠癌患者的内镜特点及病理资料进行总结和分析。结果 在1100例肠镜检查者中, 发现大肠息肉患者387例(1543枚), 大肠息肉中有42例发生癌变(42枚), 息肉好发部位为左半结肠。左半结肠息肉、宽基息肉、直径＞2cm息肉和绒毛状腺瘤容易癌变。大肠癌患者326例, 检出率29.63%。大肠息肉、大肠癌以及大肠息肉癌变高发年龄均为45岁以上, 具有相似性。大肠癌伴结直肠息肉患者92例, 多原发癌29例。术后再发息肉患者66例。结论 大肠息肉癌变与患者年龄, 息肉部位、大小、形态以及病理类型显著相关。大肠癌及腺瘤患者做全结肠镜检查可以防止漏诊, 降低死亡率。     

Fecal neutral steroids in normal conditions and in patients with polyps or cancer of the large bowel

There is evidence suggesting that the excretion and conversion of neutral sterols in the human large bowel might be somewhat related to the development of colorectal cancer. Therefore, our objectives were: to characterize the excretion and the major pattern of sterol degradation in normal conditions, both in children and in adults; and to investigate if abnormalities of these parameters are frequent in patients with colorectal cancer or polyps. The study has been carried out in: 38 adult volunteers; 29 children divided into 4 age groups; 22 patients with colorectal cancer; 16 members of 6 families with adenomatosis coli; 15 members of 2 families with a high prevalence of multiple polyps or cancer of the large bowel; 12 subjects with colorectal polyps without familiality. With the subjects kept under metabolic control, fecal samples were collected for at least 3 days and analyzed by thin layer chromatography and gas-liquid chromatography. Total neutral steroid excretion was lower in children than in adult volunteers; in contrast, there was no significant difference between the latter and the other investigated group of patients with cancer or polyps, with values ranging between 230 and 680 mg/day. All the adult volunteers were "high converters" of cholesterol to its intestinal metabolites coprostanol and coprostanone [89 +/- 10% (SE) of degradation]. Children less than 1 year old degraded little or no cholesterol (10.4 +/- 6% of total neutral sterols), whereas with increasing age the fraction of conversion became more similar to that of adults. In patients with colorectal tumors 2 populations could be defined, one characterized by a large degradation of cholesterol and the other by little or no conversion. Low degradation of cholesterol was found in 3 of 6 families with adenomatosis coli. In conclusion, we did not find any significant difference in total neutral sterol excretion among controls, colorectal cancer patients, or subjects at risk. In adult volunteers the normal pattern of cholesterol degradation is characterized by a large conversion of cholesterol to its intestinal metabolites. In children this process changes with increasing age from an absolute "nonconverter" state (after birth) to the pattern typical of adults. Finally, in a minority of patients with either polyps or cancer of the large bowel and of their first-degree relatives, cholesterol is poorly degraded and represents the most abundant fecal sterol.     

Obesity and colorectal adenomatous polyps

Obesity has been investigated as a risk factor for various malignancies, including colon cancer. A case-control study was conducted on patients in three colonoscopy practices in New York City to determine possible risk factors for colorectal adenomatous polyps, a known precursor lesion for most cases of colorectal cancer. Among 301 case subjects with incidence adenomatous polyps (174 men and 127 women) and 506 control subjects (223 men and 283 women), an increased risk was observed with increasing body mass index in women (odds ratio 2.1, 95% confidence interval 1.1-4.0; for highest versus lowest quartile, linear trend P = .02). A nonsignificant trend was observed for men. The increased risk seen in women is consistent with prior observations regarding reproductive hormonal and dietary risk factors for colorectal cancer.     

Colorectal ornithine decarboxylase activity in human mucosa and tumors: elevation of enzymatic activity in distal mucosa

To examine the value of ornithine decarboxylase (ODC) assay as a biological marker of potential malignancy in large bowel, we harvested 43 colorectal carcinoma, 7 adenoma, 6 polyps, and 77 normal-appearing mucosa at surgery from patients with colorectal carcinoma. In addition, 13 normal rectal mucosa were obtained at biopsy from patients with benign diseases or diseases unrelated to colorectal carcinoma as normal control. ODC activity was significantly higher in polyps and adenocarcinomas than in normal-appearing mucosa from patients with colorectal carcinoma. ODC activity in normal-appearing mucosa varied throughout the large intestine, with significantly higher activities in the distal segment of the large bowel. The higher ODC activity detected in the sigmoid colon and rectum correlates with the larger incidence of tumor development in this region of the large bowel. This observation needs to be taken into consideration when ODC activities of the colorectal mucosa are measured as biological markers of potential malignancies.     

Pattern of epithelial cell proliferation in colorectal mucosa of normal subjects and of patients with adenomatous polyps or cancer of the large bowel

Microautoradiography has been largely used to characterize the proliferative activity of colorectal mucosa. We used this technique in a large series of patients with polyps or cancer of the large bowel and in normal controls with the following objectives: (a) to define the normal pattern of cell replication in different tracts of the large bowel; (b) to compare the proliferative activity of colonic crypts in patients with colorectal cancer or polyps with that of controls; (c) to evaluate replicative activity of colorectal mucosa in the close vicinity and at distance from a neoplastic mass. Specimens of colorectal mucosa were taken during endoscopy (controls and polyps) or at surgery (cancer). During histological examination each intestinal hemicrypt was divided into five equal longitudinal compartments from the base to the surface and the labeled cells in each compartment were counted. In controls, total labeling index (ratio of labeled to total cells) and labeling index per crypt compartment showed only minor differences between the various large bowel tracts. Total labeling index tended to be higher in patients with polyps or cancer than in controls (13.5 +/- 0.4 and 12.5 +/- 0.4, respectively, versus 11.3 +/- 0.5). Labeling index per crypt compartment in the most superficial portions of the crypt (compartments 3 to 5) was significantly higher in the two groups of patients with tumors than in controls. This was particularly evident in the fifth compartment (the most superficial), in which labeled cells were observed in 15.8% (three subjects out of 19) of controls but in 71% (15 out of 21) and 87.5% (14 out of 16) of polyp and cancer patients, respectively. In patients with colorectal cancer there were not significant differences of cell proliferation between mucosal samples taken at various distances from the tumor margin; however, increased cell replication, especially in the most superficial portions of the crypt, has been observed. In conclusion, a significant upwards expansion of the proliferative zone of intestinal glands has been observed in patients with either polyps or cancer of the large bowel. In particular, labeling of the fifth compartment seems to possess the highest discriminatory power between subjects with or without intestinal neoplasms. Hyperproliferation of the entire colonic mucosa seems to be a common feature in patients with colorectal cancer.     

粪便免疫化学检测结果与体重、血脂等的相关性分析

目的:探讨粪便免疫化学检测结果特点及与体重、血脂等的相关性。方法:选取2019年1月至12月于中国医科大学附属盛京医院体检中心完善粪便免疫化学检测的人群1249例为研究对象,采用乳胶凝集免疫比浊法对其进行粪便潜血检测,并记录其年龄、病史、血压、血脂、血糖、血尿酸等一般资料。结果:粪便免疫化学检测阳性者212例,阳性率为16.97%,男性阳性率高于女性(P<0.05)。青年组和老年组粪便免疫化学检测阳性率与中年组比较,差异具有统计学意义(P<0.05),而青年组和老年组之间差异没有统计学意义(P>0.05)。粪便免疫化学检测阳性的单因素分析发现,收缩压、舒张压、体质量指数、血糖空腹、甘油三酯、高密度胆固醇、低密度胆固醇、载脂蛋白B、血尿酸差异有统计学意义(P<0.05)。Logistic回归分析结果显示,体质量指数、甘油三酯、高密度胆固醇、低密度胆固醇为粪便免疫化学检测阳性的危险因素(P<0.05)。结论:人群中超重或肥胖、血脂异常是粪便免疫化学检测阳性的重要风险因素。