膀胱癌血管生成和抗血管生成的研究进展

血管生成是肿瘤特殊生物学行为的重要过程之一。本文就成纤维细胞生长因子，血管内皮生长因子，肝细胞生长因子，胸苷磷酸化酶等若干种参与膀胱癌血管生成的促血管生长因子的最新研究进展作一综述，并探讨抗血管生成在膀胱癌治疗中的现状及应用前景。     

肿瘤抗血管生成靶向治疗

<正>肿瘤血管生成是所有实体肿瘤的共同特征,是实体肿瘤生长和转移必须依赖的病理学基础,与肿瘤的生长、侵袭转移关系极为密切。现已证实,不同实体肿瘤血管内皮细胞所表达的生长因子及其受体均有共性,因此抗血管生成靶向治疗已经成为肿瘤治疗的重要策略。目前,已有数     

肿瘤的抗血管生成基因治疗（文献综述）

肿瘤的生长、转移与复发均有赖于血管的新生，故抗血管生成基因治疗以肿瘤血管生成的各个环节及基发生过程中的生物学改变为靶点，同时最大程度地减少了传统化疗的全身毒剐作用。本文就肿瘤的抗血管新生基因治疗现状及相关进展作一综述。     

膀胱肿瘤血管生成的研究进展

血管生成是影响肿瘤生物学行为的重要因素之一。本文综述了肿瘤血管生成的过程及其调控机制 ,常见促血管生成因子类型 ,针对膀胱肿瘤血管生成的研究进展进行了较为详细的阐述 ,并探讨抗血管生成治疗策略及应用前景。     

肿瘤血管生成与抗血管生成研究进展

血管生成是肿瘤生物学特性之一，与肿瘤的发生，发展及预后密切相关。血管生成诱导因子与生成抑制因子的失衡是血管生成的主要原因，近年来关于血管生成调控因子的研究较多，本文就有关进展作一综述。     

肿瘤血管生成与抗血管生成研究进展

血管生成是肿瘤生物学特性之一 ,与肿瘤的发生、发展及预后密切相关。血管生成诱导因子与生成抑制因子的失衡是血管生成的主要原因 ,近年来关于血管生成调控因子的研究较多 ,本文就有关进展作一综述     

抗血管生成疗法在肿瘤外科中的作用

肿瘤的发生,发展和侵袭与血管生成密切相关,特别是转移病灶更依赖血管新生的作用,进一步阐明肿瘤血管生成和新生的机理以及开发抗血管生成制剂将在肿瘤治疗中开辟一个崭新的途径。     

肿瘤的抗血管生成治疗

肿瘤的侵袭、转移与复发是肿瘤治疗失败的主要原因。肿瘤血管生成的进程、微血管性质和微血管密度直接关系到肿瘤生长、侵袭、转移与复发的能力。以肿瘤血管生成的各个环节为靶点,研制的血管生成抑制剂具有高效、低毒和不易产生耐药性等优点,本文就此作一综述。     

内皮抑素与肿瘤的抗血管生成治疗

肿瘤的生长转移与肿瘤血管生成密切相关 ,抗血管生成是治疗肿瘤的新策略。内皮抑素是一种新发现的特异的内皮细胞增殖的抑制剂 ,具有很强的抑制血管生成的作用 ,被认为是最具有前途的血管生成抑制剂。本文对其结构、生物活性及应用前景作一概述     

VEGF-C、VEGF-D信号通路与肿瘤的淋巴管生成

肿瘤的区域(前哨)淋巴结转移是肿瘤远处播散的第一步,并且可以看做是肿瘤预后的一个重要标志.新近的研究表明,肿瘤的淋巴管生成和淋巴结转移密切相关.肿瘤细胞转移至前哨淋巴结后,可以继续促进淋巴管的生成,从而进一步促进肿瘤细胞的远处转移.血管内皮生长因子-C(VEGF-C)和血管内皮生长因子-D(VEGF-D)是首先发现的特异性淋巴管生成因子,许多临床试验表明,VEGF-C和VEGF-D的表达与肿瘤的淋巴转移密切相关.目前又发现了与淋巴管生成有关的其他细胞因子,如VEGF-A.最为重要的是,采用特异性抗体、可溶性受体结构或小的膜激酶抑制剂阻断细胞因子作用的信号途径,可以有效地阻止肿瘤淋巴管的生成,这也为肿瘤的治疗提供了一个新的途径.     

Intestinal tissue oxygenation and tumor necrosis factor-alpha release during systemic blood flow changes in pigs with left ventricular assist devices

We previously demonstrated that tumor necrosis factor-alpha (TNF-alpha) increased following a reduction in systemic blood flow to 60% or less of the original cardiac output using a left ventricular assist device (LVAD). The aim of this study was to investigate the effect of reducing systemic blood flow on tissue oxygenation in the gastrointestinal tract (GIT) and the consequences of this on TNF-alpha release. LVADs were implanted in 9 pigs. The aorta was clamped, and thus the LVAD flow represented the entire systemic blood flow. Plasma TNF-alpha of the superior mesenteric vein was measured at baseline and during systemic blood flow changes. Simultaneously, pH, lactate, oxygen delivery index (DO(2)I), oxygen consumption index (VO(2)I), and oxygen extraction (O(2)ER) in the GIT were measured. The pH decreased and the lactate level increased significantly (p < 0.05) at a systemic blood flow of 50% or less. The VO(2)I was positively correlated with DO(2)I. The O(2)ER increased significantly (p < 0.05) with reductions in systemic blood flow to 30% or less. There was a significant (p < 0.01) correlation between TNF-alpha and O(2)ER at levels higher than 55%. These data demonstrate that the GIT oxygenation is inadequate with a reduction in systemic blood flow to 50% and that GIT oxygenation becomes critical at a reduction of 30%. During LVAD weaning, careful attention must be given to the GIT. The pH and lactate may be good markers of the adequacy of tissue oxygenation in the GIT.     

胃肠间质瘤患者血浆血管内皮生长因子的检测及其临床意义

目的探讨监测胃肠间质瘤（GIST）患者血浆中血管内皮生长因子（VEGF）的水平及其在GIST转移复发及治疗效果评价中的作州．方法应用ELISA法检测61例原发GIST患者、18例转移复发患者和28例健康人（对照组）的血浆VEGF含量。结果原发GIST患者术前血浆VEGF水平[（145．31±45．58）ng／L]和转移复发患者血浆VEGF水平[（145．72±52．73）ng／L]均明显高于对照组[（89．86±18．30）ng／L]差异有统计学意义（均P〈0．01）；原发及转移复发GIST患者间血浆VEGF水平差异无统计学意义（P〉0．05）。原发患者手术后及复发转移患者手术联合格列卫治疗后，血浆VEGF水平均较治疗前明显下降，分别为（101．81±27．63）ng／L和（112．45±38．58）ng／L，差异有统计学意义（P〈0．01）。结论GIST患者和GIST转移复发患者血浆中VEGF水平明显高于正常人．监测血浆VEGF的水平有助于评价GIST治疗效果和预测GIST的转移复发。     

颈动脉体瘤诊治的临床分析：附38例报告

目的：总结颈动脉体瘤（CBT）的临床特征与诊治经验。 方法：回顾性分析2008年10月—2019年4月在中南大学湘雅医院血管外科治疗的38例CBT患者资料,其中男14例,女24例;年龄23~76岁;单侧36例,双侧2例;40个瘤体中,Shamblin I型6个、II型12个、III型22个。 结果：所有患者均行颈部CTA或MRA明确诊断。38例患者中,3例单侧患者行保守治疗,其余35例患者共37个瘤体行手术切除治疗,其中1例手术患者术前行DSA检查并行双侧颈外动脉栓塞术。无术中死亡病例,手术平均时间（140±48）min,术中平均出血量（194±148）mL;Shamblin I型病变均行单纯CBT切除,Shamblin II、III型病变行单纯CBT切除或CBT切除+其他手术（颈部动脉离断、重建、结扎）。所有手术患者术后病理检查均证实为颈部良性副神经节瘤。术后发生短暂脑神经损伤8例,永久脑神经损伤2例,死亡1例。单纯CBT切除患者的神经损伤发生率明显低于CBT切除联合其他手术患者（P<0.05）。随访半月至10年,手术患者未出现肿瘤复发及其他并发症。3例保守治疗患者均带瘤生存。 结论：CTA或MRA为诊断CBT的首选方法,手术切除是CBT的首选治疗方法。手术方式的选择还需根据瘤体的大小形态以及分型决定。     

增强CT术前预测骨肿瘤血供程度

目的 观察采用增强CT术前评估骨肿瘤血供程度的可行性。方法 回顾性分析455例骨肿瘤患者,均于栓塞前1个月内接受CT检查,获得肿瘤增强CT值、强化值（肿瘤增强CT值-肿瘤平扫CT值）及与周围肌肉差值（肿瘤增强CT值-周围肌肉增强CT值）;于外科手术前24 h接受血管造影,根据造影评分分为乏血供（≤ 1分）组及富血供（>1分）组,并接受肿瘤局部栓塞。以ROC曲线分析CT值评估肿瘤血供的效能。结果 455例骨肿瘤中,85例乏血供,370例富血供。肿瘤增强CT值、强化值及与周围肌肉差值的AUC分别为0.967、0.973及0.967,增强CT值+强化值、增强CT值+与周围肌肉差值、强化值+与周围肌肉差值的AUC分别为0.977、0.969、0.979,三者联合AUC达0.979。结论 增强CT可于术前评估骨肿瘤血供程度,其中肿瘤强化值评价效能最高。     

颈动脉体瘤的无术前栓塞手术切除的疗效分析：附单中心65例报告

背景与目的：颈动脉体瘤（CBT）是临床上非常罕见的疾病,目前外科手术是治疗CBT的金标准,由于该病变血供极其丰富,是否行术前栓塞目前国内外存在争议,支持术前栓塞者认为其可减少术中失血,反对者认为成本和卒中风险大于收益,本文总结我院CBT无术前栓塞的外科手术治疗经验及术后随访结果,为临床无术前栓塞切除瘤体的安全性提供数据参考。 方法：回顾性分析昆明医科大学第一附属医院血管外科自2017年1月—2020年1月间行手术治疗的65例CBT患者临床与随访资料（其中2例双侧CBT患者选择第一次手术侧的数据）。肿块大小为1.0 cm×0.5 cm×1.0 cm~8.0 cm×6.5 cm×8.5 cm。患者Shamblin分型分别为I型13例,II型33例,III型19例。 结果：65例患者均顺利完成外科手术切除,其中单纯瘤体切除51例（78.46%）,瘤体切除联合单纯颈外动脉结扎8例（12.31%）,瘤体切除联合颈内动脉、颈外动脉切除并颈内动脉重建6例（9.23%）;术中发现术野内淋巴结的患者行淋巴结摘除;术中失血量为10~1 800 mL,平均247 mL。2例双侧病变者均建议择期行对侧手术。病理检查结果,65例均为颈动脉副神经节瘤。围术期1例（1.54%）出现术后脑梗塞死亡。术后14例患者（21.54%）出现迷走神经损伤症状,表现为声音嘶哑、饮水呛咳;5例患者出现舌下神经损伤症状,表现为伸舌偏斜、吞咽困难。2例颈内动脉重建的III型患者（3.08%）术后随访过程中发现颈内动脉闭塞。 结论：CBT确诊后应首选手术治疗,无术前栓塞情况下切除肿瘤安全有效。     

The effect of blood transfusion on tumor growth in sarcoma-bearing rats

Background: The effect of blood transfusion on tumor growth is controversial. Under experimental conditions, even similar animal models can give varied results. This study was undertaken to characterize the nature of the effect of blood transfusion on tumor growth. Methods: Sixty-five Fischer 344 rats subcutaneously implanted with a methylcholanthrene-induced sarcoma were studied with additive blood transfusion at 1% tumor burden in two separate experiments. In experiment 1, the effects of syngeneic fresh whole blood transfusion (5, 10, and 15 ml/kg) and allogeneic (5 ml/kg) were tested. To determine if stored blood influenced the results, experiment 2 was performed with syngeneic blood transfusion (15 ml/kg) and allogeneic blood transfusion at 5 ml/kg. Tumor dimensions were determined daily by external measurement, and tumor weight and growth rate were calculated. Results: No significant differences in final tumor weights or tumor growth rates were found in transfused rats compared with controls. This held true for syngeneic blood transfusion regardless of dose, allogeneic blood transfusion, and regardless of whether the blood was fresh or stored. Conclusions: Additive blood transfusion does not affect tumor growth in this animal model. This finding, together with the general inconclusiveness in the reported literature on this topic, speaks against a dominant role for the effect of blood transfusion on tumor behavior. Presented at the 47th Annual Cancer Symposium of The Society of Surgical Oncology, Houston, Texas, 1994.     

Tumor VEGF expression correlates with tumor stage and identifies prognostically different groups in patients with clear cell renal cell carcinoma

ObjectivesVascular endothelial growth factor (VEGF) is a potent inducer of tumor angiogenesis and represents the key element in the pathogenesis of clear cell renal cell carcinoma (ccRCC). The aim of this study was to investigate the use of tumor VEGF expression as a parameter to identify tumor stage and prognostically different patient groups.Methods and materialsWe retrospectively collected clinical data of 137 patients treated with partial or radical nephrectomy at our institutions for organ-confined, locally advanced, and metastatic ccRCCs between 1984 and 2013. Tumor cell VEGF immunohistochemical expression was compared with pathological and clinical features including age, sex, tumor stage, and Fuhrman grade. Comparison of VEGF expression levels between tumor stages was performed via Kruskal-Wallis nonparametric test. Survival analysis was conducted via Kaplan-Meier product-limit method, and Mantel-Haenszel log-rank test was employed to compare survival among groups.ResultsMedian age at diagnosis was 61 years (range: 33–85 y). Tumor stage was pT1N0M0 in 67 patients (49%), pT2N0M0 in 5 (4%), and pT3N0M0 in 25 (18%), while 40 patients (29%) had metastatic tumors at diagnosis. Fuhrman nuclear grade was G1 in 22 patients (16%), G2 in 60 (44%), G3 in 33 (24%), G4 in 13 patients (9%), and unknown in 9 patients. Tumor VEGF was differentially expressed among different stages (P<0.001) and in low (G1–2) and high (G3–4) Fuhrman grade tumors (P<0.001). No significant differences were found when stratifying by sex (P = 0.06) or age (P = 0.29). Median overall survival (OS) from partial or radical nephrectomy was 161 months (range: 1–366). We observed a significantly longer OS in patients with low (<25%) vs. high (>25%) VEGF expression levels (median OS 206 vs. 65 mo, P<0.001).ConclusionsOur data show that tumor cell VEGF expression is significantly associated with tumor stage and Fuhrman grade and is able to predict patient outcome, suggesting a potential use of this parameter in identifying prognostically different patients with ccRCC.     

In vivo mathematical modeling of tumor growth from imaging data: Soon to come in the future?

The future challenges in oncology imaging are to assess the response to treatment even earlier. As an addition to functional imaging, mathematical modeling based on the imaging is an alternative, cross-disciplinary area of development. Modeling was developed in oncology not only in order to understand and predict tumor growth, but also to anticipate the effects of targeted and untargeted therapies. A very wide range of these models exist, involving many stages in the progression of tumors. Few models, however, have been proposed to reproduce in vivo tumor growth because of the complexity of the mechanisms involved. Morphological imaging combined with “spatial” models appears to perform well although functioning imaging could still provide further information on metabolism and the micro-architecture. The combination of imaging and modeling can resolve complex problems and describe many facets of tumor growth or response to treatment. It is now possible to consider its clinical use in the medium term. This review describes the basic principles of mathematical modeling and describes the advantages, limitations and future prospects for this in vivo approach based on imaging data.