人物专栏:张力教授

Education and training experience After gaining his medical degree from Medical school of Sun Yat-Sen University (SYSU)and board certification as a physician of medical oncology,prof. Li Zhang continued with his post-graduate training at Cancer Centre of Sun Yat-Sen University(CCSYSU).     

细菌的毒性能抑制结肠癌

某些能引起腹泻的细菌其实也有着非常好的作用,研究者发现来自内脏正常菌群的支系大肠杆菌,通常能产生毒素诱发疾病,但它们也能抑制肠道内癌细胞的生长.这个发现也许能解释为什么在致病性E.coli感染高发的地区,结肠癌的发生率较低.这项发现还为人们提供了一个新的治疗方向.     

医患携手奏响生命赞歌--记全国癌症患者文艺汇演

2006年新年伊始,刚刚过了传统腊八节,正值隆冬的北京,晚间气温达到零下8～9度,但是在北京展览馆剧场的演出大厅里却热闹非凡燃烧着一团火.在首都现有客容量最大剧场里,2700个座位座无虚席,就连过道也站了不少人.是来自哪里的演出会这么火?原来这是由中国抗癌协会、中国抗癌协会癌症康复会主办北京肿瘤医院协办北京癌症康复会承办的全国癌症康复者文艺汇演.这台主题为"生命恋歌"的汇演,集中了全国近30个省市、地区的癌症康复组织,300多位癌症康复患者演员.他们不是普通的演员,他们是患了癌症、重获新生的演员,他们是在用心、用全部的爱、用他们的新生命在歌唱,在舞蹈.     

卵巢癌问答(二)

(接上期) (2)"盆腔污染"和化学致癌物质也能引起卵巢癌 女性的盆腔组织通过输卵管、子宫腔、阴道和外界相通,使环境中的致癌物质有机会通过这一通道进入盆腔,并接触到卵巢,刺激卵巢表面的上皮增生,而引起肿瘤.这些物质主要有石棉、滑石粉和一些含苯环的芳香化学致癌物质,但这些污染物引起卵巢癌的作用机制仍需作进一步的研究.     

请谁做手术?--决策3:手术

化疗做上了,一边护理、监控,一边琢磨手术的事.在第一轮咨询的时候,各家医院胸外科的专家就已经告知这是一个高难度的手术,因为肿瘤把血管都包住了,有的说需要心脏外科配合,有的说可能下不了手术台,有的说如果做不下来就不做或者少做.手术成功与否不仅是漫长的治疗道路上决定性的一步,还是能不能暂时保住儿子性命的问题.     

胶质瘤患者血浆与肿瘤组织P16基因甲基化的检测及意义

Objective:To explore the clinical significance of methylation status of promoter CpG island of p16 gene in glioma tissue and plasma.Methods:Methylation specific polymerase chain reaction (MSP) was used to determine the methylation status of the promoter for p16 gene within glioma tissue and plasma.Immunohistochemicel method (SP) was used to analyze the expressions of p16 and Ki-67 proteins.Results:Hypermethylation was found in 17/40 (42.5%) of brain gliomas,in comparison with 11/40 (27.5%) plasma specimens (x2 = 1.9780,P = 0.1596).Loss of p16 expression was associated (P = 0.0229) with hypermethylation of CpG island of promoter regions.Hypermethylation of p16 gene CpG island was significantly related to the increase of malignant grade of brain glioma (Tissue:X2 = 11.4288,P = 0.0007;Plasma:X2 = 8.9439,P = 0.0028).The Ki-67 index increased significantly (P＜0.05) in brain gliomas methylated in contrast to those unmethylated.Conclusion:P16 hypermethylation may be one of the major mechanisms of tumorigenesis of gliomas.Methylated tumor-specific DNA may be as a plasma biomarker for prognosis in patients with glioma.     

喝茶有味

我辈喝茶,绝无日本人那般复杂--"老日"的茶道无疑是世界上最复杂的喝茶法,也没有文人墨客们那般精致讲究--讲究茶叶,讲究茶具,讲究氛围……我辈喝茶是想喝就喝--闲时、渴时、累时、困时……泡上一杯茶,待稍凉就"咕噜噜"地喝上几口乃至一口气喝光:也不讲究茶叶的产地、品牌、质量……有好茶喝好茶,有孬茶喝孬茶.一句话,只要是茶就行.我体会,这茶就是这样的"神",不管怎么喝--喝得复杂,喝得简单;喝得讲究,喝得随便:大口大口地喝,小口小口地呷;喝上乘的龙井茶,喝叫不上名的粗茶,都是那样的有滋有味--满口的清香,满口的爽甘.要是喝上一杯碧绿晶亮、清香扑鼻的"明前茶",更让人回味无穷,乃至心旷神怡,精神为之一振.如笔者在杭州云栖喝过的一杯茶,尽管已隔10年之久,但那色、那香、那形、那味,至今留在心头.这就是茶的魅力,茶的神韵,茶的长盛不衰,茶的源远流长……     

警惕"老毛病"掩盖下的肺癌

张大伯今年57岁,是某化工厂的老工人.从1年前起,开始只是感到胸闷、气短,常要开窗呼吸新鲜空气.到医院作了些检查,诊断为冠心病,就按冠心病治疗,自觉好了许多.几个月后又觉得胸痛,气促,常呛咳.由于他吸烟已有30多年的历史,每天要吸1～2包,早就落下个慢性支气管炎,长年咳嗽痰多,所以他没把不适放在心上,总以为是老毛病冠心病和气管炎在作怪,虽然也曾到厂医务室看过病无非就是配一些冠心病和气管炎的药物.     

米兰达拯救乳房的故事

乳房对女人意味着什么? 米兰达生于英国北部,中学毕业后进入英国航空公司当空中小姐,20岁时邂逅了比她年长22岁的西班牙电视演员法兰歌·文森特,于是,随他返回西班牙成婚定居,并相继育下一女一子.     

Cytologic classification of precancer and cancer of the endometrium and esophagus and of malignant lymphomas

The paper discusses cytological classifications of precancer and cancer of the endometrium, esophagus and malignant lymphomas presented by cytologists from five Soviet research institutes of oncology. The classifications were based on the data of 4400 cases in conformity with WHO histologic classifications.     

E-钙粘蛋白及PTEN基因编码蛋白与胃癌浸润转移

目的:观察抑癌基因PTEN蛋白和ECD在胃癌组织中的表达,探讨其与胃癌生物学行为及预后的关系。方法:以兔抗人PTEN多克隆抗体、鼠抗人ECD单克隆抗体,采用SABC免疫组化法,检测100例胃癌手术切除标本中拟测指标的表达。以χ2和Logrank检验对结果做统计学分析。结果:ECD、PTEN蛋白在非癌胃粘膜中均见表达;在胃癌组织中表达下调或缺失。ECD异常表达率为42.0%;弥漫型胃癌异常表达率(48.57%),明显高于肠型胃癌(26.67%),(P<0.05);ECD异常表达与浸润深度有关(P<0.05)。胃癌组织中PTEN蛋白缺失率为59%;弥漫型胃癌缺失率(65.71%)明显高于肠型胃癌(43.33%),(P<0.05);伴淋巴结转移的胃癌缺失率(64.47%)明显高于无淋巴结转移者(41.67%),(P<0.05);PTEN蛋白缺失的患者比阳性表达者预后差(P=0.0066)。65.85%PTEN阳性表达者同时伴ECD正常表达。结论:两种标志物与胃癌浸润转移有关,PTEN表达与胃癌患者预后密切相关。将两种指标联合检测,可作为正确判断胃癌患者预后,指导临床治疗的分子生物学指标。     

Schwannomas of Head and Neck and Review of Literature

Benign nerve cell tumours have been given various names like schwannoma, neurilemmoma, neurinoma, neurofibroma, spindle cell tumours etc. Extra cranial head and neck schwannomas usually present as solitary and well-demarcated lesions. The lesion can cause secondary symptoms, such as nasal obstruction, dysphasia, and hoarseness, depending upon the location of the lesion. Fine needle aspiration cytology, CT scans, and MRI may be of limited help in the diagnosis of schwannomas. The treatment is complete surgical excision of the benign tumour and postoperative histopathological examination establishes the final diagnosis.     

Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers

BACKGROUND: Frequent consumption of fruit and vegetables has been associated with a reduced risk of colorectal cancer in many observational studies. METHODS: We prospectively investigated the association between fruit and vegetable consumption and the incidence of colon and rectal cancers in two large cohorts: the Nurses' Health Study (88 764 women) and the Health Professionals' Follow-up Study (47 325 men). Diet was assessed and cumulatively updated in 1980, 1984, 1986, and 1990 among women and in 1986 and 1990 among men. The incidence of cancer of the colon and rectum was ascertained up to June or January of 1996, respectively. Relative risk (RR) estimates were calculated with the use of pooled logistic regression models accounting for various potential confounders. All statistical tests were two-sided. RESULTS: With a follow-up including 1 743 645 person-years and 937 cases of colon cancer, we found little association of colon cancer incidence with fruit and vegetable consumption. For women and men combined, a difference in fruit and vegetable consumption of one additional serving per day was associated with a covariate-adjusted RR of 1.02 (95% confidence interval [CI] = 0.98-1.05). A difference in vegetable consumption of one additional serving per day was associated with an RR of 1.03 (95% CI = 0.97-1.09). Similar results were obtained for women and men considered separately. A difference in fruit consumption of one additional serving per day was associated with a covariate-adjusted RR for colon cancer of 0.96 (95% CI = 0.89-1.03) among women and 1. 08 (95% CI = 1.00-1.16) among men. For rectal cancer (total, 244 cases), a difference in fruit and vegetable consumption of one additional serving per day was associated with an RR of 1.02 (95% CI = 0.95-1.09) in men and women combined. None of these associations was modified by vitamin supplement use or smoking habits. CONCLUSIONS: Although fruits and vegetables may confer protection against some chronic diseases, their frequent consumption does not appear to confer protection from colon or rectal cancer.     

世界卫生组织骨质疏松症防治工作报告和防治建议

引 言 作为对第51号综合处理非传染性疾病预防与控制的世界卫生组织决议的反应,1998年7月WHO成立了致力于不断完善对骨质疏松预防和治疗策略的工作小组。小组成员来自世界各国致力于骨质疏松研究的知名专家。Harry K.Genant为本届主席。这一项世界范围内的骨质疏松教育计划旨在通过世界范围的研究,不断改善对骨质疏松的诊断水平和发展并完善对骨质疏松病人的合理治疗。其重点将以发展中国家为主。并为各国政府及其卫生部门和病人群体提供世界性有关骨质疏松症的总体的、完整的指导性资料。该项研究、教育计划的实施将由世界各国的骨质疏松症研究和治疗机构共同完成,并经权威学术机构、政府和非政府组织进行有针对性的回顾研究,最终由WHO审议通过。     

Anastrozole and letrozole: an investigation and comparison of quality of life and tolerability

Previous studies have demonstrated that both anastrozole and letrozole are well tolerated. Letrozole suppresses estrogen to a greater degree than anastrozole in the serum and breast tumor. Concerns have been raised that greater potency may adversely affect patients?? quality of life (QOL). One hundred eighty-one postmenopausal women with invasive estrogen receptor-positive breast cancers were randomized to receive either 12 weeks of letrozole followed by 12 weeks of anastrozole or the reverse sequence. One hundred and six received immediate adjuvant aromatase inhibitors (AIs) following surgery, and 75 received extended adjuvant therapy. The Functional Assessment of Cancer Therapy Endocrine Subscale (FACT-B-ES) QOL questionnaires were completed to assess QOL on each drug. Additional side-effect profiles were collected. Each patient completed a patient preference form. Twenty-one patients withdrew before study end, 10/179 (5.6%) while taking letrozole and 4/173 (2.3%) while taking anastrozole (P = 0.12). Tamoxifen-naïve patients had a higher mean ES (endocrine symptoms subscale) score at entry versus those having extended therapy (66.0 vs. 61.9; P = 0.001). There was no significant change in FACT-B-ES (overall) scores or ES scores while patients were taking anastrozole or letrozole and no significant differences between drugs. Nearly 80% of patients reported one or more side effects with either agent. No differences in frequency, grade, or range of side effects were seen between drugs. Of 160 patients, 49 (30.6%) preferred letrozole, 57 (35.6%) preferred anastrozole, and 54 (33.8%) had no preference (P = 0.26, Pearson??s Chi-squared test). In conclusion, both AIs are equally well tolerated. There were no significant differences in QOL scores between the two drugs.     

A comparative study of knowledge and awareness of colorectal and breast cancerA comparative study of knowledge and awareness of colorectal and breast cancer

Aims: To assess and compare knowledge and awareness of colorectal cancer and breast cancer in a sample of the general population. Methods: Eleven hundred visitors to six different outpatient clinics, in a University Hospital, were given a study-specific questionnaire, based on educational material from the British Association of Cancer United Patients (CancerBACUP). The questionnaire consisted of 12 statements on the incidence, presentation, detection, treatment and prognosis of colorectal and breast cancer. Results: One thousand and sixty-eight individuals returned the questionnaire. One thousand and four completed questionnaires were analysed. The mean age (SD) of respondents was 50.1 (17.2) years, and the male to female ratio was 2:3. Respondents had read more about breast than about colorectal cancer (60.3%vs 32.4%,P <0.0001, McNemar's test). The proportion of correct answers for each statement on breast cancer was higher than for answers to corresponding items on colorectal cancer. Mean overall scores (95% CI) for breast and colorectal cancer were 88.1 (86.9, 89.2) and 64.4 (62.5, 66.3) respectively, the mean difference (95% CI) being 23.7 (22.0, 25.5). Scores were higher for breast cancer irrespective of age or gender. Conclusion: There is a low level of understanding of colorectal cancer in the general population when compared to breast cancer. This highlights the importance of public education in this common cancer.