局部间质内注射^198Au—胶体治疗恶性肿瘤浅表淋巴结转移疗效观察

各种恶性肿瘤均可以经淋巴道转移到淋巴结。阻断淋巴转移癌及控制其继续发展,是恶性肿瘤治疗中的一个重要环节。目前,国内外治疗淋巴结转移癌的方法有手术切除、放疗、热疗、全身及局部化疗。但这些方法疗效差,有的病例只短期有效,很快又复发或再转移。我们根据~(198)Au特性,采用~(198)Au-胶体局部间质内注射治疗淋巴结转移癌,收到良好效果。     

血管抑素基因联合32P-胶体治疗大鼠肝癌的疗效

目的 评价血管抑素基因联合放射性药物32P-胶体治疗肝癌的疗效.方法 大鼠分为三组:血管抑察基因治疗(治疗)组,血管抑素基因+32P-胶体联合治疗(联合)组,空白对照组,每组20只.观察肿瘤体积、肿瘤微血管密度(MVD)、肿瘤细胞凋亡指数(AI)的变化.结果 RTPCR结果显示,在治疗组和联合组的大鼠肿瘤内,可见到大小为1400 bp的血管抑素mRNA特异性表达条带；而对照组未见到血管抑素mRNA表达；治疗组和联合组不同时间的肿瘤生长率均小于对照组(P＜0.01).联合组肿瘤生长率最小,MVD最低,提示多种具有协同作用的因素相互作用后抑瘤效果最好.结论 血管抑索和放射性药物32P-胶体通过抑制肿瘤血管内皮细胞增殖及迁移达到抑瘤的目的,具有很好的抗肝癌疗效.     

^32P胶体瘤内注射治疗非小细胞肺癌的初步观察

目的 观察^32P胶体瘤内注射治疗非小细胞肺癌的近期疗效。方法：选择周围型肺癌17例,在CT引导下予胶体行瘤内注射（1mci/cm^3）,注射后1月摄胸片进行疗效评定,分为CR、PR、NC、PD。结果：14例患肺内病灶均有不同程度缩小,5例鳞癌患病灶缩小＞50％而达到PR标准。结论：^32P胶体瘤内注射治疗非小细胞肺癌是一种有效安全的新方法,值得临床使用。     

^32P胶体联合平阳霉素加激素治疗海绵状血管瘤疗效观察

海绵状血管瘤是由于血管发育畸形所致的一种先天性良性肿瘤,在儿童中发病率较高,是各种血管瘤中危害最大的一种。该病的治疗方法较多,治疗方法的选择和疗效的好坏可影响患者的一生。笔者自2006年6月-2008年1月采用^32P胶体联合平阳霉素加激素内照射治疗海绵状血管瘤患者51例,获得良好效果。现报告如下。     

CMCVm-26方案治疗32例非小细胞肺癌脑转移疗效观察

肺癌在上海地区恶性肿瘤发病率和死亡率中均居第一位，其病理类型主要分为小细胞肺癌和非小细胞肺癌两大类。非小细胞肺癌占肺癌的75％～80％，临床上脑转移多见。随着抗肿瘤药物研究的深入和联合应用，化疗已成为治疗晚期非小细胞肺癌的重要手段，     

地方性甲状腺肿伴单纯性结节的32P胶体注射治疗

目的 探索地方性甲状腺肿伴有单纯性结节的非手术疗法。方法 采用结节内注射^32P胶体方法治疗地主性甲状腺肿伴单纯性结节42例（均为女性）。结果 1次治愈率47.62%，显效率28.57%，总有效率97.62%。2次治疗总治便率73.81%，总有效率100%。结论 ^32P胶体注射治疗地方性甲大辩论腺肿伴单纯性结节的疗效主要与个体差异、^32P胶体用量及注射液体积、注射手法和两次治疗间隔时间等因素相关。^32P胶体结节内注射后长时间滞留于局部，不会吸收入血，可重复多次治疗。     

^32P磷酸铬液治疗中晚期肝癌的疗效观察

本对我院近几年来．在B超引导下经皮经肝穿癌灶内注入同位素^32P-磷酸铬液治疗中晚期肝癌，取得较好疗效．提高患生存期，现报告如下：     

三维适形放疗治疗腹腔淋巴结转移癌临床观察

随着CT、MRI等检查手段的普遍应用和肿瘤患者生存期的延长．临床上发现腹腔淋巴结转移癌患者明显增多,治疗比较困难。2002年6月-2005年12月,我们应用三维适形放疗技术治疗腹腔淋巴结转移癌患者38例,近期疗效较好。现报告如下。     

放射性同位素敷贴治疗瘢痕疙瘩疗效观察

自1999年以来,我们使用放射性同位素,马驰^90Sr和^32P敷贴治疗瘢痕疙瘩120例,取得了满意疗效。现报告如下。     

以腹股沟淋巴结转移为首发症状之一的肺癌三例

例１　男性,６２岁。１９８８年夏发现右腹股沟、右锁骨上淋巴结肿大,当时无咳嗽、咯血、胸痛等,未诊治。１９９０年４月突感右手麻木,按“卒中”治疗无效;２个月后渐出现右侧肢体活动障碍。就诊时发现右腹股沟、右锁骨上分别触及５ｃｍ×３ｃｍ、２ｃｍ×３ｃｍ肿大淋巴结,质硬、活动、无压痛。脑及胸部影像学检查发现颅内多发占位性病变;右上肺肿块３ｃｍ×４ｃｍ,纵隔淋巴结肿大。全身骨扫描和腹部Ｂ超未见异常。右锁骨上及右腹股沟淋巴结活检为淋巴结转移癌（小细胞癌）。诊断：右上肺小细胞癌（ＳＣＬＣ）（广泛期）。行头颅放…     

超声在肺癌锁骨上淋巴结转移诊断中的应用

目的：探讨超声在肺癌锁骨上淋巴结转移诊断中的准确性。方法运用随机抽样的方法选取2013年1月至2014年9月广安市人民医院超声科收治的190例确诊为肺癌的患者,其中颈部超声检查发现锁骨上淋巴结肿大67例,依据超声诊断结果将这些患者分为典型恶性转移淋巴结(A 组)和非典型转移淋巴结(B 组)两组,采用 S2000彩超显像仪和飞凡彩超显像仪对其锁骨上淋巴结进行常规检测,同时对患者进行超声引导下细针穿刺细胞学检查(FNAC),然后对两组患者的腺癌发生情况、FNAC 结果等进行统计分析。结果67例患者中,A 组患者42例,B 组患者25例;A 组患者的腺癌发生率显著高于 B 组(57.1% vs 12.0%,P <0.05),FNAC 阴性率显著低于 B 组(2.4% vs 40.0%,P <0.05),但两组患者的鳞癌、小细胞癌、未分化、结核性淋巴结肿大、炎性淋巴结肿大、恶性淋巴瘤发生率之间的差异均无统计学意义(P 值均>0.05);彩色多普勒血流显像检测、FNAC 结果下超声在肺癌锁骨上淋巴结转移诊断中的准确性均较高。结论超声在肺癌锁骨上淋巴结转移尤其是腺癌诊断中的准确性较高,可用于常规筛查。     

112例非小细胞肺癌淋巴结转移规律分析

目的分析112例非小细胞肺癌淋巴结的转移规律。方法对112例肺癌患者施行手术切除并行广泛肺门、叶间及纵隔淋巴结清扫术。术后病理资料进行统计分析。结果在共清除898组淋巴结中,单纯N1淋巴结转移率为24.1%,N2(包括N1+N2)淋巴结转移率30.4%。原发肺癌(T)分期T1、T2、T3间淋巴结转移率差异有统计学意义(P0.01)。跳跃式转移占N2转移的35.3%。结论非小细胞肺癌的淋巴结转移与T分期有关,具有较多的跳跃性纵隔淋巴结转移发生,肿瘤部位及肺癌的病理学类型与淋巴结的转移无明显关系。外科治疗中应注意广泛清扫肺内、同侧纵隔淋巴结才有可能达到根治目的。     

Prognosis of patients with gastric cancer and solitary lymph node metastasis

AIM:To investigate the relationship of solitary lymph node metastasis(SLNM)and age with patient survival in gastric cancer(GC).METHODS:The medical records databases of China’s Beijing Cancer Hospital at the Peking University School of Oncology and Shanghai Tenth People’s Hospital affiliated to Tongji University were searched retrospectively to identify patients with histologically proven GC and SLNM who underwent surgical resection between October 2003 and December 2012.Patients with distant metastasis or gastric stump carcinoma following resection for benign disease were excluded from the analysis.In total,936 patients with GC+SLNM were selected for analysis and the recorded parameters of clinicopathological disease and follow-up(range:13-2925 d)were collected.The Kaplan-Meier method was used to stratify patients by age(≤50 years-old,n=198;50-64 years-old,n=321;≥65 years-old,n=446)and by metastatic lymph node ratio[MLR<0.04(1/25),n=180;0.04-0.06(1/25-1/15),n=687;≥0.06(1/15),n=98]for 5-year survival analysis.The significance of intergroup differences between the survival curves was assessed by a log-rank test. RESULTS:The 5-year survival rate of the entire GC+SLNM patient population was 49.9%.Stratification analysis showed significant differences in survival time(post-operative days)according to age:≤50 yearsold:950.7±79.0 vs 50-64 years-old:1697.8±65.9 vs≥65 years-old:1996.2±57.6,all P<0.05.In addition,younger age(≤50 years-old)correlated significantly with mean survival time(r=0.367,P<0.001).Stratification analysis also indicated an inverse relationship between increasing MLR and shorter survival time:<0.04:52.8%and 0.04-0.06:51.1%vs≥0.06:40.5%,P<0.05.The patients with the shortest survival times and rates were younger and had a high MLR(≥0.06):≤50 years-old:496.4±133.0 and 0.0%vs 50-65 years-old:1180.9±201.8 and 21.4%vs≥65 years-old:1538.4±72.4 and 37.3%,all P<0.05.The same significant trend in shorter survival times and rates for younger patients was seen with     

可切除性肺癌胸内淋巴结转移的临床研究

目的　探讨可切除性肺癌的胸内淋巴结转移规律。方法　收集１９９２ 年１ 月～１９９８ 年７月可切除性肺癌１６０ 例,在肺癌术中分区摘除肺门淋巴结（Ｎ１） 和纵隔淋巴结（Ｎ２）,记录各区淋巴结的数量、大小和颜色,按区检查每一个淋巴结有无转移癌。结果　１６０ 例肺癌中有淋巴结转移者９９ 例（６１－９％ ）,Ｎ２ 转移者７３ 例（４５－６％ ） 。离肺门或肺根部最近的１１、１０ 、７、５ 和４ 区淋巴结的转移频度较高,较远的９、６、３、２ 和１ 区则明显降低。淋巴结≥２ ｃｍ 的癌转移度为６０－７ ％ 、≥１ ｃｍ 为１５－５％ 、＜ １ｃｍ 为４－３％ 。有转移癌的最小淋巴结为０－２ ｃｍ 。小细胞肺癌（ＳＣＬＣ）的淋巴结转移明显高于非小细胞肺癌（ＮＳＣＬＣ）（ Ｐ＜ ０－０５） 。结论　多数肺癌的淋巴结转移遵循由近向远、由下向上、由肺内经肺门向纵隔顺序转移的规律。淋巴结转移与肿瘤的部位、大小、病程均无关,ＳＣＬＣ更易发生淋巴结转移。确诊淋巴结有无转移癌必须依靠病理检查。     

Prediction of lymph node metastasis and sentinel node navigation surgery for patients with early-stage gastric cancer

Accurate prediction of lymph node (LN) status is crucially important for appropriate treatment planning in patients with early gastric cancer (EGC). However, consensus on patient and tumor characteristics associated with LN metastasis are yet to be reached. Through systematic search, we identified several independent variables associated with LN metastasis in EGC, which should be included in future research to assess which of these variables remain as significant predictors of LN metastasis. On the other hand, even if we use these promising parameters, we should realize the limitation and the difficulty of predicting LN metastasis accurately. The sentinel LN (SLN) is defined as first possible site to receive cancer cells along the route of lymphatic drainage from the primary tumor. The absence of metastasis in SLN is believed to correlate with the absence of metastasis in downstream LNs. In this review, we have attempted to focus on several independent parameters which have close relationship between tumor and LN metastasis in EGC. In addition, we evaluated the history of sentinel node navigation surgery and the usefulness for EGC.     

Risk factors of non-sentinel lymph node metastasis in 443 breast cancer patients with sentinel lymph node-positive

Axillary lymph node dissection is the standard surgical procedure for breast cancer patients with sentinel lymph node (SLN) positive. In clinical practice, axillary lymph node dissection may be an unnecessary treatment for some breast cancer patients with non-sentinel lymph node (NSLN) negative. The aim of this study was to analyze the risk factors of NSLN metastasis in breast cancer patients with SLN positive. Four hundred fifty-six clinical early stage breast cancer patients with SLN positive were collected and analyzed in the oncological surgery department of Fujian Provincial Hospital during 2013 to 2018. All these patients underwent surgical treatment. The average age and tumor size of 443 patients with SLN positive breast cancer were (49.8 ± 10.8) years and (2.42 ± 0.94) cm. Univariate analysis showed that the size of primary tumor, the number of positive SLN, the number of negative SLN, the ratio of positive SLNs, and the type of metastases in SLN were the influencing factors of NSLN metastasis. Multivariate regression analysis showed that primary tumor size T > 2 cm (P < .001, OR = 2.609), the positive number of SLNs ≥3 (P = .002, OR = 5.435), the ratio of positive SLNs ≥ 50% (P = .017, OR = 1.770), and SLN macrometastases (P < 0.001, OR = 16.099) were independent risk factors for NSLN metastasis. Combined with the 4 independent risk factors, the area under the curve to predict NSLN metastasis was 0.747 > 0.7. For clinical early breast cancer with positive SLN, primary tumor size T > 2 cm,the positive number of SLNs ≥ 3, the ratio of positive SLNs ≥ 50%, and SLN macrometastases could predict NSLN metastasis well, and guide surgery to avoid overtreatment.     

颈部淋巴结转移与甲状腺乳头状癌的治疗及预后

颈部淋巴结转移在甲状腺乳头状癌中较为普遍.尽管颈部淋巴结转移可独立预测甲状腺乳头状癌的复发,但其对于肿瘤预后的影响仍有争议.预防性中央区淋巴结对甲状腺乳头状癌患者的价值尚不清楚,尤其是术前无颈部淋巴结转移的临床或影像学证据时.对于存在危险因素的甲状腺乳头状癌患者,如男性、年龄大于45岁、肿瘤直径＞4 cm、多灶性和甲状腺外侵犯以及BRAF基因突变阳性等,术前应认真评估颈部淋巴结,必要时可行预防性中央区淋巴结清扫.     

Risk factors of lateral pelvic lymph node metastasis in advanced rectal cancer

Background  To clarify the risk factors of lateral pelvic lymph node (LPLN) metastasis of rectal cancer, we examined associations between LPLN status and clinicopathological factors including LPLN status diagnosed by computed tomography (CT). Methods  We reviewed a total of 210 patients with advanced rectal cancer, of which the lower margin was located at or below the peritoneal reflection, who underwent preoperative CT with 5-mm-thick sections and lateral pelvic lymph node dissection at the National Cancer Center Hospital between February 1998 and March 2006. Results  Forty-seven patients (22.4%) had LPLN metastasis. Multivariate analysis showed that LPLN status diagnosed by CT, pathological regional lymph node status, tumor location, and tumor differentiation were significant risk factors for LPLN metastasis. Among 45 patients with well-differentiated adenocarcinoma who were LPLN-negative and in whom CT had found no regional lymph node metastasis, none had LPLN metastasis. On the other hand, among 13 patients with moderate or less differentiated lower rectal adenocarcinoma who were LPLN-positive and in whom CT had revealed regional lymph node metastasis, 12 (92.3%) had LPLN metastasis. Conclusions  LPLN status diagnosed by CT, pathological regional LN status, tumor location, and tumor differentiation are significant risk factors for LPLN metastasis. Using these factors, patients can be classified as having a low or high risk of LPLN metastasis.     

Alpha-fetoprotein-producing colon cancer with atypical bulky lymph node metastasis

INTRODUCTIONAlpha-fetoprotein (AFP)-producing colorectal cancer isextremely rare, and only ten cases have been described in the English literature[1]. All reported cases presented with lung and/or liver metastasis and had a very poor prognosis. We here re…