食管癌组织及其区域淋巴结中树突细胞CD1a、CD80、CD86的表达

背景与目的:树突细胞(dendriticcell,DC)是重要的抗原提呈细胞,参与抗肿瘤免疫。本研究通过检测人食管癌组织及其区域淋巴结中树突细胞CD1a(特异性标志)、CD80、CD86(共刺激分子)的表达,探讨食管癌发生及其免疫逃逸的机制。方法:采用流式细胞术检测58例食管癌病例(Ⅰ-Ⅱ期27例,Ⅲ-Ⅳ期31例;G1-237例,G321例;鳞癌49例,腺癌9例;有淋巴结癌转移者37例,无淋巴结癌转移者21例)的癌组织及癌旁组织、11例食管炎性组织、12例正常食管组织、31枚有癌转移的区域淋巴结、34枚无癌转移的区域淋巴结中树突细胞CD1a及CD80、CD86的表达。结果:(1)树突细胞CD1a、CD80、CD86的表达在食管癌组织中(6.18±1.47,5.37±1.13,37.35±7.42)明显低于正常食管组织(10.28±2.11,9.67±1.94,48.76±10.23)、食管炎性组织(11.89±2.65,10.46±1.79,51.55±10.60)及癌旁组织(11.79±2.41,10.49±1.89,9.78±12.31)中的表达(P<0.01);(2)树突细胞CD1a、CD80、CD86的表达在食管癌患者有癌转移的区域淋巴结中的表达(8.34±1.66,6.78±1.42,41.70±8.71)明显低于无癌转移的淋巴结中的表达(12.23±2.14,10.82±2.11,59.63±12.52)(P<0.01);(3)癌旁组织及食管炎性组织中树突细胞CD1a、CD80、CD86的表达与正常食管组织中的表达的差异无统计学     

通里攻下法防治食管癌术后患者胃肠动力低下的临床研究

目的 观察通里攻下法防治食管癌术后胃肠动力低下的临床疗效,并探讨其作用机制。     

18F-FLT和18F-FDG PET/CT对胸段食管癌淋巴结分期诊断的对比研究

目的 评价18F-脱氧胸苷（FLT）PET/CT对未经治疗的胸段食管癌淋巴结分期诊断的价值,并与18F-脱氧葡萄糖（FDG）PET/CT进行比较.方法 选择22例拟行手术治疗的胸段食管癌患者,术前行双显像剂PET/CT检查及淋巴结分期诊断,术后以病理学诊断为＂金标准＂,比较18F-FLT和18F-FDG PET/CT对胸段食管癌淋巴结分期的灵敏度、特异性、准确性、阳性预测值和阴性预测值.应用SPSS 13.0软件进行x2检验.结果 患者均行食管癌切除和淋巴结清扫术,病理检查结果显示16例患者存在淋巴结转移,N0期7例,N1期15例,M1a期6例（其中1例为N0M1a,另外5例为N1M1a）,全组均无M1b期.共检出424枚淋巴结,其中47枚为转移淋巴结.18F-FDG PET/CT诊断呈假阳性的淋巴结14枚,而18F-FLT诊断呈假阳性的淋巴结为3枚;18F-FDG假阴性的淋巴结8枚,18F-FLT假阴性的淋巴结12枚.18F-FLT PET/CT的诊断灵敏度、特异性、准确性、阴性预测值和阳性预测值分别为74.47%（35/47）、99.20%（374/377）、96.46%（409/424）、96.89%（374/386）和92.11%（35/38）,18F-FDG分别为82.98%（39/47）、96.29%（363/377）、94.81%（402/424）、97.84%（363/371）和73.58%（39/53）;两者比较的x2值分别为0.572,6.018,1.017,0.348,3.852,P值分别＞0.05,＜0.05、＞0.05、＞0.05和＞0.05.结论 18F-FLT对食管癌区域淋巴结的诊断灵敏度与18F-FDG显像接近,特异性高于18F-FDG,但仍存在一定的局限性.     

18F-氟赤硝基咪唑PET-CT检测非小细胞肺癌乏氧的应用价值

Objective To assess the feasibility of [18F ] fluoroerythronitroimidazole (18F-FETNIM ) with integrated positron emission tomography and computed tomography (PET-CT) imaging in detection of hypoxia in non-small-cell lung cancer ( NSCLC) patients. Methods Forty-two patients with newly diagnosed NSCLC underwent 18F-FETNIM PET-CT before treatment. Nineteen patients rested for approximately 120 minutes before undergoing PET-CT,23 patients underwent 2 sequential PET-CT scans at 60 minutes and 120 minutes after intravenous injection 18F-FETNIM. 18F-FETNIM uptake was quantified by calculating the maximum standardized uptake value in the tumor (SUVmax-T) and contralateral normal lung tissue (SUVmax-N). Regions of interest (ROIs) were drawn in the tumor and contralateral position and the radioactivity ratio of tumor to normal (T/N) was calculated.Results SUVmax-T ( 2. 43 ± 1. 34) was significantly higher than SUVmax-N (0.87 ±0.46, P<0.001) at 120 min. SUVmax-T (2. 80 ± 1.09) and SUVmax-N (1. 16 ± 0. 56) at 60 min were significantly higher than SUVmax-T (2. 61 ± 1. 10) and SUVmax-N (P<0.01) at 120 min. T/N (2.56 ± 0.71) at 60 min was higher than that at 120 min (2.48 ± 0.60),but the difference between them was not significant (P =0.324). Conclusion Our results indicate that 18F-FETNIM PET-CT may be a useful tool for evaluating hypoxia and may be a means to target specifically tumor cells resistant to conventional treatment before and during ongoing therapy in NSCLC.     

63例贲门癌胸腔纵隔淋巴结转移特点分析

目的研究贲门癌胸腔内纵隔淋巴结转移特点。方法采用前瞻性分析2008年6月—2009年10月随机选择63例贲门癌患者进行胸腔内纵隔淋巴结清扫并分析其转移特点。结果63例贲门癌患者腹腔淋巴结转移度、转移率分别为 38.39% 、66.67%。胸腔淋巴结转移度、转移率分别为10.60 %、20.63%。胸腔纵隔淋巴结转移与肿瘤长度、病理分级、浸润深度、肿瘤是否累及食管下段、腹腔淋巴结有关,Logistic回归多因素分析则显示肿瘤是否累及食管下段是主要影响因素。结论贲门癌主要向腹腔、胸腔淋巴结转移,贲门癌淋巴结清扫范围应包括胸腔内纵隔淋巴结与腹腔淋巴结。     

Correlations of 99Tcm-HL91 SPECT hypoxia imaging with HIF-1α and VEGF expression in non-small cell lung cancer

Objective 99Tcm-HL91(99Tcm labeled 4,9-diaza-3,3,10,10-tetramethyldodecan-2,11-dione dioxime)is a potential noninvasive marker of tumor hypoxia.It has been reported that 99Tcm-HL91 has validity for hypoxia imaging in non-small cell lung cancer(NSCLC).The aim of this study was to evaluate the 99Tcm-HL91 SPECT hypoxia imaging of NSCLC,the expression of inducible hypoxia factor-1α (HIF-1α)and vascular endothelial growth factor(VEGF),and to analyze their correlations with clinicopathological characteristics.Methods Twenty NSCLC patients who underwent radical resection were enrolled into this study prospectively.99Tcm-HL91 SPECT scanning was performed in all patients at one or two days before surgery.After intravenous injection of approximately 740 MBq 99Tcm-HL91,anterior,posterior and lateral planar images were collected at 2,4 and 6 hours,respectively.Regions of interest (ROls)were drawn in the tumor and the contralateral normal lung tissue,and the radioactivity ratio of tumor to normal tissue(T/N)was calculated.Immunohistochemistry was used to detect the expression of HIF-1α and VEGF in sequential histological sections of specimens.Results Among the 20 NSCLC patients,13 showed positive expression of HIF-1α and 15 had positive expression of VEGF,with a positive rate of 65.0% and 75.0%,respectively.The uptake of 99Tcm-HL91 was strongly correlated with the expression status of HIF-1α.No correlation between HIF-1α and VEGF expression levels was observed.The HIF-1α expression level was not correlated with histological subtype,but with lymph node involvement.The expression levels of HIF-1α and VEGF were positively correlated with tumor stage.Conclusion The result of 99Tcm-HL91 SPECT hypoxia imaging is found to be positively correlated with expression of HIF-1α in the non-small cell lung cancer.HIF-1α expression is positively correlated with VEGF expression.Furthermore,both HIF-1α and VEGF expressions are increasing with the increase of tumor stage.     

食管癌患者的术后生存67例报告

宁阳县中医院胸外科共行食管癌手术211例,对其中生活半径较小(<30 km)的67例进行了术后跟踪随访,结果报道如下。1　临床资料1.1　一般资料1994年3月~1998年3月宁阳县中医院胸外科共行食管癌手术211例,对其中 67 例进行了术后跟踪随访。本组病例均经X ray、纵隔(或胸部)CT、内窥镜、活检确诊,手术指征明确。其中颈段2例,胸上段8例,胸中段37例,胸下段20例(含累及贲门)。男38例,女 29 例,男∶女=1 31∶1。年龄 38~74岁,中位年龄 52 3 岁。有家族史 37 例,占 55 2%;曾有烟酒嗜好26例,占38 8%。术前伴发冠心病34例,占50 7%;慢性支气管炎 15…     

幼儿节细胞神经瘤致腹泻1例

幼儿节细胞神经瘤致腹泻１例赵春燕病儿男，２岁。体重９ｋｇ。反复腹泻水样便１年余，每日４～５次，无腹痛及恶心呕吐，治疗无效；近２个月咳嗽、憋气。Ｘ线胸片及ＣＴ片示右后纵隔软组织５．７ｃｍ×４ｃｍ阴影，中央有少许钙化，包膜光滑与脊柱右侧缘关系密切。诊断为...     

食管少见性恶性肿瘤临床及病理分析（附29例报告）

食管少见性恶性肿瘤临床及病理分析（附２９例报告）山东省临沂市肿瘤医院胸外科（２７６００１）段孝凤，高晓旭我院自１９８２年至１９９４年１２年间共收治经手术病理证实的食管少见性原发性恶性肿瘤２９例，现将临床病理及治疗体会报告如下。临床资料本组２９例患者，...     

临床误诊为食管癌病例的经验教训

我院1986年1月至1989年8月,手术治疗食管、贲门癌210例,临床误诊3例(1.4%),其中食管炎症2例,食管结核1例。现报道如下:例1、男,50岁。进食时胸骨后疼痛伴咽下不畅1月。食管造影,食管下段管壁僵硬,管腔狭窄,病变以上食管扩张(图1)。食管镜检查距门齿35cm处见食管左侧壁一肿物,表面糜烂,质脆,触之易出血,累及管腔1/2周径。活检病理报告为食管粘膜组织。依据X线与内窥镜肉眼观察,临床诊断