131I标记抗CD20单克隆抗体在荷瘤裸鼠体内动态分布的实验研究

目的:探讨131I-anti-CD20 McAb经瘤内注射后在荷人Burkitts淋巴瘤细胞系Raji细胞移植瘤裸鼠体内的动态分布。方法:131I标记物的标记采用IODO-GEN碘化标记;注射标记物后第1、3、7、15天将荷瘤裸鼠活杀,定标器测量并计算瘤组织、血液等12种器官或组织的瘤/非瘤(T/NT)比值以及%ID/g值(每克组织摄入注入量的百分数)。结果:131I-anti-CD20 McAb瘤内注射组血液及其他组织器官T/NT比值在给药后第1、3和7天均显著高于腹腔注射组和131I-IgG瘤内注射组(P<0.05);该组肿瘤%ID/g值在给药后第1、3和7天分别为后两组的1.4~17倍和1.7~3.7倍;各非瘤组织和器官的%ID/g值低于后两组。结论:131I-anti-CD20 McAb经瘤内途径给药可以使肿瘤获得最高的放射性药物摄取率和最高的瘤/非瘤组织放射性药物摄取比,为下一步运用该途径进行放射免疫治疗提供了实验依据。     

原发性胃肠道淋巴瘤的诊断与治疗

目的探讨原发性胃肠道淋巴瘤的临床特点及诊治方法。方法1983年至2004年在北京大学第一医院外科接受治疗的原发性胃肠道淋巴瘤患者35例,对其临床病理资料及预后进行回顾性分析。结果本组原发性胃肠道淋巴瘤术前诊断率仅为20.0%;18例胃淋巴瘤中16例接受手术治疗,其中12例行根治性切除;17例肠道淋巴瘤均手术治疗,其中14例行根治性切除;Ann Ar-bor临床分期为:ⅠE期14例,ⅡE期10例,ⅢE期1例,ⅣE期10例。MALT淋巴瘤与非MALT淋巴瘤在年龄、性别及发病部位及早晚分期上差异无显著性。MALT淋巴瘤组手术根治率(92.9%)高于非MALT淋巴瘤(68.4%),MALT淋巴瘤组淋巴结转移率(42.9%)明显低于非MALT淋巴瘤组(84.2%)。结论胃肠道淋巴瘤临床表现缺乏特异性,术前诊断率低;胃淋巴瘤与肠淋巴瘤在性别、年龄、手术根治性及临床分期方面无明显区别;MALT淋巴瘤组确诊时分期较早,手术根治率高,淋巴结转移率低,预后优于非MALT淋巴瘤组。外科手术是诊断和治疗原发性胃肠道淋巴瘤的主要方法。     

Cognitive functions in primary central nervous system lymphoma: literature review and assessment guidelines.

BACKGROUND: Treatment-related neurotoxicity has been recognized as a significant problem in patients with primary central nervous system lymphoma (PCNSL) as effective treatment has increased survival rates. There is, however, a paucity of research on cognitive functions in this population. DESIGN: In a review of the literature, a total of 17 articles that described cognitive outcome in adult PCNSL patients were identified. RESULTS: The studies that assessed cognitive functions after whole-brain radiotherapy combined with chemotherapy reported cognitive impairment in most patients. Patients treated with chemotherapy alone had either stable or improved cognitive performance in most studies. Methodological problems, however, limited the ability to ascertain the specific contribution of disease and various treatment interventions to cognitive outcome. On the basis of the literature review, a battery of cognitive and quality-of-life (QoL) measures to be used in prospective clinical trials was proposed. The battery is composed of five standardized neuropsychological tests, covering four domains sensitive to disease and treatment effects (attention, executive functions, memory, psychomotor speed), and QoL questionnaires, and meets criteria for use in collaborative trials. CONCLUSION: The incorporation of formal and systematic cognitive evaluations in PCNSL studies will improve our understanding of treatment-related neurotoxicity in this population.     

长春地辛、吡柔比星、环磷酰胺、地塞米松联合治疗非霍奇金淋巴瘤的疗效观察

目的观察应用长春地辛(VDS)、吡柔比星(THP)、环磷酰胺(CTX)、地塞米松(DXM)联合治疗非霍奇金淋巴瘤的疗效及不良反应。方法患者予以VDS 2.5 mg.m-2,d1,8;THP 25 mg.m-2,d1,8;CTX 0.6 g.m-2,d1,8;DXM 10 mg.d-1,d1-10。28 d重复,2个疗程予以评价。结果总有效率(CR PR)为82.1%,不良反应为血液毒性,经G-CSF治疗可恢复,未见明显的外周神经毒性。结论VDS、THP、CTX和DXM联合治疗淋巴瘤安全有效。     

眼附属器黏膜相关淋巴组织淋巴瘤的研究进展

黏膜相关淋巴组织（MALT）淋巴瘤是非霍奇金淋巴瘤中结外边缘带淋巴瘤（MZL）的一种特殊类型。眼附属器MALT淋巴瘤是眼眶恶性肿瘤中较常见的一种，可发生在结膜、泪腺、眼睑和眼眶。近年来，国外许多学者在MALT淋巴瘤的临床特点、病理形态学、免疫表型、分子遗传学及分子生物学方面对它的发生机制在基因水平有了新的认识。就国外对眼附属器MALT淋巴瘤的分子遗传学异常在肿瘤细胞内部信号转导通路中作用的研究做一综述。     

T细胞选择性核苷类似物奈拉滨

奈拉滨为T细胞选择性核苷类似物，为9-β—D-阿糖呋喃糖乌嘌呤（ara—G）的水溶性前体药物，ara—G在白血病的原始细胞中转化为ara—G的三磷酸盐（ara—GTP），从而抑制DNA合成，导致细胞死亡。主要用于治疗病情复发或对药物无应答的T细胞急性淋巴细胞性白血病（T—ALL）和T细胞淋巴瘤（T—LBL）患者。现对其作用机制、药效学、药动学和临床评价做一介绍。     

原发性眼内淋巴瘤

原发性眼内淋巴瘤是一种少见的眼部恶性肿瘤，其淋巴瘤病理分类为结节外型弥漫型大细胞B细胞淋巴瘤，属于原发性中枢系统淋巴瘤（PCNSL）的一种。近年来发病率逐渐上升，在过去的20a里，美国PCNSL的发病率增长了3倍。该病临床表现无特异性，往往表现为假性葡萄膜炎，玻璃体或病变组织细胞病理学检查是诊断的金标准；但由于玻璃体活检手术，标本保存和病理诊断方法要求较高，所以诊断困难。治疗上主要应用大剂量甲氨蝶呤治疗。由于往往有神经系统受累，预后不佳，随着治疗方法的改进PIOL的平均存活率已经从1～1．5a提高到3a以上。     

Lead induces oxidative stress, DNA damage and alteration of p53, Bax and Bcl-2 expressions in mice.

Oxidative stress is considered as a possible molecular mechanism involved in lead toxicity. This study was carried out to investigate whether lead acetate could induce oxidative stress in mice, and the following damages as well. Lead acetate was given orally to mice for 4 weeks at doses of 0, 10, 50, 100mg/kg body weight every other day, respectively. Production of reactive oxygen species (ROS) and malondialdehyde (MDA) were measured as indicators of oxidative stress. DNA damage in peripheral blood lymphocytes was determined by comet assay. Ultrastructure alteration was detected using transmission electron microscopy. The alterations of p53, Bax, and Bcl-2 expression were determined by western blotting. The results showed that lead acetate significantly increased the levels of ROS and MDA in mice. Meanwhile, severe DNA damage and ultrastructure alterations were obviously observed. In addition, p53 and Bax expressions increased and the imbalance of Bax/Bcl-2 occurred. Therefore, it strongly suggests that lead may induce oxidative stress and change the expressions of apoptosis-related proteins in mouse liver.     

锰对大鼠生精细胞凋亡及p53和Bcl-2表达的影响

目的 研究氯化锰对大鼠生精细胞凋亡及p53、Bcl-2表达的影响.方法 将24只健康雄性SD大鼠随机分为3组,即15和30 mg/kg染锰组和0 mg/kg(阴性对照)组,腹腔注射给药,每天1次,每周5 d,连续4周.停药2周后,称重并应用电镜和原位末端脱氧核苷酸转移酶标记法(TUNEL法)检测睾丸生精细胞凋亡;免疫组化S-P法检测生精细胞p53和B淋巴细胞瘤/白血病-2(B-cell lymphoma/leukemia-2,Bcl-2)蛋白的表达.结果 电镜下各组大鼠可见生精细胞凋亡表现;15和30 mg/kg组生精细胞凋亡指数(apoptosis index,AI)和p53阳性细胞率均明显高于对照组,差异有统计学意义(P＜0.01),且30 mg/kg组高于15 mg/kg组,差异有统计学意义(P＜0.01).30 mg/kg组Bcl-2阳性细胞率明显低于0和15 mg/kg组,差异有统计学意义(P＜0.01).结论 锰可诱导大鼠生精细胞凋亡,p53表达上调和Bcl-2表达下调可能是生精细胞凋亡增加的重要原因之一.     

美罗华联合CHOP方案治疗滤泡型非霍奇金氏淋巴瘤1例

[目的]评价美罗华联合CHOP方案治疗滤泡型NHL的临床效果及不良反应.[方法]第1天:美罗华375mg/m2,600 mg静点;地塞米松15 mg静推;第2天:环磷酰胺750 mg/m2,1.2 g静推;长春新碱1.4 mg/m2,2mg静推;法玛新60 mg/m2,110 mg静推;第2～5天:强的松100毫克口服.每21天1周期,连用7周期.[结果]完全缓解.毒副反应主要是骨髓抑制Ⅲ°、口腔炎Ⅲ°、便秘Ⅲ°、脱发Ⅱ°、恶心呕吐I°,可耐受.[结论]美罗华联合CHOP方案治疗滤泡型NHL可获得较好疗效,毒副反应可以耐受,是一个较好的化疗方案.