晚期食管癌联合放化疗与单纯放疗疗效比较及复发情况分析

目的　观察晚期食管癌联合放化疗后的治疗效果及复发和转移时间。方法　 4 0例晚期食管癌患者分为两组 ,联合放化疗组 (综合组 )和单纯放疗组 (单放组 )。用60 CO治疗机照射 2Gy/次 ,总量 5 0～ 6 0Gy/ 5～ 6周 ,综合组在放疗d1、5、8周分别给予DDP、VCR、F -FU化疗 ,并随访 1年。结果　综合组和单放组疗效相仿 ,无显著统计学差异 (P <0 0 5 ) ,随访 6个月～ 12个月 ,单放组患者共 14例发生远处转移 ,2例局部复发 ,综合组仅 1例转移 (P <0 0 1) ,有显著统计学意义 ,毒副反应综合组略高于单放组。结论　联合放化疗是控制晚期食管癌复发和转移的主要治疗方案。     

Symptoms of Early Cancer Especially Barrett''''s Carcinoma

The incidence of the adenocarcinoma of the esophagus (AC) has been rising exponentiallyin the Western World within the last 30 years.The reasons for this increase are not yet understood.Massive and long lasting gastroesophageal reflux causes the Barrett's esophagus which is considered tobe a precaneerosis.Therefore early diagnosis and appropriate treatment of gastroesophageal reflux isessential for the prevention of this tumor.This makes heartburn the leading clinical symptom in thepatient's history.In patients with heartburn it is possible to early endoscopically diagnose a Barrett'sesophagus or adenocarcinoma of the esophagus.However only few patients with this increased risk receivean index-endoscopy.In clinical studies a high rate of early carcinomas could be found and could be treatedwith mueosectomie or ablation.The majority of patients with AC present with symptoms suggestive ofprogressed disease such as dysphagia or weight loss.The prognosis in patients in late disease stages are witha 5-year survival of only 30% far worse than in patients with early carcinoma (85%).However the earlysymptoms such as heartburn or regurgitation are unspecific and make an effective diagnostical strategydifficult.To optimize screening it would be beneficial to identify patients with high risk for the developmentof adenocarcinoina of the esophagus.     

Squamous Cell Carcinoma and Adenocarcinoma of the Esophagus–Di?erences in Etiology, Epidemiology and Prevention

Incidence of esophageal carcinoma With more than 300 000 new cases per year, cancerof the esophagus, predominantly squamous cell carcinoma(SCC), is one of the 10 most frequently diagnosed tumortypes. Esophageal cancer occurs often in developing coun-tries and shows great regional di?erences[1]. While in re-cent history the incidence of SCC has decreased slightly inregions of high risk and stayed constant in the USA andWestern Europe, the rate of adenocarcinoma of the esoph-agus (AC) has…     

食管癌早期癌变的研究和annexin I表达的意义

目的 检查annexin Ⅰ在食管癌前病变到食管鳞癌不同病变过程中的表达。方法 按照研究食管癌早期病变的病理学取材方法取材,选择含有不同程度癌前病变的食管鳞癌标本11例,经连续取材制片和免疫组化分析,比较同一病例由食管癌前病变发展到食管鳞癌的全过程中annexin Ⅰ的表达改变。结果 Annexin Ⅰ表达水平在食管正常鳞状上皮中呈强阳性(11/11,100％),低度癌前病变(轻度不典型增生和中度不典型增生)减弱(3/8,37.5％),高度癌前病变(重度不典型增生和原位癌)明显减弱(12/14,85.7/％),食管浸润癌和淋巴结转移癌中阴性或显著减弱(15/15和3/3,100％)。Annex.in Ⅰ在食管低度癌前病变中的改变具有显著意义(P=0.002)。结论 Annexin Ⅰ是食管鳞癌早期侯选标志蛋白,在食管低度癌前病变时表达异常。     

食管拔脱结肠重建食管(附18例分析)

 目的　探讨食管拔脱结肠重建食管术 (esophagealreplacementwithcolonERC)治疗颈、胸上段食管癌的可行性和实用性。方法　经颈、腹径路实施食管内翻拔脱切除病变食管 ,并用ERC获得了满意疗效 ,对该术操作要点 ,食管拔脱的可行性进行讨论。结果　全组无手术死亡 ,1例发生颈部吻合口瘘 ,1 8例术后随访 6年 ,存活超过 1年者 1 3例 ,超过 3年者 8例 ,超过 5年者 5例 ,5年生存率为 2 7.8%。结论　食管内翻拔脱ERC治疗颈 ,胸上段食管癌的特点为 :避免开胸术创伤 ,保留自体胃功能 ,术后生存期长 ,生活质量好。     

武汉地区食管癌发病因素的病例对照研究

 目的　探讨武汉地区食管癌发病的危险因素。方法　进行 1∶1配比病例对照研究 ,采用统一的调查表 ,分别对 5 8例病人和 5 8例对照进行问卷调查。结果　A型性格、精神压抑、吸烟、家庭被动吸烟和经常食用烟熏食品可增加食管癌发病的危险性 ;而多食用新鲜蔬菜、水果则为保护因素。结论　食管癌是多种内外因素反复长期作用于人体的结果。     

食管异物摘取术的麻醉选择

为探讨食管异物摘取术的麻醉方法，提高手术效果，对７２例食管异物患者采用强化表面麻醉法和气管内插管麻醉法进行了手术和对比观察。７２例异物均取出顺利，无严重并发症发生。资料显示：两种麻醉各具优越性，前者适用于年龄较大的儿童和成人，后者适用于食管异物并呼吸困难的小儿。     

食管鳞状上皮非典型增生细胞核的形态计量研究

本文用计算机图像分析仪对73例食管鳞状上皮非典型增生的细胞核进行形态计量测量，检测了胞核面积、周长、形态因子、异形指数、园球等5个指标，并与正常组相对照，结果表明，传统的组织学分级与形态定量分级基本一致，有其客观性。同时发现组织学诊断与形态计量诊断间有一些病例交叉，即下级病变的测量指标高于上级病变均值或上级病变的测量指标低于下级病变均值的情况。如果具体到某一病人，多指标形态定量可能比组织学诊断更准确，更能代表病变的现状。本文从食管鳞癌发生学的角度，对组织学诊断、细胞学诊断及形态定量诊断相互之间的关系及意义作了深入的分析，认为对食管非典型增生细胞核进行多指标形态分析，可为临床诊疗及估计预后提供帮助。     

人胚食管异种移植和诱癌研究

［目的］探讨人胚食管在裸鼠体内的异种移植及苯并在诱癌。［方法］人胚食管移植至探鼠，移植的人胚食管用苯并芘诱癌，观察移植物1－4个月并取材进行光镜、电镜和免疫级化检查。［结果］人胚食管在裸鼠皮下可存活4个月以上。移植的人胚食管用苯并芘诱癌，2个月可出现浸润性鳞状上皮癌。其病变有粘膜上皮坏死脱落、再生、增生、乳头状瘤样增生、不典型增生、原位癌及浸润癌。［结论］苯并芘能诱发人食管上皮癌。实验结果将有助于食管癌病因和发病机理研究。     

Difference of Gene Expression Profiles between Barrett’s Esophagus and Cardia Intestinal Metaplasia by Gene Chip

Theincidenceofadenocarcinomaintheesoph agusandgastroesophagealjunction(GEJ)isin creasingforthetwodecadesinNorthAmericaandEurope[1].Barrett'sesophagus(BE)isthoughttobeapremalignantconditionforesophagealadeno carcinomaandmostofadenocarcinomasatGEJ[2].Recentlythepresenceofcardiaintestinalmetapla sia(CIM)insomenormalappearingGEJhasbeendescribed[3].TherelationofthisconditiontoBEhasnotyetbeeninvestigated.Inthisexperiment,wehadperformedoura nalysisonthree4096chipsinordertoacquirethedifference…