卵巢恶性肿瘤80例临床分析

本资料对我院1980～1989年12月底收治的卵巢恶性肿瘤80例进行临床分析。结果表明发病的高峰年龄在45～55岁之间。77.5%的病人有盆腔包块,65%的病人有腹痛,45%有月经改变或合并腹水,71.2%合并贫血,半数以上为Ⅲ～Ⅳ期的晚期病人。65%为上皮性癌。经随访表明:基本切净者5年生存率为60.4%,残余癌≥2cm 绝大部分在2～3年内死亡。上皮性腺癌中以浆液性腺癌恶性程度高,内胚窦瘤和转移癌预后最差。临床分期越高预后越差。因此卵巢恶性肿瘤治疗的关键是:早期诊断、彻底治疗。     

恶性胸水的综合诊断

对４２例恶性胸水患者进行胸水脱落细胞检查、胸膜活检、纤维支气管镜等多项检查方法诊断。结果：胸水脱落细胞检查阳性为３０／４２（７１．４％），胸膜活检阳性为２１／３２（６５．６％），两项检查其中一项或两项阳性３５例（８３．３％），并对各项检查意义进行讨论。     

卡铂、5－Fu序贯腔内用药治疗癌性腹水

作者对５０例癌性腹水病人应用卡铂．５－Ｆｕ序贯腔内给药治疗，其中完全缓解（ＣＲ）２２例，占４４％，部分缓解（ＰＲ）２４例，占４８％，总有效率（ＣＲ＋ＰＲ）为９２％，毒副作用主要表现为恶心、厌食，偶见低热、腹痛和一过性白细胞下降，表明本疗法对癌性腹水近期疗效高，毒性低、缓解期长，值得在基层医院推广。     

Prepubertal melanoma in a medium-sized congenital naevus

A case of malignant melanoma in a medium-sized congenital naevus in a prepubertal girl is presented. Risk factors for developing melanoma during childhood include giant congenital naevi, dysplastic naevus syndrome and xeroderma pigmentosum. The lifetime risk of melanoma associated with giant congenital naevi has been estimated to be 4%–20%; the risk associated with small and medium-sized congenital naevi however remains controversial. In the latter lesions, malignant transformation is considered an almost exclusively postpubertal phenomenon, in contrast to giant congenital naevi where it often occurs prior to puberty. In our patient, malignant transformation in a medium-sized congenital naevus occurred before puberty. We suggest that the true incidence of malignant transformation within these lesions and the time at which it occurs, should be documented by prospective studies and that not only the giant congenital naevi but also the smaller congenital naevi should be considered for prophylactic excision in early childhood.     

Anaplastic large cell lymphoma of true histiocytic origin in an infant: Unusual clinical,hematological, and cytogenetic features

We report here the case of a 7-month-old boy who developed anaplastic large cell lymphoma of true histiocytic origin or malignant histiocytosis, with fever, bone and bone marrow infiltration. Usual clinical features were absent. The neoplastic nature of the disease was supported by the presence of clonal chromosomal abnormalities [t(6;8)(p23;P21),der(8)del(8)(q11aq13), der(22) t(11;22) (q13;13)]. Neither B nor T lineage could be demonstrated here. Morphology, ultrastructural analysis, surface antigens expression, and cytogenetics were more specific for the monocyte-macrophage lineage.     

Malignant histiocytosis and large cell anaplastic (Ki-1) lymphoma in childhood: Guidelines for differential diagnosis—report of the histiocyte society

A workshop of the Histiocyte Society was recently held, in order to discuss the problems and confusion of malignant histiocytosis (MH) and large cell anaplastic (Ki-1) lymphoma (LCAL). The aims of this workshop were to clarify the terminology for malignant histiocytic disorders and LCAL and to produce reliable criteria for diagnosis of both MH and LCAL. This article summarises the conclusions reached. © 1994 Wiley-Liss, inc.     

Soluble interleukin-2 receptor, intercellular adhesion molecule-1 and interleukin-10 serum levels in patients with melanoma

Serum soluble interleukin-2 receptor (sIL-2R), intercellular adhesion molecule-1 (sICAM-1) and interleukin-10 (IL-10) have each been reported as useful markers for melanoma progression. To evaluate the clinical relevance of these three markers, we simultaneously analysed their serum levels in patients with melanoma. A longitudinal study with a 3-year follow-up was performed and different stages of the disease were considered. Mean values of sIL-2R were significantly higher than in normal controls in all stages and correlated with the disease progression. The prognosis of patients with levels > 529 U/ml of sIL-2R was significantly poorer than in patients with sIL-2R levels < 529 U/ml. Levels of sICAM-1 were also elevated in melanoma patients, specially at the time of the metastatic disease. Serum IL-10 levels were more frequently detectable in the patients that developed metastasis during follow-up, and the prognosis of patients with detectable IL-10 levels was significantly poorer than in those patients with IL-10 undetected levels. Statistical analysis based on Logistic and Cox regression models showed that only sex, stage and sIL-2R value are factors significantly associated with metastatic progression. Moreover, high levels of sIL-2R could be a risk factor for malignant progression in melanoma.     

Telomere length and telomerase activity in malignant lymphomas at diagnosis and relapse

Telomere length maintenance, in the vast majority of cases executed by telomerase, is a prerequisite for long-term proliferation. Most malignant tumours, including lymphomas, are telomerase-positive and this activity is a potential target for future therapeutic interventions since inhibition of telomerase has been shown to result in telomere shortening and cell death in vitro. One prerequisite for the suitability of anti-telomerase drugs in treating cancer is that tumours exhibit shortened telomeres compared to telomerase-positive stem cells. A scenario is envisioned where the tumour burden is reduced using conventional therapy whereafter remaining tumour cells are treated with telomerase inhibitors. In evaluating the realism of such an approach it is essential to know the effects on telomere status by traditional therapeutic regimens. We have studied the telomere lengths in 47 diagnostic lymphomas and a significant telomere shortening was observed compared to benign lymphoid tissues. In addition, telomere length and telomerase activity were studied in consecutive samples from patients with relapsing non-Hodgkin's lymphomas. Shortened, unchanged and elongated telomere lengths were observed in the relapse samples. The telomere length alterations found in the relapsing lymphomas appeared to be independent of telomerase and rather represented clonal selection random at the telomere length level. These data indicate that anti-telomerase therapy would be suitable in only a fraction of malignant lymphomas.