结肠肝曲癌侵犯十二指肠的外科治疗

目的:探讨结肠肝曲癌侵犯十二指肠的外科治疗。方法:对1996年1月—2006年8月12例结肠肝曲癌侵犯十二指肠的临床资料进行回顾性分析。结果:结肠肝曲癌侵犯十二指肠程度分两种类型:Ⅰ型局部浸润型,Ⅱ型广泛浸润型或癌性穿孔并内瘘形成。本组12例均行手术治疗,分别采取姑息性手术2例,右半结肠连同十二指肠浸润灶局部切除9例,右半结肠连同十二指肠节段性切除1例．十二指肠缺损单纯修补6例,十二指肠、空肠Roux-en-Y吻合术4例。术后无肠瘘及十二指肠梗阻等并发症。结论:根据结肠肝曲癌侵犯十二指肠不同特点,采取积极合理的手术方式有助于改善病情或减少术后并发症。     

Non-steroidal anti-inflammatory drug (NSAID)-induced colonic strictures and perforation: A case report

Although non-steroidal anti-inflammatory drug-induced colopathy is well described, colonic perforations complicating non-steroidal anti-inflammatory drug intake are rare. We report a patient with rheumatoid arthritis who was on long-term diclofenac and presented with early colonic stricture formation and a caecal perforation, which to the best of our knowledge, has only been reported once before. It is important to suspect this diagnosis in patients on non-steroidal anti-inflammatory drug therapy who present with an acute abdomen.     

小肝细胞癌的螺旋CT诊断

目的探讨小肝细胞癌的CT影像表现。方法回顾我院2001年2月-2005年2月经病理证实的12例小肝细胞癌的CT表现。结果通过平扫、动脉期、门脉期及部分延迟扫描均可对小肝细胞癌作出定性诊断。结论螺旋CT作为非创伤性容积扫描技术对小肝细胞癌的早期检出、定位、定性诊断具有十分重要的临床价值。     

大肠癌手术前后血清CA199和CEA水平变化临床价值的研究

目的:研究大肠癌患者手术前后(包括根治术及姑息手术)血清CA199和CEA水平的变化.并探讨其应用价值。方法:应用全自动化学发光免疫分析法,分别测定临床确诊的50例大肠癌患者(术前和手术30 d后)及50例正常成人血清CA199与CEA含量变化。结果:50例大肠癌患者手术前后血清CA199和CEA检测显示,术前血清CA199和CEA均高于对照组(P<0.01),术后血清CEA较CA199下降快,而且大肠癌患者术前血清CA199和CEA含量较根治术30 d后有明显增加,差异有统计学意义(P<0.05)。而姑息性切除手术前后血清CA199和CEA含量变化不大(P>0.05),差异无统计学意义。结论:大肠癌患者术前血青CA199和CEA含量显著增高.而根治术后血清CA199和CEA均有较明显下降。因此,术后定期联合监测血清CA199和CEA有利于临床观察大肠癌患者病情变化,评价手术效果,预测首程化疗疗效,为判断预后、及早发现术后复发病人提供依据。     

经支气管动脉灌注丹参联合动脉化学栓塞术治疗中晚期肺癌的疗效分析

目的：探讨经支气管动脉灌注丹参联合动脉化学栓塞术治疗中晚期肺癌的近期疗效。方法：对31例经病理学确诊的原发性中心型肺癌进行选择性支气管动脉造影，并将3F同轴微导管置于肿瘤的供血动脉内灌注复方丹参注射液16ml，随之在透视监视下注入适当剂量的碘化油一顺铂乳剂。结果：临床症状改善率为100％，且无严重并发症发生，1年生存率为90．32％(28／31)。结论：经支气管动脉灌注丹参联合化学栓塞术治疗中晚期肺癌具有较好的临床疗效。     

Association between age and clinical characteristics of renal cell carcinoma in adult patients

AIM: To study the association between age and clinical characteristics of renal cell carcinoma in adult patients. METHODS: Three hundred and ten patients with renal cell carcinoma were classified into three groups: or=60 years group. The clinical characteristics of the three groups were compared to define the association. RESULTS: The male/female ratio was 1.3/1, 2.0/1, 3.3/1 in the three groups, respectively, and a significant difference appeared when comparing the or=60 years group (P=0.010). The respective percentage of incidental renal cell carcinoma was 27.9%, 43.2%, 31.2%, and it was significantly higher in the 41-59 years group than the >or=60 years group (P=0.047). The incidence of poorly differentiated renal cell carcinoma decreased with age increasing (11.6% vs 5.2% vs 2.7%), and there was significant difference between the or=60 years group (P=0.038). In the 相似文献   

丁酸对人结肠癌细胞株SW1116增殖及分化状态的影响

目的:探讨结肠中膳食纤维的酵解产物丁酸对人结肠癌细胞株生长、增殖及分化状态的影响。方法:将传代人结肠癌SW1116细胞株接种于不含及合不同浓度(2、3、4、7、10 mmol/L)丁酸的培养基中。经6、24、48和72h后,用四唑蓝(MTT)法测定细胞增殖率、细胞匀浆中癌胚抗原(CEA)及和碱性磷酸酶(ALP)的表达;同时用电镜观察细胞形态的改变。结果:丁酸对SW1116细胞株的生长抑制作用呈浓度依赖性,在所观察的丁酸浓度及时限内,最高抑制率达53.9％。同时丁酸能大大增加SW1116细胞CEA和ALP的表达;当丁酸浓度≥7mmol/L和培养时间≥48h时,二者增加最为显著(P<0.001)。电镜显示丁酸能使细胞表面微绒毛明显增多。结论:丁酸能抑制SW1116细胞株的生长并诱导其分化。     

脾原发性淋巴瘤超微结构观察与流式细胞分析

目的 探讨诊断电镜（DEM）对脾原发性淋巴瘤的病理分型的超微结构特征。流式细胞术（FCM）测定瘤细胞DNA倍性与恶性程度的关系。方法 应用透射电镜和流式细胞术观察分析41例脾原发性淋巴瘤的超微结构和瘤细胞DNA倍性。结果41例脾原发性淋巴瘤中霍奇金淋巴瘤5例,电镜下R-S细胞呈双叶不规则核和对称致密大核仁,核内常染色质明显,胞质内见中等量线粒体,较长的粗面内质网。非霍奇金B细胞性淋巴瘤21例,裂细胞性5例,细胞核大,核伴有较深的裂沟,胞浆少,胞质见少数肿胀线粒体,无核裂细胞性7例,细胞核规则,呈圆或卵圆型,异染色质多呈条块状,核仁中等大,胞质少,见少量线粒体及长粗面内质网。混合细胞性,瘤细胞大小悬殊,大畸形核较多,核扭曲,不规则深沟及不对称分叶,形成多叶核。非霍奇金T免疫母细胞淋巴瘤11例,瘤细胞较大,核小胞质相对多,胞质透明,核多形性,有的呈圆或卵圆形,核膜薄,有深浅不一的凹陷,可见小核仁。淋巴母细胞性5例,淋巴母曲核性淋巴瘤,细胞为中小形,呈锯齿状核和扭曲状核,异染色质沿核膜聚集,核仁小。毛细胞性淋巴瘤1例,毛细胞的绒毛宽基底,核仁大,胞浆无核糖体板层复合物。组织细胞性淋巴瘤3例,细胞浆丰富,核圆或椭圆形,偶见核膜呈锯齿状或折叠,线粒体和溶酶体丰富,无细胞连接和Birbeck颗粒。FCM     

E-钙黏附蛋白、CD44v6在卵巢上皮性肿瘤及卵巢癌转移灶中的表达

目的：在基因表达水平上研究黏附分子(E-cadherin，CD44v6)与卵巢癌转移的关系。方法：用免疫组化S-P法，选取1997～2002年间石蜡包埋的卵巢上皮性肿瘤组织块107块，其中良性上皮性肿瘤30例，交界瘤13例，恶性34例(Ⅰ、Ⅱ期4例，Ⅲ、Ⅳ期30例)，对30例恶性晚期(Ⅲ、Ⅳ期)病例选取对应的大网膜转移组织。结果：30例良性上皮性肿瘤组织中，E-钙黏附蛋白100％强阳性表达，CD44v6100％阴性。13例交界瘤中，E-钙黏附蛋白有11例(84．6％)强阳性，CD44v6有1例弱阳性表达。34例恶性上皮性肿瘤中，E-钙黏附素有24例(70．6％)阳性表达，CD44v6有11例(32．4％)阳性表达。二指标在良性上皮性肿瘤与卵巢癌之间的阳性表达有显著性差异(P=0．001，P=0．000)。二指标在原发灶和大网膜转移灶之间表达无显著差别(P=1．000，P=1．000)。结论：E-cadherin及CD44v6在上皮性卵巢肿瘤中的表达呈相反趋势，E-cadherin及CD44v6与卵巢癌组织学分级及预后无明显相关性。     

Cytokeratin 7 and 20 as immunohistochemical markers in identification of primary tumors in craniospinal metastases: Do they have a significant role?

Cytokeratin (CK)7 and CK20, the low molecular weight cytokeratins, have been found to have a benefit in the differential diagnosis of some epithelial neoplasms. In the present study, the actual role of these markers in the search of primary tumors in 32 patients with craniospinal metastasis of an unknown primary site at presentation, is evaluated. A series of 36 patients with a known primary tumor were presented for comparison. In the first group, two CK7 and CK20 expression profiles were observed; 87% of metastatic tumors were CK7+/CK20‐ and 13% CK7‐/CK20‐. The lung was the major source (82%) of CK7+/CK20‐ metastatic tumors, whereas it represented only 38% of primary tumor in the second group of a known primary site (P = 0.006). Given the fact that metastatic tumors to the craniospinal axis of an unknown primary site are frequently CK7+/CK20‐, and they have commonly metastasized from the lung, it is doubtful that immunohistochemistry is really helpful. However, CT scan and MRI of the chest still play an important role. Many patients in the present study had to undertake these imaging studies, regardless of the CK7/CK20 result. The immunostains may be useful in cases with other expression profiles, but such examples constituted only a minority in the present study.