3DCRT技术治疗原发性肝癌的临床剂量学研究

目的探讨3DCRT技术治疗原发性肝癌的方法、处方剂量与疗效的关系。方法27例有随访结果的肝癌患者,对其肿瘤体积大小、位置、处方剂量及生存期作回顾性总结。结果治疗后肿瘤局部控制率为85.2%(23/27),1年生存率为70.4%(19/27),2年生存率为55.6%(15/27),3年生存率为33.3%(9/27)。所有病人无放射性肝炎等严重副反应发生。结论3DCRT技术治疗不宜手术的肝癌是一种无创而有效的治疗方法,可提高肝癌的局部控制率,不良反应轻微,病人生存质量得到提高。     

大肠癌手术后肝转移的诊断与治疗

目的：探讨大肠癌手术后肝转移的诊断与治疗。方法：对35例大肠癌手术后肝转移的诊治效果进行回顾性分析。结果：所有的病例均得到CEA、B超和（或）CT检查证实，其1年和3年生存率在根治性手术切除组明显高于其他治疗组。结论：肝转移癌的早期诊断是提高生存率的关键，手术切除及选择性肝动脉栓塞化疗是改善其预后的选择。     

肝癌及癌旁组织中丙型肝炎病毒基因负链的研究

运用巢式聚合酶链反应（ＰＣＲ）等方法检测了５例丙型肝炎病毒核糖核酸（ＨＣＶ—ＲＮＡ）阳性患者的肝癌、癌旁组织和周围血清中ＨＣＶ—ＲＮＡ正链和负链，其中男４例，女１例。结果，正链检测：血清及癌旁组织全部阳性，癌组织中３例阳性。负链检测：血清中均阴性，癌组织３例阳性，癌旁组织５例均阳性。本组５例患者肝脏ＨＣＶ—ＲＮＡ负链阳性，推测ＨＣＶ以ＨＣＶ—ＲＮＡ负链作为模板在感染的肝脏组织中复制，ＨＣＶ持续存在于肝脏组织中对肝癌的发生起了一定的作用。     

肝癌的介入放射治疗

作者对８６５例行介入放射治疗的肝癌（７７３例原发性，９２例转移性）进行放射形态学的观察。将病例分为三组：巨块型４５７例，结节型１２４例和弥散型２８４例。介入疗法包括：一次或重复化疗药物栓塞或肝动脉灌注，临床症状明显改善。术后平均存活期１４．８个月。同时也观察了因栓塞及各类不同栓塞剂而引起的明显并发症。同时讨论了患者存活期以及重复栓塞和肝转移性肿瘤的某些特性，并着重讨论过去认为单用化疗药物肝动脉灌注治疗效果不好的转移性肝癌与同时使用栓塞治疗的不同效果。     

羟磷灰石加阿霉素瘤内注射治疗小鼠肝癌的实验研究

作者通过动物实验研究了羟磷灰石(HA)的抑癌效果及其机理。将80只移植有H_(22)肝癌的BALB/c小鼠分为4组:Ⅰ组HA加阿霉素(ADM)瘤内注射;Ⅱ组HA瘤内注射;Ⅲ组ADM瘤内注射;Ⅳ组未给药。结果Ⅰ～Ⅲ组的肿瘤生长抑制率分别为65.9％、41.9％及51.1％。Ⅰ～Ⅳ组的生存时间分别为32、22、26及18天。作者认为HA抑癌作用的机理可能是:①直接界面作用;②诱导组织纤维化;③免疫激活作用;④药物载体和缓释作用。结果显示HA加ADM瘤内注射可能成为一种治疗恶性肿瘤的新方法。     

差异筛选肝癌凋亡细胞cDNA文库的简便方法

目的差异筛选人肝癌凋亡细胞ｃＤＮＡ文库。方法消减杂交和点杂交相结合的噬菌斑原位杂交法筛选ｃＤＮＡ文库，首先采用（－）ｃＤＮＡ探针杂交，挑取（－）的噬菌斑克隆，再用（－）和（＋）两种ｃＤＮＡ探针与初筛出的噬菌斑克隆杂交的差异筛选方法。结果得到４个充分孤立的噬菌斑克隆，其插入片段长度为１．５ｋｂ左右。结论该方法简便、快速，是差异筛选ｃＤＮＡ文库的一种较为可行的简便方法。     

NECROSIS OF PORTAL TUMOR EMBOLUS OF HEPATOCELLULAR CARCINOMA BY LIPIODOL TRANSCATHETER CHEMO-EMBOLIZATION. A Case Report

We describe a case of hepatocellular carcinoma in which a tumor embolus in the portal vein and 3 of 4 intrahepatic metastases were necrosed completely by Lipiodol transcatheter chemo-embolization (Lipiodol-TCE). Tumor emboli in the portal vein and intrahepatic metastases usually cannot be necrosed by conventional transcatheter chemo-embolization alone, because small nodules such as intrahepatic metastases and tumor emboli in the portal vein are supplied blood from the portal vein. However, in this case, Lipiodol-TCE was effective against tumor emboli in the portal vein and intrahepatic metastases. ACTA PATHOL JPN 38: 1363-1367, 1988.     

人肝癌原位移植转移模型特性实验研究

目的　建立人肝癌细胞系HCC-9724(简称H)淋巴结转移模型,研究肿瘤转移机理。方法　采用裸鼠肝脏原位移植法,接种肿瘤细胞,取其淋巴结转移灶反复肝内接种,连续传三代后,观察其转移特性,采用SABC法测定淋巴结中nm23和Ⅳ型胶原酶表达。结果　裸鼠原位接种50d,肝内长出约1.7cm×6.0cm大小的肿瘤,呈分叶状,质地较软,周围血供丰富,瘤组织与邻近脏器粘连,有明显的浸润和转移,经裸鼠三次筛选后肿瘤潜伏期短(15d),瘤体大,形成广泛的肠系膜淋巴结转移,淋巴结中Ⅳ型胶原酶表达呈强阳性;而nm23呈弱阳性。结论　采用裸鼠肝原位移植法,反复筛选,获得了人肝癌淋巴结高转移模型。     

TWEAK蛋白对肝癌细胞增殖的影响

目的 观察TWEAK蛋白对肝癌细胞系增殖的影响,探讨TWEAK对肝癌细胞增殖的作用.方法构建PAVU6-TWEAK siRNA干涉质粒,转染HepG2和QGY7703肝癌细胞株,MTT法检测抑制TWEAK蛋白表达对肝癌细胞增殖的影响,并于培养体系中加入TWEAK蛋白,检测肝癌细胞增殖活性.结果成功构建PAVU6-TWEAK siRNA干涉质粒,转化肝癌细胞后肝癌细胞增殖受抑.肝癌培养体系中加入TWEAK蛋白后,肝癌细胞增殖活性有所增强.结论 TWEAK蛋白可促进肝癌细胞的增殖活性,抑制TWEAK表达,一定程度上可抑制肝癌细胞增殖.     

Recurrence after resection ofα-fetoprotein-positive hepatocellular carcinoma

The long-term prognosis of surgery for hepatocellular carcinoma (HCC) is not yet satisfactory, the main reason being the high recurrence rate. The authors report the results of a long-term follow-up of 308 patients with HCC who became -fetoprotein-(AFP)-negative after resection between 1975 and 1991. By March 1992, there was recurrence in 134 patients (43.5%). The 1-, 3-, 5- and 10-year recurrence rates were 9.2%, 38.8%, 54.9% and 85.0%, respectively. The 5-year survival rate was 49.7% for patients who had undergone a second hepatic resection (n=48). Analysis of factors influencing postoperative recurrence indicated that patients subjected to mass survey, with a lower -glutamyltransferase level, at an early stage of TNM classification, with a tumour of less than 5 cm, without tumour embolus, and with postoperative immunotherapy had a lower incidence of recurrence. It is concluded that the earlier the disease is diagnosed, the less the recurrence rate; adjuvant immunotherapy may reduce postoperative recurrence, and the early detection and resection of a recurrent tumour are important to prolonging survival further after curative resection of HCC.Abbreviations HCC hepatocellular carcinoma - AFP -fetoprotein - HBsAg hepatitis B surface antigen Presented in part at the 4th Wilson T. S. Wang International Surgical Symposium, 11–13 December 1992, Hong Kong.