复合核黄素阻断治疗食管上皮重度增生人群12年结果分析

1978～1989年在食管癌高发现场用复合核黄素对食管上皮重度增生患者进行阻断治疗,约2年吞(拉)网细胞学随诊一次,共6次。本文报告137例效果评价分析。第6年时与对照组比较,两组好转率分别为47.2%(42/89)及20%(7/35),进展率为19.1%(17/89)和42.9%(15/35),癌变率为1.1%(1/89)及14.3%(5/35),两组间差别均有显著性(P<0.025)。治疗组第12年好转率为46.6%(34/73),癌变率为5.5%(4/73)。12年中累计发现癌患者8例,占5.8%。远低于文献回顾调查1～12年的自然癌变率(14.9%,79/530)。     

食管上皮增生的细胞学分级方法及其实验研究

 食管拉网细胞学在我国开展和应用已三十年，在食管癌及癌前病变临床和基础研究中发挥着重要作用。不仅用于食管癌的早期发现，现场普查时还利用细胞学分级衡量上皮增生的程度，进行预防对象选择和预防效果评价。本文论述食管上皮增生的细胞学分级方法及其可行性和可靠性的实验研究进展情况。     

早期食管原发性腺癌初步病理分析

通过7例早期食管原发性腺癌手术标本系列大切片的观察,证明在早期食管癌中确有原发性腺癌存在。患者平均年龄46岁,较中晚期癌患者年轻约10岁。病理类型以浅表缺损型为主,癌灶平均长度13mm。病理特征为:(1)癌变多起始于食管固有腺腺管上段,可在相邻数个腺体内同时发生;(2)组织学上多表现为腺管癌;(3)癌灶表面和周围覆盖有受压变薄或呈增生性改变的鳞状上皮;(4)多伴有鳞癌成分。     

食管癌二级预防研究中细胞组织病理学的应用

前言二级预防是在细胞的增生阶段采取有效措施使增生停滞发展或回复正常以减少或消除癌变机会。在食管癌的二级预防工作中必须建立对增生病变的有效诊断方法,即增生细胞的分级。按级别的轻重选择预防对象,也用服药后细胞级别的变化作为评价疗效的标准。慢性食管炎具有促食管上皮增生癌变的作用,治疗食管炎有防癌的意义,因此应研究     

食管细胞学的定量研究：I.食管鳞状上皮正常,增生癌细胞形态...

On cytosmears of esophageal epithelium of individuals from high-risk area of esophageal cancer squamous epithelial cells, according to standard cytologic diagnostic criteria, can be categorized as normal, hyperplasia, severely dysplastic grade I and grade II, nearly-carcinoma and early carcinoma. Cytosmears from 60 patients, 10 for each category, were studied with a semiautomatic image analysis system. Thirteen morphologic parameters so obtained were further analyzed by computer-based stepwise regression and linear correlation analyses. The results showed that the following 5 parameters could be used to judge the nature of the cells, i.e. a) cytoplasmic area, b) cytoplasmic mean diameter, c) cytoplasmic form factor, d) nuclear form factor and e) N/C ratio. Comparing with cells of the other categories, values of the first 4 parameters for early cancer cells were decreased whereas that of the fifth parameter was significantly increased. From normal to hyperplastic and to dysplastic cells, the nuclear area and mean nuclear diameter were gradually increasing. Therefore, they were the major parameters in judging the degree of hyperplasia and dysplasia. These numerical features of morphologic quantitation conformed with the cytologic diagnostic criteria for cancer, hyperplasia and dysplasia under light microscope. It indicates that visual judgement is relatively accurate and application of the ocular micrometer to measure the cells would make this grading more objective.     

食管细胞学与活检诊断对比分析

对在食管癌高发区普查中诊断为重度增生的患者,进行食管拉网细胞学、内镜刷检细胞学与内镜活检组织学的复查,并对诊断结果进行对比。结果细胞学诊断与组织学诊断在癌前增生阶段的符合率较低。细胞学癌前增生检出率高于组织学。二者对于鳞癌的诊断符合率较高。提示:食管拉网细胞学检查适合于食管癌前病变的研究,并可作为早期食管癌诊断及筛选方法。     

食管鳞状上皮各级涂片细胞的扫描电镜观察

应用扫描电镜技术观察了22例在河南林县取材的食管拉网涂片中,经光镜定性、定位的正常、轻度增生、重度增生Ⅰ级、重度增生Ⅱ级、近癌和癌变鳞状上皮细胞的表面超微结构的变化。发现从正常到近癌阶段细胞间嵴由清晰渐至消失,微嵴渐增多致密,由正常的条纹状平行排列逐渐变为不规则的螺纹、漩涡和线团状排列。癌细胞形态不规则、细胞明显增厚、微嵴及间嵴消失,与正常和增生细胞明显不同。文内还讨论了各级细胞表面结构与分化和代谢变化的关系。     

食管上皮增生细胞学显微测量分级的图像分析

应用图像分析技术检测50例食管拉网涂片中经光镜测量协诊的食管鳞状上皮正常、轻度增生、重增Ⅰ级、重增Ⅱ级和近癌细胞的核面积、平均卡规直径及最大和最小直径四项参数。结果表明:各项参数均值随着增生级别增高逐级增加(P<0.01),判别回代符合率为84％,各级增生细胞核增大的程度与分级判别标准一致。证实在食管上皮增生细胞学分级诊断时应用显微测量定量方法经光镜测微目尺测算核的算术平均直径代表核面积进行增生细胞的分级是可行的。     

食管细胞学的定量研究：II.食管鳞状上皮正常,增生,癌变细胞...

The relative DNA contents of normal esophageal squamous epithelial cells, hyperplastic, dysplastic (grade I and II), nearly malignant and early malignant squamous epithelial cells of the esophagus were measured in 74 cases by microspectrophotometric technique. The results showed that from normal cells to early stage of malignancy, the DNA contents gradually increased with the increase in severity. In addition, the distribution of DNA values became broader; the peak DNA values shifted to the right, reduced and disappeared. In the meantime, aneuploid cells appeared. There was a definite positive correlation between DNA content and nuclear area in precancerous dysplasia (r greater than 0.9). The results indicate that the current grading of esophageal cytology has its quantitative biochemical basis.     

食管癌细胞株Eca109中人乳头瘤病毒(HPV)DNA的检测

应用分子生物学核酸杂交技术,以人乳头瘤病毒HPV6及HPV11型混合探针对食管ECA109鳞癌细胞株进行DNA斑点杂交。检测结果为阳性。为HPV与食管癌关系的研究进一步提供了证据。