重组人血管内皮抑制素联合化疗治疗晚期乳腺癌疗效观察

目的探讨重组人血管内皮抑素联合TC方案（多西紫杉醇＋环磷酰胺）治疗晚期乳腺癌的近期疗效、安全性,观察治疗前、后血清血管内皮生长因子（vascular endothelial growth factor,VEGF）水平变化。方法晚期乳腺癌患者56例,随机分为观察组和治疗组各28例,治疗组应用TC方案化疗,观察组在治疗组基础上给予重组人血管内皮抑素,2组均21d为1个周期,治疗2个周期后评价不良反应与疗效。分别于治疗前及治疗2个周期后检测2组血清VEGF水平,并与同期28例健康体检者（对照组）比较。结果观察组有效率（75．0％）高于治疗组（46．4％）（P〈0．05）,骨髓抑制、恶心呕吐、脱发发生率与治疗组比较差异无统计学意义（P〉0．05）;观察组、治疗组治疗前血清VEGF水平均高于对照组（P〈0．05）,观察组治疗后血清VEGF水平低于治疗前与治疗组（P〈0．05）,治疗组治疗后血清VEGF水平与治疗前比较差异无统计学意义（P〉0．05）。结论重组人血管内皮抑制素联合TC方案治疗晚期乳腺癌可提高疗效,降低血清VEGF水平,且不增加化疗的不良反应。     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

干细胞标志物SOX-2、β-catenin表达与胃癌术后复发转移关系

背景与目的：胃癌术后复发转移严重影响患者生存情况,SOX基因是经典Wnt信号通路的调控因子,其在胃癌术后复发及转移过程中可能发挥重要作用。本研究旨在探讨胃癌术后复发、远处转移患者肿瘤组织中SOX-2、β-catenin表达情况,探讨两者在胃癌术后复发及转移的作用。方法：采用免疫组化方法检测71例经手术切除胃癌患者的肿瘤组织中SOX-2和β-catenin蛋白表达情况,并分析其与临床病理特征和无病生存时间(disease free survival,DFS)的关系。结果：SOX-2在胃癌中的表达与胃癌复发转移、淋巴结浸润及分化程度有关(P=0.011,P=0.036,P=0.034),与患者性别、年龄及T分期无关。β-catenin在胃癌中的表达与胃癌复发转移、淋巴结浸润及T分期有关(P=0.025,P=0.014,P=0.026),与分化程度、患者性别及年龄无关。且二者均呈阳性表达者其术后复发转移率高于任意单阳性者,复发转移率分别为84%(21/25)和66.7%(24/36),二者均阴性表达者其复发转移率为30%(3/10)。生存分析显示SOX-2和β-catenin的表达与患者DFS相关。结论：SOX-2、β-catenin表达可能是胃癌术后复发转移有效的预测因子,两者联合检测有利于预测胃癌患者术后复发转移。     

泮托拉唑联合托烷司琼、地塞米松治疗化疗所致的消化道反应

目的：观察泮托拉唑联合托烷司琼、地塞米松防治卡培他滨联合奥沙利铂（XELOX）方案所致消化道反应的疗效和不良反应。方法：将98例使用XELOX化疗方案的晚期胃癌肿瘤患者随机分为两组,干预组化疗期间给予托烷司琼、泮托拉唑和地塞米松,对照组化疗期间给予托烷司琼和地塞米松,比较两组的临床效果与药物不良反应。结果：干预组在预防肿瘤患者食欲不振、抑制恶心、呕吐等方面明显优于对照组（P〈0．01）,两组其他不良反应发生率无明显差异（P〉0．05）。结论：泮托拉唑联合托烷司琼、地塞米松防治XELOX方案化疗所致消化道反应疗效较好,值得临床应用。     

盐酸羟考酮缓释片治疗中重度癌痛临床观察

目的观察盐酸羟考酮缓释片治疗中重度癌痛的疗效、不良反应及对患者生活质量改善情况。方法120例中重度癌痛患者,均口服盐酸羟考酮缓释片,初始剂量为10～20rag／次,1次／12h,并根据疼痛缓解程度调整剂量至理想镇痛。用药14d后观察患者疼痛数字评分法（numericalratingscale,NRS）评分、疼痛缓解率、生活质量改善及不良反应发生情况。结果治疗后NRS评分（1．46±1．13）低于治疗前（6．37±1．63）（P〈O．05）;治疗后疼痛完全缓解64例,部分缓解52例,疼痛总缓解率为96．7％;治疗后生活质量评分较治疗前增高（P〈O．05）;不良反应轻。结论盐酸羟考酮缓释片治疗中重度癌痛效果满意,可改善患者生活质量。     

大肠癌中Survivin、Bcl-2的表达及意义

目的 探讨结直肠肿瘤中Bcl-2和Survivin蛋白的表达及其临床意义.方法 取42例结直肠腺癌、10例正常结直肠黏膜组织,以免疫组化方法(S-P法)检测其中Bcl-2和Survivin蛋白的表达,分析其表达与结直肠腺癌临床病理特征的关系.结果 Bcl-2、Survivin在正常组织和大肠癌组织中的表达差异具有统计学意义(P<0.05);Bcl-2和Survivin与大肠癌分级有关(P< 0.05),但与Dukes分期、淋巴结转移无关(P>0.05).结论 腺癌组织中Bcl-2和Survivin可能参与了结直肠癌的发生、发展过程,对大肠癌及腺瘤进行Bcl-2和Survivin基因检测有助于大肠癌的早期诊断及预后评估.     

粉防己碱对人结肠癌细胞株HT-29增殖与凋亡的影响

目的:通过观察粉防己碱对人结肠癌细胞株HT-29增殖与凋亡的影响,初步探讨粉防己碱对结肠癌的体外抗肿瘤效应。方法:采用MTT比色法观察粉防己碱对HT-29细胞的增殖抑制效应,利用细胞DNA琼脂糖凝胶电泳及细胞凋亡荧光染色法检测粉防己碱诱导肿瘤细胞凋亡的作用,以免疫细胞化学法检测粉防己碱对Bcl-2和BAX表达水平的影响。结果:MTT比色法显示粉防己碱对人结肠癌细胞株HT-29增殖有抑制作用,其抑制效应具有剂量依赖的特点,细胞凋亡荧光染色法、琼脂糖凝胶电泳表明粉防己碱可诱导HT-29细胞凋亡,免疫细胞化学法显示粉防己碱上调BAX基因表达,下调Bcl-2基因表达。结论:粉防己碱对人结肠癌细胞株HT-29增殖的抑制效应具有剂量依赖性,并可诱导细胞凋亡,其抗肿瘤效应可能与凋亡相关基因表达的调控有关。