宫腔镜电切术治疗宫颈上皮内瘤变84例临床观察

160例宫颈上皮内瘤变患者随机分为治疗组(84例)和对照组(76例),治疗组采用宫腔镜电切术治疗,对照组同期行冷刀宫颈锥切术,治疗组手术时间为(0.23±2.56)min、术中出血量(15.00±6.25)ml、宫颈愈合时间(37.0±2.5)d;对照组分别为(24.50±10.03)min、(40.40±15.75)ml、(51.5±13.5)d,与实验租比较,P均＜0.05.认为宫腔镜电切为治疗宫颈上皮内瘤变在直视下操作,精确性高,手术时间短,出血少,并发症少,术后恢复快,是治疗宫颈上皮内瘤变的良好方法之一.     

西妥昔单抗联合放化疗治疗晚期头颈部恶性肿瘤

目的 观察西妥昔单抗联合放化疗治疗晚期头颈部恶性肿瘤（HNSCC）的有效性和安全性.方法 2007年11月至2010年5月经病理证实的26例晚期HNSCC患者,接受西妥昔单抗联合放化疗治疗.西妥昔单抗静脉滴注给药,首剂400mg/m2,后续剂量250mg/m2,每周1次,连用5~12周.其中23例患者同时接受放疗,原发灶剂量为60~74.25Gy,转移淋巴结为60~72Gy.18例患者同时接受化疗,方案为PF或TPF.结果 评估患者近期疗效和急性不良反应.所有患者在治疗后3个月时进行疗效评价：完全缓解（CR）65.4%（17/26）,部分缓解（PR）15.38%（4/26）,稳定（SD）11.5%（3/26）,进展（PD）3.8%（1/26）,术后无法评价疗效1例.其中19例初治的HNSCC患者中,CR73.7%（14/19）,PR15.7%（3/19）,SD5.3%（1/19）,PD5.3%（1/19）;7例复发或转移的患者中,CR42.8%（3/7）,SD28.6%（2/7）,PD28.6%（2/7）.治疗中出现的主要不良反应包括口咽黏膜炎、舌黏膜炎和特异性痤疮样皮疹.26例患者均完成随访,中位随访时间11个月,随访中5例PD,疾病进展时间（TTP）为4~22个月,中位数为7个月,生存时间4~33个月,中位数为11个月.10例初治鼻咽癌患者无一出现转移或复发.结论 西妥昔单抗联合放化疗治疗晚期HNSCC,近期疗效满意,痤疮样皮疹为药物特异性副作用,未出现影响治疗进行的严重特异性不良反应.     

LEEP刀手术和宫腔镜下宫颈锥切术治疗宫颈上皮内瘤样病变疗效比较

将270例宫颈上皮内瘤样病变(CIN)患者随机分为两组,A组行高频电波(LEEP)刀术,B组行宫腔镜宫颈锥切术(TCRC),观察两组手术时间、术中出血量、脱痂期出血量、切口愈合时间.结果A组CIN Ⅰ-Ⅲ级患者手术时间短于B组(P＜0.05),Ⅰ、Ⅱ级患者术中出血量少于B组,P均＜0.05;两组脱痂期出血、愈合时间无显著差异.认为对于CIN Ⅰ、Ⅱ级患者,LEEP刀手术优于TCRC;而TcRC适用于CIN Ⅲ级患者.     

鼻咽癌颈部转移性淋巴结的超声造影特征及时间强度曲线分析

Objective To study the character of cervical lymph nodes metastasis in nasopharyngeal carcinoma(NPC) by contrast-enhanced uhrasonography(CEUS) and time-intensity curve. Methods Forty-one lymph nodes of metastasis from 32 patients were studied by CEUS. The enhancement of echogenicity was evaluated,and the time-intensity curve was analyzed. Results Of the 41 lymph nodes examined, 10 (24.4%) showed intense homogeneous enhancement by CEUS, 23 (56.1%) showed inhomogeneous enhancement and 8 (19.5 %) showed scarce intranodal enhancement. There were 20 (48.8%) lymph nodes showed necrosis. Most of the lymph nodes (92.7%) showed peripheral type blood flow, 3 (7.3) % showed mixed type blood flow. There were significant differences in them(P < 0.01). The time-intensity curve displayed steeply in upslope, and gently in decent. The arrival time(AT), time to peak(TTP), peak intensity (PI) ,area and gradient were (7.2±2.5)s,(7.6±2.3)s,(9.5±3.3)dB,(203.4±45.7)dB· s,1.2±0.5 respectively. Between the lymph nodes with envelope infringed and not, there were significant differences in PI and area, while there were not significant differences in AT, TTP and gradient. Conclusions The metastasis cervical lymph nodes of NPC had specific character by CEUS and time-intensity curve. In this way,it may help us to diagnosis cervical lymph nodes metastasis of NPC,and provide more information for the therapy and prognosis judgement.     

中国科学院大学附属肿瘤医院（浙江省肿瘤医院）鼻咽癌诊治研究进展

中国科学院大学附属肿瘤医院近年来就鼻咽癌诊治开展了数十项研究,这些研究大部分是针对Ⅱ期、局部晚期、转移鼻咽癌的治疗干预性研究,其余的是针对预后因素、分期以及放疗毒副反应的研究。全文就这数十项研究作一综述,一方面是对浙江省鼻咽癌学科发展的宣传与肯定,另一方面为临床医师合理制定临床治疗策略提供一些参考,也为扩大国内外鼻咽癌学科的交流和发展提供契机。     

中国城乡11市县常见恶性肿瘤发病趋势分析

目的 探讨中国恶性肿瘤发病特点及时间趋势.方法 采用中国城乡11个市县肿瘤登记处的1988-2002年资料进行统计与分析,描述恶性肿瘤发病现状,研究其时间趋势与发病特点.结果 11个市县肿瘤登记处覆盖地区15年内新发恶性肿瘤695 050例,粗发病率为215.50/10万,世界标准人口调整发病率为170.97/10万.主要恶性肿瘤发病率排序依次为肺癌、胃癌、肝癌、食管癌、乳腺癌、结肠癌、直肠癌、胰腺癌、膀胱癌、白血病.16种主要恶性肿瘤占全部的85.56%.1988-2002年恶性肿瘤合并的粗发病率呈较快上升趋势.按部位分析,增幅最大的是前列腺癌(185.48%),其次为胆囊癌、乳腺癌、结肠癌等.发病率下降幅度最大的是宫颈癌(17.00%),其次为食管癌、胃癌、鼻咽癌.结论 中国11个市县1988-2002年恶性肿瘤总的粗发病率呈上升趋势,调整年龄因素后变化不明显.胰腺癌、膀胱癌、白血病已进入前10位,成为常见恶性肿瘤.前列腺癌和胆囊癌发病率虽然较低,但是增长幅度最大.     

单药VP—16低剂量长疗程口服治疗42例中晚期肺癌疗效分析

自１９９５年～１９９７年对４２例未行其它治疗的原发肺癌进行单药足叶乙甙（ＶＰ－１６）的口服治疗，现将结果报告如下。１材料与方法临床资料全组病例均为经病理学证实的肺癌患者，男３２例，女１０例；年龄３６～７２岁，中位年龄６３岁。其中小细胞肺癌１８例，非小...     

肺鳞癌化放疗夹心治疗探讨

肺鳞癌化放疗夹心治疗探讨陈秀勇郑晓郭金水朱永红陈晓钟杜向慧浙江省肿瘤医院（杭州３１００２２）本院从１９９３年７月～１９９４年９月共收治中晚期肺鳞癌８０例，一组采用化、放疗夹心治疗，另一组为单纯放疗，临床观察一年，对即期与近期疗效报告如下：材料与方法一...     

鼻咽癌颈部转移性淋巴结的超声造影特征及时间强度曲线分析

Objective To study the character of cervical lymph nodes metastasis in nasopharyngeal carcinoma(NPC) by contrast-enhanced uhrasonography(CEUS) and time-intensity curve. Methods Forty-one lymph nodes of metastasis from 32 patients were studied by CEUS. The enhancement of echogenicity was evaluated,and the time-intensity curve was analyzed. Results Of the 41 lymph nodes examined, 10 (24.4%) showed intense homogeneous enhancement by CEUS, 23 (56.1%) showed inhomogeneous enhancement and 8 (19.5 %) showed scarce intranodal enhancement. There were 20 (48.8%) lymph nodes showed necrosis. Most of the lymph nodes (92.7%) showed peripheral type blood flow, 3 (7.3) % showed mixed type blood flow. There were significant differences in them(P < 0.01). The time-intensity curve displayed steeply in upslope, and gently in decent. The arrival time(AT), time to peak(TTP), peak intensity (PI) ,area and gradient were (7.2±2.5)s,(7.6±2.3)s,(9.5±3.3)dB,(203.4±45.7)dB· s,1.2±0.5 respectively. Between the lymph nodes with envelope infringed and not, there were significant differences in PI and area, while there were not significant differences in AT, TTP and gradient. Conclusions The metastasis cervical lymph nodes of NPC had specific character by CEUS and time-intensity curve. In this way,it may help us to diagnosis cervical lymph nodes metastasis of NPC,and provide more information for the therapy and prognosis judgement.