“邪毒传舍”理论与转移性卵巢癌

目前,转移性卵巢癌的发病率逐年上升,因此,探讨其病因病机以指导临床治疗意义重大。而文章则在经络理论、疾病传变的基础上运用“邪毒传舍”理论分析了转移性卵巢癌的发病机制。     

非生殖道来源的转移性卵巢癌的护理

非生殖道来源的转移性卵巢癌是一种继发性卵巢恶性肿瘤，据报道约占卵巢癌的10％-30％，大约80％90％的卵巢转移性癌的原发病灶在胃肠道，且非生殖道来源的转移性卵巢癌预后较差，大多数患者在发现卵巢转移后1年内死亡。我院自2000年至2006年间收治14例非生殖道来源的转移性卵巢癌的患者，现将护理体会介绍如下。     

原发卵巢癌及卵巢之转移性结肠癌组织中CDX-2与CK7和CK20的表达及其临床意义

目的探讨原发卵巢癌及卵巢之转移性结肠癌组织中CDX-2与CK7和CK20的表达及其临床意义,为卵巢癌的诊断治疗提供理论依据。方法回顾性分析我院2002年4月~2011年6月收治的均经临床和病理学确诊的卵巢癌患者40例临床资料。采用免疫组织化学（SP法）检测40例原发卵巢癌及卵巢之转移性结肠癌患者癌组织中CDX-2、CK7和CK20的表达,并进行对比分析。结果卵巢之转移性结肠癌与原发性卵巢癌患者血清中3种肿瘤标记物血清中水平均明显升高,CDX-2,CK7和CK20在原发卵巢上皮性癌组织中的阳性表达率分别为10%（2/20）、95%（19/20）、30%（6/20）,在结肠转移性卵巢癌组织中的阳性表达率分别为100%（20/20）、15%（3/20）、85%（17/20）。CDX-2、CK7和CK20在原发性与卵巢之转移性结肠癌组织中阳性表达率差异均有高度统计学意义（均P〈0.01）。结论采用SP法检测原发卵巢癌及卵巢之转移性结肠癌组织中CDX-2、CK7和CK20的表达,有助于提高原发卵巢癌与卵巢之转移性结肠癌鉴别诊断准确率,值得临床推广。     

比较继发性与原发性卵巢恶性肿瘤术前及术中特点的区别

目的:术前鉴别卵巢癌是原发性还是转移性的比较困难。一般认为继发性卵巢癌患者通常年龄小,双侧发生,且多房性癌组织较少。本研究旨在探寻有助于区分转移性和原发性卵巢癌的术前及术中因素。患者与方法:对1996—2003年间在本院就诊的38例继发性卵巢癌患者,以及作为对照的76例原     

CEA、CA125联合检测对转移性卵巢癌诊断的价值

多数恶性肿瘤,尤其是胃肠道恶性肿瘤、肺癌等血清CEA含量都会明显升高,因此将它作为常见的恶性肿瘤的初筛指标之一。CA125是一个分子量在200~1000kD的大分子糖蛋白,近年来研究发现它与卵巢癌明显相关[1]。本文通过化学发光法检测转移性卵巢癌患者组与卵巢癌未转移组(对照组)及正常人血清中CEA和CA125,并就CEA和CA125联合测定在转移性卵巢癌诊断中的价值进行探讨。     

原发及转移性卵巢癌组织中绒毛蛋白、细胞角蛋白7及20的表达

目的:检测原发及转移性卵巢癌组织中绒毛蛋白(Villin)、细胞角蛋白7及20(CK7、CK20)的表达.方法:采用免疫组织化学方法检测卵巢原发性腺癌45例(浆液性腺癌18例、黏液性腺癌15例、内膜样腺癌12例)、结肠转移性卵巢癌15例、原发结肠腺癌20例、正常卵巢组织10例中Villin、CK7和CK20的表达. 结果:正常卵巢、原发性卵巢腺癌、结肠转移性卵巢癌及原发性结肠腺癌组织间比较,Villin、CK7和CK20的阳性表达率差异均有统计学意义(P＜0.001);且原发卵巢癌组织中Villin的阳性表达率低于CK20(P＜0.005).结论:Villin、CK7和CK20的测定对鉴别原发及转移性卵巢癌有重要意义,Villin在特异性方面强于CK20 .     

紫杉醇联合顺铂腹腔化疗治疗晚期卵巢癌转移性腹水的效果观察

目的:观察紫杉醇联合顺铂腹腔化疗治疗晚期卵巢癌转移性腹水的效果。方法:将我科收治的晚期卵巢癌合并转移性腹水患者31例分为对照组和研究组,对照组予以紫杉醇和顺铂静脉滴注治疗,研究组予以紫杉醇静脉滴注和顺铂腹腔注射治疗。结果:治疗后,对照组的腹水改善有效率明显低于研究组,P0.05;对照组的血小板下降、肾功能损害和肌肉关节痛的发生率高于研究组,P0.05。结论:紫杉醇联合顺铂腹腔化疗治疗晚期卵巢癌转移性腹水效果较好,毒副反应较小,可行临床应用和深入研究。     

卵巢转移性癌二例报告

转移性卵巢癌的原发部位很广,可来自胃肠道、乳房、肺、子宫等,其中以原发于胃肠道者为最多。自1896年Krukenberg首次报导以来,含有印戒状癌细胞并且以间质纤维组织增生为特征的转移性卵巢癌,传统的称为库肯勃氏瘤。1979年以来我科遇到二例,现报告如下:     

卵巢癌转移体细胞突变及其相关功能通路分析

目的 借助癌症体细胞突变目录（COSMIC）数据库中原发性卵巢癌和转移性卵巢癌两类癌组织的全外显子测序数据,筛选转移性癌相对于原发性癌突变率差异具有统计学意义的体细胞基因群,并对其影响的功能和信号通路进行分析。方法 从COSMIC数据库下载全部肿瘤的全外显子测序数据,从中提取全部卵巢癌全外显子测序数据,在R 3.5.3环境下,对每个基因突变在原发性卵巢癌和转移性卵巢癌两类样本中的突变率行χ²检验或Fisher确切概率法分析,寻找突变率差异具有统计学意义的基因群,并进一步将差异突变基因群进行基因本体（GO）功能及京都基因与基因组百科全书（KEGG）通路富集分析,探寻其显著富集的GO功能和KEGG通路。结果 对比原发性卵巢癌与转移性卵巢癌两类组织样本共发现520个突变率差异具有统计学意义的体细胞突变基因,包括跨膜丝氨酸蛋白酶13（TMPRSS13）、高尔基蛋白转运抑制剂A抗性因子1（GBF1）、Fos样抗体2（FOSL2）、主导控制样蛋白3（MAML3）等。突变基因群GO功能富集分析发现显著富集的GO功能包括突触前组织、树突发育、通过质膜黏附分子的细胞黏附、肌动蛋白结合等,突变基因群KEGG通路富集分析发现显著富集通路包括肌动蛋白细胞骨架的调节、三磷酸腺苷结合盒运载体等。结论 探寻原发性卵巢癌与转移性卵巢癌之间差异体细胞突变基因群及其相关功能通路可为深入揭示卵巢癌的转移调控机制提供线索,显著突变基因群可能成为卵巢癌转移诊治的生物标志物。     

38例卵巢转移性癌临床诊治疗效分析

卵巢恶性转移性肿瘤是来源于其他器官的恶性肿瘤,由于卵巢癌本身及原发疾病的各种特点,首次手术即确诊卵巢转移性癌的比率一直偏低,影响患者的康复及预后[1,2].2001年1月至2009年12月我院共收治卵巢恶性转移性肿瘤患者38例.现分析报告如下.     

人消化道癌卵巢及子宫颈转移癌细胞生物学行为特征的组化研究

关于消化道癌卵巢及子宫颈转移的途径文献中很有争议。有关卵巢及宫颈转移灶建立的机制报道较少。作者对２３例人消化道癌卵巢及宫颈转移的病例进行了雌激素受体（ｅｓｔｒｏｇｅｎｒｅｃｅｐｔｏｒ，ＥＲ）和粘液组化染色，发现全部癌细胞均有不同程度粘液分泌功能分化，９４．４７％的病例中癌细胞具有较强的ＥＲ活性。本文对消化道肿瘤发生卵巢及宫颈转移的机制作了初步探讨。     

女性膀胱转移癌临床分析

目的总结女性膀胱转移癌的发病及诊治状况,提高女性膀胱转移癌的诊治水平.方法对20年来收治的29例女性膀胱转移癌患者的原发病因、诊治、预后及部分病例误诊的原因进行了回顾总结,并结合近年来的有关文献对女性膀胱转移癌的原发病因、诊治及预后进行了分析.结果29例女性膀胱转移癌患者,年龄26～82岁,平均48岁.其原发肿瘤为:9例子宫颈癌,5例卵巢癌,5例嗜铬细胞瘤,4例结肠癌,3例绒癌,3例子宫体癌.结论膀胱转移癌原发灶多为膀胱邻近器官,出现膀胱转移时绝大多数已出现其他器官转移或组织侵犯,预后较差.     

Establishment of orthotopic impact／metastasis model of human ovary cancer in nude mice

Ovarycarcinoma ,secludingly locatedandhardtobedetectedattheearlierstage ,istheoneofthehigh estmortalityrateinthegynecologictumors ,therefore ,itisalwaystoughfortheearlydiagnosisandtreatmentofthecancer .Atpresent ,althoughmanyamodelofovarycarcinomahavebeenestablishedforvariousstudy ,theyareallquitedifferentfromthenaturalde velopmentofthetumor .Ovarycarcinomaderivesmainlyfromthe germinalepitheliumoftheovary ,whichliesintheoutmostlayeroftheovaryandhasthediverse potentialsfordifferentiation .Byimp…     

Krukenberg tumor: report of two cases

Krukenberg tumor (KT) is a metastatic signet-ring adenocarcinoma of the ovary with variants of gastro-intestinal primary either detected synchronously or metachronously. Here two cases of Krukenberg tumor are reported with detected primary sites, one arising from the stomach and the second from the pancreas. The first case, a 35 year old multiparous woman with a past history of endoscopically proven gastric ulcer was diagnosed as a case of advanced gastric carcinoma with concomitant right adnexal mass. Endoscopic biopsy from the gastric growth revealed adenocarcimona (signet ring variety). As the primary gastric growth was not feasilble for surgical resection, palliative total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology of the ovary revealed metastatic adenocarcinoma with negative peritoneal cytology. After 4 cycles of chemotherapy, the patient died due to progression of primary cancer. The second patient, a 55 year old menopausal lady was diagnosed as a case of metastatic ovarian tumour with recurring ascitis upon chemotherapy. Comprehensive scanning revealed a thick walled lesion in the left side of the body and tail of the pancreas along with a left adnexal mass. Upon surgical exploration a vascular solid mass was identified in the pancreas which was not feasible for any sort of resection. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Poorly differentiated adenocarcinoma was found in the apparently shriveled up right ovary with positive peritoneal cytology. She succumbed to death due to reappearance of epigastric pain and haemorrhagic ascitis.     

Metastatic ovarian squamous cell carcinoma

Ovarian squamous cell carcinoma is usually associated with germ cell tumours (dermoid cyst) or endometriosis in primary cancer. While tumour metastasis to the ovary is common and often bilateral in over 50 percent of cases, metastatic cervical squamous cell carcinoma to the ovary is infrequent compared to adenocarcinoma from other extraovarian primaries and the cervix. We report two cases of unilateral metastatic ovarian squamous cell carcinoma from the uterine cervix in two women aged 38 years and 48 years, respectively. They presented with abdominopelvic masses, clinically thought to be tuberculosis and primary ovarian tumour, respectively. Both had laparotomy which revealed multinodular ovarian masses with extensive extra-ovarian involvement of the corpus and uterine cervix by tumour and omental seedlings. Tissue microscopy showed total replacement of ovarian stroma by tumour with necrotic foci and containing infiltrating nests and cords of malignant squamous cells with prominent intercellular bridges. No evidence of teratoma or endometriosis was seen in the histology sections. They were both diagnosed with metastatic ovarian squamous cell carcinoma with advanced stage disease primary in the uterine cervix. Ovarian metastatic squamous cell carcinoma from the uterine cervix may occur with advanced stage cervical carcinoma. Unilateral multinodular ovarian mass with extensive extra-ovarian tumour involvement should raise suspicion of metastasis rather than of primary tumour. Early and prompt diagnosis is desirable in the management of these patients.     

Carcinoma of the cervix, endometrium, and ovary: an 11-year review.

Over an 11-year period, 164 patients with genital tract carcinoma were managed at the Austin Hospital, Melbourne. For patients receiving primary treatment at the hospital, the five-year survival rates of patients with carcinoma of the cervix, endometrium, and ovary were 47.8%, 41.6% and 4.3% respectively. Improved results rest upon earlier diagnosis and alternative therapeutic measures, especially for carcinoma of the endometrium and ovary. Routine surveillance after initial therapy may detect asymptomatic metastatic disease when curative treatment is still possible.     

9例正常大小卵巢癌综合征的临床分析

目的 :探讨正常大小卵巢癌综合征的临床特点、诊断要点以及处理方案。方法 :回顾性分析 1990～ 1996年在我院治疗及病理复核证实的 9例正常大小卵巢癌综合征 ,其中 6例为卵巢外腹膜浆液性乳头状腺癌 (EPSPC) ,2例为卵巢浆液性腺癌 ,1例为原发灶不明的转移性腺癌。上述 9例病人均行肿瘤细胞减灭术 ,术后均辅以有效多疗程化疗。结果 :2例EPSPC分别存活 84个月及 72个月 ,随访至 1997年 12月仍健在。 7例已死亡 ,患者平均生存 16 5个月。结论 :该综合征治疗上仍首选手术 ,术后宜辅以有效多疗程化疗     

9例正常大小卵巢癌综合征的临床分析

目的：探讨正常大小卵巢癌综合征的临床特点、诊断要点以及处理方案。方法：回顾性分析1990－1996年在我院治疗及病理复核证实的9例正常大小卵巢癌综合征,其中6例为卵巢外腹膜浆液性乳头状腺癌（EPSPC）,2例为卵巢浆液性腺癌,1例为原发灶不明的转移性腺癌。上述9例病人均行肿瘤细胞减灭术,术后均辅以有效多疗程化疗。结果：2例EPSPC分别存活84个月及72个月,随访至1997年12月仍健在。7例已死亡,患者平均生存16．5个月。结论：该综合征治疗上仍首选手术,术后宜辅以有效多疗程化疗。