Immunosuppressive drugs and their effect on experimental tumor growth

The effect of cyclosporin (CyA), FK 506, and mycophenolate mofetil (MPM) on tumor growth was investigated using syngeneic mouse colon carcinoma 38. Mice were laparotomized and the tumor cells were injected into the portal vein to establish liver metastasis. The animals were grouped as follows: groups A-1, B-1, and C-1 were given CyA [15 mg/kg body weight (BW)], FK 506 (0.15 mg/kg BW), and MPM (100 mg/kg BW), respectively, 30 min before tumor inoculation and daily for 5 days by gavage; groups A-2, B-2, and C-2 were given CyA (30 mg/kg BW), FK 506 (0.3 mg/kg BW), and MPM (200 mg/kg BW), respectively, with the same dose timing; and groups A-3, B-3, and C-3 received CyA (30 mg/kg BW), FK 506 (0.3 mg/kg BW), and MPM (200 mg/kg BW), respectively, on the 7th post-tumor inoculation day and on the following 5 days. The mean tumor diameter in groups A-1 and A-2 was greater than that in the control group and in groups C-1 and C-2 at 3 weeks (P<0.05). The mean tumor numbers in groups A-1 and A-2 were greater than those in the control group and in groups C-1 and C-2 at 4 weeks (P<0.05). With in vitro MTT assay, all three drugs acted cytostatically on tumor cells with a higher concentration (10^-6–10^-4 mol/l), while no cytostatic effect was noted with CyA at a lower concentration (10^-9–10^-7 mol/l). Labeling indexes (%) by bromodeoxyuridine (BrdUrd) immunohistochemistry in groups A-1, A-2, and B-1 were significantly greater than those in the control group and in groups C-1 and C-2 (P<0.05). Although the mechanism of cytoproliferative action of CyA and FK 506 is not well understood, a decrease in immunosurveillance capability by natural kill cells due to suppression of interleukin-2, their direct action as growth factors, and/or enhanced tumor cell adhesion can be considered.     

胃肠内外间质瘤临床病理特征及预后比较分析

目的 分析比较胃肠外间质瘤（EGIST）与胃肠间质瘤（GIST）的临床病理特征和预后差异。方法 回顾性分析2011年1月至2018年8月经西南医科大学附属医院病理科确诊的33例EGIST和315例GIST病人的临床病理及预后资料。结果 33例EGIST中男性11例（33.3%）,女性22例(66.7%),发病年龄（53.2±13.1）岁;315例GIST中男性141例（44.8%）,女性174例（55.2%）,发病年龄（56.3±11.8）岁。与GIST病人相比,EGIST病人肿瘤直径更大（χ2=24.644,P<0.001）、肿瘤易破裂（χ2=5.534,P=0.019）、肿瘤易发生囊性变（χ2=15.375,P=0.002）、核分裂象计数＞5个/50HPF者更多（χ2=24.867,P<0.001）,NIH危险度分级更高（χ2=39.583,P<0.001）。接受肿瘤切除术后,EGIST与GIST病人5年总生存率分别为55.3%、81.2%,5年无进展生存率分别为43.1%、74.6%,差异有统计学意义（P值均＜0.001）,EGIST病人的预后更差,并且更易复发转移（χ2=11.418,P=0.005）。多因素分析显示肿瘤直径是影响EGIST组病人5年总生存率的独立因素（P=0.028）。结论 与GIST病人相比,EGIST病人的肿瘤体积更大,更易发生破裂,核分裂象计数更高,高危险度者更多,预后更差,更易发生复发转移,而肿瘤直径是影响EGIST病人预后的独立因素。     

A Case of Mediastinal Granular Cell Tumor with Horner’s Syndrome

Granular cell tumor (GCT) is found in various organs but is rare in the mediastinum. We report a case of mediastinal GCT in a 19-year-old woman who presented with left ptosis and miosis. CT and MRI revealed a 29-mm well-circumscribed tumor located close to the first thoracic vertebra with features suggesting a neurogenic tumor. The tumor was completely excised using single-port video-assisted thoracoscopic surgery. Histopathological and immunohistochemical analysis revealed that the tumor was a benign GCT. Postoperatively, left ptosis and miosis had improved slightly. To our knowledge, this is the first report regarding mediastinal GCT presenting with preoperative Horner’s syndrome.     

Efficacy of One‐stage Paravertebral Approach using a Micro‐Tubular Technique in Treating Thoracic Dumbbell Tumors

ObjectiveThe aim of the present study was to investigate the feasibility and efficacy of one‐stage surgical resection of thoracic dumbbell tumors using a paravertebral approach and a micro‐tubular technique.MethodsClinical data of thoracic dumbbell tumors resected using a paravertebral approach and a micro‐tubular technique (14 mm, non‐expandable type) in the Department of Neurosurgery at our hospital from July 2014 to July 2019 were retrospectively analyzed. Tumors were found between T1 and T12 vertebrae. Operation time, blood loss, hospitalization, recovery of neurological function, complications, the Japanese Orthopaedic Association (JOA) score, and the visual analogue scale (VAS) score were used to evaluate clinical efficacy.ResultsIn all 31 cases, tumors were completely resected in one operation, with a mean blood loss of 53.23 ± 33.08 mL (20–150 mL) and a mean operation time of 95.16 ± 20.31 min (60–180 min). According to the Eden classification, there were four type II cases, 16 type III cases, and 11 type IV cases. The incidence of tumors in the lower thoracic segment (T8–T12) was 51.6% (16/31 cases), while the incidences in the upper thoracic segment (T1–T4) and middle segment (T5–T8) were 25.8% (8/31 cases) and 22.6% (7/31 cases), respectively. Pathological diagnoses were schwannoma (n = 22), gangliocytoma (n = 4), metastatic tumor (n = 2), neurofibroma (n = 1), granuloma (n = 1), and lipoma (n = 1). After surgery, symptoms were relieved in all patients. VAS and JOA scores significantly improved (P < 0.001). There was no pleural or lung injury, and there were no complications, such as cerebrospinal fluid leakage. The average follow‐up duration was 29 months (13–59 months), during which time no tumor recurrence or spinal instability occurred. The group of Eden type II tumors had lower JOA scores at 12 months postoperatively, longer operation times, and more estimated blood loss compared with other groups (P < 0.05). There were no significant influences on VAS scores at 12 months postoperatively and postoperative hospital stay from the different types of tumors.ConclusionThe paravertebral approach with a micro‐tubular technique is a safe and effective minimally invasive surgical approach for thoracic dumbbell tumors that allows one‐stage tumor resection using a single incision. Using this approach significantly reduces intraoperative blood loss and postoperative complications, shortens hospital stay, and reduces the rates of postoperative spinal instability.     

安全实施肝尾状叶切除术的技术原则与难点

肝尾状叶切除是治疗尾状叶恶性肿瘤的首要手段。由于尾状叶位于肝脏深面,显露困难,周围重要血管结构较多,因此曾被认为是外科手术的禁区。随着肝脏外科技术的不断发展,尾状叶手术也得到了长足进步。根据肿瘤的位置、大小和肝脏的质地选择合理的手术入路,术中熟练处理和保护周围重要的血管结构是尾状叶手术主要的技术原则和难点。而肿瘤外科无瘤技术原则在手术中也仍然不能忽视。     

肿瘤抗血管生成靶向治疗

<正>肿瘤血管生成是所有实体肿瘤的共同特征,是实体肿瘤生长和转移必须依赖的病理学基础,与肿瘤的生长、侵袭转移关系极为密切。现已证实,不同实体肿瘤血管内皮细胞所表达的生长因子及其受体均有共性,因此抗血管生成靶向治疗已经成为肿瘤治疗的重要策略。目前,已有数     

Adult Wilms’ tumor masquerading as pyonephrosis: a diagnostic dilemma

In the era of modern imaging, modalities like ultrasonography, computed tomography and magnetic resonance imaging diagnosis of renal mass lesions has become more accurate. Nevertheless, rare cases of renal adenocarcinoma and other primary renal tumors have been rarely reported to mimic pyonephrosis, renal abscess, perinephric abscess or tuberculosis. We report, for the first time in literature, a case of Wilms’ tumor mimicking as a case of pyonephrosis. The incidence, possible causes and implications of such a misdiagnosis and the measures to avoid the same are discussed.     

肝脏不典型增生结节20例诊治及预后分析

目的 总结肝脏不典型增生结节（HDN）病例的临床、病理特点及治疗经验。方法 回顾性分析2002年10月至2014年12月北京协和医院收治的20例HDN病人临床资料,总结临床特征并进行随访。结果 所有病人均行手术 ,且术后恢复良好。术后大体病理检查中仅1例病人肿物边界不完整。12例HDN病人合并肝硬化。病理诊断：10例为单纯HDN,1例为HDN合并局灶性结节性增生,7例为HDN合并HCC,1例为HDN合并灶性癌变,1例为HDN合并肝细胞腺瘤。术后1例失访。5例HDN合并癌变病人术后6～24个月肝癌复发,其余病人术后随访至2015年1月无复发。结论 HDN可能是具有相对良好预后的癌前病变,如发生癌变则将改变预后,应密切随访,病史、肿瘤标记物及影像学检查有助于诊断,对于难以鉴别或怀疑性质改变时可考虑积极手术处理。     

基层医院后腹腔镜肾上腺肿瘤切除术的体会和疗效

目的 探讨基层医院开展后腹腔镜肾上腺肿瘤切除术的疗效和经验.方法 回顾性分析我院2003 年1 月至2011 年2 月完成的10 例后腹腔镜肾上腺肿瘤切除术,分析手术疗效,总结手术经验.结果 所有手术均成功,无一例中转开放手术,无手术并发症.术后病理报告均为肾上腺皮质腺瘤.肿瘤平均直径大小2.8依2.3 cm.随访3~24 个月,所有患者临床症状均消失,CT 复查未见肿瘤复发.结论 基层医院根据自身情况开展后腹腔镜肾上腺肿瘤切除术安全可靠,疗效确切,但要严格把握适应症、充分术前准备、循序渐进.     

脾炎性肌纤维母细胞瘤4例报告及文献复习

<正>炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor,IMT)是一种少见肿瘤,而脾IMT则更少见。广州军区广州总医院2001-2010年收治4例脾IMT,结合2001年1月至2012年1月国内文献报道的46例进行回顾性分析总结,探讨脾IMT的临床病理特点[1-15]。现报告如下。1临床资料1.1一般资料共纳入50例脾IMT,其中笔者医院收治4     

Detection of prostate cancer using serum proteomics pattern in a histologically confirmed population

PURPOSE: We retrospectively identified a panel of serum proteins that can discriminate between men with prostate cancer (clinically organ confined) and men with benign prostate disease. MATERIALS AND METHODS: A contemporary set of 345 men who had an archival serum sample available were included in this study. The cancer group consisted of 246 men who underwent radical prostatectomy at the Johns Hopkins Hospital between March 1999 and April 2001. The noncancer group included 99 men with no histological evidence of prostate cancer on biopsy between April 1997 and April 2001 at the same institution. Serum proteomics mass spectra of these patients were generated using ProteinChip arrays and a ProteinChip Biomarker System II surface enhanced laser desorption/ionization time of flight mass spectrometer (Ciphergen Biosystems, Inc., Fremont, California). The cases and controls were randomly split into training and testing groups by a stratified sampling procedure. A combination of bioinformatics tools including ProPeak (3Z Informatics, Charleston, South Carolina) was used to reveal the optimal panel of biomarkers for maximum separation of the prostate cancer and the benign prostate disease cohorts. RESULTS: A panel of 3 proteins (PC-1, PC-2 and PC-3) was selected using the training data. Performance of each of the protein markers and a linear regression derived composite index (PC-com3) were evaluated on the testing data. The area under the curve for prostate specific antigen (PSA), PC-1, PC-2, PC-3 and PC-com3 was 0.542, 0.585, 0.600, 0.636 and 0.643, respectively. Improvement of PC-com3 compared to PSA is observed at specificity range 30% to 80%. At a selected specificity of 45% the sensitivity of PC-com3 is 76%, significantly better than the PSA sensitivity of 57% (p <0.0001). CONCLUSIONS: Serum proteomics patterns may potentially aid in the early detection of prostate cancer.     

Leiomyoma originating from the extrapleural tissue of the chest wall

We describe a rare case of leiomyoma of the chest wall in a 55-year-old female. Computed tomography showed a well-circumscribed neoplasm with a diameter of 2 cm in the right chest wall. The tumor was excised with video-assisted thoracic surgery. Histopathology confirmed that the tumor was leiomyoma arising from the microvascular smooth muscle in the chest wall. We present the immunohistochemical profiles of the tumor in detail, critically reviewing the previously reported cases.     

A chemically defined medium for the propagation of rat prostate adenocarcinoma cells

A chemically defined medium (MB-DF) has been developed for the propagation of the rat prostate adenocarcinoma cell line (PA-III). The medium (MB-DF) was supplemented with fetuin, insulin, transferrin, dexamethasone, and 5α-dihydrotestosterone, but require no serum supplement. The adapted line, PA-III,. has been grown in this serum-free medium for 30 passages over a period of 12 months without losing the malignant or other characteristics of the parent line. When transplanted into syngeneic rats, the PA-III, cells reconstituted the adenocarcinoma and metastasized spontaneously via ipsilateral lymphatic channels to the lungs. This cell line will be of use in further analyses of enzymes associated with biological properties of the tumor cells.     

根治性直肠癌术后局部复发的预后分析

目的根据临床资料的回顾性分析,探讨影响直肠癌根治术后局部复发患者预后的相关因素。方法回顾性分析本科535例根治性直肠癌手术病例的临床资料和随访结果,比较各临床病理因子与局部复发患者生存率的关系。Log—rank检验初筛影响生存率的因素,Cox模型多因素分析确定影响局部复发后生存率的独立因素,Kaplan—Meier生存分析计算生存率。结果535例行直肠癌根治性手术患者中,局部复发病例53例（9．91％）。首次手术至复发时间为4～54个月,中位时间12个月。其中吻合口复发9例,盆会阴复发27例,盆会阴并远处复发17例;无症状复发8例,有症状复发45例。肠镜检查阳性11例,阴性24例,未行肠镜检查18例;CT检查阳性42例,阴性11例;CEA正常32例,CEA大于5μg／L21例;再次手术根治切除21例,姑息切除17例,探查手术6例,未行手术9例,P〈0．01。再次手术并发症率24％（13／44）,3年生存率为30．78％,5年生存率为16．68％。结论局部复发的直肠癌能否再行根治性手术是影响其预后的独立因素,直肠癌根治术后局部复发的患者如条件允许应积极手术治疗。     

胰头部肿块治疗策略

随着影像学诊断技术的进步和普及,发现胰头部肿块病例日渐增多。胰头肿块涉及多种病变,因此诊断胰头实性肿块确切的性质十分辣手。目前主要根据病人的临床表现、影像学检查及肿瘤标志物等综合判断,经足够的检查后,选择治疗方案。术前应该与病人和家人讨论治疗方案,详述手术目的、风险和疗效。     

成人睾丸内胚窦瘤诊治经验

目的 总结成人睾丸内胚窦瘤的诊治经验.方法 成人睾丸内胚窦瘤患者6例.年龄18～37岁,平均28岁.主诉患侧睾丸肿大5例,患侧隐睾部位疼痛1例.查体患侧睾丸均明显增大,伴腹部肿物及腹腔积液2例.B超及CT检查均提示腹膜后淋巴结转移.UICC分期:I期2例、Ⅱ期3例、Ⅲ期1例.6例均行患侧根治性睾丸切除术,其中1例行腹膜后淋巴结清扫术(RPLND).术后6例均行化疗.5例行硫酸长春碱加顺铂加博来霉素或顺铂加依托泊苷加博来霉素方案;1例行RPLND者联合腹膜后、盆腔区域高能X线放疗,总剂量30Gy,5周内完成.1例行N-甲酰溶肉瘤素加顺铂方案化疗.结果 6例术后病理诊断均为睾丸内胚窦瘤.肿瘤切面呈实质性,质地脆软,色灰白或浅黄,呈海绵状;镜下见血管周围肿瘤细胞呈放射样排列,外围肿瘤细胞呈圈状,与原始的肾小球极为相似,细胞核有异型性,可见核分裂象.瘤细胞胞质互相联合成网状、腺泡状、管状,相互沟通吻合如迷路.1例术后2个月失访.5例随访1.5～8.0年.每3个月复查胸部X线片及B超,每6个月复查腹部CT或MRI扫描,未见局部复发及远处转移.结论成人睾丸内胚窦瘤临床罕见,确诊主要依靠病理学检查,根治性睾丸切除术加术后放化疗能明显提高治愈率. 顺铂方案化疗.结果 6例术后病理诊断均为睾丸内胚窦瘤.肿瘤切面呈实质性,质地脆软,色灰白或浅黄,呈海绵状;镜下见血管周围肿瘤细胞呈放射样排列,外围肿瘤细胞呈圈状,与原始的肾小球极为相似,细胞核有异型性,可见核分裂象.瘤细胞胞质互相联合成网状、腺泡状、管状,相互沟通吻合如迷路.1例术后2个月失访.5例随访1.5～8.0年.每3个月复查胸部X线片及B超,每6个月复查腹部CT或MRI扫描,未见局部复发及远处转移.结论成人睾丸内胚窦瘤临床罕见,确诊主要依靠病理学检查,根治性睾丸切除术加术后放化疗能 显提高治愈率. 顺铂方案化疗.结果 6例术后病理诊断均为睾丸内胚窦瘤.肿瘤切面呈实质性,质地脆软,色灰白或浅黄,呈海绵状;镜下见血管周围肿瘤细胞呈放射样排列,外围肿瘤细胞呈圈状,与原始的肾小球极为相似,细胞核有异型性,可见核分裂象.瘤细胞胞质互相联合成网状、腺泡状、管状,相互沟通吻合如迷路.1例术后2个月失访.5例随访1.5～     

肝细胞癌经导管动脉化疗栓塞术后Survivin, Bax和Caspase-3的表达水平

目的探讨经导管动脉化疗栓塞术(TACE)对肝细胞癌(HCC)癌细胞凋亡的影响及意义。方法取经TACE治疗后手术切除的HCC组织标本24份(TACE组)和未经其他治疗直接手术切除的HCC组织标本30份(单纯手术组),采用免疫组化SP法检测癌组织中Survivin,Bax,Caspase-3的表达水平。结果 TACE组癌组织中Survivin表达阳性率为41.67%,低于单纯手术组(73.33%,P0.05);Bax,Caspase-3表达阳性率分别为54.17%、58.33%,高于单纯手术组(26.67%、30.00%,P均0.05)。TACE组癌组织中Survivin的表达与Bax,Caspase-3的表达分别呈负相关(r=-0.580、-0.829,P均0.05);Bax与Caspase-3的表达呈正相关(r=0.749,P0.05)。结论 TACE可通过抑制Sur-vivin表达,促进Bax,Caspase-3表达诱导癌细胞凋亡,这可能是TACE治疗肝癌的主要机制之一。