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1.
目的探讨无辅助切口完全腹腔镜下直肠外翻拖出式直肠癌根治术的临床疗效。方法选取2015年9月至2016年6月期间高州市人民医院收治的95例直肠癌患者,采用随机数字表分为观察组(n=47)和对照组(n=48)。对照组行腹腔镜直肠前切除术治疗,观察组行无辅助切口完全腹腔镜下直肠外翻拖出式直肠癌根治术。观察两组患者术中术后一般情况、术后并发症发生情况、术后排便情况和预后情况。结果观察组患者手术出血量少于对照组,胃肠功能恢复时间和术后平均住院时间短于对照组,住院费用少于对照组(P0.05);观察组患者术后并发症发生率低于对照组(P0.05);观察组患者术后2周内日均排便次数和术后半年内日均排便次数均高于对照组,差异有统计学意义(P0.05);两组患者术后2年生存率和复发率比较均无统计学意义(P0.05)。结论无辅助切口完全腹腔镜下直肠外翻拖出式直肠癌根治术安全可靠,疗效显著。  相似文献   

2.
目的:探讨人重组肝细胞生长因子(rhHGF)对结肠癌细胞SW480和SW620中3种内皮生长因子VEGF-A、VEGF-C和VEGF-D表达的影响.方法:实验分对照组(5%胎牛血清)和HGF组(80 ng/mL的HGF).采用MTT法分析HGF对肿瘤细胞增殖的作用,流式细胞术检测HGF对细胞周期的影响.48 h后进行蛋白质印迹法检测,并对信号强度进行相对定量分析.结果:HGF能促进SW480和SW620增殖.流式细胞术结果显示,与对照组相比,SW480的HGF组中的G0/G1期细胞减少,S期细胞增多,G2/M期细胞增多,但HGF对SW620细胞周期的影响不明显.SW480细胞HGF组的VEGF-A表达量是对照组的1.59倍,SW620细胞HGF组的VEGF-A表达量是对照组的2.08倍(P<0.01);SW480细胞HGF组的VEGF-C表达量是对照组的1.37倍,SW620细胞HGF组的VEGF-C表达量是对照组的1.27倍(P<0.01);SW480细胞HGF组的VEGF-D表达量是对照组的1.46倍,SW620细胞HGF组的VEGF-D表达量是对照组的1.38倍(P<0.01).结论:HGF通过上调结直肠癌细胞VEGF-A、VEGF-C和VEGF-D的表达而促进肿瘤血管和淋巴管的新生,可能是潜在的结直肠癌治疗的新靶点.  相似文献   

3.
目的 研究胃痛组织中血管内皮生成因子(VEGF)-A、VEGF-C和VEGF-D的表达对血管和淋巴管生成的影响及其预后意义.方法 采用免疫组化法检测123例原发性胃癌组织中VEGF-A、VEGF-C和VEGF-D的表达,采用D2-40和CD34免疫组化双染法分别标记淋巴管和血管,并测定淋巴管密度(LVD)和血管密度(MVD).采用单因素分析VEGF-A、VEGF-C和VEGF-D表达与胃癌临床病理特征的关系;采用Kaplan-Meier法和Log rank检验评价VEGF-A、VEGF-C和VEGF-D表达与胃癌患者预后的关系,并用Cox比例风险模型进行多因素分析.结果 123例胃癌组织中,VEGF-A、VEGF-C和VEGF-D的高表达率分别为64.2%、65.9%和41.5%.VEGF-A、VEGF-C或VEGF-D高表达及两两高表达均与LVD有关(均P<0.05);VEGF-A和VEGF-C高表达还与浸润深度、淋巴管浸润、静脉浸润、淋巴结转移和MVD有关(均P<0.05);VEGF-C和VEGF-D高表达均与淋巴管浸润和淋巴结转移有关(均P<0.05).VEGF-A、VEGF-C或VEGF-D高表达者的生存时间均明显短于其低表达者(均P<0.05),其中VEGF-A和VEGF-C均高表达者的生存时间最短(56个月).VEGF-A的表达水平、MVD、淋巴结转移及浸润深度是影响胃癌患者预后的独立因素.结论 VEGF-A和VEGFC均高表达的胃癌有更强的促进血管和淋巴管生成的能力,并可促进肿瘤转移和影响患者预后;VEGF-C和VEGF-D可共同介导淋巴管生成,促进淋巴结转移;但仅VEGF-A高表达是影响患者预后的独立危险因素.  相似文献   

4.
目的探讨腹腔镜辅助下直肠外翻拖出式手术治疗直肠癌的疗效与安全性。方法选取2008年12月至2012年6月间接受腹腔镜辅助下直肠外翻拖出式手术的40位直肠癌患者作为研究组,同时抽取同期接受腹腔镜辅助下直肠前切除直肠癌根治术的40例患者作为对照组。回顾性分析两组手术的并发症、术后肛门功能和短期局部复发率的情况。结果两组患者各有1例出现吻合口漏,对照组患者有1例吻合口出血,无手术死亡病例。随访6个月2年,研究组患者有1例复发,对照组患者有2例复发。两组患者肛门均保存了控制排便功能,研究组患者在恢复进食2周后每天排便次数多于对照组(P=0.025)。结论腹腔镜辅助下直肠外翻拖出式手术操作简洁方便、安全可靠、疗效明显,提高了患者的生活质量,值得推广运用。  相似文献   

5.
目的 评价腹腔镜辅助经肛外翻拖出式直肠切除治疗低位直肠癌根治术的安全性和疗效.方法 对我院2008年12月至2010年6月接受腹腔镜辅助经肛直肠外翻拖出式直肠癌根治术的30例低位直肠癌患者(肿瘤下缘距齿状线3~5 cm,A组)资料进行回顾性分析,在数据库中,抽取同期接受腹腔镜辅助直肠前切除直肠癌根治术(Dixon)的中低位直肠癌30例作为对照组(肿瘤下缘距齿状线5~10 cm,B组).观察两组手术近期并发症发生率、术后肛门排便功能和短期局部复发率.结果 两组60例均保留了有控制大便功能的肛门,A组术后恢复进食两周内每天大便次数多于B组(P=0.025),术后6个月后.两组每天排便次数无统计学差异(P=0.652).两组均各有1例吻合口漏,B组有1例吻合口出血,无手术死亡,随访6个月至2年,两组均有1例局部复发.结论 腹腔镜辅助经肛直肠外翻拖出式直肠癌根治术操作方便,安全可行、疗效确切,提高了患者生存质量.  相似文献   

6.
目的:比较腹腔镜结肠癌根治术与开腹结肠癌根治术的临床治疗效果,并观察近期与远期预后状况。方法:选择2012年1月-2014年9月在本院诊治的结肠癌患者89例,根据手术方式分为对照组(41例)和观察组(48例),对照组采用开腹结肠癌根治术,观察组采用腹腔镜结肠癌根治术。主要观察两组手术基本情况、术后恢复、并发症及远期疗效结果。结果:观察组术中出血量为(157.36±11.42)ml,低于对照组,差异具有统计学意义(P<0.05);观察组手术时间为(166.38±15.59)min,长于对照组,差异具有统计学意义(P<0.05);观察组排气时间、术后镇痛时间和术后住院时间分别为(2.06±0.19)d、(20.31±2.16)h和(12.53±1.08)d,均短于对照组,差异具有统计学意义(P<0.05);观察组患者总并发症为8.33%(4/48),低于对照组,差异具有统计学意义(P<0.05)。两组癌细胞转移率、复发率和2年生存率比较,差异无统计学意义(P>0.05)。结论:腹腔镜结肠癌根治术具有术中出血量少,术后康复时间短、并发症较少等优点,并可达到开腹手术的根治效果。  相似文献   

7.
目的观察腹腔镜下子宫腺肌瘤切除术和阻断子宫动脉术的临床效果。方法将2010年4月至2012年5月确诊的80例子宫腺肌瘤患者随机分为两组,治疗组(43例)应用腹腔镜超声辅助下阻断子宫动脉后行子宫腺肌瘤切除术治疗,对照组(37例)应用腹腔镜超声辅助下行子宫腺肌瘤切除术治疗,观察两组患者的术中出血量、手术时间、住院天数、术后病率、并发症及术后复发率。结果治疗组患者术中出血量明显小于对照组(P〈0.05);治疗组患者手术时间明显大于对照组(P〈0.05);两组患者的住院天数、术后病率及并发症差异无统计学意义(P〉0.05)。治疗组患者术后复发率明显小于对照组(P〈0.05)。结论腹腔镜辅助下子宫腺肌瘤切除术合并阻断子宫动脉术的止血效果良好,有效控制术中出血量,显著地降低术后复发率。此法可靠性强,操作性良好,具有较好临床应用价值。  相似文献   

8.
目的:研究人乳腺癌组织中淋巴管内皮细胞生长因子的表达及临床意义。方法:乳腺癌患者手术标本86例,采用蛋白质印迹法检测VEGF-B、VEGF-C、VEGF-D和flt-4表达含量。结果:86例乳腺癌患者中VEGF-B高表达44例(51.2%),低表达42例(48.8%);VEGF-C高表达46例(53.5%),低表达40例(46.5%);VEGF-D高表达43例(50.0%),低表达43例(50.0%);flt-4高表达48例(55.8%),低表达38例(44.2%)。乳腺癌组织中VEGF-C、VEGF-D与flt-4蛋白的表达呈正相关。VEGF-C、VEGF-D、flt-4蛋白的表达与乳腺癌的淋巴结转移有关,但与乳腺癌组织病理学分型、肿瘤大小和分级无关。VEGF-C、VEGF-D高表达组总生存率较差。结论:VEGF-C、VEGF-D和flt-4蛋白的表达与乳腺癌淋巴转移有关,VEGF-C、VEGF-D可作为提示临床预后较差的指标。  相似文献   

9.
Chen JS  Zhang YJ  Hu SE  Zhang HQ 《癌症》2007,26(9):972-976
背景与目的:肿瘤脉管生成与肿瘤的生长和转移密切相关,血管内皮生长因子A(vascular endothelial growth factor-A,VEGF-A)可能是最强的促血管生成因子,而VEGF-C是VEGF家族中最强的促淋巴管生成因子,在肿瘤血管生成中与VEGF-A具有协同促进效应.本研究旨在探讨VEGF-A/VEGF-C反义脱氧寡核苷酸(antisense oligodeoxynucleoude,ASODN)对乳腺癌生长及其脉管生成的影响.方法:将VEGF-A/VEGF-C ASODN注入人乳腺癌裸鼠原位移植癌模型中,观察肿瘤生长;运用RT-PCR法检测肿瘤组织VEGF-A/VEGF-C mRNA表达,免疫组织化学法检测其蛋白表达情况;5'-Nase-ALPase双重酶组织化学染色标记肿瘤微血管和微淋巴管,并计算肿瘤微血管密度(microvessel density,MVD)和微淋巴管密度(lymphatic microvessel density,LMVD).结果:反义组成瘤时间较对照组长[(13.00±2.83)天vs.(7.67±1.63)天,P<0.05],移植瘤生长速度较对照组缓慢,肿瘤重量明显低于对照组[(0.45±0.14)g vs.(0.92±0.37)g,P<0.05],抑瘤率达51.09%;反义组VEGF-A和VEGF-C mRNA及蛋白表达较对照组明显减弱(P<0.05),且MVD(21.83±2.86 vs.41.33±4.03)及LMVD(18.67±4.67 vs.31.83±2.33)显著低于对照组(P<0.05).结论:VEGF-A/VEGF-C ASODN通过抑制VEGF-A及VEGF-C表达抑制乳腺癌脉管生成,进而抑制肿瘤生长.  相似文献   

10.
目的探讨新辅助化疗联合腹腔镜远端胃癌D2根治术治疗进展期胃癌的临床疗效及安全性。方法选取2013年8月至2017年7月间咸阳彬州市人民医院收治的100例进展期胃癌患者,按随机抽签法分为观察组和对照组,每组50例。观察组患者采用新辅助化疗联合腹腔镜远端胃癌D2根治术治疗,对照组患者采用腹腔镜远端胃癌D2根治术治疗,比较两组患者的根治性切除率、手术情况、恢复情况、淋巴结清除数量、并发症情况及生存质量。结果观察组患者根治清除率为88. 0%(44例),高于对照组的70. 0%(35例),两组比较,差异有统计学意义(P <0. 05)。两组患者术中失血量、手术时长和淋巴结清除数量比较,差异无统计学意义(P> 0. 05)。两组患者下床活动时间、排气时间及住院天数比较,差异无统计学意义(P> 0. 05)。两组患者并发症发生率比较,差异无统计学意义(P> 0. 05)。治疗前,两组患者生存质量评分比较,差异无统计学意义(P> 0. 05);治疗后,观察组患者评分高于对照组,差异有统计学意义(P <0. 05)。结论进展期胃癌患者采用新辅助化疗联合腹腔镜远端胃癌D2根治术治疗,在不影响手术及术后恢复的情况下,可提高根治性切除率,改善生存质量,且不增加并发症。  相似文献   

11.
Yang W  Klos K  Yang Y  Smith TL  Shi D  Yu D 《Cancer》2002,94(11):2855-2861
BACKGROUND: The angiogenic factor vascular endothelial growth factor (VEGF)-A plays an important role in breast cancer progression. However, the involvement of VEGF-C and VEGF-D, two newer members of the VEGF family, in breast carcinoma and their relationship with clinicopathologic parameters have not been clearly demonstrated. METHODS: In this study, the expression levels of VEGF-A, VEGF-C, and VEGF-D protein in 107 breast carcinoma cases and 22 nonmalignant breast tissue samples were examined by immunohistochemistry and quantitated by image analysis. RESULTS: Higher expression of VEGF-C and VEGF-D was found in breast carcinomas than in nonmalignant breast tissue samples. Moreover, expression of VEGF-A, VEGF-C, and VEGF-D was significantly and positively correlated with ErbB2 expression. High levels of VEGF-A expression were associated with shorter disease-free survival (DFS). Patients with tumors expressing high levels of VEGF-C or VEGF-D showed a notable trend for worse DFS, however, it was not statistically significant. The combination of VEGF-A and VEGF-C status predicted survival better than either marker alone. CONCLUSIONS: Our study suggests that expression of the angiogenic and lymphangiogenic factors (i.e., VEGFs) might be regulated at least in part by ErbB2. In addition, the combination of VEGF-A and VEGF-C status may better predict prognosis of patients with breast carcinoma than VEGF-A alone.  相似文献   

12.
13.
目的:观察乏氧干预对人胃癌细胞SGC-7901乏氧诱导因子-1α(HIF-1α)、血管内皮生长因子-A(VEGF-A)和血管内皮生长因子 D(VEGF-D)表达的影响,以及乏氧诱导因子-1α和血管内皮生长因子表达的相关性。方法:将人胃癌细胞SGC-7901体外培养并乏氧干预0、4、16、24h,以反转录 聚合酶链式反应(RT-PCR)方法检测4组HIF-1α、VEGF-A、VEGF-DmRNA的表达情况;免疫印迹(Westernblot)检测4组HIF-1α、VEGF-A、VEGF-D蛋白表达情况。结果:与0h相比,4hHIF-1αmRNA转录处于下降水平(P<0.05),16hHIF-1αmRNA转录上升(P<0.05),24h转录达到最高水平(P<0.05)。VEGF-AmRNA和VEGF-DmRNA表达量均随时间的延长逐渐增加(P<0.5)。HIF-1α、VEGF-A、VEGF-D蛋白表达量随乏氧时间的延长逐渐增加(P<0.05)。结论:胃癌细胞株SGC-7901乏氧环境中,HIF-1α、VEGF-A和VEGF-D的mRNA与蛋白表达均明显增加。  相似文献   

14.
目的 分析胰腺癌肿瘤中心和肿瘤周边组织中血管内皮生长因子(VEGF)-C、VEGF-D与微血管密度(MVD)、微淋巴管密度(MLVD)的关系,探讨VEGF-C、VEGF-D在胰腺癌淋巴结转移及发展中的意义.方法 免疫组织化学法检测30例胰腺癌组织中VEGF-C、VEGF-D、VEGF受体(VEGFR)-3、CDM蛋白的表达情况.结果 30例胰腺癌中肿瘤周边部位VEGF-C、VEGF-D蛋白阳性率分别为73.3%和56.7%,显著高于肿瘤中心部位(30.0%和16.7%,P<0.01).VEGF-C、VEGF-D高表达的肿瘤周边部位淋巴结转移、淋巴管和血管浸润显著增加(P<0.01).VEGF-C蛋白阳性组MVD高于阴性组,MLVD显著高于阴性组(P<0.01),淋巴结转移增多;VEGF-D蛋白阳性组与阴性组相比MVD无变化(P=0.07),MLVD高于阴性组(P<0.01),淋巴结转移增加.结论 胰腺癌中肿瘤周边区域中VEGF-C、VEGF-D的表达与患者淋巴结转移显著相关,并介导其淋巴管生成;而VEGF-C可能主要参与胰腺癌的血管生成和淋巴管生成的调节,VEGF-D可能仅参与其淋巴管生成的调节.  相似文献   

15.

Aims

Vascular endothelial growth factors VEGF-A, VEGF-C and VEGF-D are considered to be potentially angiogenetic and lymphangiogenetic. “Minimal residual disease” is responsible for cancer progression and recurrence. In this study, we investigated the relation between expressions of VEGF-A, VEGF-C and VEGF-D in gastric cancer tissue and the presence of tumour cells in bone marrow.

Methods

A total of 50 resected primary gastric adenocarcinomas, 44 non-cancerous gastric mucosa and 36 lymph node metastases were analyzed by immunohistochemistry for VEGF-A, VEGF-C and VEGF-D. The specimens used were drawn from a previous study cohort, where the presence of ITC in bone marrow was confirmed with immunohistochemical assay with cytokeratin (CK)-18.

Results

The levels of expression of VEGF-A, VEGF-C and VEGF-D were highest in tumour (p < 0.001), and the level in lymph node metastases was significantly higher (p < 0.01) than in mucosa. The expression of VEGF-A was correlated significantly with venous tumour invasion (p < 0.05) and the presence of tumour cells in bone marrow (p < 0.05). Tumours expressing high levels of VEGF-D showed significantly advanced stages of tumour infiltration (p < 0.05) and lymph node metastasis (p < 0.01).

Conclusions

VEGF-A is a significant marker for the presence of tumour cells in the bone marrow of gastric cancer patients. Our results confirm VEGF-D as a predictor for the lymphatic spread of tumour cells. Therefore, the route of metastatic spread of gastric cancer could be determined, at least in part, by the profile of VEGF family members expressed in the primary tumour of gastric cancer patients.  相似文献   

16.
The expression of vascular endothelial growth factors (VEGFs) in tumors including lung cancer is considered to be associated with tumor development via capillary and lymph vessel neogenesis. Dissemination of the tumor cells to the pleura or regional lymph nodes is a critical poor prognostic factor for lung cancer patients. To investigate how VEGFs expressed in the intrathoracic infiltrating lung cancer cells participate in disease progression, we established stably VEGF-A-, VEGF-C-, VEGF-D-, VEGF-A and VEGF-C-, and VEGF-A and VEGF-D-expressing large cell lung cancer clones (TKB5/VEGF-A, TKB5/VEGF-C, TKB5/VEGF-D, TKB5/VEGF-A/C, and TKB5/VEGF-A/D), orthotopically inoculated these into the right thoracic cavity (i.t.) of nude mice, and evaluated the subsequent development of lung lesion, pleural effusion, pleural dissemination, and lymph node metastasis. While there were no significant differences either in culture or in subcutaneous tumor cell growth between the empty vector-transfected group (TKB5/empty) and each transfectant, the i.t. model demonstrated significantly different biological properties between the transfectants. TKB5/empty-inoculated mice frequently developed a large tumor on the pleura without pleural effusion, dissemination, or lymph node (LN) metastasis. In contrast, VEGF-A promoted a bloody pleural effusion (6/14), and VEGF-A and VEGF-D frequently generated pleural dissemination (11/14 and 9/11, respectively). Although both VEGF-C and VEGF-D generated LN metastasis (6/10 and 8/11, respectively), the locations of the metastasized LNs were quite different. TKB5/VEGF-C metastasized on the same side of axillary LNs as i.t. (right axillary LNs), whereas TKB5/VEGF-D metastasized to the mediastinal and left axillary and/or cervical LNs. Since the TKB5/VEGF-A/C or TKB5/VEGF-A/D co-transfectants revealed overlapping tumor progression patterns of VEGF-A and VEGF-C or VEGF-D, the metastatic LNs had abundant new capillaries and were larger than those of TKB5/VEGF-C or TKB5/VEGF-D-inoculated mice. Our results clearly demonstrate that VEGF-A secreted from intrathoracic lung cancer cells plays important roles in producing pleural effusion, dissemination, and capillary neogenesis, that VEGF-C is involved in LN metastasis, and VEGF-D in pleural dissemination and LN metastasis. It is most likely, however, that the mechanisms by which VEGF-C promotes LN metastasis are different from those of VEGF-D. The regulation of the expression of VEGFs in intrathoracic lung cancer cells might be a useful therapeutic approach to inhibiting tumor development and improving patient prognosis.  相似文献   

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Available evidence suggests that vascular endothelial growth factor (VEGF) a potent regulator of vasculogenesis and tumor angiogenesis may be a predictor of recurrence in breast cancer patients. We sought to determine whether VEGF serum levels (VEGF-A, VEGF-C and VEGF-D) in 377 patients with malignant and benign breast tumors differ and whether there is association between vascular growth factors, clinicopathologic features and prognosis. There was no significant difference in investigated circulating angiogenic markers between patients with malignant and non malignant lesions. We found strong correlation between VEGF-A and VEGF-D and between VEGF- C and VEGF-D. Besides serum VEGF-D levels and estrogen receptor (ER) expressions no other correlations between VEGF and clinicopathologic variables were observed. However, elevated VEGF-A and VEGF-C concentrations were associated with increased number of erythrocytes, leukocytes and platelets. In Cox model values of angiogenic serum markers and recognized prognostic markers in breast cancer, VEGF-C turned out as independent prognostic factor. Our study is the first analysis showing correlation between serum concentrations of three angiogenic factors: VEGF-A, VEGF-C, VEGF-D. Associations between angiogenic cytokines and number of blood cells may be due to release of VEGF from platelets and leucocytes. Prognostic role of VEGF is still uncertain, though VEGF-C has a potential to serve as a prognostic marker.  相似文献   

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目的探讨经皮穴位电刺激辅助麻醉对腹腔镜直肠癌手术患者胃肠激素及免疫功能的影响。方法选取2019年1月至2019年12月间西安交通大学附属红会医院收治的94例接受腹腔镜直肠癌手术的患者,采用随机数表法分为观察组和对照组,每组47例。对照组患者采用常规全麻,观察组患者采用经皮穴位刺激联合常规全麻,比较两组患者手术情况、术后并发症、血清胃肠激素[胃泌素(GAS)、胃动素(MTL)、胆囊收缩素(CCK)]和外周血T细胞亚群(CD3+、CD4+和CD8+)。结果两组患者手术时间和术中出血量比较,差异无统计学意义(P> 0.05)。观察组患者首次肛门排气时间和首次下床活动时间均短于对照组,差异均有统计学意义(均P <0.05)。两组患者术后均发生切口感染、吻合口瘘、吻合口出血和肠梗阻,观察组患者总发生率为10.6%,对照组为6.4%,两组比较,差异无统计学意义(P> 0.05)。术后,两组患者手血清GAS、MTL和CCK均较术前降低,但观察组患者高于对照组,差异均有统计学意义(均P <0.05)。术后,两组患者CD3+和CD4+T细胞亚群均降低,差异有统计学意义(P <0.05),CD8+T细胞无明显变化,差异无统计学意义(P>0.05);且观察组患者CD3+和CD4+T细胞亚群均高于对照组,差异有统计学意义(P <0.05),CD8+T细胞无明显变化,差异无统计学意义(P> 0.05)。结论经皮穴位电刺激辅助麻醉能够促进腹腔镜直肠癌手术后的恢复,减轻手术及麻醉对胃肠激素及免疫功能的影响。  相似文献   

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