胃底贲门癌介入治疗的疗效观察

目的观察胃底贲门癌介入治疗的疗效。方法对34例胃底贲门癌患者,进行胃左动脉插管的介入灌注化疗。结果所有患者取得了明显的疗效。结论胃左动脉的介入灌注化疗是治疗胃底贲门癌的一种有效方法。     

动脉灌注与栓塞治疗中晚期大肠癌的临床研究

目的　研究和探讨动脉灌注与栓塞治疗中晚期大肠癌的价值。方法　26例中晚期大肠癌,按Seldinger法进行血管造影了解肿瘤血供后,超选择性插管至肿瘤供血动脉进行灌注与栓塞治疗。结果　灌注栓塞术后病人症状改善。所有病灶均有不同程度的缩小,不完全梗阻症状消失,近期疗效明显。结论　采用动脉灌注化疗与栓塞是治疗中晚期大肠癌的一种有效方法,特别是对已有肝转移的病例;同时行转移瘤的介入治疗具有重要价值。     

以卡铂为主的抗癌药合并化疗行支气管动脉灌注治疗肺癌疗效观察

目的 探讨卡铂为主的抗癌药联合化疗行支气管动脉灌注治疗肺癌的疗效。方法 在数字减影X光机下对83例肺癌行支气管动脉灌注化疗。结果 83例中小细胞肺癌25例，CR＋PR21例，有效率84％；非小细胞肺癌58倒，CR＋PR30例，有效率51．7％。结论 以卡铂为主联合选择支气管动脉灌注化疗，可将药物直接灌入肿瘤的供血血管患侧支气管动脉，有效地选择性地形成肿瘤局部药物的高浓度，增强抗癌作用，并能一次性大剂量联合给药，临床应用不必水化，利尿，使用方便，奏效快，疗效高，安全，全身毒性反应低，适应症广泛，且能多次重复进行，特别是对无法手术治疗的中晚期肺癌患者，不失为一种有效安全的治疗手段。     

支气管动脉灌注治疗中晚期肺癌258例临床分析

目的探讨经支气管动脉灌注抗癌药治疗中晚期肺癌的方法和疗效。方法258例中晚期肺癌患者进行687次支气管动脉灌注化疗,2次治疗137例,3次和3次以上121例。统计分析治疗效果。结果258例肺癌患者中,完全缓解(CR)125例,部分缓解(PR)83例,稳定(NC)29例,进展(PD)21例;支气管动脉造影显示肿瘤单病灶染色83例,多病灶染色175例。结论应用支气管动脉灌注抗癌药治疗中晚期肺癌,近期效果使肿瘤缩小,患者症状改善,副作用低于全身静脉化疗。     

介入治疗中晚期口腔颌面部鳞癌13例报告

目的探讨区域性动脉化疗口腔颌面部鳞癌的可行性及疗效。方法对13例病理诊断为口腔颌面部鳞癌的中晚期患者超选择性直接动脉灌注顺铂和阿霉素进行化疗,观察术中反应及术后疗效并随访,评价治疗的可行性及疗效。结果动脉化疗术中没有明显异常反映;动脉化疗的有效率为100.0%,肿瘤在化疗后当天或第2天,化疗局部疼痛和肿胀感缓解,口、鼻腔内出现分泌物或坏死组织脱落。13例中完全缓解(completeresponse,CR)5例,部分缓解(partialresponse,PR)8例。结论"介入动脉化疗"是治疗口腔颌面部鳞状细胞癌的有效手段之一,其疗效显著,避免手术之苦,可以作为综合序列治疗的重要组成部分。     

区域灌注疗法治疗原发性肝癌的临床观察

目的：探讨肝动脉、门静脉双重插管区域灌注化疗在中晚期不能切除原发性肝癌应用方法及临床疗效。方法：将1988年－1999年68例中晚期不能切除原发性肝癌肝动脉、门静脉插管皮下埋藏灌注器区域灌注化疗,对其疗效进行观察。结果：本组显效率22．1％、有效率57．3％、无效率20．6％。半年带瘤存活率73．5％、一年带瘤存活率55．9％、二年带瘤存活率8．8％。结论：中晚期不能切除的原发性肝癌使用肝动脉、门静脉双重插管灌注化疗,可以改善临床症状、延长存活期。     

原发性肝癌的血管影像解剖及其临床意义

原发性肝癌是我国常见的恶性肿瘤之一,患者就诊时通常已属中晚期,90％患者已丧失手术机会。在临床工作中,肝肿瘤的介入治疗已成为主要治疗手段之一。其基本原理是经导管进行肿瘤供血动脉的局部治疗,包括化疗药物灌注及栓塞,达到肿瘤组织坏死、缩小的目的。肝癌的血供是影响肝动脉化疗栓塞的关键因素,与其疗效直接相关。因此,充分研究肝癌组织血供特点,并且根据不同的血供类型采用不同的介入治疗方法,对提高肝癌的介入治疗效果具有十分重要的意义。     

中晚期肝癌介入治疗及预后分析

目的探讨中晚期肝癌的治疗方法和预后因素.方法将我院323例住院的中晚期肝癌患者,经股动脉穿刺行肝动脉灌注化疗栓塞术(Transcatheterarterialchemoembolization,TACE)的病例资料进行回顾性分析,依据影像学,血生化指标及生存时间判断疗效.结果323例患者术后肿块缩小占60.3%,症状改善,1年生存率48.9%,2年生存率6.2%,3年生存率4.9%,中位生存期14.9个月.结论介入治疗是中晚期肝癌的有效治疗手段,可减轻症状,延长患者寿命,但要注意并发症的发生.     

选择骨髂内动脉插管灌注对盆腔恶性肿瘤介入性治疗的手术研究…

本文旨在探讨盆腔恶性肿瘤的介入治疗问题，对４５例患有盆腔恶性肿瘤的患者，采用Ｓｅｌｄｌｎｇｅｒ法，经双侧股动脉插管，先端选择性对侧髂内动脉；或一侧导入肠系膜下动脉；另侧导入髂内动脉，留置导管１２小时，使用突击剂量持续灌注化疗药物，并经手术，Ｂ，ＣＴ，内窥镜及指检等方法进行化疗前后的对比观察，结果：其中病灶消失持续１个月以上者９例，病灶缩小５０％以上并持续超过一个月者２３例，缩小不足５０％，且增大未     

中晚期肝癌介入治疗及预后分析

目的探讨中晚期肝癌的治疗方法和预后因素.方法将我院323例住院的中晚期肝癌患者,经股动脉穿刺行肝动脉灌注化疗栓塞术(Transcatheter arterial chemoembolization,TACE)的病例资料进行回顾性分析,依据影像学,血生化指标及生存时间判断疗效.结果 323例患者术后肿块缩小占60.3%,症状改善,1年生存率48.9%,2年生存率6.2%,3年生存率4.9%,中位生存期14.9个月.结论介入治疗是中晚期肝癌的有效治疗手段,可减轻症状,延长患者寿命,但要注意并发症的发生.     

Adenocarcinoma of the stomach with invasion limited to the muscularis propria

Adenocarcinoma of the stomach having invasion limited to the muscularis propria with or without lymph node metastasis, termed PM (proper muscle) gastric cancer by Japanese investigators, has a prognosis superior to that of carcinoma extending to the serosa and approaching that of early gastric cancer in Japan. To evaluate the occurrence and significance of PM gastric cancer in the United States, we analyzed 272 gastric carcinomas resected at our institution between 1964 and 1983. Forty-two PM cancers (15%) were identified. Improved 5-year survival rate was noted for PM cancer when compared with survival rate for 215 neoplasms exhibiting serosal invasion (29% versus 7%, P less than 0.001). In univariate analysis, a survival advantage was also associated with absence of lymph node metastasis, intestinal-type histopathology of the Lauren classification, the expanding pattern of the Ming classification, and polypoid or fungating gross configuration of tumor. In multivariate analysis, depth of tumor invasion remained significantly associated with improved 5-year survival rate independently of other variables, including lymph node metastasis. Using continuous survival curves, the prognostic significance of PM cancer prevailed throughout the 5-year postgastrectomy interval. Our data indicate that PM gastric cancer occurs in the United States and need not be considered "advanced" gastric carcinoma; depth of tumor invasion should be recognized as a nodal metastasis-independent prognosticator of gastric cancer survival.     

Flow cytometric DNA analysis of gastric cancer--correlation with histology and clinical outcome.

Nuclear DNA content was analysed by means of flow cytometric measurements in 103 patients with gastric carcinomas, using paraffin-embedded archival tissue. DNA aneuploidy was found in 40 cases (38.8%). The mean DNA index of aneuploid tumors was 1.45(range 1.13 to 2.37). No significant association between ploidy and either age, sex, tumor location, size, stage, growth pattern, or histologic type was found. However, the incidence of aneuploidy was higher in high grade carcinomas than in low grade carcinomas; the incidence of aneuploidy was 10%, 68.8%, and 45.8% for Grade II, III, and IV carcinomas, respectively, as compared with Grade I carcinomas which were all diploid. On statistical analysis, Abnormal cellular DNA content was significantly correlated with high histologic grade (P < 0.005). Patients with aneuploid cancer (39.2%) had a poorer prognosis than those with diploid cancer (70.0%) based on (P < 0.01). The 2-year survival rate for advanced gastric carcinoma. Therefore, DNA ploidy might be a useful prognostic factor in cases of advanced gastric cancer.     

胃淋巴瘤临床病理分析

目的探讨胃淋巴瘤的临床病理特点及预后相关因素。方法结合2001年版WHO关于淋巴造血组织肿瘤的分类标准,回顾83例胃淋巴瘤临床及病理资料,对其中78例进行随访,随访时间5～192个月。对临床病理特征及治疗方式等多种因素与生存率进行比较分析。结果(1)临床表现：临床症状以腹痛最多见,83例胃淋巴瘤中有60例(72％);39例(47％)有B症状(发热、盗汗、消瘦);21例(25％)有长期慢性胃病史;胃肠黏膜多部位病变13例(16％);淋巴结受累51例(61％)。(2)组织学类型：黏膜相关淋巴组织结外边缘区B细胞淋巴瘤(MALT淋巴瘤)为57例(69％),弥漫大B细胞淋巴瘤合并MALT淋巴瘤23例(28％),弥漫大B细胞淋巴瘤2例(2％),滤泡性淋巴瘤1例(1％)。(3)临床分期与生存率：临床ⅠE期31例,ⅡE期38例,ⅢE期8例,Ⅳ期6例。总5年和10年生存率分别为77．8％和70．1％,平均生存期146个月。MALT淋巴瘤的5、10年生存率分别为77．4％和72．3％,弥漫大B细胞淋巴瘤合并MALT淋巴瘤的5、10年生存率分别为81．8％和68．2％,弥漫大B细胞淋巴瘤的5年生存率为50．0％。结论胃淋巴瘤患者无特异临床症状。MALT淋巴瘤是最常见的病理组织学类型。胃淋巴瘤病变可长期局限,预后较好。患者生存率与淋巴结受累、临床分期密切相关,与发病年龄、性别、有无B症状、病变深度及范围和治疗方式等因素均不相关。     

早期腹腔化疗在进展期胃癌术后的临床疗效观察

目的研究腹腔化疗对进展期胃癌术后早期应用的临床疗效。方法1998年1月至2002年12月的80例进展期胃癌患者行胃癌根治术后,早期应用皮下置入式化疗泵行腹腔化疗（IPC）的病例进行回顾性分析,并与同期行静脉化疗（IVC）的80例患者进行分析比较。结果80例腹腔化疗病人（治疗组）和80例静脉化疗病人（对照组）均完成全部6个疗程的化疗,治疗组腹腔转移率、肝转移率和血清肿瘤标记物水平明显低于对照组,3年生存率为70.5%,5年生存率为54.8%,高于静脉化疗组（42.4%,36.7%,P〈0.05）。结论进展期胃癌患者术后早期行腹腔化疗,药物的毒副反应小,可以提高胃癌术后病人的生存率和生存质量。     

Neural invasion in gastric carcinoma.

AIMS--To determine whether neural invasion in advanced gastric cancer is of clinicopathological significance. METHODS--The study population comprised 121 cases of primary advanced gastric carcinoma. Two paraffin wax embedded blocks taken from the central tissue slice in each primary tumour were used. For definitive recognition of neural invasion, immunostaining for S-100 protein was applied to one slide; the other slide was stained with haematoxylin and eosin. RESULTS--Neural invasion was recognised in 34 of 121 (28%) primary gastric carcinomas. There were significant differences in tumour size, depth of tumour invasion, stage, and curability between patients with and without neural invasion. The five year survival rates of patients with and without neural invasion were 10 and 50%, respectively. Multivariate analysis, however, demonstrated that neural invasion was not an independent prognostic factor. CONCLUSIONS--Neural invasion could be an additional useful factor for providing information about the malignant potential of gastric carcinoma. This may be analogous to vessel permeation which is thought to be important, but is not an independent prognostic factor.     

Is DNA ploidy and proliferative activity of prognostic value in advanced gastric carcinoma?

We analyzed the DNA content of 116 gastric carcinomas and lymph node metastasis in 53 of these using flow cytometry on archival material. DNA index and proliferative activity (% S-phase) values were obtained in 111 and 76 tumors, respectively, and survival rates were obtained for 108. Tumor classification was based on histologic type, grade, and growth pattern and stage. All were advanced gastric carcinomas. Fifty four tumors (47%) were aneuploid. In single variable analysis, survival was related to stage (muscularis propria versus serosa P = .002) and lymph node metastasis (P = .04). Infiltrative tumor growth had a slightly worse prognosis (P = .06). In multifactorial analysis, tumor stage was the only independent prognostic factor. Neither DNA ploidy nor % S-phase values had any effect on survival, although, patients with tumors with higher DNA indexes (greater than 1.7) showed a tendency toward worse survival rates. We failed to prove the prognostic value of DNA ploidy in gastric carcinoma. Before its effect is ruled out, some factors have to be considered: (1) all tumors were in advanced stage and the true effect of ploidy on survival may have been diluted, (2) quality of fixation--near diploid aneuploid populations may have been overlooked, and (3) intratumoral DNA ploidy heterogeneity can cause sample discrepancy (20% in our series).     

Survival prognosis and clinicopathological features of the lymph nodes along the left gastric artery in gastric cancer: implications for D2 lymphadenectomy

The Japanese Gastric Cancer Treatment Guidelines (third edition) have assigned No. 7 station left gastric artery lymph nodes (LNs) to the D1 range of lymphatic dissection. We investigated the clinicopathological characteristics, survival impact, and appropriateness of ascribing No. 7 station LNs to D1 lymphadenectomy in gastric cancer. Patients (n=608) undergoing radical resection with No. 7 station LN dissection were recruited between January 1997 and June 2008. They were subdivided into four groups: N0, no LN metastasis; D1, LN without No. 7 station LN metastasis in the D1 lymphadenectomy region; No. 7, No. 7 station LN without LN metastasis in the D2 lymphadenectomy region; and D2, LN without No. 7 station LN metastasis in the D2 lymphadenectomy region. Of these, 17.2% (n=105) were positive for No. 7 LN metastasis, an important, independent prognostic factor associated with poor clinicopathological parameters, advanced tumor stage, and reduced survival. Tumor behavior in the No. 7 group was similar to that in the D2 group, but poorer than in the D1 group in terms of advanced tumor stage, with 5-year survival rates of 34.3%, 25.9% and 54.6%, respectively. Five-year survival rates in the No. 7 group were comparable to those in the D2 group (P>0.05), but significantly lower than in the D1 group (P<0.05). Logistic multivariate regression analysis established No. 3 and 9 station LN metastasis, node classification, and tumor-node-metastasis stage as independent risk factors for No. 7 station LN metastasis. Thus, No. 7 station LNs should be ascribed to D2 lymphadenectomy in gastric cancer.     

Galectin-3与CDC25B在胃癌中的表达及意义

目的 探讨半乳糖凝集素3 mRNA(Galectin-3)和细胞分裂周期蛋白25B mRNA(cell division cycle 25B,CDC25B)在胃癌中的表达及其与临床病理参数及预后的关系.方法 应用组织微阵列技术和原位杂交法检测220例胃癌组织和31份正常胃黏膜组织中Galectin-3 mRNA和CDC25B mRNA 的表达情况.结果 220例胃癌中Galectin-3 mRNA和CDC25B mRNA的阳性表达率分别为58.6%、54.1%;Galectin-3 mRNA表达与肿瘤大小、TNM(tumor,lymph node,metastasis)分期、浸润深度、脉管侵犯、淋巴结转移及远处转移呈正相关;CDC25B mRNA表达也与肿瘤大小、TNM分期、脉管侵犯、淋巴结转移及远处转移呈正相关;Galectin-3 mRNA表达与CDC25B mRNA表达呈正相关;Galectim3 mRNA和CDC25B mRNA阳性表达病例的平均生存时间和5年生存率均明显低于阴性表达的病例.结论 Galectin-3 和CDC25B基因的表达促进了胃癌的发生和发展,是指导临床治疗及评估预后的有效指标.     

Galectin-3与CDC25B在胃癌中的表达及意义

目的 探讨半乳糖凝集素3 mRNA(Galectin-3)和细胞分裂周期蛋白25B mRNA(cell division cycle 25B,CDC25B)在胃癌中的表达及其与临床病理参数及预后的关系.方法 应用组织微阵列技术和原位杂交法检测220例胃癌组织和31份正常胃黏膜组织中Galectin-3 mRNA和CDC25B mRNA 的表达情况.结果 220例胃癌中Galectin-3 mRNA和CDC25B mRNA的阳性表达率分别为58.6%、54.1%;Galectin-3 mRNA表达与肿瘤大小、TNM(tumor,lymph node,metastasis)分期、浸润深度、脉管侵犯、淋巴结转移及远处转移呈正相关;CDC25B mRNA表达也与肿瘤大小、TNM分期、脉管侵犯、淋巴结转移及远处转移呈正相关;Galectin-3 mRNA表达与CDC25B mRNA表达呈正相关;Galectim3 mRNA和CDC25B mRNA阳性表达病例的平均生存时间和5年生存率均明显低于阴性表达的病例.结论 Galectin-3 和CDC25B基因的表达促进了胃癌的发生和发展,是指导临床治疗及评估预后的有效指标.