尿液和血清中铁元素与膀胱癌关系的研究

目的：比较膀胱癌患者和正常人尿液和血液中铁元素含量的差异和相关危险因素,为膀胱癌预防和诊断提供依据。方法：80例膀胱癌患者80例正常人参加了实验,通过火焰原子吸收分光光谱法检测血清和尿液中铁元素的含量,采用t检验比较两组之间的差别,采用logistic回归分析相关因素。结果：血清铁元素含量膀胱癌组显著低于正常人组,P=0．026,尿液中铁元素含量膀胱癌组显著高于正常人组,P=0．020。吸烟和药物是膀胱癌的危险因素（P〈0．05）。结论：血清中的铁含量下降和尿液中铁含量的升高可能是膀胱癌发生中重要的原因。长期服用药物和吸烟在膀胱癌发生发展中起重要作用。     

放射治疗联合顺铂加替加氟治疗中晚期食管癌临床观察

目的探讨中晚期食管癌单纯放疗与放疗＋化疗的治疗效果。方法对148例中晚期食管癌患者随机分为两个组（各74例），两组均给以60～65Gy／6—6．5周的常规放疗，化放组在放疗前1周、放疗第3周及放疗结束后加顺铂（DDP）、替加氟（Tegafur）化疗，于放疗全程加用替加氟口服，共4个周期。结果近期疗效单放组总有效率为81．1％，化放组为90．5％，两组比较差异无统计学意义（x^2=2．719，P=0．09）；1，3，5年生存率分别为单放组43．2％，16．2％。9．5％，化放组71．6％，33．8％，21．6％，化放组生存率高于单放组，两组比较差异有统计学意义（x^2=8．684，P〈0．01），化放组的毒副反应主要为食管黏膜反应和白细胞下降，均能耐受。结论应用DDP＋替加氟方案化疗可提高中晚期食管癌放射治疗的疗效。     

膀胱癌抗原在膀胱移行细胞癌诊断中的价值

目的评价膀胱癌抗原(UBC)对膀胱移行细胞癌(BTCC)的诊断价值.方法采用ELISA法对89例BTCC及108例泌尿系非移行细胞癌(TCC)患者的尿UBC进行检测,并同时行尿脱落细胞学检查.结果 BTCC患者尿UBC均值为30.5 μg/L,与泌尿系非TCC患者8.2μg/L的均值比较,差别有显著性意义(P＜0.01).尿UBC(以8.4μg/L为最适临界值)和尿细胞学诊断BTCC的敏感性分别为75.3%和16.9%,特异性分别为77.8%和100%,两者差别均有显著性意义(P＜0.01).结论尿UBC检测对BTCC的诊断是一种较为敏感、特异且无创的方法,敏感性明显优于尿细胞学,但临床上不能完全替代尿细胞学检查.     

Transplantable cancer of the urinary bladder and hemangiopericytoma obtained by means of the ectopic transplantation of tissues of the fetal urinary bladder]

Organ-like cysts appear to develop after subcutaneous transplantation of minced tissues of fetal urinary bladder into adult syngeneic recipients. These are multilocular cysts lined with epithelium and filled with secretion. Many months later they undergo a spontaneous malignant tranformation. Transplantable strains of vesical cancer and hemangiopericytoma have been obtained.     

Radiotherapy for squamous carcinoma of the urinary bladder

One hundred and seven patients with squamous cell carcinoma of the bladder were reviewed. They form 6.8% of patients with bladder cancer seen in this department. There were more females than males, 1.28 to 1. The patients had a mean age of 67.5 years. Patients were found to have tumors that invariably invaded to the muscle. Almost all tumors were solitary and described as ulcerated or solid (non-papillary) in appearance. Forty-nine patients completed a course of radical megavoltage X ray therapy of whom 35 had T3 cancers, with a complete regression rate of 42.3%. The actuarial local control rate for patients with T3 squamous cancer was 33.7% at 3 years. Their survival, however, was poor, being only 18.3% at 3 years.     

Plasma and tissue concentration of tegafur by a new soft capsule type suppository in colorectal carcinoma

Plasma, tissue, and Lymph-node concentrations of tegafur and 5-FU were examined in 19 patients with colonic and rectal carcinoma after administration of tegafur by a new soft capsule type suppository: Plasma levels of tegafur and 5-FU after administration by soft capsule were much higher than those seen using supp. type suppositories. Tissue levels of 5-FU were high in tumor tissue compared to levels found in adjacent normal tissue. Lymph node levels of 5-FU were higher than plasma levels. Lymph node levels of 5-FU in the first-group lymph nodes were higher than in the second-group. These results suggest the clinical usefulness of administration of tegafur by soft-capsule suppository.     

膀胱癌患者尿液和血清微量元素钙镁测定临床意义分析

目的:比较膀胱癌患者及正常人尿液及血液中微量元素钙、镁含量的差异,研究膀胱癌相关危险因素.方法:选取76例膀胱癌患者为膀胱癌组和80名正常人为对照组,采集血清和尿液标本,并进行问卷调查.通过火焰原子吸收光谱法检测两组样本尿液及血清中的钙、镁元素.采用独立样本t检验比较两组的差异,问卷资料中相关危险因素用Logistic回归分析.结果:正常人组血清中的钙含量高于膀胱癌组(P=0.002),尿液中的钙和镁含量均低于膀胱癌组,P值分别为0.005和0.039,问卷调查提示服用非甾体抗炎药、吸烟和长期不良憋尿习惯是膀胱癌的危险因素,P值分别为0.000、0.004和0.000.结论:钙镁离子的代谢失衡和膀胱癌的发生发展有一定的相关性,服用非甾体抗炎药、吸烟和长期不良憋尿习惯在膀胱癌发生发展中是一危险因素.     

Small cell carcinoma of the urinary bladder with hypercalcemia

This report describes three cases of undifferentiated small cell carcinoma of the urinary bladder. Their light microscopic appearance is closely akin to the small cell carcinoma of lung. The neoplastic cells exhibit few cytoplasmic dense core neurosecretory granules ultrastructurally and immunoreactivity to enolase. Two patients manifested clinically hypercalcemia which is rare in small cell carcinoma in general and, to the best of our knowledge, has not been described in association with bladder small cell carcinoma.     

Selective bladder preservation for muscle-invasive transitional cell carcinoma of the urinary bladder

Invasive transitional cell carcinoma (TCC) of the urinary bladder is traditionally treated with radical cystectomy. This approach results in great morbidity and lifestyle changes, and approximately half of the patients treated in this way will experience recurrent TCC despite surgery. An alternative approach using selective bladder-preservation techniques incorporates transurethral resection of bladder tumours, radiation therapy, and chemotherapy. Over the past 20 years, international experience has demonstrated that this approach is feasible, safe, and well tolerated. Furthermore, the long-term outcomes of overall survival and disease-free survival compare favourably with the outcomes from radical cystectomy. The most important predictor of response is stage, with significantly higher long-term survival in patients with T2 disease. Another important positive predictor of complete response to therapy is the ability of the urologic oncologist to remove all visible tumour through a transurethral approach prior to initiation of radiation therapy. A negative predictive factor is the presence of hydronephrosis, and age and gender do not affect disease-free survival. The majority of patients who enjoy long-term survival do so with an intact native bladder. Quality of life studies have demonstrated that the retained bladder functions well in nearly all of these patients. Selective bladder preservation will not entirely take the place of radical cystectomy, but should be offered as an important alternative to patients newly diagnosed with muscle-invasive TCC.     

Monoclonal antibodies against carcinoma cells of the human urinary bladder: immunohistochemical staining of tissues

We have previously described the generation of mouse monoclonal antibodies (Mabs) directed to cell surface antigens of human bladder carcinoma. Based on experiments with cultured cells and a limited number of freshly isolated tissues, four distinct antigens were identified as being associated with this disease. In the present investigation, comprising the immunostaining of tissues of normal, malignant, and fetal origin, we have confirmed and extended the close association of these antigens with bladder cancer. Antibodies to all four antigens could clearly discriminate between malignant and normal uroepithelium. Two of the antibodies, SK4H-12 and 4E8, showed no additional reaction when tested with various adult tissues of normal or malignant origin. Antibodies to the remaining two antigens gave a positive staining of a few other tissue types.     

Split-course radiotherapy for urinary bladder cancer

In this retrospective study 119 patients with T1-T4 carcinoma of the urinary bladder were treated with split-course radiotherapy. The 3-week rest period was compensated with a 10% increase in the total radiation dose to 6600 cGy. Therapy was completed as planned by 86% of the patients. The actuarial 5-year survival for these patients was 20%. Both the 3- and 5-year survival figures were better for patients with local control of the tumour achieved either by combined surgery and radiotherapy or by radiotherapy alone, than for patients with recurrent tumours after radiotherapy. The results of the split-course regimen were comparable to the results of continuous radiotherapy used for urinary bladder cancer.     

Intra-operative radiotherapy with excision of urinary bladder carcinoma

From June, 1979 through Oct., 1986 forty patients (32 males and 8 females) with cancer of the urinary bladder have been treated by intraoperative radiotherapy (IORT) after surgical excision of their tumors. The five-year survival rate, by the Kaplan-Meier Method, was 100% in Grade I patients (n = 6), 56% in Grade II (n = 19), 49% in Grade III and 58% in all patients, respectively. Similarly, it was 62% for 33 patients in stages T1 and T2 of the disease and 42% for 7 patients graded T3 and T4 of only three patients out of eleven lost in this series, their deaths caused by urinary bladder cancer. IORT with a surgical excision of their bladder tumor provided excellent results in the control of recurrence.     

Long-term administration of tegafur in postoperative adjuvant chemotherapy in gastric cancer patients. Serial analysis of serum tegafur and 5-fluorouracil concentrations, and influence from PSK combination

We investigated the pharmacokinetics of long-term (2-year) daily oral administration of FT-207-E or UFT for postoperative adjuvant chemotherapy in 85 gastric cancer patients by measuring serum FT-207 and 5-FU concentration serially. There were no significant changes in serum FT-207.5-FU concentration during observation period between FT-207-E and UFT groups. There was different operative modality between partial gastrectomy (Billroth I) and total gastrectomy, but no significant difference in serum FT-207.5-FU concentration between the two groups, and no significant serial changes in serum FT-207.5-FU concentrations were observed in both groups. Conversion from FT-207 to 5-FU measured by serum concentration was not suppressed by combination with the biological response modifier PSK.     

Hypermethylation of multiple genes in tumor tissues and voided urine in urinary bladder cancer patients.

PURPOSE: We aimed to investigate the methylation pattern in bladder cancer and assess the diagnostic potential of such epigenetic changes in urine. EXPERIMENTAL DESIGN: The methylation status of 7 genes (RARbeta, DAPK, E-cadherin, p16, p15, GSTP1, and MGMT) in 98 cases of bladder transitional cell carcinoma and 4 cases of carcinoma in situ was analyzed by methylation-specific PCR. Twenty-two cases had paired voided urine samples for analysis. RESULTS: In transitional cell carcinoma tumor tissues, aberrant methylation was frequently detected in RARbeta (87.8%), DAPK (58.2%), E-cadherin (63.3%), and p16 (26.5%), whereas methylation of p15 (13.3%), GSTP1 (5.1%), and MGMT (5.1%) is not common. No association between methylation status and grading or muscle invasiveness was demonstrated. In 22 paired voided urine samples of bladder cancer, methylation of DAPK, RARbeta, E-cadherin, and p16 could be detected in 45.5%, 68.2%, 59.1%, and 13.6% of the cases, respectively. The sensitivity of methylation analysis (90.9%) was higher than that of urine cytology (45.5%) for cancer detection. Methylation of RARbeta(50%), DAPK (75%), and E-cadherin (50%) was also detected in carcinoma in situ. In 7 normal urothelium samples and 17 normal urine controls, no aberrant methylation was detected except for RARbeta methylation in 3 normal urothelium samples (42.9%) and 4 normal urine samples (23.5%), respectively. CONCLUSIONS: Our results demonstrated a distinct methylation pattern in bladder cancer with frequent methylation of RARbeta, DAPK, E-cadherin, and p16. Detection of gene methylation in routine voided urine using selected markers appeared to be more sensitive than conventional urine cytology.     

Oral combination of cyclophosphamide, uracil plus tegafur and estramustine for hormone-refractory prostate cancer

OBJECTIVE: To evaluate the clinical usefulness of an oral combination of cyclophosphamide, uracil plus tegafur (UFT) and estramustine in the treatment of patients with hormone-refractory prostate cancer (HRPC). METHODS: Twenty-one patients were treated with oral administration of cyclophosphamide (100 mg/day), UFT (400 mg/day) and estramustine phosphate (560 mg/day). The median age of the patients was 70 years. Twelve patients had symptomatic bone metastasis, 6 had asymptomatic bone metastasis, 5 had lymph node metastasis, while 2 had only biochemical progression evaluated by prostate-specific antigen (PSA). RESULTS: Twelve (57%) out of 21 patients showed a PSA decline of 50% or greater. The median response duration was 7 months (range 2-15 months). Among the 20 patients assessable for bone pain, 2 (10%) improved, 12 (60%) remained stable and 6 (30%) progressed. Among the 10 patients assessable for bone metastasis, 1 (10%) improved, 5 (50%) were stable and 4 (40%) progressed on bone scan. Among 3 patients assessable for measurable disease (lymph node metastasis), 2 (67%) showed partial response and 1 (33%) progression. Most toxicities were mild. CONCLUSIONS: The combination of cyclophosphamide, UFT and estramustine is an active and well-tolerated regimen for HRPC. To evaluate the survival benefit, further randomized studies are required.     

Serum and tissue concentration of tegafur and 5-FU after administration of tegafur suppository in patients with lung cancer--correcting the influence of residual blood in the tissue

Tissue concentration of tegafur and 5-FU was studied in 25 patients with of primary lung cancer, given 2 x 750 mg of tegafur suppository daily preoperatively (total doses 3.75-9.75 g, mean 5.16 g). Furthermore, the influence of blood remaining in the tissue was corrected in the determination of tegafur and 5-FU concentration. The tegafur level in tumor tissue (9.614 +/- 5.739 micrograms/g) was significantly (p less than 0.01) low compared with those in serum and normal lung tissue (13.185 +/- 8.198 micrograms/ml, 12.954 +/- 10.048 micrograms/g). On the other hand, the 5-FU level in tumor tissue (0.124 +/- 0.208) was significantly (p less than 0.01, p less than 0.05) high compared with those in serum and normal lung tissue (0.019 +/- 0.013 micrograms/ml, 0.035 +/- 0.031 micrograms/g) and showed approximately 2.5 times more minimum effective concentration against tumor cells (0.05 micrograms/g). The results show that preoperative administration of 2 x 750 mg of tegafur suppository daily is effective for the transfer of tegafur and 5-FU to lung cancer tissue.