乳腺癌眼部转移的临床研究现状

随着乳腺癌原发肿瘤治疗的进展,患者的生存率有了很大的提高,越来越多不同部位的转移灶被发现,其中包括乳腺癌眼部转移。眼部转移多见于转移性或临床Ⅳ期肿瘤患者,随着转移性乳腺癌生存率的提高,越来越多的眼部转移患者被确诊。乳腺癌眼转移为全身最小的转移病灶,患者常无明显眼部症状且易被全身其他器官转移灶症状所掩盖,从而导致漏诊。     

乳腺癌前期病变的诊治进展

乳腺癌是女性中最常见的恶性肿瘤之一,而乳腺癌的癌前期疾病是一组与乳腺癌相关的良性增生性疾病。不同病理类型的癌前疾病在诊断后10--20年内发生乳腺癌的危险度为1.5--10不等。它们中的大多数亦增加对侧乳腺癌的发生机率。随着近期有关乳腺癌前期疾病与乳腺癌关系研究的深入,乳腺癌前疾病的诊治越来越受到临床医师的重视,并成为预防乳腺癌的一个重要手段。     

男性乳腺癌的诊治

男性乳腺癌近年来其发病率有所增加.诊断主要依靠病理检查,细针吸取细胞学检查被认为是一种安全快速有效的方法.治疗采取以手术为主的综合治疗.男性乳腺癌生存率较女性患者差,提高对男性乳腺癌的认识,做到早期诊断,综合治疗,可提高生存率.     

妊娠期乳腺癌的诊治研究进展

妊娠期乳腺癌临床表现、病理、诊治、预后都有其特殊性。由于延迟诊断,患者的生存率低,预后较差。需临床医生尽早明确诊断,通过手术、放化疗等个体化综合治疗方案,改善患者预后,延长生存期。     

隐匿性乳腺癌36例诊治分析

回顾分析临沂市肿瘤医院乳腺外科收治的36例隐匿性乳腺癌(OBC)患者的临床资料,并结合文献进行讨论。所有病例腋下肿物均经切检病理确诊。乳腺钼靶检查2例诊断为乳腺癌,3例患者为可疑乳腺癌;乳房彩超检查1例诊为乳腺癌,3例患者为可疑乳腺癌。行改良根治术28例,乳腺癌根治术4例,保留乳房手术2例,腋窝淋巴结清除加全乳放疗2例。30例患者获得随访,15例生存时间>5年。回顾分析结果提示,对腋下肿块应行切除活检以明确诊断;乳腺钼靶、彩超及腋下肿物激素受体检测有一定价值;乳腺核磁共振扫描能够提高OBC的检出率。手术方式宜采用改良根治术或保留乳房后全乳照射,并辅以化疗及内分泌治疗等以提高长期生存率。     

副乳腺癌诊治研究

目的：探讨副乳腺癌的临床特点及诊治方法。方法：应用PubMed及CNKI期刊全文数据库检索系统,以“副乳腺、副乳腺癌、诊断、治疗”等为关键词,检索1990-2013年相关文献。纳入标准：1）副乳腺癌的临床及病理;2）副乳腺癌的诊断及鉴别;3）副乳腺癌的治疗及预后。根据纳入标准符合分析文献43篇。结果：副乳是一种男女都能够出现的先天性发育异常,女性患者多见。副乳腺癌病变部位异常,临床表现常以腋下肿块为首发症状,易被漏诊和误诊。肿瘤生长迅速,发现较晚且副乳癌区域淋巴结丰富,发生转移早,确诊时患者常处于临床晚期阶段。副乳腺癌的预后比乳腺癌差。诊断时需要与腋窝淋巴结转移性乳腺癌、淋巴结肿大和汗腺癌等疾病鉴别。副乳腺癌在病理及影像学表现方面有其独特性,能够为诊治提供帮助。结论：副乳腺癌临床较为少见,预后较差。诊断主要依据影像学资料和术后病理。治疗应遵循以手术为主的综合治疗,手术方法推荐副乳腺区扩大切除加腋窝淋巴清除。争取早期诊断是改善预后的关键。     

乳腺癌脑转移的治疗

乳腺癌是仅次于肺癌易发生脑转移的恶性肿瘤,常规放射治疗可以提高生存率,孤立病灶可以外科手术切除,化学疗法有利于杀灭脑内亚临床病灶,放化疗结合能提高疗效,立体定向放射外科是安全、精确、有效的治疗方法。     

乳腺癌脑转移的治疗

乳腺癌是仅次于肺癌易发生脑转移的恶性肿瘤,常规放射治疗可以提高生存率,孤立病灶可以外科手术切除,化学疗法有利于杀灭脑内亚临床病灶,放化疗结合能提高疗效,立体定向放射外科是安全、精确、有效的治疗方法。     

乳腺癌术后胸壁转移的外科治疗

目的　探讨乳腺癌术后胸壁转移的外科治疗及方法。方法　 1997年 6月～ 2 0 0 0年 12月手术治疗 30例乳腺癌术后胸壁转移瘤。胸壁肿物切除后行对侧乳腺劈裂瓣修补术 16例 ,行同侧腹直肌瓣修补术 6例 ,行大网膜瓣修补+中厚皮瓣植皮术 8例。术后予以CAF方案化疗 14例 ,NP方案化疗 16例。结果　术后皮瓣部分坏死 2例 ,均为大网膜瓣修补 +中厚皮瓣植皮术治疗病例 ,经清创再植皮而痊愈。全部病例均获得随访。术后肿瘤远处再发转移 5例 ,予以继续化疗获得缓解。结论　外科治疗使乳腺癌术后胸壁转移取得良好效果 ,提高患者的生活质量。     

隐匿性乳腺癌的诊断和治疗

目的：探讨隐匿性乳腺癌（occult breast cancer,OBC）的发病特点、诊断和治疗方法.方法：回顾性分析21例OBC的临床、病理资料及随访结果.结果：21例均以腋下肿块为首发症状且均行手术治疗及术后综合治疗,5年生存率为78.70%,与我院同期乳腺癌5年总生存率75.94%（2 099/2 764）相似.结论：对原因不明的腋下肿块,应考虑到OBC的可能,同时应予切除并送检病理确诊.一经确诊,宜选择乳腺癌根治术或改良根治术,并予辅助性放疗、化疗.     

隐匿性乳腺癌的诊断和治疗

目的:探讨隐匿性乳腺癌(occultbreast cancer,OBC)的发病特点、诊断和治疗方法。方法:回顾性分析21例OBC的临床、病理资料及随访结果。结果:21例均以腋下肿块为首发症状且均行手术治疗及术后综合治疗,5年生存率为78·70%,与我院同期乳腺癌5年总生存率75·94%(2099/2764)相似。结论:对原因不明的腋下肿块,应考虑到OBC的可能,同时应予切除并送检病理确诊。一经确诊,宜选择乳腺癌根治术或改良根治术,并予辅助性放疗、化疗。肿瘤防治杂志,2005,12(19):1497-1498     

胃癌腹膜转移的诊断及治疗

 腹膜是胃癌复发或转移的最常见部位之一。腹膜转移严重影响患者的生活质量,缩短生存时间。早期诊断和积极治疗对预后有重要影响。诸多生物标志物的不断探索和新的影像学技术的广泛运用使得早期诊断胃癌腹膜转移更有希望,同时随着腹腔化疗和分子靶向治疗的迅速发展,治疗上也有了更多的选择。     

Anti-RANKL antibody for treatment of patients with bone metastasis from breast cancer

Breast cancer is known to be associated with a high incidence of bone metastases. Recent advances in treatment for breast cancer have improved patient prognosis, including those with bone metastasis, highlighting the importance of treating bone metastasis to reduce incidence of skeletal complications and to improve patients' QOL. Currently, bisphosphonates(BP), which are recommended by domestic and international clinical practice guidelines, are commonly used for the treatment of bone metastasis. However, the outcomes of BP therapy leave room for improvement in regard to their efficacy, safety, and convenience. Prior studies have indicated that RANK ligand(RANKL), a cytokine mainly expressed in osteoblasts and bone marrow stromal cells, plays an important role in bone resorption by osteoclasts, which are key mediators in the formation and progression of bone metastasis. Denosumab is a fully human monoclonal anti-RANKL antibody which suppresses differentiation, activation, and survival of osteoclasts by inhibiting the binding of RANKL to its receptor, RANK. In a phase III clinical trial, denosumab significantly decreased the time-to-first and time-to-first-and-subsequent skeletal related events(SRE), compared with zoledronic acid in advanced breast cancer patients with bone metastases. Further more, denosumab was more effective than zoledronic acid in preventing the progression of bone pain and maintaining patients QOL. In the future, treatment of bone metastases for breast cancer patients is expected to evolve further with the introduction of denosumab, which is conveniently administered by subcutaneous injection.     

Diagnosis and treatment of cerebral metastasis from lung cancer

A clinical analysis of 38 patients with cerebral metastasis from lung cancer is reported 17 patients had primary cancer symptoms prior to the increased intracranial pressure 34 patients were examined by cerebral angiography or ventriculography and 4 by CT scan. The incidence of cerebral metastasis with lung as the primary focus ranks first (54.7%). Three pathologic processes of intracranial metastasis: (1) cancer cell thrombosis stage (2) growth reaction stage (3) increased intracranial pressure stage. In this series, 16 patients were given conservative treatment and 22 were operated by craniotomy and resection. The results show that the operation could improve the symptoms and signs and prolong the survival time. The surgical treatment of lesions in the brain is emphasized and the indications are discussed.