乳腺叶状肿瘤33例诊治分析

[目的]探讨乳腺叶状肿瘤的临床表现、诊治方法及预后情况。[方法]回顾分析33例经手术后病理证实为乳腺叶状肿瘤患者的临床治疗情况。[结果]乳腺叶状肿瘤33例中良性23例,交界性8例,恶性2例。20例行局部切除术,11例行局部扩大切除术,2例行乳房单纯切除术。术后随访18例,随访时间8～74个月,2例复发,无死亡病例。[结论]乳腺叶状肿瘤生物学行为较难测定,应结合肿块大小及病理类型选择局部扩大切除或单纯乳腺切除。     

乳腺分叶状肿瘤诊疗及预后的探讨

为了探讨乳腺分叶状肿瘤外科治疗方法的选择,观察其影响预后的因素,对我院2001-01-2008-01收治的65例乳腺分叶状肿瘤的临床资料进行回顾性分析.65例分叶状肿瘤均经手术治疗,病理良性32例,交界性13例,恶性20例;15例肿块切除术复发8例,30例行局部扩大切除术复发3例,15例行乳房单切术复发2例,5例发现腋淋巴结肿大行乳房单切+腋淋巴结清除术,其中2例分别于术后10和18个月死于远处转移.初步研究结果提示,局部扩大切除术是治疗乳腺分叶状肿瘤的首选方案,但应保证组织学上干净的切缘,乳房单切术对恶性分叶状肿瘤没有生存优势,对局部复发的交界性或恶性肿瘤选择乳房单切术,无需行淋巴结清除.     

乳腺叶状肿瘤17例诊疗分析

目的:探讨乳腺叶状肿瘤的治疗原则和影响预后因素。方法:对经手术和病理诊断确诊的17例乳腺叶状肿瘤的临床资料进行回顾性分析。结果:17例患者中良性叶状肿瘤9例,交界性叶状肿瘤5例,恶性3例。行局部肿块切除7例,单纯乳房切除术6例,改良根治术3例,姑息性肿块切除术1例。其中随访13例,平均随访时间21(5~84)个月,1例行乳腺癌改良根治术后2.5年死于远处转移,2例行局部肿块切除术后复发。结论:乳腺叶状肿瘤的预后与手术方式有关,良性和交界性应首选扩大区段切除术,切除肿瘤边缘不少于2cm;复发的交界性和恶性应尽早行单纯乳房切除术。     

乳腺分叶状肿瘤诊治及预后分析

目的探讨乳腺分叶状肿瘤的病理特点,治疗方法及预后的影响因素。方法回顾性分析我院2003年1月至2011年1月收治的30例乳腺分叶状肿瘤患者临床资料。结果 30例患者均手术治疗,病理诊断：分叶状纤维瘤24例;叶状囊肉瘤6例,其中低度恶性1例,中度恶性3例,高度恶性2例。有3例行肿块切除后局部复发,再行扩大切除。结论乳腺分叶状肿瘤病理诊断复杂,空芯针穿刺活检及冰冻切片诊断价值有限,选择合理术式是预后关键。     

乳腺叶状肿瘤89例临床分析

目的:探讨乳腺叶状肿瘤的临床特点及影响预后的因素。方法:对我院收治的89例经病理确诊的乳腺叶状肿瘤临床资料进行回顾性分析。结果:89例患者均行手术治疗,肿块切除15例;乳腺区段切除16例;乳腺单纯切除26例;改良根治术32例。术后病理腋窝淋巴结转移1例。全组共有13例局部复发,局部复发率为14·6%(13/89)。肿块切除、乳腺区段切除、乳腺单纯切除和改良根治术者的局部复发率分别为60·0%(9/15)、12·5%(2/16)、7·7%(2/26)和0(0/32),差异有统计学意义,P<0·01。5例有远处转移,其中3例肺转移,1例脑转移,1例胰腺转移。用Cox比例风险模型分析影响生存预后的因素,远处转移是影响生存预后的主要因素,P<0·01。结论:乳腺叶状肿瘤确诊有赖术后病理检查。行肿块切除术的复发率较高,必须慎用;腋窝淋巴结转移率低,腋窝清除不需常规进行。预后较好,远处转移是影响生存预后的主要因素。     

61例乳腺叶状肿瘤诊疗分析

目的探讨乳腺叶状肿瘤的临床诊断、病理以及治疗和预后的关系。方法回顾分析1973年4月至2005年2月收治的61例经病理证实为乳腺分叶状肿瘤患者的临床资料。结果61例患者平均年龄43岁,按WHO分类标准,其中36例为良性,19例为交界性,6例为恶性;34例行局部扩大切除术,18例行单纯乳房切除术,3例行单纯切除+植皮术,6例行改良根治术(1例发现淋巴结转移)。随访52例,平均随访92个月(16~378个月),共13例局部复发和转移,死亡4例。结论局部扩大切除或单纯乳房切除术是治疗乳腺分叶状肿瘤的首选治疗方法,但术前检查证实同侧腋窝淋巴结肿大的患者,考虑行改良根治术。复发治疗以手术为主,需足够的手术范围,以根治为目的。     

乳腺叶状肿瘤临床病理观察

目的 探讨乳腺叶状肿瘤的临床、病理特点。方法 复习15例乳腺叶状肿瘤的临床、病理资料。结果 15例均为女性，年龄28岁～57岁，平均42.2岁。所有病例均表现为乳腺肿块，以单侧单发性为主，肿块直径3cm～18cm，平均7．8cm。良性叶状肿瘤8例，交界性4例，恶性3例。镜下见肿瘤由良性的上皮成分和丰富的间质细胞组成，大部分形成叶状结构。均未见腋下淋巴结转移。1例恶性患者术后17个月死于肺转移，4例患者发生局部复发。结论 乳腺叶状肿瘤好发于40岁～50岁女性，很少发生淋巴结转移，可血行转移，易复发。组织学上需与富含细胞的纤维腺瘤、真性肉瘤等鉴别。对良性叶状肿瘤一般选择肿块扩大切除术，肿瘤较大者、交界性及恶性者宜作乳腺切除术。     

乳腺叶状肿瘤89例临床分析

目的：探讨乳腺叶状肿瘤的临床特点及影响预后的因素。方法：对我院收治的89例经病理确诊的乳腺叶状肿瘤临床资料进行回顾性分析。结果：89例患者均行手术治疗，肿块切除15例；乳腺区段切除16例；乳腺单纯切除26例；改良根治术32例。术后病理腋窝淋巴结转移1例。全组共有13例局部复发，局部复发率为14．6％（13／89）。肿块切除、乳腺区段切除、乳腺单纯切除和改良根治术者的局部复发率分别为60．0％（9／15）、12．5％（2／16）、7．7％（2／26）和0（o／32），差异有统计学意义，P〈0．01。5例有远处转移，其中3例肺转移，1例脑转移．1例胰腺转移。用Cox比例风险模型分析影响生存顸后的因素，远处转移是影响生存预后的主要因素，P〈0.01。结论：乳腺叶状肿瘤确诊有赖术后病理检查。行肿块切除术的复发率较高，必须慎用；腋窝淋巴结转移率低，腋窝清除不需常规进行。顸后较好．远处转移是影响生存预后的主要因素。     

乳腺分叶状肿瘤八例报告

回顾分析8例乳腺分叶状肿瘤患者的临床病理资料,良性2例,交界性2例,恶性4例,患者年龄29～50岁,平均年龄41岁。肿块最大径平均6．6cm（3～38cm）。4例有肿块短时间内迅速增大的病史,4例曾接受2～3次肿瘤局部切除术,1例行局部扩大切除术,2例行乳腺单纯切除术,3例行乳腺改良根治术,1例胸壁复发的巨大肿瘤行皮肤与肋骨的全层切除、背阔肌-侧胸-腹直肌跨区皮瓣转移修复,1例在20个月内做过5次手术。随访3～72个月,8例患者均生存,其中2例分别于首次手术后8和21个月出现肺转移。回顾分析提示,乳腺分叶状肿瘤术前诊断困难,易局部复发,保证切缘阴性的局部扩大切除术是治疗乳腺分叶状肿瘤的合适的手段。     

乳腺叶状肿瘤17例诊治分析

[目的]总结乳腺叶状肿瘤的诊治情况。[方法]回顾分析17例经病理证实乳腺叶状肿瘤的临床资料。[结果]17例中良性11例,交界性3例,恶性3例。行乳腺肿瘤局部切除3例,乳腺肿瘤扩大切除7例,乳房切除术4例,乳房改良根治术3例,3例乳腺肿瘤术后出现复发。[结论]乳腺叶状肿瘤术前诊断较困难,主要依靠组织学检查,其局部复发与是否手术彻底切除密切相关。     

Bacteria and cancer--antagonisms and benefits

There is considerable historical and recent evidence concerning the antagonisms between acute bacterial infections or their toxins and cancer and allied diseases. These data provide renewed incentives to undertake clinical programmes with mixed bacterial vaccines in many countries at the present time.     

Religiosity and physical and emotional functioning among African American and White colorectal and lung cancer patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

Renal irradiation and the pharmacology and toxicity of methotrexate and cisplatinum

We used a rat model to study the effects of renal irradiation on the pharmacology of methotrexate (MTX) and cisplatinum (cis-Pt). Unanesthetized rats were given bilateral kidney irradiation (20 Gy in 9 fractions). At 9 months after irradiation, 3% of the animals had died and survivors showed moderately impaired renal function. At 15 months, 30% of the animals had died and survivors showed severely impaired renal function. Some animals were given i.v. MTX 1 week to 15 months after irradiation. In irradiated rats, the area under the MTX plasma clearance curve equaled that of controls through 6 months, and was significantly above controls from 9 months on. Other animals were given i.p. cis-Pt 1 week to 9 months after irradiation. The acute toxicity of cis-Pt was the same in control and irradiated rats when cis-Pt was given immediately before or after irradiation. Beginning 3 months after irradiation there was a progressive increase in cis-Pt toxicity and a simultaneous decrease in urinary platinum excretion. Irradiated animals that survived cis-Pt treatment showed increased radiation nephritis; the greatest effect occurred when cis-Pt was given 3 months or more after irradiation. MTX and cis-Pt clearance decreased when renal dysfunction was first observed and changes in renal function preceded changes in drug clearance and toxicity.     

VEGF及KDR在大肠腺瘤和腺癌中的表达及意义

目的：探讨VEGF和KDR在大肠腺瘤和大肠腺癌中的表达及临床病理特征的关系。方法：大肠腺瘤和大肠腺癌组织标本各100例,采用免疫组织化学染色法检测VEGF和KDR在标本中的表达情况。结果：VEGF和KDR在大肠腺癌组中的阳性表达明显高于大肠腺瘤组（P〈0.05）;在正常大肠黏膜均未见VEGF和KDR表达的阳性染色;VEGF阳性表达组中KDR的阳性表达率为70%,显著高于VEGF阴性表达组中KDR的阳性表达率16%,两组比较有统计学意义（P〈0.01）。结论：大肠腺癌组织中KDR的表达与肿瘤大小、转移情况、浸润深度密切相关;VEGF和KDR在大肠腺瘤中的表达与患者的年龄、性别及分型均无相关性,而与增生程度相关（P〈0.05）。在大肠腺癌患者中VEGF及KDR表达更高,二者具有协同效应。     

Morphine and tumor growth and metastasis

Morphine is an analgesic widely used to alleviate cancer pain. In addition, the perioperative management of pain in cancer surgery patients most often includes opioids. However, there are reports that these drugs may alter cancer recurrence or metastasis. Several mechanisms have been proposed, such as the modulation of the immune response or cellular pathways that control the survival and migratory behavior of cancer cells. The published literature, however, presents some discrepancies, with reports suggesting that opioids may either promote or prevent the spread of cancer. It is of great importance to determine whether opioids, in particular the most widely used, morphine, may increase the risk of metastasis when used in cancer surgery. This review examines the available data on the effects of morphine which influence cancer metastasis or recurrence, including immunomodulation, tumor cell aggressiveness, and angiogenesis, with special emphasis on recently published clinical and laboratory based studies. We further discuss the parameters that may explain the difference between reports on the effects of morphine on cancer.     

肾上腺素能β受体与肿瘤生长及转移

大量研究表明肿瘤细胞可表达β受体，而一些神经递质、药物和社会心理因素可能通过β受体影响肿瘤的生长和转移，β受体激动剂、β受体阻滞剂以及抑郁等社会心理因素可加强或削弱这种作用。这为表达β受体肿瘤的治疗开辟了新的道路，提供了新的治疗靶点。