胃癌综合整体治疗新探

肿瘤已成为世界范围内的常见病、多发病，对人类健康构成严重威胁，为人类健康的主要“杀手”，在人类死因顺位中占第3位。胃癌系消化道最常见的恶性肿瘤，占消化道肿瘤的第1位。在我国城乡发病均高。据流行病学、临床流行病学和胃镜检出率显示，其发病率以惊人的速度递增，占恶性的第1位或第2位。因此，对胃癌综合整体治疗进行新的探讨．有着     

老年胃癌手术治疗135例临床体会

现就我院老年胃癌临床特点及手术治疗体会做一总结。1　临床资料老年胃癌手术治疗患者 13 5例 ,男 10 2例 ,女 3 3例。 60～69岁 85例 ,70～ 79岁 43例 ,≥ 80岁 7例。症状与病程 :上腹不适或胀痛 51例 ,反酸嗳气及腹部肿物 2 9例 ,黑便及呕血 7例 ,消瘦、贫血、低蛋白血症 2 1例 ,幽门梗阻 2 7例。术前并存病 :高血压、冠心病 77例 ,肺气肿 13例 ,糖尿病 2 5例。肿瘤部位 :胃窦部 68例 ,胃角部 3 2例 ,胃体部 2 6例 ,胃底部 9例。肿瘤直径<3 cm 15例 ,<5cm 58例 ,>5cm 62例。病理分型及浸润转移 :高分化腺癌 19例 ,中分化腺癌 56例 ,低分化…     

老年胃癌临床特点及外科治疗方法

目的分析老年胃癌临床特点及探讨其外科治疗方法。方法随机抽取2013年1月-2014年1月期间我院收治的老年胃癌患者86例,将86例老年胃癌患者分为观察组(高龄组)与对照组(低龄组),对两组患者的临床资料进行回顾性分析,比较分析两组患者的胃癌的临床特点,对治疗老年胃癌患者的治疗方法进行探讨。结果观察组与对照组老年胃癌患者主要有上恶心呕吐、吞咽困难、腹部包块、腹部疼痛、消瘦乏力等临床症状,观察组的发生率明显高于对照组(P<0.05);在临床症状的发生率方面观察组与对照组相比,观察组显著高于低龄组;观察组胃癌发生于胃底贲门区;低龄组胃癌发生于胃窦幽门区,以上差异均具有统计意义(P<0.05)。结论老年胃癌患者在可实施手术的情况下,应积极施行手术进行根治,做好精心的手术处理,可有效降低老年患者术后并发症发生率,降低胃癌死亡率。     

胃癌致胃穿孔40例临床分析

自1998年以来，我们收治胃癌致胃穿孔患者40例．获得满意疗效。现报告如下。     

ELFP方案治疗老年晚期胃癌36例临床观察

2000年1月至2003年8月，我院采用ELFP[足叶乙甙(VP-16)、亚叶酸钙(CF)、氟尿嘧啶(5-Fu)和顺铂(DDP)]方案治疗老年晚期胃癌患者36例，疗效较好。现报告如下。     

综合治疗糖尿病足临床分析

目的对糖尿病足患者综合治疗的临床疗效进行分析。方法资料选自本院于2011年6月-2013年6月收治的糖尿病足患者106例,随机分为两组,对照组53例患者行常规治疗,实验组53例患者行综合治疗,并对两组患者的临床治疗效果作回顾性分析。结果采用综合治疗的实验组患者治疗总有效率、生活质量改善情况均明显优于采用常规治疗的对照组,组间比较差异具有统计学意义(P<0.05)。结论临床上采用综合治疗方法治疗糖尿病足患者,能有效降低该病的致残率及致死率,提高患者的生活质量,因此也值得在临床大力推广使用。     

通阳回春丹治疗中晚期胃癌的临床疗效

中晚期胃癌，特别是有其他部位转移的患者，已失去手术时机，化疗是其主要治疗方法，但该类患者一般情况较差，承受能力差，致目前化疗的有效率较低，治疗非常棘手。近年来，笔者课题组运用通阳回春丹治疗中晚期胃癌患者52例，在改善症状、延长生命、提高生存质量方面取得了良好的疗效。现报告如下。     

腹腔CEA mRNA检测在胃癌穿孔治疗中的意义

胃癌穿孔是进展期胃癌的严重并发症之一,多发生于老年患者,在胃癌中的发生率为0.49%～3.64%[1].胃癌穿孔患者往往全身情况差、高龄、腹腔污染较重,且脱落的癌细胞易发生腹腔内种植,然而针对胃癌穿孔病例是否该行根治性手术尚有争议.复发与转移是胃癌治疗失败和死亡的主要原因,因此监测肿瘤转移以判断预后在指导胃癌穿孔的治疗中具有重要意义.目前研究认为相对于腹腔脱落细胞学检查,采用RT-PCR法检测癌胚抗原(CEA)mRNA是检测腹腔游离癌细胞的敏感指标,可以作为胃癌患者腹膜转移情况及预后判断的良好指标,并对治疗有指导意义.本研究探讨癌胚抗原(CEA)分子生物学检测技术对比研究肿瘤细胞在其腹水和腹膜中的分布特点及随访结果,以期为胃癌穿孔治疗提供依据.     

肺癌多学科综合治疗的临床思维

肺癌多学科综合治疗的临床思维涉及制定治疗方案，实施治疗方案和考核治疗方案三个方面。制定治疗方案时应依据肿瘤的生物学特性，病人的全身和局部情况以及各种治疗措施的特点。实施治疗方案时应处理好局部治疗和全身治疗的关系，疗效和副作用的关系以及抗癌治疗和辅助治疗的关系。考核治疗方案应凭借影像学改变，生存时间和生活质量。     

57例残胃癌临床分析

５７例残胃癌临床分析陈红绉，林谷珍，林凡，周凯，郑兰本文根据我院１６年来内镜及病理诊断ＲＧＣ５７例的资料进行分析，提示可能预防ＴＧＣ的几点措施。临床资料１９７９年６月至１９９４年１２月对良性胃病行胃切除术后５年及胃癌术后１０年以上有胃肠道症状者２７９...     

Prospective cohort study of comprehensive prevention to gastric cancer

AIM: To evaluate the preliminary effects of comprehensive prevention of gastric cancer in Zhuanghe County epidemiologically. METHODS: Stratified sampling and cluster sampling were applied to define the intervention group and the control group. The prospective cohort study was used for evaluating the effect of preventing gastric cancer. The relative risk (RR) and attributable risk percent (AR %) of intervention on gastric cancer death were calculated. Potential years of life lost (PLYY) of the disease was analyzed, and the RR and AR % of PYLL were calculated. Survival analysis was applied among the screened patients. RESULTS: In the first 4 years after intervening, the relative risk (RR) of intervention on death was 0.5059 (95 % CI: 0.3462-0.7392, P<0.05) with significance statistically. AR % of the intervention on death was 49.41 %. The RR of intervention on cumulative PYLL was 0.6778 (95 % CI: 0.5604-0.8198, P<0.05) with statistic significance. AR % of the intervention on cumulative PYLL was 30.32 %. The four-year survival rate of the screened patients was 0.6751 (95 % CI: 0.5298-0.9047). CONCLUSION: The initiative intervention results showed that the intervention approach used in the trial was effective, it reduced mortality and increased survival rate, and alleviated the adverse effect of gastric cancer on the health and life of screened population.     

Systemic treatment of gastric cancer

Gastric cancer is one of the commonest cancers worldwide and is associated with a poor prognosis. Surgery remains the only potentially curative treatment, but is associated with a high rate of locoregional recurrence. Hence, there is ongoing debate regarding both the extent of lymph node dissection and the role of perioperative chemotherapy or chemoradiation for localized disease. Untreated metastatic gastric cancer is associated with a median survival of only 3-4 months, but this can be increased to 8-10 months, associated with improved quality of life, with combination chemotherapy. Currently, no standard combination chemotherapy regimen exists, although regimens utilizing both cisplatin and 5-fluorouracil, such as epirubicin/cisplatin/fluorouracil (ECF), are amongst the most active. Newer chemotherapeutic agents, including irinotecan, oxaliplatin and taxanes, show promising activity, and are currently being tested in phase III trials.     

Systemic treatment of gastric cancer

Treatment of gastric cancer is improved over the past years, but unanswered questions remain regarding the efficacy of systemic treatments in adjuvant, neoadjuvant and metastatic setting. It has not been definitively demonstrated the efficacy of adjuvant chemotherapy, that should not be adopted as a standard approach to localized gastric cancer. On the contrary, compelling evidence in support of perioperative chemotherapy with ECF regimen has been recently provided by the MAGIC trial, although many criticisms have been moved to this study. For metastatic setting, a recent meta-analysis showed a small, but significant survival benefit for combination vs single agent chemotherapy, and the V-325 trial demonstrated the superiority of a docetaxel containing regimen (DCF) over a doublet (CF). Finally, the results of ongoing clinical trials on a number of new molecular-targeted drugs should confirm their role in gastric cancer.     

胃癌综合治疗现状与进展

手术是胃癌治疗的首选方式,目前比较统一的观点是将D2手术作为标准的手术方式.微创技术的发展为胃癌手术带来了新的挑战,目前有限的资料证实腹腔镜胃癌手术可以达到开腹手术相同的治疗效果.新辅助化疗为部分Ⅲb或Ⅳ期胃癌患者提供了可以切除的机会.腹腔热疗也逐步取得了良好的治疗效果.对于胃癌微观领域的研究将为其早期诊断和治疗提供更多的依据.目前胃癌治疗方法多种多样,尚无统一标准,需要深入研究.     

早期胃癌的内镜下治疗

随着内镜技术的不断进步,越来越多的早期胃癌可经内镜下治疗.本文简要地介绍了早期胃癌内镜下治疗的发展史.重点介绍了目前早期胃癌内镜下治疗最先进的方法一黏膜剥离术的特点、适应征、并发症及处理对策.     

原发性肝癌综合治疗进展

目前原发性肝癌的治疗方法虽然很多,但肿瘤治疗的预后效果仍不理想。主要阐述了肝切除、肝移植、消融治疗、介入治疗、放射治疗、药物治疗及生物免疫等方法治疗原发性肝癌的进展,并对肝癌的多学科综合治疗方法进行了简要的介绍。认为综合治疗可以发挥各种治疗方法的优势,达到最好的治疗效果,是提高肝癌患者总体疗效的关键措施。     

Endoscopic treatment for early gastric cancer

Gastric cancer remains one of the most common causes of cancer death.However the proportion of early gastric cancer(EGC)at diagnosis is increasing.Endoscopic treatment for EGC is actively performed worldwide in cases meeting specific criteria.Endoscopic mucosal resection can treat EGC with comparable results to surgery for selected cases.Endoscopic submucosal dissection(ESD)increases the en bloc and complete resection rates and reduces the local recurrence rate.ESD has been performed with expanded indication and is expected to be more widely used in the treatment of EGC through the technological advances in the near future.This review will describe the techniques,indications and outcomes of endoscopic treatment for EGC.     

Identification of IL11RA and MELK amplification in gastric cancer by comprehensive genomic profiling of gastric cancer cell lines

AIM To identify common copy number alterations on gastric cancer cell lines.METHODS Four gastric cancer cell lines(ACP02, ACP03, AGP01 and PG100) underwent chromosomal comparative genome hybridization and array comparative genome hybridization. We also confirmed the results by fluorescence in situ hybridization analysis using the bacterial artificial chromosome clone and quantitative real time PCR analysis.RESULTS The amplification of 9p13.3 was detected in all cell lines by both methodologies. An increase in the copy number of 9p13.3 was also confirmed by fluorescence in situ hybridization analysis. Moreover, the interleukin 11 receptor alpha(IL11RA) and maternal embryonic leucine zipper kinase(MELK) genes, which are present in the 9p13.3 amplicon, revealed gains of the MELK gene in all the cell lines studied. Additionally, a gain in the copy number of IL11 RA and MELK was observed in 19.1%(13/68) and 55.9%(38/68) of primary gastric adenocarcinoma samples, respectively. CONCLUSION The characterization of a small gain region at 9p13.3 in gastric cancer cell lines and primary gastric adenocarcinoma samples has revealed MELK as a candidate target gene that is possibly related to the development of gastric cancer.