放射导向手术在食管癌转移淋巴结检测的临床价值

目的：采用放射导向手术检测经99mTc-MIBI标记的食管癌病人30例,食管平滑肌瘤及贲门失弛缓症病人10例,探讨对食管癌转移淋巴结检测的临床价值。方法：用放射导向手术探测病灶,胸内和腹部淋巴结及切除的标本,术后对常规病理为阴性（即假阳性）的淋巴结,进行连续切片,HE染色,显微镜下观察。然后计算及统计学处理。结果：30例病人当中,廓清淋巴结694枚,转移者共有148枚。淋巴结转移以局部转移多见;其次为连续性转移与跳跃性转移,多向性转移最为少见。用放射导向手术探测淋巴结的灵敏度为100,特异度96.3,准确率98.9。结论：淋巴结转移情况是影响食管癌病人预后的重要因素。放射导向手术不仅能检测出微小的转移淋巴结,而且术中就能准确地判断肿瘤的临床分期,指导手术廓清的进行。使食管癌手术的根治度迈向一个新的高度。     

非小细胞肺癌淋巴结转移预测模型研究

在非小细胞肺癌的治疗过程中,淋巴结转移状态是决定治疗方案的重要因素。为了辅助临床医生制定更精确的治疗方案,开发并验证了一种基于CT影像组学非小细胞肺癌淋巴结转移的预测模型。从TCIA数据库的NSCLCRadiogenomics公共数据集中选取了134例符合试验要求的患者数据,然后从每例患者的CT影像数据中提取了1 648个特征,并用特征优化方法进行特征降维和选择,然后用朴素贝叶斯、线性判别分析、支持向量机和高斯过程5种机器学习方法建立预测模型,最后使用上海市胸科医院收集的44例患者数据进行外部验证。其中,最优淋巴结转移预测模型在训练集和测试集上准确率分别为0.802和0.795,AUC值分别为0.852和0.810。试验结果表明,所提出的预测模型分类性能良好,可以辅助医生更准确地评估淋巴结转移状态,从而制定出更精准的个性化治疗方案。     

手术治疗非小细胞肺癌合并孤立肾上腺转移32例临床分析

目的：探讨非小细胞肺癌(NSCLC)合并孤立肾上腺转移的手术治疗方法与效果。方法回顾分析32例接受手术治疗的NSCLC合并孤立肾上腺转移的方法以及临床预后。结果本组32例患者均获得手术成功,5年生存率为40.63%。结论 NSCLC孤立肾上腺转移应用手术治疗具有可行性,合理设计辅助放化疗方案有利于提高临床疗效。     

前哨淋巴结在非小细胞肺癌的临床研究

目前手术治疗仍是非小细胞肺癌的首选治疗方案，肺门和纵隔淋巴结清扫方式还没有统一标准，为了避免不必要的淋巴结清扫及组织过度创伤，导致患者生存率及术后生活质量低下，又能保证治疗的彻底和分期的准确，并提高患者生存率降低及术后生活质量，近年来对肺癌前哨淋巴结（sentinel lymphnode，SLN）进行相关的探究。肺癌前哨淋巴结的判定及性质作为一种预测淋巴结有无转移的诊断方法，对术中淋巴结的清扫具有指导性的作用。本文就目前前哨淋巴结在非小细胞肺癌的临床研究进行综述。     

纳米复合材料GO@AgPt对非小细胞肺癌的放射增敏作用

目的:制备新型纳米复合材料GO@AgPt，探究其对非小细胞肺癌的放射增敏效果。方法:通过改进型的水热法合成纳米复合材料GO@AgPt，通过透射电子显微镜、原子力显微镜、X射线光电子能谱分析、傅里叶红外光谱仪等方法对材料进行形貌及组分分析。应用细胞活性检测试剂盒CCK-8检测材料对肺癌细胞A549和人肺微血管细胞HPMEC的细胞活性的影响；然后通过流式检测及细胞克隆形成实验探究材料对于A549细胞的放射增敏效果。结果:成功制备出粒径大小均匀、化学成分稳定的纳米复合材料GO@AgPt。在一定浓度范围内该材料对肺癌细胞A549有毒性而对正常细胞HPMEC没有明显毒性。该材料能促进癌细胞产生活性氧，与X射线联合作用能促进细胞的凋亡。细胞克隆形成的结果也显示该材料对肺癌细胞具有放射增敏效果。结论:成功制备了纳米复合材料GO@AgPt，证明了该材料对于非小细胞肺癌有明显的放疗增敏效果。     

TSGF和CEA检测对非小细胞肺癌诊断的临床价值

探讨恶性肿瘤特异性生长因子（TSGF）和癌胚抗原（CEA）对非小细胞肺癌（NSCLC）治疗预后判断的临床价值,本文对99例NSCLC患者用电化学发光免疫分析法检测血清TSGF和CEA水平,比较患者不同病理类型、不同临床分期血清TSGF和CEA的阳性率。结果表明：血清TSGF和CEA的阳性率与NSCLC临床分期和病理类型有关;临床分期越晚,其阳性率越高;TSGF和CEA联合检测可用于观察NSCLC患者的治疗疗效和协助制定正确有效的治疗方案。     

Endoglin在非小细胞肺癌中的表达及临床意义

目的 研究不同转移潜能非小细胞肺癌(NSCLC)细胞系中以及癌与癌旁组织中endoglin (ENG)的表达情况,探讨ENG在NSCLC的发生发展和转移复发中的作用.方法 体外培养5株NSCLC细胞及1株正常支气管上皮细胞(HBE),随机选取22例NSCLC手术切除后癌与癌旁组织样本,分别采用real time PCR及Western blot法检测其中ENG mRNA和蛋白表达情况.采用x2检验分析ENG的表达和临床资料之间的相关性.结果 高转移性3株肺癌细胞系中ENG mRNA和蛋白表达显著升高,而正常细胞株及低转移性2株肺癌细胞中ENG表达缺失.22例肺癌样本中,其中19例癌组织中ENG mRNA和蛋白呈阳性表达(86.36％),且表达量明显高于相对应的癌旁组织(P＜0.01).ENG表达与患者临床病理特征年龄、性别、肿瘤大小、临床分期、病理分级、组织类型等均无关,而与患者淋巴结转移情况密切相关(P＜0.01).结论 ENG在NSCLC中的表达与淋巴结转移显著相关,有可能作为预测NSCLC转移及预后的分子标志.     

针吸活检与基因突变检测诊断非小细胞肺癌的临床价值

目的探讨经支气管镜针吸活检(Transbronchial needle aspiration,TBNA)组织学和基因突变检测在非小细胞肺癌的分型诊断及治疗中的价值。方法探讨经支气管镜针吸活检组织学和基因突变检测在非小细胞肺癌的分型诊断及治疗中的价值。结果进行TTF-1、p63、ck7、ck5/6特异性标记物免疫组化检测的28例TBNA样本的检测结果为:鳞癌15例,腺癌13例。其中10例腺癌进行了EGFR/KRAS/ALK的基因突变检测,检出EGFR突变阳性2例,KRAS阳性1例,未检测到ALK突变。结论通过TTF-1、p63、ck7、ck5/6特异性标记物联合基因突变检测可以较准确区分出鳞癌和腺癌,为临床用药提供指导。     

Immunohistochemical Detection of Metastatic Breast Carcinoma in Axillary Lymph Nodes

Abstract

Some dyes used in histotechnology fade within months; others remain unaltered for many years. Problems of fading are well known since antiquity and have been thoroughly investigated. Yet textbooks of histotechnology do not provide information concerning the sensitivity of dyes to light, acids, alkalis, and other reagents, though quantitative data are easily accessible in technical and chemical publications. Investigations in this laboratory demonstrated the usefulness of these data for the design of new reactions and modifications of traditional technics to prevent or minimize fading. It seemed, therefore, of interest to review pertinent literature on fastness properties of dyes. This report will deal mainly with standards of the fastness of dyes to light, acids and alkalis, effects of different light sources, dye concentration, and fluorochromes. (The J Histotechno 1 12:57, 1989.)     

CYFRA21-1、CA125与CEA联检对非小细胞肺癌诊断的临床应用

目的:探讨CYFRA21-1、CA125、CEA单项及联检对小细胞肺癌的临床应用价值.方法:采用化学发光法、放射免疫分析联检我院从2000年元月～2007年3月由病理证实的非小细胞肺癌患者171例血清CYFRA21-1、CA125、CEA值.结果:CYFRA21-1在鳞癌中阳性率最高为54.3%,CA125、CEA在腺癌中阳性率最高,分别为59.8%、49.0%.三项联检总阳性率明显升高为80.7%.结论:联检CYFRA21-1、CA125和CEA可起到互补作用,从而明显提高非小细胞肺癌的阳性检出率,且肿瘤的阳性检出率随病情的进展而升高.     

The Expression and Clinical Signification of PD-1 in Lymph Nodes of Patients with Non-small Cell Lung Cancer

To screen anti-programmed cell death protein 1 (PD-1) antibody treatment of the dominant population, it is necessary to understand the expression of PD-1 in tumor metastasis microenvironment. The aim of the present study was to detect the expression of PD-1 in lymph nodes of 51 patients with non-small cell lung cancer (NSCLC) by using flow cytometry (FCM). The results showed that the PD-1 expression on CD3⁺ T cells was significantly increased in NSCLC metastatic lymph nodes (50.08 ± 8.03%) compared with nonmetastatic lymph nodes (36.25 ± 11.27%) (t = 5.208, p < 0.001).We also found that PD-1 expression was not associated with age, sex, and smoking, and it is associated with pathological type and staging of lung cancer. This study demonstrated that PD-1 may involve in lymph nodes metastasis and promote the understanding of the mechanism of immunotherapies in the NSCLC.     

伊立替康或多西他赛联合奥沙利铂治疗晚期非小细胞肺癌的临床观察

目的：观察伊立替康或多西他赛联合奥沙利铂治疗晚期非小细胞肺癌（NSCLC）的近期疗效及毒副作用。方法1晚期非小细胞肺癌68例中,伊立替康联合奥沙利铂组（A组）36例,采用伊立替康100mg／m2,第1、8天;奥沙利铂130mg／m2,第2天,静脉滴注。多西他赛联合奥沙利铂组（B组）32例,采用多西他赛75mg／m2,第1天;奥沙利铂130mg／m2,第2天,静脉滴注。21天为1周期,连用2周期后评定疗效。结果：A组和B组有效率分别为41．67％和31．25％,两组差异无统计学意义（P〉0．05）。A组迟发性腹泻和胆碱性综合征发生率明显高于B组（P〈0．01）,但A组粒细胞减少发生率明显低于B组（P〈0．05）。结论：伊立替康或多西他赛联合奥沙利铂治疗晚期非小细胞肺癌有较好的疗效,不良反应可以耐受,安全性好,可以考虑作为晚期非小细胞肺癌治疗方案之一。     

Utility of Kynurenic Acid for Non-Invasive Detection of Metastatic Spread to Lymph Nodes in Non-Small Cell Lung Cancer

Background: Kynurenic acid (KYNA) is a side-stream product of the kynurenine metabolic pathway that plays a controversial role in malignancies either enabling escape of malignant cells from immune surveillance or exerting antiproliferative effect on cancer cells, and is associated with differences in invasiveness related to metastatic spread to lymph nodes in lung cancer. Nodal involvement is a significant negative prognostic factor usually considered a contraindication for primary surgical resection.Objective: To assess potential value of circulating KYNA for non-invasive identification of patients with metastatic lymph nodes (N+) in non-small cell lung cancer (NSCLC).Methods: KYNA level in venous blood serum was determined with use of high performance liquid chromatography (HPLC) in 312 subjects including 230 patients with NSCLC and 32 healthy controls.Results: Circulating KYNA level in NSCLC patients was higher than in controls (93.6±61.9pmol/ml vs. 31.4±16.6pmol/ml; p=2.2•10^-15) and positively correlated with N (R=0.326; p=2•^10-6) but not with T or M stage (p>0.05). In N+ patients it was higher than in N0 patients (137.7±51.8pmol/ml vs. 71.9±41.7pmol/ml; p=4.8•10^-16). KYNA effectively discriminated N+ from N0 patients at a cut-off value 82.3 pmol/ml with sensitivity 94.7% (95%CI 87.1-98.5%), specificity 80.5% (95%CI 73.4-86.5%), negative predictive value NPV=96.8%, PPV=70.5% and area under the ROC curve AUC=0.900 (95%CI 0.854-0.935; p=0.0001).Discussion and Conclusion: Circulating KYNA level measurement offers reliable non-invasive discrimination between N0 and N+ patients in NSCLC. Robust discriminatory characteristics of KYNA assay predestines it for clinical use as an adjunct facilitating selection of candidates for primary surgical resection.     

非小细胞肺癌中端粒酶催化基团mRNA表达的临床意义及其与P53的相关性

目的:研究非小细胞肺癌与正常肺组织穿刺标本中端粒酶催化基团mRNA表达与肿瘤分期与分级关系,探讨其在非小细胞肺癌早期诊断中的临床意义.观察肿瘤抑制基因P53与hTRT mRNA表达的关系.方法:采用原位杂交技术检测非小细胞肺癌与正常肺组织中端粒酶催化基团mRNA表达;用免疫组化方法检测非小细胞肺癌的P53蛋白表达.结果...     

Metastatic Small Cell Carcinoma to the Thyroid Gland: a Pathologic and Molecular Study Demonstrating the Origin in the Urinary Bladder

Small cell carcinomas may occur in the thyroid gland. Infrequently, they are primary tumors, and have been interpreted as variants of medullary thyroid carcinoma. However, the vast majority of small cell carcinomas involving the thyroid gland are metastatic tumors. In some cases, demonstration of the primary tumor is not easy. An example of a small cell carcinoma metastatic to the thyroid is presented in this report. The primary tumor was a small cell carcinoma that occurred as a minor component in a transitional carcinoma of the urinary bladder. The microscopical and immunohistochemical features of both tumors, in the thyroid and the bladder, were identical. Moreover, both tumors exhibited an identical mutation in p53, as well as similar loss of heterozygosity at 10q23 and RASSF1A promoter hypermethylation, clearly indicating that the bladder tumor was the site for the primary tumor of the patient.     

趋化因子受体CXCR4在胃癌颈部转移淋巴结中表达的研究

目的 研究趋化因子受体CXCR4在胃癌转移性淋巴结中表达的情况.方法 应用免疫组化韵方法研究胃癌患者颈部转移性淋巴结、非转移性淋巴结及健康人颈部正常淋巴结CXCR4的表达情况.结果 实验组1(胃癌颈淋巴结转移)CXCR4的阳性率为98.1%,与实验组2(胃癌颈部非转移淋巴结)对照组比较差异具有统计学意义.结论 CXCR4在胃癌的转移过程中有重要的作用.