未成熟网织红细胞指数在造血干细胞移植中的应用价值

目的探讨未成熟网织红细胞指数在造血干细胞移植后造血恢复中的应用价值。方法用Sysmex-2000i型自动血细胞分析仪检测25例患者造血干细胞移植后血液的未成熟网织红细胞指数(IRF)、网织红细胞绝对数(RET)、绝对中性粒细胞计数(ANC)等指标。结果25例患者中移植后IRF恢复的天数为14天,比ANC恢复天数早3天,比RET恢复天数早4天。有75%的患者IRF是最早的造血恢复指标。IRF恢复天数分别与ANC、RET恢复天数比较P值均小于0.01,有显著性差异,而ANC和RET恢复天数间比较P值大于0.05,无统计学意义。PBSCT组比BMT组移植后IRF,ANC和RET均提前恢复。结论IRF是造血干细胞移植后骨髓造血功能开始恢复的较敏感指标,可用于病情观察及指导临床治疗。     

网织红细胞及其组份测定在实体肿瘤化疗中的应用

网织红细胞（Ret）是成熟红细胞的前体，根据其RNA含量的不同可分为低荧光率（LFR）、中荧光率（MFR）和高荧光率（HFR）三种组份，用SysmexR－3000TM流式细胞仪对32例肿瘤患者化疗前后的Ret及其三种组份进行测定，并对照血常规的检查。研究结果表明：Ret比WBC和Plat的减少平均提前4天出现降低，MFR＋HFR比WBC的恢复平均提前3天出现升高。由此看出Ret及MFR＋HFR是预测骨髓抑制及恢复的一个敏感指标，对指导临床用药有一定作用。     

急性髓系白血病患者巩固化疗过程中未成熟网织红细胞分数检测的临床意义

 目的　探讨急性髓系白血病（AML）患者在接受大剂量阿糖胞苷巩固化疗后骨髓抑制和恢复过程中包括未成熟网织红细胞分数（IRF）在内的外周血各参数的变化及其临床意义。方法　采用全自动血细胞分析仪动态检测30例AML患者接受大剂量阿糖胞苷巩固化疗前后外周血中性粒细胞绝对计数（ANC）、血小板计数（Plt）和IRF,并对各个参数的变化进行分析比较。结果　患者巩固化疗后,ANC、Plt和IRF平均恢复时间分别为（9.2±2.5）d、（11.3±3.7）d和（5.0±2.6）d,IRF恢复时间短于ANC和Plt回升时间（P＜0.05）,而ANC恢复时间短于Plt回升时间（P＜0.05）。不同FAB分型患者间及基于细胞遗传学和分子生物学危险因素分层患者间ANC、Plt和IRF平均恢复时间差异均无统计学意义（P＞0.05）。结论　IRF是AML患者接受大剂量阿糖胞苷巩固化疗后提示骨髓造血功能恢复的早期指标,对于评估疗效具有重要临床意义。     

外周血网织红细胞和T淋巴细胞亚群用于辐射损伤快速剂量估算的可行性研究

目的：通过观察受不同剂量照射小鼠的外周血网织红细胞的百分率变化以及辅助T淋巴细胞（helperT cells,Th）与抑制T淋巴细胞（suppressor T cells,Ts）的比值（rTh/Ts））和照射剂量的关系,探索其用于辐射损伤生物剂量估算的可行性。方法：C57BL/6小鼠,7～8周龄,60Coγ线全身照射0～7Gy,分别收集辐照前和辐射后不同时间点的静脉血,流式细胞术（FCM）检测外周血中网织红细胞百分率和rTh/Ts）情况,分析时间-效应关系并拟合剂量-效应曲线。结果：照射剂量在0～7 Gy范围内,小鼠的外周血网织红细胞百分率均随时间而降低,并于照射后3 d降到最低,且剂量越大恢复越晚;照射后72 h内小鼠的外周血rTh/Ts）均随剂量增加而递增。照射剂量在1～3 Gy范围内,在照射后24、48和72h,小鼠的外周血网织红细胞百分率均随剂量增加而递减;照射剂量在1～7Gy范围内,在照射后6、24和72 h,小鼠的外周血rTh/Ts）均随剂量增加而递增。网织红细胞百分率和_（Th/Ts）的剂量-效应关系均满足直线模型。结论：FCM检测网织红细胞百分率和rTh/Ts）可成为早期快速、高通量的辐射损伤生物剂量计。     

网织红细胞在乳腺癌化疗前后的变化及临床意义

目的 了解乳腺癌患者化疗前后网织红细胞的变化及临床价值.方法 采用流式细胞术检测33例乳腺癌患者化疗前后网织红细胞的含量,采用血液分析仪检测外周血的自细胞变化.结果 化疗后第6、10天白细胞进行性明显下降(P＜0.01),第14天较第10天已逐渐回升(P＜0.05),但仍明显低于化疗前水平(P＜0.01);而网织红细胞第6、10天较化疗前明显下降(P＜0.01),但第10天较第6天无差异(P＞0.05),第14天恢复至化疗前水平(P＞0.05).结论 网织红细胞的变化可作为乳腺癌患者化疗后骨髓抑制和恢复的较敏感指标.     

晚期非小细胞肺癌GP方案化疗前后网织红细胞与白细胞的变化及临床价值

目的了解晚期非小细胞肺癌采用吉西他滨联合顺铂化疗前后网织红细胞与白细胞的变化及临床价值。方法87例晚期非小细胞肺癌患者予GP方案化疗前后采用流式细胞术检测网织红细胞的含量,采用血液分析仪检测外周血的白细胞变化。结果化疗后第6天、第10天白细胞计数进行性下降,明显低于化疗前,第10天明显低于第6天（P<0.01）,第14天较第10天明显回升（P<0.01）,但仍低于化疗前水平（P<0.01）;而网织红细胞计数第6天、第10天较化疗前明显下降（P<0.01）,第10天较第6天无差异（P>0.05）,第14天较第10天明显回升（P<0.01）,恢复至化疗前水平（P>0.05）。结论网织红细胞的变化可作为晚期非小细胞肺癌化疗后骨髓抑制和恢复的较敏感指标,值得临床推广应用。     

儿童恶性肿瘤患者红细胞免疫功能的研究

1981年Siegel等提出“红细胞免疫系统”新概念,开拓了免疫学新领域。认为红细胞也和白细胞同样具有免疫功能。现已知红细胞具有免疫粘附、清除抗原;增强吞噬;激发淋巴细胞免疫及转运,消毁免疫复合物等功能。癌细胞遇到红细胞的机会比白细胞多1000倍,所以在肿瘤免疫上应该起到很大作用。目前国内外对儿童恶性肿瘤患者的红细胞免疫功能研究     

骆驼蓬总硷对小鼠网织细胞肉瘤L—Ⅱ细胞超微结构的影响

电子显微镜观察到骆驼蓬总硷(TAH)对小鼠网织细胞肉瘤L-Ⅱ细胞超微结构有明显的破坏作用,粗面内质网、线粒体、细胞膜、核膜及染色质均有损害,甚至出现细胞浆空泡化、核固缩和核溶解,表明细胞已坏死。结果提示骆驼蓬总硷主要损伤细胞生物膜结构,以粗面内质网、线粒体和细胞膜较明显。     

恶性肿瘤性贫血患者红细胞分布宽度分析

目的探讨恶性肿瘤性贫血患者的红细胞体积分布宽度(RDW)的差异。方法用SCC型血细胞分析仪检测恶性肿瘤性贫血组和正常健康组RDW值。结果轻度恶性肿瘤性贫血组和中重度恶性肿瘤性贫血组RDW值分别为15.43和15.36,均高于正常对照组,差异有统计学意义(P<0.001)。结论恶性肿瘤性贫血患者RDW值明显高于正常人。     

恶性肿瘤病人血清FDP检测及临床意义的探讨

应用单克隆抗体检测恶性肿瘤病人血中FDP,结果显示,肿瘤病人血液中FDP含量明显高于正常人(P<0.01).在消化、呼吸系统等多种恶性肿瘤病人中,FDP值以高恶性的肝细胞癌含量最高.临床观察结果显示肿瘤增长速度快以及发生了转移的患者比病情稳定的患者FDP含量普遍增高(P<0.01).本文结果提示FDP检测还可能对肿瘤的转移及预后判断有一定作用.     

Prognostic Significance of Peripheral Blood Flow Cytometry Parameters in Patients with Non-Metastatic Breast Cancer

Background: Immune functions and their relation to prognosis in breast cancer patients have become areasof great interest in recent years. Correlations between survival outcomes and peripheral blood flow cytometryparameters are therefore of interest. Here we focused on patients with non-metastatic breast cancer (BC).Materials and Methods: A total of 29 patients with pathological confirmed breast carcinoma and flow cytometrydata were assessed for overall survival (OS) and progression free survival (PFS). Results: The median age of thepatients was 54 years (range, 29-83). Multivariate analysis revealed that OS was significantly associated withabsolute cytotoxic T cell count (95%CI, coef 2.26, p=0.035), tumor size (95%CI, coef -14.5, p 0.004), chemotherapy(95%CI, coef 12.9, p 0.0001), MFI of CD4 (95%CI, coef -5.1, P 0.04), MFI of HLA DR (95%CI, coef -5.9, p0.008) and tumor grade (95%CI, coef -13, P 0.049) with R-Sq(adj)=67%. Similar findings were obtained forPFS. Conclusions: OS and PFS were significantly associated with tumor grade, tumor size, chemotherapy, MFIof CD4, HLA DR and absolute cytotoxic T cell count. The study revealed that MFI of basic CD markers andabsolute cytotoxic T cell number may be a prognostic factors in women with non-metastatic BC.     

Lack of Prognostic Value of Blood Parameters in Patients Receiving Adjuvant Radiotherapy for Breast Cancer

Aim: To determine prognostic value of blood parameters on overall and progression-free survival in casesreceived adjuvant radiotherapy and chemotherapy with diagnosis of stage I-III breast cancer. Materials andMethods: We retrospectively reviewed files of 350 patients with non-metastatic breast cancer who were treatedin the Radiation Oncology Department of Kayseri Teaching Hospital between 2005 and 2010. Pretreatmentwhite blood cell (WBC), neutrophil, monocyte, basophil and eosinophil counts, and the neutrophil/lymphocyteratio (NLR) and platelet lymphocyte ratio (PLR) were recorded. The relationship between clinicopathologicalfindings and blood parameters was assessed. Results: Overall, 344 women and 6 men were recruited. Median agewas 55.3±0.3 years (range: 22-86). Of the cases, 243 (61.4%) received radiotherapy while 329 (94.3%), receivedchemotherapy and 215 (61.4%) received hormone therapy. Mean overall survival (OS) and progression-freesurvival (PFS) was 84.4 and 78.8 months, respectively. During follow-up, 48 patients died due to either diseaserelatedor non-related causes. Local recurrence was detected in 14 cases, while distant metastasis was noted in45 cases. In univariate analysis, age, pathology, perinodal invasion were significantly associated with overallsurvival, whereas gender, stage and hormone therapy were significantly associated with progression-free survival.In multivariate analysis, histopathological diagnosis (OR: 0.3; 95%: 0.1-0.7; p=0.006) and perinodal invasion(OR: 0.1; 95% CI: 0.1-1.3; p=0.026) were significantly associated with overall survival, whereas tumor stage(OR: 2.1; 95% CI: 0.0-0.7; p=0.014) and hormone therapy (OR: 2.1; 95%: 1.2-3.8; p=0.010) were significantlyassociated with progression-free survival. Conclusions: It was found that serum inflammatory markers includingWBC, neutrophil, lymphocyte and monocyte counts, and NLR and PLR had no effect on prognosis in patientswith breast cancer who underwent surgery and received adjuvant radiotherapy and chemotherapy.     

肿瘤患者外周血淋巴细胞p53高表达的临床意义

[目的]研究恶性肿瘤患者外周血中p53高表达的临床意义。[方法]应用FCM检测85例癌症患者及88例对照组的外周血中p53的表达。[结果]肿瘤患者p53表达为(7.67±7.14)% ,显著高于正常对照组的表达(0.66±0.5) %(P<0.01)。70.6%的恶性肿瘤患者出现p53高表达 ,p53表达水平与治疗状况和转移无关(P<0.05)。[结论]p53高表达可作为监测和筛选肿瘤高危人群的一个较好的实验室指标     

Diagnostic Power of Blood Parameters as Screening Markers in Gastric Cancer Patients

Background: Gastric cancer (GC) is the fifth most common cancer worldwide. Since development is usually asymptomatic, it is generally diagnosed at an advanced stage. The value of screening in patients with nonspecific symptoms for GC is controversial. Aim: The study aimed to evaluate whether hematological parameters (platelet count (PC), mean platelet volume (MPV), MPV/PC ratio, red blood cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR)) are useful markers to differentiate between gastric cancer patients and healthy individuals. Materials and Methods: Sixty-one patients with gastric cancer and sixty-one healthy individuals were enrolled to the survey and a retrospective analysis of selected blood parameters was performed. Results: The mean values of PC, MPV, RDW, NLR, and PLR were significantly higher in GC patients compared to the control group. No statistical differences were observed in MPV/PC ratios. Likewise, no significant statistical differences were revealed in values of blood parameters among TNM stage groups. The RDW showed the highest diagnostic specificity and sensitivity. Conclusions: Hematological parameters: PC, MPV, RDW, NLR, PLR have diagnostic power and can discriminate patients with gastric cancer from patients without cancer. Blood parameters compared with clinical symptoms might alert physicians and patients and lead to performancce of upper gastrointestinal endoscopy, the gold standard in gastric cancer screening and thereby increase the early detection of cancer.     

不同剂量rmhTNF治疗晚期肿瘤恶性心包积液的疗效观察

目的 探讨重组改构人肿瘤坏死因子（rmhTNF）在治疗恶性心包积液中的疗效、不良反应及对生活质量的影响;并比较两种不同剂量rmhTNF的疗效差异。方法64例肿瘤患者采用计算机随机法分为A、B两组,分别于心包腔内置管灌注rmhTNF 1500 万IU（大剂量A组）、rmhTNF 500 万IU（常规剂量B组）,连续治疗4次。治疗结束1月后按WHO标准评价疗效和不良反应及对生活质量的影响。结果A组总有效率90.6%,完全缓解率达到62.5%;B组总有效率达到56.2%,完全缓解率达到37.5%,两组比较差异有统计学意义（P<0.05）。不良反应两组相似,差异无统计学意义（P>0.05）。两组患者生活质量都有不同程度改善,在精神好转、食欲增加、体力增加、体重增加上两组比较差异无统计学意义（P>0.05）;在睡眠、KPS评分两组比较有明显差异,A组改善更明显（P<0.05）。结论rmhTNF治疗癌性心包积液疗效好,不良反应小,可以改善患者生活质量。大剂量A组与常规剂量B组比较,完全缓解率更高,疗效更显著,而不良反应差别不明显。     

不同PEEP对全麻下骨肿瘤患者的血流动力学及呼吸功能影响

目的探讨不同呼末二氧化碳分压(PEEP)对全麻下骨肿瘤患者的血流动力学及呼吸功能影响。方法选择行手术切除与机械通气的股骨近段骨肿瘤患者88例,根据通气方法的不同分为观察组48例与对照组44例,观察组给予小流量PEEP通气,对照组给予常规流量PEEP通气,记录两组不同时间点的血流动力学及呼吸功能变化情况。结果所有患者都顺利完成麻醉、通气与手术,不同时间点的HR与MAP值都在正常范围内波动,组间与组内对比差异都无统计学意义(P>0.05)。两组术后7 d的FEV1/FVC、FEV1值都显著高于术后1 d(P<0.05),观察组也显著高于对照组(P<0.05)。两组术后7 d的血清IL-6与TNF-α值都显著低于术后1 d(P<0.05),观察组也显著低于对照组(P<0.05)。术后3个月观察组的Harris肢体功能优良率为97.9%,显著高于对照组的82.5%(P<0.05)。结论小流量PEEP通气在全麻下骨肿瘤患者手术中的应用能保持血流动力学平稳,促进呼吸功能的功能,抑制炎症因子的释放,从而改善患者的预后。     

Activities of Four Enzymes in Blood Serum Determined Simultaneously in Patients with Malignancy before Radical Surgery

The activities of serum alkaline phosphatase (ALP), glutamicoxaloacetic transaminase (GOT), glutamic pyruvic transaminase(GPT) and lactate de-hydrogenase (LDH) were determined simultaneouslyin a group of healthy subjects (351) and in groups of patientswith carcinoma of the lung (379), the stomach (797), the cervix(293), the breast (865), the liver (30) and the pancreas (6)before radical operation. In general, LDH gave the highest rateof positivity of the four enzymes and the activity of this enzymeabove the upper limit of the normal range (M+2SD) was foundin 44.9, 24.1, 19.1 and 13.0% of the patients with carcinomaof the lung, the stomach, the breast and the cervix, respectively. In the patients with adenocarcinoma of the lung, the positivityof serum LDH activity before surgery was shown to increase withthe size of the radically resected tumor. In the two other carcinomas,however, the serum enzyme with the highest rate of positivitywas not LDH but GOT and ALP in pancreatic carcinoma and GOTin hepatocellular carcinoma. As for the rate of independentelevation of serum enzyme activity, LDH exhibited the highestpercentage in all the carcinomas examined, with the exceptionof pancreatic carcinoma in which ALP showed the highest rate.Combined assays of these four enzyme activities gave positivityrates of 100%, 93.3%, 56.5%, 35.9%, 25.4% and 25.3% in carcinomaof the pancreas, the liver, the lung, the stomach, the breastand the cervix, respectively, demonstrating the practical diagnosticvalue of this combined assay system.     

彩色多普勒超声对卵巢肿瘤血流参数与微血管密度相关性的评估价值

目的探讨卵巢肿瘤血流参数与微血管密度的相关性。方法收集卵巢肿瘤患者62例作为研究对象,依据术后病理确诊结果分为良性组30例以及恶性组32例。2组患者均于术前使用彩色多普勒超声及免疫组化检查。记录并比较2组彩色多普勒超声血流参数与微血管密度,探讨其相关性。结果恶性组患者彩色多普勒信号分级以Ⅲ~Ⅳ级为主,良性组患者以Ⅰ~Ⅱ级为主,不同FIGO分期患者彩色多普勒信号分级存在统计学差异(P<0.05)。恶性组患者血管波动指数(PI)及阻力指数(RI)均明显低于良性组患者,微血管密度明显高于良性组患者;FIGO分期越高,PI及RI越低,微血管密度越高(P<0.05)。卵巢肿瘤彩色多普勒超声血流参数PI及RI分别与微血管密度呈负相关(γ1=-0.563,P=0.001;γ2=-0.645,P=0.000)。结论卵巢肿瘤彩色多普勒超声血流参数与微血管密度存在负相关性,可用于早期诊断中血管形成情况的评估,具有重要的临床价值。