肺癌细胞AgNOR计数与DNA含量测定之间相关性研究

目的研究肺癌细胞ＤＮＡ倍体类型和核仁组织区嗜银蛋白（ＡｇＮＯＲ）及两者之间的相互关系。方法对３６例肺癌石蜡标本进行细胞ＡｇＮＯＲ定量计数和ＤＮＡ含量的流式细胞术（ＦＣＭ）检测。检测结果进行ｔ检验和Ｘ２检验。结果二倍体肺癌细胞ＡｇＮＯＲ计数（１．６５±０．８７）显著低于异倍体肺癌细胞者（３．０９±１．０３）细胞周期中Ｓ期细胞＜２０％的肺癌细胞ＡｇＮＯＲ计数（１．３８±１．０２）显著低于Ｓ期细胞≥２０％者（２．７７±１．１４）。在二倍体肿瘤中，分化Ⅱ级和Ⅲ级细胞的ＡｇＮＯＲ计数显著高于分化Ⅰ级者，但在Ⅱ、Ⅲ级之间ＡｇＮＯＲ计数则无显著差异；分化Ⅲ级肿瘤的异倍体检出率显著高于分化Ⅰ、Ⅱ级肿瘤，但在Ⅰ、Ⅱ级之间异倍体检出率则无显著差异。结论细胞ＤＮＡ含量和ＡｇＮＯＲ计数与肺癌细胞的增殖状态、恶性程度及预后有密切相关性；在病理分级中以上两种检测具有互补性。     

乳腺癌患者的DNA倍体、S期细胞比率、激素受体和淋巴结转移的检测

目的探讨ＤＮＡ倍体、Ｓ期细胞比率（ＳＰＦ）、激素受体和淋巴结转移与肿瘤恶性程度和患者预后的关系。方法用流式细胞术和免疫组织化学技术同步检测１２８例女性乳腺癌患者的ＤＮＡ倍体、Ｓ期细胞比率、雌激素受体（ＥＲ）和淋巴结转移（ＬＮＭ）等４项指标。结果ＥＲ（—）患者的异倍体率、ＳＰＦ和ＬＮＭ（＋）率均显著高于ＥＲ（＋）患者（分别为９３．３％、３０．７±７．２％、８０．０％和６４．０％、１５．２±６．２％、５２．０％，Ｐ＜０．０５或Ｐ＜０．０１）。异倍体患者ＳＰＦ、ＥＲ（－）率也显著高于二倍体患者（分别为２３．１％±１０．１％、３１．０％和１３．４％±５．３％、８．７％，Ｐ＜０．０５或Ｐ＜０．０１）。根据患者对４项指标反应程度不同，将患者分为预后好坏程度不同的５级，“１”级各项指标均为预后较好指标，而“５”级各项指标均为预后不好指标。这样从“１”级到“５”级患者肿瘤恶性度越来越高，预后越来越差，其５年生存率分别为１００％、８７．２％、６８．７％、３５．７％和２３．１％。结论ＤＮＡ倍体、细胞增殖特性、激素受体表达和淋巴结转移是反映肿瘤恶性程度和判断预后的重要参数。     

小细胞肺癌术后辅助化疗的远期结果分析(附65例报告)

分析小细胞肺癌术后辅助化疗的远期结果。方法搜集１９８３年至１９９４年采用手术加术后辅助化疗的小细胞肺癌６５例，其中行脑预防照射２２例。结果在６４例可统计１年以上生存率的病人中，１，３和５年生存率分别为８７．５％、５３．２％和３６．３％，根治性手术加辅助化疗的１，３和５年生存率达９２．５％、５８．５％和４３．８％。Ⅰ与Ⅱ期、Ⅰ与ⅢＡ期的３年生存率相比，差异有显著性（Ｐ＜０．０３）；Ｎ０与Ｎ１期的３年生存率相比，差异有显著性（Ｐ＜０．０２１）；术后２～３与４～６周期化疗相比，１年生存率差异有显著性（Ｐ＜０．００７）。结论对Ⅰ、Ⅱ期和Ｎ０、Ｎ１病人，手术与术后化、放疗综合治疗是最佳选择；而对ⅢＡ或Ｎ２期病变，应首选化疗，先行手术不能改善生存率和生存期     

肿瘤坏死因子对恶性肿瘤蛋白质代谢和细胞周期动力学的影响

Ｓｐｒａｇｕｅ－Ｄａｗｌｅｙ大鼠皮下接种Ｗａｌｋｅｒ２５６癌肉瘤细胞后，连续３天腹腔内注射重组人肿瘤坏死因子－α（ＴＮＦ）之后，分别切取肿瘤进行细胞周期动力学测定和蛋白质代谢分析。结果表明，ＴＮＦ治疗组肿瘤体积和重量显著减少，肿瘤蛋白分段合成率（２５．３％±３．５％·ｄ－１，对照组４２．９％±２．７％·ｄ－１，ｐ＜０．０１）、蛋白合成率（０．２０±０．０５ｇ·ｄ－１，对照组１．１４±０．２０ｇ·ｄ－１，Ｐ＜０．００１）和分段生长率（２４．３％±２．１％·ｄ－１，对照组３５．８％±２．３％·ｄ－１，Ｐ＜０．０１）均显著降低，肿瘤蛋白分段降解率则无明显改变。流式细胞仪测定表明，ＴＮＦ治疗组在５’－溴脱氧尿苷注射６小时后，肿瘤细胞标记指数（３０．８％±４．２％，对照组４４．７％±４．２％，Ｐ＜０．０１）和Ｇ１期增长率（６．０％±１３％，对照组１２．２％±２．５％，Ｐ＜０．０１）均显著减少，相对移动率无明显改变。研究结果提示，ＴＮＦ在荷瘤大鼠中抗肿瘤作用的代谢机理，在于减少肿瘤细胞ＤＮＡ和肿瘤蛋白质的合成，从而抑制肿瘤的生长。     

Barrett食管癌51例报告

报告５１例Ｂａｎｅｔｔ食管癌的外科治疗效果，占同期食管癌切除总数的１０．２％。患者平均年龄８岁，主要就诊症状为吞咽困难。按ＰＴＮＭ分期，Ⅱ期１８例，占３５．３％；Ⅲ期２９例，占５６．９％；Ⅳ期４例，占７．８％。５１例均行食管部分切除、胃食管重建术。术后３０天死亡率为３．９％，１、２和５年生存率分别为４５．９％、２５．０％和１３．６％。Ⅱ期肿瘤５年生存率（２５．０％）明显高于Ⅲ＋Ⅳ期（４．５％），两者差异有显著意义（Ｐ＜０．０５）。肿瘤直径＜６ｃｍ＜或＞６ｃｍ者，５年生存率分别为２５．０％和０（Ｐ＜０．０５）。结果表明，术后长期生存率与临床分期及肿瘤大小等因素有密切关系。     

DNA与AgNOR在甲状腺良、恶性病变中的定量研究

本研究采用Ｆｅｕｌｇｅｎ染色和ＡｇＮＯＲ银染色，检测ＤＮＡ及ＡｇＮＯＲ物质，发现：ＤＮＡ含量Ⅲ级为甲状腺癌组＞非典型结节组＞结甲肿组＞对照组，而Ⅰ级则反之；ＡｇＮＯＲ均数为甲状腺癌组（９．２７±２：７２）＞非典型结节组（４．７８±１．６６）＞结甲肿组（３．１６±１．３８）＞对照组（３．０８±０．４１）；甲状腺癌组与各组间差异有显著意义（Ｐ＜０．０１），非典型结节组与结甲肿组、对照组间差异也有显著意义（Ｐ＜０．０１），而结甲肿组与对照组间则无差异（Ｐ＞０．０５）。作者认为Ⅲ级ＤＡＮ含量的细胞出现频率越高或／和ＡｇＮＯＲ均数越高，恶性的可能性就越大或分化程度越低；本研究提示ＡｇＮＯＲ的均数与ＤＮＡ含量具有显著的相关性，并与细胞增生的程度呈正比，故对鉴别良、恶性肿瘤及交界性病变有肯定价值。     

血卟啉衍生物对鼠肿瘤细胞DNA含量,AgNORs的影响

应用图像分析技术测定大鼠移植Ｗ２５６肿瘤单纯放射治疗组（对照组）和血卟啉衍生物并放射治疗组（实验组）肿瘤细胞的ＤＮＡ含量及ＡｇＮＯＲｓ计数，探讨血卟啉衍生物对恶性肿瘤放射治疗的增敏作用。结果显示实验组大鼠肿瘤细胞ＤＮＡ含量为（５．８４±１．２２）Ｃ，ＡｇＮＯＲｓ计数为２．４２±０．７３；对照组大鼠肿瘤细胞ＤＮＡ含量为（７．８３±０．６８）Ｃ，ＡｇＮＯＲｓ计数为５．３５±０．８４；前者ＤＮＡ含量及ＡｇＮＯＲｓ计数显著低于后者（ｔ＝６．３７，ｔ＝１１．７７，Ｐ＜０．０１）。表明血卟啉衍生物对恶性肿瘤放射治疗有明显的增敏作用     

紫外光血液辐照疗法对放射治疗鼠肿瘤细胞DNA含量、AgNORs计数的影响

应用多功能图像分析仪，检测了鼠Ｗ２５６移植性肿瘤细胞ＤＮＡ含量，并同时测定细胞ＡｇＮＯＲｓ计数，探讨紫外光血液辐照疗法（ＵＢＩ）对放射治疗的增敏作用。结果表明；光量＋放疗组肿瘤细胞ＤＮＡ含量为５．３４±１．０９Ｃ，ＡｇＮＯＲｓ计数为２．２４±０．４３；单纯放疗组肿瘤细胞ＤＮＡ含量为７．８３±０．８６Ｃ，ＡｇＮＯＲｓ计数为５．３５±０．８４；前者ＤＮＡ含量及ＡｇＮＯＲｓ计数显著小于后者（Ｐ＜０．０５）。表明ＵＢＩ对放疗恶性肿瘤有明显的增敏作用。     

67例结肠癌DNA倍体和Ag—NOR计数分析对判断患者预后价值的初步探讨

对６７例结肠癌石蜡包埋组织材料做ＤＮＡ倍体水平分析和Ａｇ—ＮＯＲ计数。结果见：ＤＮＡ二倍体肿瘤５年、７年生存率分别为７８．０％（３２／４１）、３９．０％（１６／４１）；非二倍体肿瘤则为２６．９％（７／２６）、１１．５％（３／２６）（ｐ＜０．０１、ｐ＜０．０５）；Ａｇ─ＮＯＲ计数小于均值（６．９±１．０）组５年、７年生存率为８０．０％（２８／３５）、４０．０（１４／３５），大于均值组则为３４．４％（１１／３２）、１５．６％（５／３２）（ｐ＜０．０１、ｐ＜０．０５）。Ａｇ－ＮＯＲ计数小于均值组ＤＮＡ二倍体肿瘤占９７．１％（３４／３５）；大于均值组二倍体肿瘤占２１．９％（７／３２）（ｐ＜０．０１）。结果表明：ＤＮＡ倍体水平和Ａｇ－ＮＯＲ计数具有一致性，可以做为判断结肠癌预后指标。     

放射治疗192例非小细胞肺癌的预后因子分析

对１９２例非小细胞肺癌（ＮＳＣＬＣ）接受以放射治疗为主的非手术根治性治疗后，研究有影响的预后因子。方法采用单因素分析和ＣＯＸ多因素模型分析。结果病期早者，鳞癌患者，采用非常规分割放疗者，放疗结束时即期疗效好者，其生存预后好。在各分组中，一、二年生存率为：鳞癌患者８０．３％，４３．６％，非鳞癌患者６２．４％，３２．１％（Ｐ＝０．００５）；Ⅰ＋Ⅱ期８２．４％，６４．２％，Ⅲａ７８．２％，４２．９％，Ⅲｂ６３．８％，２６．８％（Ｐ＝０．００３）；常规放疗６９．３％，２９．０％，超分割７６．４％，４１．４％，加速超分割７８．２％，５４．０％（Ｐ＝０．０１１）；即期疗效完缓解者８１．１％，５７．４％，部分缓解者８０．１％，４２．２％，无变化或进展者５２．５％，１８．３％（Ｐ＜０．００１）。结论病理类型，病期，放射治疗方法，放疗结束时即期疗效为独立的预后因子。     

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.     

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。     

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.     

Fruit and vegetables and cancer risk

The possibility that fruit and vegetables may help to reduce the risk of cancer has been studied for over 30 years, but no protective effects have been firmly established. For cancers of the upper gastrointestinal tract, epidemiological studies have generally observed that people with a relatively high intake of fruit and vegetables have a moderately reduced risk, but these observations must be interpreted cautiously because of potential confounding by smoking and alcohol. For lung cancer, recent large prospective analyses with detailed adjustment for smoking have not shown a convincing association between fruit and vegetable intake and reduced risk. For other common cancers, including colorectal, breast and prostate cancer, epidemiological studies suggest little or no association between total fruit and vegetable consumption and risk. It is still possible that there are benefits to be identified: there could be benefits in populations with low average intakes of fruit and vegetables, such that those eating moderate amounts have a lower cancer risk than those eating very low amounts, and there could also be effects of particular nutrients in certain fruits and vegetables, as fruit and vegetables have very varied composition. Nutritional principles indicate that healthy diets should include at least moderate amounts of fruit and vegetables, but the available data suggest that general increases in fruit and vegetable intake would not have much effect on cancer rates, at least in well-nourished populations. Current advice in relation to diet and cancer should include the recommendation to consume adequate amounts of fruit and vegetables, but should put most emphasis on the well-established adverse effects of obesity and high alcohol intakes.     

New and emerging radiosensitizers and radioprotectors

The combination of chemotherapy and radiation has led to clinical breakthroughs in several disease sites, and current work continues to define optimum combinations of proven chemotherapy as well as more recently available, noncytotoxic agents. Administration of systemic therapies allows modulation of radiation response to improve tumor control (radiosensitization) or to prevent normal tissue toxicity (radioprotection). Substantial progress has been made in identifying the targets of standard chemotherapeutic radiation sensitizers and protectors as well as in the introduction of a new generation of molecularly targeted therapies in combination with radiation. We have reviewed the most recent, predominantly early phase clinical trials combining systemic agents with radiation. Although the proof of an improved schedule ultimately needs to come from well-run Phase III trials, the search among schedules could be shortened by the use of surrogate endpoints such as presence of active drug metabolites in the tumor. This has been accomplished only in a few cases and needs to become a more standard part of radiation sensitizer and protector trials.