唾液测定与肺癌诊断相关性的研究

应用酶法测定药盒对５４例胸部肿瘤患者进行了血清唾液酸（ＳＡ）测定，以探讨ＳＡ对肺癌的诊断价值。结果提示：肺癌患者ＳＡ水平显著增高（Ｐ〈０．０５），但无特异性，ＳＡ结合其他辅助检查，对肺癌的诊断及疗效观察有一定实用价值，也用于肺癌高发人群的普查，以及良性和恶性肿瘤的鉴别。     

肺癌患者血清与支气管肺泡灌洗液四项放免肿瘤指标同步检测的结果 …

对３８例肺癌患者的血清和支气管肺泡灌洗液（ＢＡＬＦ）同步进行ＣＥＡ，ＣＡ－５０，ＡＦＰ，ＳＦ的检测。结果显示：肺癌ＢＡＬＦ的ＣＥＡ浓度测值７３％明显高于血清中ＣＥＡ浓度，ＣＡ－５０浓度测值６８％，高于血清ＳＦ９２％明显低于轿清中测值，ＡＦＰ在肺癌患者无论血清及灌洗液中，阳性率均低于７％，但仍是ＢＡＬＦ的浓度测值敏感于血清，提示支气管肺泡灌洗液的ＣＥＡ，ＣＡ－５０与血清的同步检测是目前肺癌早期诊断的     

糖链抗原50测定在肺癌中的应用

采用免疫放射分析法检测７０例肺癌患者血清糖链抗原５０（ＣＡ５０）。结果表明，肺癌患者血清ＣＡ５０明显升高，与非癌性肺病组相比差异非常显著（Ｐ〈０．０１），且ＣＡ５０含量随肿瘤进展而上升，以１７Ｕ／ｍｌ为阻性界值，诊断肺癌的敏感性为６８．６％，特异性为９０．６％，ＣＡ５０检测可作为肺癌辅助诊断，病情监测的手段。     

测定心钠素对良性和恶性胸腔积液性质的鉴别诊断

目的：为了研究心钠素（ＡＮＰ）对良性和恶性胸腔积液性质鉴别诊断价值。方法：使用放射免疫测定法，对象为肺结核胸腔积液３０例和肺癌胸腔积液２６例。结果：肺癌组血浆中ＡＮＰ水平显著高于正常人组血浆中ＡＮＰ水平（Ｐ＜０．０５），亦明显高于肺结核血浆中ＡＮＰ水平（Ｐ＜０．０１），差异非常显著。肺癌组胸腔积液中ＡＮＰ水平明显高于肺结核胸腔积液水平（Ｐ＜０．０１），非常显著。结论：测定ＡＮＰ可以提高对良性和恶性     

检测细胞角蛋白19片段和腺苷脱氨酶对良,恶性胸水鉴别诊断的意义

目的：联合检测血清和胸水中细胞角蛋白１９片段（ＣＹＦＲＡ２１－１）和腺苷脱氨酶（ＡＤＡ）活性,旨在探讨其对良、恶性胸水的鉴别诊断意义。方法：用免疫放射法（ＩＲＭＡ）检测血清及胸水ＣＹＦＲＡ２１－１并用Ｇirsti改良法检测ＡＤＡ活性。结果：非小细胞肺癌（ＮＳＣＬＣ）组胸水ＣＹＦＲＡ２１－１较结核组及水细胞肺癌（ＳＣＬＣ）组明显增高（Ｐ＜０．０１）;ＮＳＣＬＣ组胸水ＣＹＦＲＡ２１－１较血清ＣＹＦＲＡ２１     

IL—6对结核性渗出性胸膜炎及肺癌胸膜转移鉴别诊断价值的探讨

为探讨白细胞介素６（ＩＬ－６）对结核及肺癌胸膜转移所致胸腔积液诊断的价值。用酶联免疫吸附试验（ＥＬＩＳＡ）检测了结核性渗出性胸膜炎及肺癌胸膜转移患者各４０例的胸水及血清ＩＬ－６水平。结果显示：结核性渗出性胸膜炎组胸水ＩＬ－６水平及ＩＬ－６胸水／血清比值显著高于肺癌胸膜转移组（Ｐ〈０．０１，Ｐ〈０．０５）。提示检测胸水及血清ＩＬ－６水平有助于结核及肺癌胸膜转移所致胸水的鉴别诊断。     

AG,Schaefer和URA图在诊断膀胱出口梗阻中的应用

目的 评价ＡＧ，Ｓｃｈａｆｅｒ和ＵＲＡ图诊断前列腺增生症（ＢＰＨ）膀胱出口梗阻（ＢＯＯ）的价值。方法 应用ＡＧ，Ｓｃｈａｅｆｅｒ和ＵＲＡ图对１６０例，ＢＰＨ患者的压力－流率检查结果进行比较分析。结果 ＡＧＳｃｈａｅｆｅｒ和ＵＲＡ图诊断ＢＯＯ者分别为７３．７％，７３．７％和７６．２％，结果 ＡＧＳｃｈａｅｆｅｒ和ＵＲＡ图诊断ＢＯＯ的结果差异无显著性，对于ＡＧ图中可疑梗阻和Ｓｃｈａｅｆｅｒ图中Ⅱ级以下     

脊髓型颈椎病磁刺激运动诱发电位的临床研究

目的：为脊髓型颈椎病（ＣＳＭ）早期诊断寻找一种客观、敏感的检查方法。方法：采用磁刺激运动诱发电位（ＭＥＰ）和电刺激Ｆ波相结合的方法，测定１９例脊髓型颈椎病人外展拇短肌（ＡＰＢ）和胫前肌（ＡＴ）的中枢运动传导时间（ＣＭＣＴ），并与２０例正常受试者作对照。结果：１８例（９４．７％）ＣＳＭ病人上、下肢ＭＥＰ异常，ＡＰＢ肌及ＡＴ肌ＣＭＣＴ明显延迟，并与临床功能障碍（ＪＯＡ评分）显著相关，与ＭＲＩ所示脊髓受压程度无相关性。结论：磁刺激ＭＥＰ作为检测ＣＳＭ患者运动功能状态的客观指标具有重要的诊断价值。     

肘部尺神经卡压的定位诊断和电生理学研究

目的：对肘部尺神经卡压进行精确定位和电生理学研究。方法：对４６例临床诊断为肘部尺神经卡压患者，除进行常规ＥＭＧ、ＮＣＶ、和尺神经混合神经动作电位（ＭＮＡＰ）测定以外，还进行尺神经短段传导时间（ｓｈｏｒｔｓｅｇｍｅｎｔｃｏｎｄｕｃｔｉｏｎｔｉｍｅ，ＳＳＣＴ）测定。结果：４６例经ＳＳＣＴ测定，发现了卡压最常发生的４个部位，即肱骨内上髁后神经沟、肱尺弓、尺侧腕屈肌的出口和内侧肌间隔。结论：和传统的电生理测定方法相比较，ＳＳＣＴ技术可以更精确地对尺神经卡压进行定位诊断     

自建血清前列腺特异抗原测定方法的临床应用

作者建立了血清前列腺特异抗原（ＰＳＡ）的生物素－亲和素酶联免疫（ＢＡ－ＥＬＩＳＡ）测定法并用于临床。测定结果表明，合并前列腺急或慢性炎症患者的血清ＰＳＡ水平显著高于单纯前列腺增生患者。以１０ｎｇ／ｍｌ为界值诊断前列腺癌，其敏感性为６２．９６％，特异性为９１．８１％。我们用自建的ＢＡ－ＥＬＩＳＡ法和进口试剂盒Ｔａｎｄｅｍ－Ｅ法平行测定了良性前列腺增生组的血清ＰＳＡ水平，结果表明ＢＡ－ＥＬＩＳＡ法用于临床比Ｔａｎｄｅｍ－Ｅ法更灵敏、更经济。     

颅内肿瘤患者血浆脂质结合唾液酸检测的意义

目的 探讨检测血浆脂质结合唾液酸含量诊断颅内肿瘤的价值及判断预后的作用。方法 采用朱翔和李平升改良硫代巴比妥酸比色法测定正常对照组７３例、内良性肿瘤对照组３２例,恶性胶质瘤组３８例,脑转移瘤组１３例中血浆ＬＳＡ含量。结果 各组血浆ＬＳＡ含量均高于正常对照组,其中脑转移瘤患者ＬＳＡ平均含量显著高离恶性胶质瘤患者,恶性胶质瘤患者血浆ＬＳＡ含量又显著高于颅内衣性肿瘤患者。随访２４例患者,血浆ＬＳＡ均高于     

肺癌支气管肺泡灌洗液中内皮抑素的表达

目的 探讨肺癌病人术前血清及支气管肺泡灌洗液(BALF)中内皮抑素(endostatin)表达情况,分析其与肿瘤临床病理特征和预后的关系.方法 酶联免疫吸附(ELISA)法检测57例肺癌及34例肺良性病变者术前血清及BALF中endostatin含量.结果 肺癌病人血清及BALF术前内皮抑素含量显著高于肺良性病变者,差异有统计学意义(P＜0.05).淋巴结及远处转移组术前内皮抑素含量明显高于无转移组(P＜0.05);肺腺癌病人外周血清及BALF中内皮抑素表达高于鳞癌、小细胞癌者;Ⅲ～Ⅳ期病人血清、BALF内皮抑素水平高于Ⅰ～Ⅱ期者(P＜0.01).肺癌病人内皮抑素在外周血清及BALF中的表达呈线性正相关(P=0.000).结论 肺癌病人血清及支气管肺泡灌洗液中内皮抑素含量明显高于良性病变者,且与肿瘤组织学类型、分化程度、TNM分期、淋巴结转移呈明显正相关,肺泡灌洗液中内皮抑素含量较血清中高且更敏感,可能有助于肺癌病人预后的评估及肿瘤分化程度判断.     

The significance of serum lipid-bound sialic acid in bladder tumours

Tumour markers with high sensitivity and specificity for bladder cancer are still lacking and several markers have been investigated up to now. Serum lipid-bound sialic acid (LSA) was claimed to be a tumour marker by some investigators and this study tried to assess the value of LSA as a tumour marker in patients with bladder cancer. The results obtained from 27 patients and 30 controls showed that serum LSA levels remained within the suggested normal limits of the method used but they were significantly higher than in the controls. The value of serum LSA is questionable as an initial tumour marker for bladder cancer, but variations from the basal level may indeed be helpful in monitoring the efficacy of the therapy and in detecting relapses during follow-ups.     

图像处理和人工神经网络在肺癌细胞病理诊断中的应用

目的探求基于计算机图像处理和人工神经网络的“肺癌早期细胞病理电脑诊断系统”（lung cancer diagnosing system，LCDS）在肺癌临床细胞病理诊断中的应用价值。方法运用LCDS对512例经皮肺穿刺标本的细胞学涂片进行检测评判和综合分析，并对其中手术治疗的362例进行LCDS细胞病理诊断与术后组织病理诊断对比分析研究。结果LCDS能运用图像处理和专家系统完成对肺部病灶癌细胞和非癌细胞的识别诊断，进而运用人工神经网络能完成肺鳞癌、腺癌、小细胞癌等主要病理类型的细胞病理诊断，与临床组织病理或细胞病理诊断结果对比，总符合率为91．80％。其中362例接受外科手术者以术后组织病理诊断结果为标准，LCDS检测诊断的敏感性为94．79％（291／307例），特异性为90．91％（50／55例），准确性为94．20％（341／362例）。结论LCDS所采用的诊断模型是实用而有效的，具有诊断准确率高、易于操作培训等优势，有可能为肺癌早期细胞病理诊断提供又一实用有效的手段。     

3项肿瘤标志物联合检测在肺癌诊断中的价值

目的:探讨联合检测血清癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)水平对肺癌的诊断价值.方法:用电化学发光法检测113例肺癌确诊患者、60例肺良性病变患者血清中CEA、CYFRA21-1、NSE水平.结果:肺癌组CEA、CYFRA21-1、NSE检测阳性率均明显高于肺良性...     

Risk of subsequent primary neoplasms developing in lung cancer patients with prior malignancies

BACKGROUND: This study was performed to test the hypothesis that a history of other primary neoplasms before a lung cancer diagnosis increases the risk of subsequent malignancy. METHODS: Of 8363 lung cancer patients seen from 1978 to 2002, 881 (11%) had at least 1 previous nonlung primary malignancy. Charts were analyzed for the occurrence of subsequent malignancies. RESULTS: Lung cancer diagnosis in 881 patients consisted of 75% non-small cell, 12% small cell, and 13% other histologies. The median age was 66 years, with 56% male, 76% white, and 86% smokers. Of the 881 patients, 92% had no subsequent cancer (group 1), and 8% went on to experience the development of a new primary neoplasm (including lung) after their lung cancer (group 2). After adequate follow-up, the cumulative probability of developing a subsequent cancer did not differ markedly between those with and without a prior non-lung cancer diagnosis at 2 years (12% vs 10%) or 5 years (16% vs 15%). Group 1 patients had a significantly lower 1- and 5-year survival than group 2 patients (59% vs 48% and 29% vs 17%, respectively; P =.008). Although multivariate analysis suggested that stage, history of tobacco-associated neoplasm, and history of definitive surgical resection were important determinants in predicting long-term survival, a prior malignancy was not an independent risk factor in the development of subsequent malignancy. CONCLUSIONS: The risk of developing a subsequent malignancy is very high in lung cancer patients with prior primary malignancies, but it is not markedly different from the risks experienced by patients with no prior malignancies.     

Surgical treatment for primary non-small cell lung cancer with synchronous brain metastases

The brain is one of the most common sites of metastasis from lung cancer. The strategies of treatment for non-small cell lung cancer patient with synchronous brain metastases (stage IV) is controversial. We evaluate retrospectively the effectiveness of surgical treatment for these patients. Forty patients were divided into 3 groups on the basis of surgical treatment, group A of patients received both lung and brain resection, group B of patients received lung resection plus gamma knife therapy, group C of patients received brain resection. Median survival from the date of diagnosis of brain metastasis was as follows: group A 331 days, group B 151 days and group C 92 days. Univariate analysis revealed that adenocarcinoma histology and serum LDH significantly affected survival. Multivariate analysis found that only adeocarcinoma histology also affected the survival. It is concluded that surgical treatment may acceptable in selected group of non-small cell lung cancer patients with synchronous brain metastases.     

Lignosulfonic acid blocks in vitro fertilization of macaque oocytes when sperm are treated either before or after capacitation

Lignin-derived macromolecules (LDMs) are biologically active compounds that affect a variety of cell-to-cell interactions including the inhibition of fertilization and embryo development in a number of nonmammalian species. The effect of ligno-sulfonic acid (LSA), a highly sulfonated LDM, on cynomolgus macaque sperm-oocyte interaction was evaluated with a zona pellucida binding assay and by in vitro fertilization (IVF). Sperm were treated with LSA (1.5 mg/mL) either before washing or after capacitation. Capacitation included centrifugation through 80% Percoll followed by 2 consecutive washes with medium, overnight incubation, and activation with dibutyryl cyclic adenosine monophosphate and caffeine. The zona binding assay was performed using immature oocytes that had adhered to the center of glass "binding chambers." The number of capacitated sperm that attached to the zona over a 3-minute period was recorded. Sperm attachment was significantly inhibited by LSA as compared to controls whether treatment occurred after capacitation (92.5%; P <.001) or before washing (82.5%; P <.001). When sperm were treated similarly with fucoidin, a sulfated polysaccharide known to inhibit sperm-oocyte interaction, sperm-zona binding was significantly inhibited by postcapacitation treatment but not by prewash treatment. Treatment of sperm with LSA consistently blocked fertilization over 4 IVF cycles both before washing and after capacitation. Fertilization rate for controls was 65% +/- 17%. No LSA-treated sperm were observed on the surface of lightly rinsed oocytes after 4 hours of coincubation. Localization of biotinylated LSA showed labeling over the entire sperm surface with the greatest intensity observed over the head and midpiece. LSA treatment had no effect on the percentage of motile sperm or quality of sperm motility. Due to the antifertility properties of this nontoxic molecule, LSA appears to have potential as a vaginal contraceptive.     

Age and the treatment of lung cancer.

BACKGROUND: The average age of patients with lung cancer is increasing and there are large numbers of elderly symptomatic patients with this common disease. However, there are few data on how the treatment of this group differs from that of younger patients. METHODS: From 1 January 1990 information was collected for the Southend Lung Cancer Registry on all patients with a diagnosis of lung cancer in a geographically well defined health district of the UK with a population of 325,000. Every effort was made to find new cases from all departments of the hospital, including all clinical diagnoses, histopathological and cytological reports, and necropsies. All death certificates in the district were examined, irrespective of age, for any diagnosis of lung cancer. This therefore included any patient not seen by the hospital services. The differences in initial treatment have been analysed for three age groups: under 65, 65-74 years, and over 75. RESULTS: The 563 cases of lung cancer diagnosed during a 30 month period were included in the study, of whom 240 (43%) were aged over 75 years. The overall mean age was 71 years (range 31-95). The incidence of lung cancer in the general population was 69 per 100,000, but in men over 75 years of age it rose to 751 per 100,000. For all patients the active treatment rate (chemotherapy, surgery, or radiotherapy) was 49%, but for patients not reviewed by a chest physician (n = 86) it was only 21%. There were large differences in initial treatment between age groups. For patients with non-small cell lung cancer (NSCLC) reviewed by a chest physician, surgery was undertaken in 18% of those under 65, 12% of the 65-74 age group, and 2.1% of those over 75. For patients with small cell lung cancer (SCLC) reviewed by a chest physician, 79% of those aged under 65, 64% of the 65-74 age group, and 41% of patients aged over 75 received chemotherapy. In patients with NSCLC reviewed by a chest physician, chemotherapy was given to 21% under 65, 6.4% in the 65-74 age group, and none over 75. If no histological diagnosis was made 37% of patients aged under 75 and only 5.4% of those over 75 received either surgery, radiotherapy, or chemotherapy. Patients not reviewed by a chest physician were less likely to have had a histological diagnosis. Differences in treatment rates with age persisted even after allowing for performance score status at presentation. CONCLUSIONS: Lung cancer is a common disease in the elderly and, in our district, 43% of patients were aged 75 or over at presentation. Age alone appeared to be a major factor in influencing treatment choices, and treatment was more likely if histological confirmation was obtained. Further detailed analysis of the reasons for the differences is needed. Patients referred to chest physicians were more likely to have both histological confirmation and active treatment. This study supports the contention that all patients with a diagnosis of lung cancer, irrespective of age or condition, should be assessed by an accredited chest physician.     

Prognose nach operativem Wirbelsäuleneingriff bei Bronchialkarzinommetastasen

BACKGROUND: Patients with spine metastaes due to lung cancer suffer from a reduced lifespan. For a more precise prognosis, it is important to define parameters which influence the individual survival time. This study reviewed the mean survival time of patients who had undergone surgery because of spine metastases due to lung cancer. It should be evaluated whether the postsurgical survival time is dependent on the length of time between diagnosis and surgery and from the histological type of the tumor. MATERIAL AND METHODS: Between January 1999 and December 2003, 68 patients had undergone spine surgery because of spine metastases due to lung cancer at the department of traumatology of the St. Georg General Hospital in Hamburg, Germany. Retrospective data were collected from the hospital documentary system regarding the period between diagnosis of lung cancer and date of surgical treatment, and regarding the histological type of the tumor. The postsurgical survival times were evaluated using data from the Hamburger Cancer Index and from general practitioners. These times were analysed afterward according to the defined parameters. RESULTS: The average age was 62.6 years, and 24 female and 44 male patients were included. It was possible to evaluate the survival time of 65 Patients. The average survival time of those with preoperative unknown primary manifestation (20 Patients) was 88 days, in the group of patients with lung cancer histories of less than 12 months (35 Patients) 141 days, and with patients with lung cancer histories of lung cancer longer than 12 months (13 Patients) it was 171 days. The mean survival times after surgical treatment were 122 days for patients suffering from non-small-cell lung cancer (45 Patients), 128 days for those with small-cell lung cancer (20 Patients), and 247 days for patients with other histological types (three patients). DISCUSSION: The prognosis of patients after spine surgery for lung cancer metastases is poor. The indication for surgical treatment of spinal metastases due to lung cancer should be critically discussed. Especially patients with unknown primary manifestation might benefit from a conservative approach. With respect to the patients' reduced lifespan, they, their relatives, and the nursing staff should be carefully informed.