颈部原发不明转移癌的治疗

目的 探讨颈部原发不明转移癌的合理治疗方式。方法 回顾分析６８例颈部原发不明转移癌患者的临床资料。结果 中上颈低分化转移癌最好的治疗方式是放疗,转移性鳞癌则采用手术后加放疗,转移性腺癌中的乳头状腺癌治疗应采用甲状腺癌联合根治术。其５年生存率分别为５０．０％（２／４）、６６．７（８／１２）、６６．７（８／１２）和８５．７％（１２／１４）。锁骨上区转称癌尤其右侧者应力争手术切除,辅之以化疗。随访中有１５．２％颈部原发不明转移癌患者发现原发病灶。结论 对颈部原发不明转移癌的治疗方式,应根据淋巴结的病理性质、部位、局部和全身情况进行综合考虑。     

原发灶不明颈淋巴结转移癌42例临床分析

目的探讨原发灶不明颈淋巴结转移癌的诊断、治疗方法与预后的影响因素。方法回顾分析我院1992年2月～1999年2月收治的42例原发灶不明颈淋巴结转移癌患者的临床资料。结果全组的1、3、5年生存率分别为71．4％(30／42)，45．2％(19／42)，33．3％(14／42．)。随诊中有14．3％(6／42．)的原发灶不明颈淋巴结转移癌患者发现了原发灶。结论影响原发灶不明颈淋巴结转移癌预后的主要因素是组织学类型，N分期，转移癌的部位，原发灶是否找到。对颈部转移性低分化癌、未分化癌或鳞癌应采用放射治疗，位于中上颈者应采用面颈联合野放射治疗，转移性腺癌应以手术治疗为主，晚期颈转移癌应采用化疗、放疗为主的综合治疗。锁骨上区转移癌应以化疗为首选。     

颈部原发不明转移癌的治疗与转归

目的 探索颈部原发不明转移癌的最佳治疗方式。方法 回顾分析我院１９７６年２月￣１９９８年１０月间１１４例颈部原发不明转移癌患者的临床资料。结果 中上颈低分化转移癌最好的治疗方式是放疗,转移性鳞癌则采用术前放疗加手术治疗,转移性腺癌中的乳头状腺癌治疗应采取甲状腺癌联合根治术,它们的５年生存率分别为４５．２％、５３．８％和６２．５％。锁骨上区转移癌以化疗为首选。随诊中有１１．２％颈部原发不明转移癌的患     

原发部位不明的颈部转移癌

 原发部位不明的颈部转移癌是指颈部转移癌经病理证实而原发灶不明者。 在临床上并非偶见,病人常经过几个医院、多个科室、多个医生、多次检查仍不能发现原发灶, 所以作出恰当的诊断、治疗是比较困难的。     

原发灶不明的颈部转移癌的治疗和预后：附51例分析

临床上原发灶不明的颈部转移癌比较少见 ,约占颈部转移癌的 5 .5 % [1 ] 。对原发灶不明的颈部转移癌应积极治疗 ,密切随访 ,持续寻找原发灶 ,以取得一定的远期疗效 [2 ] 。我们回顾性分析了 5 1例原发灶不明的颈部转移癌患者的临床资料 ,以探讨原发灶不明的颈部转移癌患者的治疗和预后。1　临床资料1.1　一般资料　原发灶不明的颈部转移癌须具备下列四个条件 :(1)颈部肿物经病理检查确诊为淋巴结转移癌 (不包括恶性淋巴瘤 ) ;(2 )未找到原发肿瘤 ;(3)既往无恶性肿瘤病史 (包括不明性质的肿块切除史 ) ;(4)治疗过程中无颈部以外的转移灶。 1…     

颈部原发不明转移癌的胃镜检查结果分析

不明来源的转移癌占实体瘤的10%～15%,常发生于淋巴结,尤以颈部淋巴结最多见.其原发灶部位是否明确与临床治疗及预后密切相关.我科1994～2001年间有104例颈部原发不明转移癌患者行胃镜检查,其中47例明确了原发灶来源,为探讨胃镜检查在颈部转移癌原发灶寻找中的诊断价值,我们对胃镜明确来源者进行分析,现报告如下.     

隐性乳腺癌9例报道

原发病灶部位不详的腋淋巴结转移性癌的诊断和治疗常是临床工作中引起争论的问题。Feuerman认为其中三分之一可能来自乳腺。乳腺癌在原发灶未能被临床发现之前,先出现腋淋巴结转移,一般称     

脑转移性肿瘤的诊断与治疗(附312例报告)

目的：探讨脑转移性肿瘤的有效诊治方法。方法：对312例脑转移性肿瘤的病理类型、原发灶和转移灶的关系、诊断及治疗进行回顾性分析。结果：肺癌、消化系统及泌尿系统癌最常发生脑内转移；腺癌、鳞癌最常见；脑转移性肿瘤CT和MRI增强扫描有强化效应，肿瘤周围有脑水肿；单发肿瘤手术加放疗效果明显。结论：癌症患者出现神经系统体征，应考虑脑内转移；脑内转移性肿瘤尽早手术和放射治疗。     

原发灶不明的颈部转移癌临床分析

临床上原发病灶不明的颈部淋巴结转移癌比较常见,国外有报道约占颈部转移癌的４％～９％［１］。各地对原发灶不明的颈部转移癌的诊断标准没有统一,一般符合以下标准：（１）以往无恶性肿瘤作者单位：浙江省衢州市人民医院３２４０００衢州市钟楼底１号病史,包括性质不...     

原发灶不明的骨转移性癌24例分析

骨骼是恶性肿瘤较为常见的转移部位之一。以肺癌、前列腺癌为常见。但仍有相当一部分患者虽然经过多种检查仍然无法发现原发病灶，给治疗带来一定困难。我院2000年1月～2003年5月收治的24例原发灶不明骨转移性癌患者进行动态随访，并就有效的鉴别诊断检查进行了探讨，总结报道如下。     

E-钙粘蛋白及PTEN基因编码蛋白与胃癌浸润转移

目的:观察抑癌基因PTEN蛋白和ECD在胃癌组织中的表达,探讨其与胃癌生物学行为及预后的关系。方法:以兔抗人PTEN多克隆抗体、鼠抗人ECD单克隆抗体,采用SABC免疫组化法,检测100例胃癌手术切除标本中拟测指标的表达。以χ2和Logrank检验对结果做统计学分析。结果:ECD、PTEN蛋白在非癌胃粘膜中均见表达;在胃癌组织中表达下调或缺失。ECD异常表达率为42.0%;弥漫型胃癌异常表达率(48.57%),明显高于肠型胃癌(26.67%),(P<0.05);ECD异常表达与浸润深度有关(P<0.05)。胃癌组织中PTEN蛋白缺失率为59%;弥漫型胃癌缺失率(65.71%)明显高于肠型胃癌(43.33%),(P<0.05);伴淋巴结转移的胃癌缺失率(64.47%)明显高于无淋巴结转移者(41.67%),(P<0.05);PTEN蛋白缺失的患者比阳性表达者预后差(P=0.0066)。65.85%PTEN阳性表达者同时伴ECD正常表达。结论:两种标志物与胃癌浸润转移有关,PTEN表达与胃癌患者预后密切相关。将两种指标联合检测,可作为正确判断胃癌患者预后,指导临床治疗的分子生物学指标。     

Cytologic classification of precancer and cancer of the endometrium and esophagus and of malignant lymphomas

The paper discusses cytological classifications of precancer and cancer of the endometrium, esophagus and malignant lymphomas presented by cytologists from five Soviet research institutes of oncology. The classifications were based on the data of 4400 cases in conformity with WHO histologic classifications.     

世界卫生组织骨质疏松症防治工作报告和防治建议

引 言 作为对第51号综合处理非传染性疾病预防与控制的世界卫生组织决议的反应,1998年7月WHO成立了致力于不断完善对骨质疏松预防和治疗策略的工作小组。小组成员来自世界各国致力于骨质疏松研究的知名专家。Harry K.Genant为本届主席。这一项世界范围内的骨质疏松教育计划旨在通过世界范围的研究,不断改善对骨质疏松的诊断水平和发展并完善对骨质疏松病人的合理治疗。其重点将以发展中国家为主。并为各国政府及其卫生部门和病人群体提供世界性有关骨质疏松症的总体的、完整的指导性资料。该项研究、教育计划的实施将由世界各国的骨质疏松症研究和治疗机构共同完成,并经权威学术机构、政府和非政府组织进行有针对性的回顾研究,最终由WHO审议通过。     

Schwannomas of Head and Neck and Review of Literature

Benign nerve cell tumours have been given various names like schwannoma, neurilemmoma, neurinoma, neurofibroma, spindle cell tumours etc. Extra cranial head and neck schwannomas usually present as solitary and well-demarcated lesions. The lesion can cause secondary symptoms, such as nasal obstruction, dysphasia, and hoarseness, depending upon the location of the lesion. Fine needle aspiration cytology, CT scans, and MRI may be of limited help in the diagnosis of schwannomas. The treatment is complete surgical excision of the benign tumour and postoperative histopathological examination establishes the final diagnosis.     

Quality of life and care in leukemia,myeloma and non-malignant disease. Opinions of patients and relatives,and effects of geography and time

In a questionnaire study 140 subjects answered 4200 questions in 1980 and 1986. They consisted of patients with myeloma, acute leukemia, lung carcinoma, and non-malignant disease and their relatives. In 22 additional cases the questionnaire was not answered. The results show that myeloma patients are less content with the general care than leukemia patients (P < 0.05). Similarly, relatives of deceased myeloma patients are less satisfied with the information given to them than relatives of deceased leukemia patients (P < 0.001). The information has improved with time, however, since the patients were more satisfied in 1986 than in 1980 (P < 0.001) and relatives of myeloma patients still alive were more satisfied than relatives of patients who had died earlier (P < 0.001).     

A comparative study of knowledge and awareness of colorectal and breast cancerA comparative study of knowledge and awareness of colorectal and breast cancer

Aims: To assess and compare knowledge and awareness of colorectal cancer and breast cancer in a sample of the general population. Methods: Eleven hundred visitors to six different outpatient clinics, in a University Hospital, were given a study-specific questionnaire, based on educational material from the British Association of Cancer United Patients (CancerBACUP). The questionnaire consisted of 12 statements on the incidence, presentation, detection, treatment and prognosis of colorectal and breast cancer. Results: One thousand and sixty-eight individuals returned the questionnaire. One thousand and four completed questionnaires were analysed. The mean age (SD) of respondents was 50.1 (17.2) years, and the male to female ratio was 2:3. Respondents had read more about breast than about colorectal cancer (60.3%vs 32.4%,P <0.0001, McNemar's test). The proportion of correct answers for each statement on breast cancer was higher than for answers to corresponding items on colorectal cancer. Mean overall scores (95% CI) for breast and colorectal cancer were 88.1 (86.9, 89.2) and 64.4 (62.5, 66.3) respectively, the mean difference (95% CI) being 23.7 (22.0, 25.5). Scores were higher for breast cancer irrespective of age or gender. Conclusion: There is a low level of understanding of colorectal cancer in the general population when compared to breast cancer. This highlights the importance of public education in this common cancer.     

Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers

BACKGROUND: Frequent consumption of fruit and vegetables has been associated with a reduced risk of colorectal cancer in many observational studies. METHODS: We prospectively investigated the association between fruit and vegetable consumption and the incidence of colon and rectal cancers in two large cohorts: the Nurses' Health Study (88 764 women) and the Health Professionals' Follow-up Study (47 325 men). Diet was assessed and cumulatively updated in 1980, 1984, 1986, and 1990 among women and in 1986 and 1990 among men. The incidence of cancer of the colon and rectum was ascertained up to June or January of 1996, respectively. Relative risk (RR) estimates were calculated with the use of pooled logistic regression models accounting for various potential confounders. All statistical tests were two-sided. RESULTS: With a follow-up including 1 743 645 person-years and 937 cases of colon cancer, we found little association of colon cancer incidence with fruit and vegetable consumption. For women and men combined, a difference in fruit and vegetable consumption of one additional serving per day was associated with a covariate-adjusted RR of 1.02 (95% confidence interval [CI] = 0.98-1.05). A difference in vegetable consumption of one additional serving per day was associated with an RR of 1.03 (95% CI = 0.97-1.09). Similar results were obtained for women and men considered separately. A difference in fruit consumption of one additional serving per day was associated with a covariate-adjusted RR for colon cancer of 0.96 (95% CI = 0.89-1.03) among women and 1. 08 (95% CI = 1.00-1.16) among men. For rectal cancer (total, 244 cases), a difference in fruit and vegetable consumption of one additional serving per day was associated with an RR of 1.02 (95% CI = 0.95-1.09) in men and women combined. None of these associations was modified by vitamin supplement use or smoking habits. CONCLUSIONS: Although fruits and vegetables may confer protection against some chronic diseases, their frequent consumption does not appear to confer protection from colon or rectal cancer.