脐尿管印戒细胞癌1例报告

脐尿管印戒细胞癌（urachal signet ring cell carcinoma,USRCC）是一种罕见的恶性肿瘤。2009年8月海南省农垦总医院收治1例,报告如下。     

后尿道转移性印戒细胞癌1例

印戒细胞癌为黏液腺癌,多发生于胃肠道,易发生转移,转移至后尿道罕见.     

原发性肺印戒细胞癌1例

正患者男,50岁,因"咳嗽、咳痰伴痰中带血1月余"入院;既往吸烟24余年。查体未见明显异常。实验室检查:神经元特异性烯醇化酶(neuron-specific enolase, NSE)35.04 ng/ml,细胞角蛋白19片段(cytokeratin-19-fragment, CY211)9.45 ng/ml,胃泌素释放肽前体(progastrin-releasing peptide, proGRP) 19.50 pg/ml。CT:右肺中     

原发性前列腺印戒细胞癌诊疗分析

目的 提高对原发性前列腺印戒细胞癌临床特点的认识和诊治水平. 方法 原发性前列腺印戒细胞癌患者23例.年龄57～90岁,平均74岁.有排尿症状者18例,体检偶然发现PSA升高者5例.实验室检查PSA平均45.3(7.4～126.8)ng/ml.MRI多示外周带有异常区呈T1w低信号、T2W高信号,增强后明显强化,中央带见增生结节,呈混杂信号.其中行前列腺癌根治术7例,2例切缘阳性者术后辅以全雄激素阻断治疗及体外放射治疗,16例行全雄激素阻断治疗,其中11例因存在下尿路梗阻而行前列腺绿激光汽化术,3例行体外放射治疗.23例均行消化道内镜或钡餐检查排除转移性印戒细胞癌. 结果 23例均经病理证实为印戒细胞癌,其中纯印戒细胞癌6例,混有典型前列腺癌成分17例,其中典型癌成分均为Gleason评分7～10分的高级别低分化前列腺癌.免疫标记PSA、前列腺酸性磷酸酶均为阳性,AB/PAS阴性,CEA阴性21例.TNM临床分期Ⅱ期7例,Ⅲ期10例,Ⅳ期6例.20例平均随访24(6～56)个月,8例生存6～42个月后因肿瘤转移死亡,5例12～21个月后出现生化复发,失访3例. 结论 原发性前列腺印戒细胞癌侵袭性强、转移快且累及前列腺外各种脏器、复发早,早期诊断及综合治疗或能提高远期生存率.     

原发性膀胱印戒细胞癌1例报告并文献复习

目的：探讨原发性膀胱印戒细胞癌的临床特征。方法：报告1例原发性膀胱印戒细胞癌患者的临床资料。患者因间歇性肉眼血尿就诊,术前检查未找到任何膀胱外病灶,行膀胱全切除术＋输尿管造瘘术。结果：术后病检报告为膀胱印戒细胞癌。患者术后转肿瘤科化疗,目前正在随访中。结论：原发性膀胱SRCC非常罕见,进展快、恶性程度高,局部浸润性生长,有早期扩散转移倾向,预后差。其确诊主要依靠病理组织学检查。     

结直肠印戒细胞癌

目的 探讨结直肠印戒细胞癌的临床病理特点和预后相关因素.方法 对62例结直肠印戒细胞癌和281例低分化腺癌的临床病理资料进行同顾性分析,并进行随访.计数资料比较采用X2检验,应用COX比例风险模型进行多因素分析.结果 印戒细胞癌好发于青壮年,以直肠多发;二者在性别、术前CEA水平、大体病理类型和肝转移方面差异无统计学意义(X2=0.07,0.04,0.06,1.79,P>0.05);而在有无肠梗阻、手术方式、脉管瘤栓、浸润深度、淋巴结转移方面差异有统计学意义(X2=8.96,75.1,18.5,72.0,7.44,P<0.05).印戒细胞癌的中位生存期为28个月,低分化腺癌的中位生存期为49个月,差异有统计学意义(X2=12.51,P<0.05).多因素回归分析显示:浸润深度、淋巴结转移、手术方式和术后辅助治疗是影响印戒细胞癌预后的独立因素.结论 结直肠印戒细胞癌的恶性程度显著高于低分化腺癌,根治性手术切除结合术后辅助治疗是有效的治疗方法.     

原发性膀胱印戒细胞癌1例

患者,男,62岁.因左肾区不适伴尿频、尿急、尿痛6个月,血尿10天,于2005年10月18日入院.体检:生命体征平稳.左肾区无隆起,有压痛及叩击痛,双侧输尿管走形区无压痛,膀胱区压痛,肉眼可见血尿.辅助检查:尿液分析酸碱度为5HP,其余正常.尿结核杆菌培养阴性.腹部盆腔CT检查:左侧肾脏2.0 cm×2.0 cm低密度影,增强后无强化,CT值16 Hu;右侧肾脏密度减低,腹膜后未见肿大淋巴结,腹腔内无腹水征.     

原发性前列腺印戒细胞癌三例报告

20 0 0年 11月至 2 0 0 1年 8月 ,我院收治原发性前列腺印戒细胞癌患者 3例 ,报告如下。临床资料　本组 3例 ,年龄 6 2～ 72岁 ,平均 6 5岁。排尿困难 3例 ,其中 2例因尿潴留入院。直肠指诊前列腺质硬2例 ,其中 1例质坚如石 ,触及结节 1例。1例尿流率测定 :ＭＦＲ 2 .5ｍｌ/ｓ     

原发性前列腺印戒细胞癌(附二例报告及文献复习)

目的：探讨原发性前列腺印戒细胞癌的临床特点。方法：分析2例原发性前列腺印戒细胞癌患者的临床资料，结合文献得以讨论。结果：2例患者年龄分别为64岁和73岁，临床表现为排尿困难、膀胱刺激症及会阴不适。组织学：印戒状癌细胞呈圆形，胞质丰富透明，胞核呈新月状位于细胞一侧，核分裂像多见。免疫组化染色PCA（ ）、PAP( )、AR( )、低分子CK( )，CEA（-）、AB/PAS（-）。1例D期患者行双侧睾丸切除及氟他胺治疗，术后6个月死于广泛转移；1例B2期患者行根治性前列腺切除、双侧睾丸切除、内分泌和局部放射治疗，随访25个月未见复发和转移。结论：原发性前列腺印戒细胞癌是一种罕见、高度恶性的肿瘤，确诊需依赖组织病理学及免疫组织化学检查。     

隐匿性乳腺癌36例诊治分析

目的探讨隐匿性乳腺癌的诊断和治疗方法。方法对36例隐匿性乳腺癌患者分别采用乳房X线、MRI检查,对肿块切除活检病理免疫组化检查;治疗采用乳腺癌根治术、改良根治术或保乳术后加放疗。结果乳腺钼靶的阳性率45．8％（11／24）,MRI的阳性率70％（7／10）;免疫组化检查阳性率62％（18／29）;乳腺癌根治术、改良根治术和保乳术后加放疗的5年生存率分别73．9％、77．8％（P〉0．05）。结论乳腺钼靶和MRI有重要诊断价值,切检和免疫组化检查有助于确诊;乳腺癌根治术或改良根治和保乳术后放疗的5年生存率相同。     

进展期胃印戒细胞癌患者的临床病理特点与预后

目的研究进展期胃印戒细胞癌患者的临床病理特点及预后.方法对571例进展期胃癌患者的临床病理特点及术后5年生存率进行回顾性分析.结果进展期胃印戒细胞癌75例,多见于中老年女性（70.0%）,胃中部多发（46.7%）.肿瘤大小、淋巴结转移、肝脏转移、腹膜转移等方面与进展期胃非印戒细胞癌相比差异无统计学意义（P＞0.05）;大体分型以BorrmannⅢ型、Ⅳ型多见（P＜0.01）,且浸润深度T3、T4比胃非印戒细胞癌多见（P＜0.01）;行根治性手术后5年生存率为44%,与其他类型进展期胃癌根治性手术后5年生存率相比差异无统计学意义（P＞0.05）.结论进展期胃印戒细胞癌与其他组织学类型的胃癌相比恶性程度无差异.     

Signet ring cell adenocarcinoma of the urachus

Signet ring cell adenocarcinoma of the urachus is an extremely rare variety of adenocarcinoma of the urachus; only 23 cases have been reported in the literature to date. In the present report we discuss two more cases of this type and review the literature. For our first case, a 17-year-old man was treated with partial cystectomy with en-bloc excision of the urachus and umbilicus. He received local radiotherapy because of positive surgical margins. Local recurrence occurred after 21 months of diagnosis and he was lost to follow up. For our second case, a 31-year-old man was found to have peritoneal carcinomatosis at the time of surgery and partial cystectomy was carried out as a palliative procedure for hematuria. He received six cycles of chemotherapy, a combination of methotrexate, vinblastine, adriamycin and cisplatinum. The patient's response to the chemotherapy lasted for 8 months, after which his disease progressed and he died 19 months after diagnosis.     

原发性前列腺印戒细胞癌(1例报告并文献复习)

目的探讨原发性前列腺印戒细胞癌的临床特征。方法回顾性分析1例原发性前列腺印戒细胞癌患者的临床资料,并结合文献进行复习讨论。结果患者前列腺穿刺活检病理报告为前列腺印戒细胞癌,免疫组织化学检查示PSA( ),PAS、CEA、LCA、CKH(-),行双侧睾丸切除术和氟他胺治疗,术后1月死于肺部转移。结论原发性前列腺印戒细胞癌来自前列腺腺泡上皮,确诊依靠病理组织学和免疫组化检查。临床罕见,恶性程度高,预后较差。     

乳腺乳头状癌17例的诊断与治疗

目的 探讨乳腺乳头状癌的临床特征、病理和诊治.方法 回顾性分析温州医学院附属第一医院收治的17例乳腺乳头状癌的临床资料.结果 乳腺乳头状癌发病率占同期收治所有乳腺癌的0.64％.患者均可触及肿块.12例患者行乳腺癌改良根治术,2例行单纯乳房切除术,2例行保乳手术,1例行乳房单纯切除+前哨淋巴结活检术.术后15例行辅助化疗,其中5例另行放射治疗.术后随访时间1个月～8年,中位随访时间为32.5个月.1例发生骨转移于术后2年死亡,1例发生多器官转移于术后7年死亡.结论 乳腺乳头状癌患者的治疗及预后与其病理类型密切相关.对导管内乳头状癌的治疗宜选择低创伤的手段,对浸润性乳头状癌及浸润性微乳头状癌须按浸润性导管癌治疗原则处理.     

Clinicopathological characteristics of signet ring cell carcinoma of the stomach

BACKGROUND: Signet ring cell (SRC) carcinoma of the stomach is characterized by its poor prognosis and potential to infiltrate the wall of stomach, although survival studies comparing carcinomas with and without SRC features have yielded inconsistent results. This study compared the clinicopathological features and prognosis of patients with SRC carcinoma with those with non-signet ring cell carcinoma of the stomach (NSRC). METHODS: We reviewed the records of 2358 patients diagnosed with gastric carcinoma who were treated surgically between January 1980 and December 1999 at the Department of Surgery, Chonnam National University Hospital. There were 204 patients (8.7%) with SRC carcinoma as compared to 2154 with NSRC. RESULTS: Significant differences were noted in the mean patient age, mean tumour size, depth of invasion, prevalence of hepatic and regional lymph node metastases, tumour stage, and curability between the patients with SRC histology and NSRC. There were no statistically significant differences in patient gender, location, or peritoneal dissemination between patients with SRC carcinoma and NSRC. SRC carcinoma of the stomach had a higher prevalence of early gastric carcinoma (46.1%) than NSRC (21.7%). The overall 5-year survival of all the patients with SRC carcinoma was 60.2% as compared with 48.9% for the patients with NSRC (P < 0.01). Using Cox proportional hazards model, lymph node metastasis and curability were significant factors affecting the outcome. Signet ring cell histology itself was not an independent prognostic factor. CONCLUSIONS: Patients with SRC histology do not have a worse prognosis than patients with other types of gastric carcinoma.