2015-2018年贵州省都匀地区孕产妇弓形虫感染情况调查

为调查贵州省都匀地区孕产妇弓形虫感染情况,收集2015-2018年就诊于贵州省都匀地区黔南州人民医院进行孕期、产前检查的妇女及曾出现过流产、死胎、畸形等病理妊娠的孕产妇血清,进行弓形虫特异性抗体IgM及IgG的ELISA检测。应用SPSS 17.0软件进行统计学分析,弓形虫抗体阳性率采用χ^2检验进行比较。共征集6931例孕产妇,包括6825例正常孕产妇和106例病理妊娠孕产妇。年龄为18~45岁,以汉族、布依族、苗族等为主。孕产妇弓形虫总抗体阳性率为6.1%(424/6931),其中正常孕产妇弓形虫抗体阳性率为5.9%(403/6825),病理妊娠孕产妇弓形虫抗体阳性率为19.8%(21/106),差异有统计学意义(P<0.01)。汉族、布依族、苗族、水族、土家族、侗族的孕产妇弓形虫抗体阳性率分别为7.5%(215/2886)、5.4%(132/2453)、5.5%(71/1300)、2.3%(3/131)、2.0%(2/100)、1.6%(1/61),差异有统计学意义(P<0.05)。职业为干部、教师、农村劳作、其他的孕产妇弓形虫抗体阳性率分别为1.3%(22/1714)、1.8%(22/1216)、13.2%(320/2418)、3.8%(60/1583),差异有统计学意义(P<0.01)。有、无动物接触史的孕产妇弓形虫抗体阳性率分别为26.2%(361/1379)和1.1%(63/5552),差异有统计学意义(P<0.01)。提示贵州省都匀地区孕产妇弓形虫抗体阳性者以有病理妊娠反应、汉族、主要从事农村劳作、有动物接触史等为主。     

ELISA检测白血病和淋巴瘤患者弓形虫抗体阳性率

ELISA检测贵州省白血病和淋巴瘤患者各150例血样中弓形虫特异性抗体(Ig G、Ig M)和循环抗原(CAg),计算阳性率。PCR扩增弓形虫529 bp特异性片段。结果显示,白血病患者弓形虫Ig G和Ig M抗体阳性率分别为16.0%(24/150)和2.7%(4/150),CAg阳性率为2.0%(3/150)。淋巴瘤患者弓形虫Ig G和Ig M抗体阳性率分别为20.0%(30/150)和1.3%(2/150),CAg阳性率为0.7%(1/150)。健康人Ig G和Ig M抗体阳性率分别为6.4%(7/110)和0.9%(1/110),CAg阳性率为0.9%(1/110)。白血病患者、淋巴瘤患者和健康人之间弓形虫Ig G抗体阳性率差异有统计学意义(P0.05),白血病和淋巴瘤患者间Ig G抗体阳性率差异无统计学意义(P0.05);弓形虫Ig M抗体和CAg阳性率在各组间差异均无统计学意义(P0.05)。白血病患者、淋巴瘤患者和健康人血样中均未扩增出529 bp特异性条带。     

贵州省抑郁症患者刚地弓形虫感染状况调查及其基因型鉴定

目的了解贵州省抑郁症患者弓形虫感染状况及弓形虫基因型。方法 ELISA检测141例抑郁症患者和150例健康对照外周血弓形虫特异性抗体(IgG、IgM)和循环抗原(CAg),PCR扩增血样弓形虫高重复DNA片段(529 bp),多重-巢式PCR-限制性片段长度多态性(Mn-PCR-RFLP)方法鉴定弓形虫529 bp阳性样本的基因型。结果 ELISA检测结果显示,抑郁症患者组和健康对照组弓形虫抗体阳性率分别为21.3%(30/141)和7.3%(11/150),两者间差异有统计学意义(χ~2=11.674,P0.05);抑郁症患者组的IgG、IgM、CAg阳性率分别为18.4%(26/141)、1.4%(2/141)、1.4%(2/141);健康对照组IgG阳性率为7.3%(11/150),与抑郁症患者组间差异有统计学意义(P0.05),未检测到IgM和CAg。PCR结果显示,抑郁症患者组检测出1例弓形虫核酸阳性,经Mn-PCR-RFLP方法鉴定其基因型,结果为非典型Toxo DB#9(Chinese 1型)。结论贵州省抑郁症患者弓形虫抗体阳性率高于健康人群,1例抑郁症患者感染的弓形虫基因型为Chinese 1型。     

海南地区消化道恶性肿瘤患者弓形虫感染调查

目的　了解海南地区消化道恶性肿瘤患者血清抗弓形虫抗体水平,为消化道恶性肿瘤患者弓形虫病防控提供参考依据。方法　2016–2019年收集海南省1 932例消化道恶性肿瘤患者作为调查对象,其中食管癌患者376例、胃癌患者475例、结直肠癌患者401例、肝癌患者427例、胰腺癌患者253例,以400例健康体检者作为对照。采用酶联免疫吸附试验检测消化道恶性肿瘤患者和健康体检者血清抗弓形虫IgG和IgM抗体,比较组间抗体阳性率差异。结果　消化道恶性肿瘤患者总体血清抗弓形虫IgG抗体阳性率为19.82%,显著高于健康对照的3.75%（χ2 = 60.49,P < 0.01）,两者总体抗弓形虫IgM抗体阳性率差异无统计学意义（1.09%和0.50%;χ2 = 1.17,P > 0.05）。食管癌、胃癌、结直肠癌、肝癌和胰腺癌患者抗弓形虫IgG抗体阳性率分别为15.16%、19.58%、21.70%、23.65%和17.79%,均显著高于健康对照（χ2 = 29.97、50.29、58.03、67.85、36.59,P均< 0.01）;抗弓形虫IgM抗体阳性率分别为1.06%、1.47%、0.75%、1.17%和0.79%,与健康对照差异均无统计学意义（χ2 = 0.80、2.02、0.20、1.11、0.21,P均> 0.05）。不同类型消化道恶性肿瘤患者抗弓形虫IgG抗体阳性率差异有统计学意义（χ2 = 10.65,P < 0.05）,但抗弓形虫IgM抗体阳性率差异无统计学意义（χ2= 1.33,P > 0.05）。结论 　海南地区消化道恶性肿瘤患者血清抗弓形虫IgG抗体阳性率较高,不同类型消化道恶性肿瘤患者抗弓形虫IgG抗体阳性率间存在显著差异。建议今后应加强消化道恶性肿瘤患者弓形虫感染筛查,从而有效防控弓形虫感染对消化道恶性肿瘤患者造成的危害。     

海南地区消化道恶性肿瘤患者弓形虫感染调查

目的　了解海南地区消化道恶性肿瘤患者血清抗弓形虫抗体水平，为消化道恶性肿瘤患者弓形虫病防控提供参考依据。方法　2016–2019年收集海南省1 932例消化道恶性肿瘤患者作为调查对象，其中食管癌患者376例、胃癌患者475例、结直肠癌患者401例、肝癌患者427例、胰腺癌患者253例，以400例健康体检者作为对照。采用酶联免疫吸附试验检测消化道恶性肿瘤患者和健康体检者血清抗弓形虫IgG和IgM抗体，比较组间抗体阳性率差异。结果　消化道恶性肿瘤患者总体血清抗弓形虫IgG抗体阳性率为19.82%，显著高于健康对照的3.75%（χ2 = 60.49，P < 0.01），两者总体抗弓形虫IgM抗体阳性率差异无统计学意义（1.09%和0.50%；χ2 = 1.17，P > 0.05）。食管癌、胃癌、结直肠癌、肝癌和胰腺癌患者抗弓形虫IgG抗体阳性率分别为15.16%、19.58%、21.70%、23.65%和17.79%，均显著高于健康对照（χ2 = 29.97、50.29、58.03、67.85、36.59，P均< 0.01）；抗弓形虫IgM抗体阳性率分别为1.06%、1.47%、0.75%、1.17%和0.79%，与健康对照差异均无统计学意义（χ2 = 0.80、2.02、0.20、1.11、0.21，P均> 0.05）。不同类型消化道恶性肿瘤患者抗弓形虫IgG抗体阳性率差异有统计学意义（χ2 = 10.65，P < 0.05），但抗弓形虫IgM抗体阳性率差异无统计学意义（χ2= 1.33，P > 0.05）。结论 　海南地区消化道恶性肿瘤患者血清抗弓形虫IgG抗体阳性率较高，不同类型消化道恶性肿瘤患者抗弓形虫IgG抗体阳性率间存在显著差异。建议今后应加强消化道恶性肿瘤患者弓形虫感染筛查，从而有效防控弓形虫感染对消化道恶性肿瘤患者造成的危害。     

妇科恶性肿瘤患者弓形虫感染血清流行病学调查

目的 了解妇科恶性肿瘤患者弓形虫感染情况,为后续该类人群弓形虫感染防控提供依据。方法 收集327例临床妇科恶性肿瘤患者血清样本,同时收集200例女性体检正常者血清作为对照,采用酶联免疫吸附试验（ELISA）检测血清抗弓形虫IgG和IgM抗体,分析不同人群抗弓形虫抗体阳性率差异。结果 327例妇科恶性肿瘤患者总体弓形虫感染率为26.91%（88/327）,高于健康体检者的5.00%（[χ2] = 39.36,[P< 0.01]）;其中血清抗弓形虫IgG抗体阳性率高于健康体检者（26.30% vs. 5.00%;[χ2] = 37.79,[P< 0.01]）,血清抗弓形虫IgM抗体阳性率与健康体检者差异无统计学意义（0.92% vs. 0;校正[χ2] = 0.58,[P> 0.01]）。卵巢癌、子宫颈癌和乳腺癌患者血清抗弓形虫IgG抗体阳性率分别为27.68%、25.47%和25.69%,均高于健康体检者（[χ2] = 32.35、27.32、28.00,P 均 < 0.01）,但卵巢癌、子宫颈癌和乳腺癌患者血清抗弓形虫IgG抗体阳性率差异无统计学意义（[χ2] = 0.17,[P> 0.05]）。卵巢癌、子宫颈癌和乳腺癌患者血清抗弓形虫IgM抗体阳性率分别为1.79%、0和0.92%,与健康体检者差异均无统计学意义（P 均 > 0.05）。结论 妇科恶性肿瘤患者弓形虫感染率较高,应加强妇科恶性肿瘤患者弓形虫感染防控。     

自愿无偿献血者弓形虫IgG抗体与传染病常规筛检项目关系

在745例常规检测不合格的血液样本中,弓形虫IgG抗体总阳性率为21.9%,显著高于常规检测合格献血者的阳性率(P<0.01)。ALT异常者、HBsAg阳性者、抗HCV阳性者、抗HIV阳性者、ALT异常合并HBsAg阳性者、ALT异常合并抗HCV阳性者的弓形虫IgG抗体阳性率分别为22.8%(99/435)、13.7%(16/117)、12.2%(15/123)、10.0%(5/50)、31.0%(9/29)、34.2%(13/38),均显著高于常规筛检合格献血员弓形虫IgG抗体阳性率(P<0.05或P<0.01)。结果提示,自愿无偿献血者弓形虫IgG抗体阳性率与献血员传染病常规筛检项目ALT、HBsAg、抗HCV、抗HIV是否合格有一定相关性。     

长春地区孕产妇和肿瘤病人血清弓形虫抗体IgG的检测

目的 检测长春地区孕产妇和肿瘤病人弓形虫感染抗体IgG.方法 采用酶联免疫吸附试验对47例孕产妇和267例恶性肿瘤病人血清标本进行弓形虫抗体检测.结果 长春地区孕产妇和肿瘤病人血清弓形虫抗体IgG阳性率分别为10.64%和23.97%,显著高于健康人群阳性率6.08%(P＜0.05);鼻咽癌和直肠癌患者弓形虫抗体IgG阳性率高于其他类型肿瘤病人(P＜0.01).结论 孕产妇和肿瘤病人为弓形虫易感人群,应作常规性弓形虫抗体检测.     

河北省霸州地区不良妊娠史孕妇弓形虫感染状况调查

目的调查河北省霸州地区不良妊娠史孕妇弓形虫感染状况及其危险因素。方法选择2012年3月至2015年12月廊坊市第四人民医院妇产科接诊的不良妊娠史孕妇302例为调查对象(实验组),正常对照组为产前检查无异常妊娠史的孕妇197例。采用酶联免疫吸附法检测2组孕妇血清弓形虫IgG(TOX-IgG)和IgM抗体(TOX-IgM)含量。同时,对2组孕妇进行弓形虫感染危险因素问卷调查。收集整理数据并进行统计分析。结果实验组弓形虫抗体总阳性率为28.15%(85/302),对照组总阳性率为9.64%(19/197),差异有统计学意义(χ~2=24.76,P0.05)。其中实验组TOX-IgM阳性率为6.95%(21/302),TOX-IgG阳性率为18.54%(56/302),TOX-IgM和TOX-IgG同为阳性者占2.65%(8/302),均高于对照组的2.03%(4/197)、7.61%(15/197)和0(0/197)(χ~2值分别为6.07、11.67、3.76、P均0.05)。调查显示弓形虫感染孕妇中饲养宠物、菜板生熟不分、喜吃火锅或烧烤、吃生肉习惯、经常在外就餐等比例均明显高于未感染弓形虫的孕妇(χ~2值分别为22.57、3.96、5.87、7.40、4.86,P均0.05),提示上述不良生活或卫生习惯可能是孕妇感染弓形虫的重要危险因素。结论弓形虫感染可导致不良妊娠的发生。避免与宠物密切接触、不吃未煮熟的肉类以及加强个人卫生防护等是避免育龄妇女发生不良妊娠结局的有效途径。     

2022年北京市犬猫刚地弓形虫感染血清流行病学调查

为了解北京市犬、猫刚地弓形虫感染情况,根据“2022年北京市动物疫病监测实施方案”,从全市不同区域的散户、动物医院、养殖场采集并提取犬血清920份、猫血清816份,采用间接血凝试验进行弓形虫抗体检测。结果显示,犬和猫血清弓形虫抗体阳性率分别为5.2%(48/920)和7.5%(61/816)。秋季犬血清弓形虫抗体阳性率为6.8%(30/440),高于春季的3.8%(18/480),具有中等强度关联(χ²=4.37,P<0.05,0.42=28.42,P<0.05,0.12=25.31、9.31,均P<0.05)。城六区犬血清抗体阳性率为11.4%(40/350),远郊区的为1.4%(8/570),具有强关联(χ^2...     

青年人胰腺恶性肿瘤46例临床分析

目的 探讨40岁以下青年胰腺恶性肿瘤患者的临床特点,以提高青年人胰腺恶性肿瘤早期诊断水平和治疗效果.方法 回顾性分析46例40岁以下青年胰腺恶性肿瘤的临床表现、临床病理参数、血清CA19-9和CEA水平、误诊情况、治疗与生存时间.结果 青年胰腺恶性肿瘤患者首发症状主要为:上腹部饱胀(78.26%)、上腹部不适(73.91%)、消瘦(73.91%)、食欲不振(69.57%)、腹痛(60.87%);肿瘤多位于胰头部(52.17%);病理证实30例(65.22%)发生转移,其中13例累及多器官;胰腺外分泌肿瘤占72.73%(24/33),胰腺内分泌肿瘤占27.27%(9/33);CA19-9和CEA阳性率分别为73.91%(34/46)、32.61%(15/46);误诊率为80.43%(37/46),主要误诊为急、慢性胃炎(36.96%);根治性手术率为23.91%;平均生存期12.6个月.结论 40岁以下青年人胰腺恶性肿瘤早期无特异性临床表现、误诊率高、预后差,应重视早期诊断.     

Ultrasound-guided core biopsy of thoracic tumors.

Two hundred and eighteen patients, with thoracic tumors larger than 3 cm in size, underwent ultrasound-guided percutaneous transthoracic core biopsy with a large-bore Tru-Cut needle. Fifty-five tumors were in the mediastinum, and 122 tumors were located at subpleural area, and 42 tumors were within the lungs. In 122 subpleural tumors, the sensitivity of ultrasound-guided core biopsy for the diagnosis of malignancy was 96.8%, and accuracy was 97.5%. Sensitivity for the diagnosis of malignant tumors located within the lungs was 94.6%, and accuracy was 95.2%. In 54 patients with mediastinal tumors, definite histologic diagnosis could be obtained in 48 patients (88.9%). The sensitivity of ultrasound-guided biopsy for the diagnosis of malignancy in these 48 mediastinal tumors was 97.1%, with an accuracy of 97.9%. Three patients had complications with minimal pneumothorax and one with mild hemoptysis. We conclude that percutaneous transthoracic core biopsy with Tru-Cut needle under ultrasound guidance is a safe and sensitive way to obtain specimens for accurate histologic diagnosis of thoracic tumors. The diagnostic yield is high, and the technique, relatively simple, can also be used for outpatients.     

Endoscopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas

Preoperative localization of pancreatic neuroendocrine tumors with traditional imaging fails in 40-60% of patients. Endoscopic ultrasound (EUS) is highly sensitive in the detection of these tumors. Previous reports included relatively few patients or required the collaboration of multiple centers. We report the results of EUS evaluation of 82 patients with pancreatic neuroendocrine tumors. METHODS: We prospectively used EUS early in the diagnostic evaluation of patients with biochemical or clinical evidence of neuroendocrine tumors. Patients had surgical confirmation of tumor localization or clinical follow-up of >1 yr. RESULTS: Eighty-two patients underwent 91 examinations (cases). Thirty patients had multiple endocrine neoplasia syndrome type 1. One hundred pancreatic tumors were visualized by EUS in 54 different patients. The remaining 28 patients had no pancreatic tumor or an extrapancreatic tumor. Surgical/pathological confirmation was obtained in 75 patients. The mean tumor diameter was 1.51 cm and 71% of the tumors were < or =2.0 cm in diameter. Of the 54 explorations with surgical confirmation of a pancreatic tumor, EUS correctly localized the tumor in 50 patients (93%). Twenty-nine insulinomas, 18 gastrinomas, as well as one glucagonoma, one carcinoid tumor, and one somatostatinoma were localized. The most common site for tumor localization was the pancreatic head (46 patients). Most tumors were hypoechoic, homogenous, and had distinct margins. EUS of the pancreas was correctly negative in 20 of 21 patients (specificity, 95%). EUS was more accurate than angiography with or without stimulation testing (secretin for gastrinoma, calcium for insulinoma), transcutaneous ultrasound, and CT in those patients undergoing further imaging procedures. EUS was not reliable in localizing extrapancreatic tumors. CONCLUSIONS: In this series, the largest single center experience reported to date, EUS had an overall sensitivity and accuracy of 93% for pancreatic neuroendocrine tumors. Our results support the use of EUS as a primary diagnostic modality in the evaluation and management of patients with neuroendocrine tumors of the pancreas.     

Metachronous colon tumors: risk factors and rationale for the surveillance colonoscopy after initial polypectomy

PURPOSE: We analyzed the possible risk factors for metachronous colon tumors after endoscopic resection of initial tumors. METHODS: Three hundred and twenty-one patients entered the surveillance study after colonoscopic resection of initial tumors between 1985 and 1999. Histology of initial tumors was adenoma in 214 patients and carcinoma in 107 patients. Solitary tumor was observed in 196 patients and multiple tumors in 125 at initial endoscopy. The median surveillance period was 39 (range, 12-112) months, and the median frequency of surveillance colonoscopy was three (range, 2-10) times. RESULTS: Metachronous neoplasms were identified in 114 of 321 surveillance cases (36%). In the 114 cases, the number of patients with metachronous adenoma was 103 (90%) and that of carcinoma was 11 (10%). Clinical characteristics at entry - including age, gender, multiplicity of polyp, histology of polyp, and site of polyp - were not different between patients with metachronous tumors and those without metachronous tumors. Kaplan-Meier analysis revealed that patients with a histology of carcinoma and those with multiple polyps at entry developed metachronous tumors significantly earlier than did patients with initial adenomas and initial solitary polyp, respectively ( P<0.001, P<0.001). However, other characteristics at entry did not produce significant differences in the rate of the development of metachronous tumors using Kaplan-Meier analysis. Proportional hazards model analysis revealed that histology of the initial tumor as carcinoma (relative risk, 1.690, 95% confidence interval, 1.118-2.555) and multiplicity (1.472, 1011-2.143) were significant risk factors for metachronous colon tumors. The 75%, 50%, and 25% metachronous tumor-free periods after initial polypectomy were 14, 21, and 39 months, respectively. CONCLUSIONS: These results may help optimizing surveillance strategies for metachronous colon tumors and raising the economic benefit of colonoscopy.     

耦合剂充盈法腔内超声对直肠肿瘤的诊断价值

目的探讨耦合剂充盈法腔内超声对直肠肿瘤的诊断价值。 方法2009年1月至2016年1月,选取中国医学科学院肿瘤医院诊治的直肠占位患者60例,均在术前行耦合剂充盈法腔内超声检查。对照手术或活检病理结果,评估耦合剂充盈法腔内超声检查对直肠肿瘤的诊断价值。 结果60例患者中直肠腺瘤8例,直肠癌40例,直肠间质瘤12例。腔内超声判断直肠腺瘤的敏感度、特异度、阳性预测值、阴性预测值、准确性分别为72.2%、100%、100%、94.2%、95.0%。 结论耦合剂充盈法腔内超声可以较准确地诊断直肠肿瘤,为临床手术方式选择提供可靠的术前影像学依据。     

Associated primary tumors in patients with gastric cancer

GOAL: To determine the prevalence of associated primary tumors in patients with gastric cancer. STUDY: Retrospective study of 2,668 patients with gastric cancer observed at our department between July 1974 and December 1999. Associated tumors were diagnosed using Warren and Gates criteria, and included tumors that were not considered to be a metastasis, invasion, or recurrence of gastric cancer. RESULTS: Of all, 3.4% (n = 78) had primary tumors other than gastric cancer, 27% of which were synchronous (n = 21) and 73%, metachronous (n = 57). The mean follow-up time was 4 years (range, 1-13 years), and the male-to-female ratio was 1:1. The median age at diagnosis of gastric cancer was 67 years (range, 37-84 years), 69 years for patients with synchronous tumors versus 60 years for those with metachronous (p = 0.050). For at least half the patients the median time interval to metachronous cancer was 3 years (range, 1-22 years). Seventy-eight percent (n = 61) had two cancers; most were colonic (19%), uterine and ovarian (16%), and breast tumors (13%). Seventeen percent (n = 13) had three tumors: colon (46%), breast (23%), and skin (23%). Four percent (n = 3) had four tumors. One case with seven tumors was also observed [colon, breast (two tumors), uterus, skin, and stomach (two tumors)]. No statistically significant differences were found between synchronous and metachronous with regard to sex, gastric cancer location, and staging (TNM). Sixty-three percent (n = 49) died while under observation. CONCLUSIONS: We found associated tumors in 3.4% of patients with gastric cancer. The most frequent associated tumors were breast and colon cancer. Surveillance for these tumors would be appropriate, at least in first years, after diagnosis of gastric cancer.     

Prevalence of pancreatic and biliary tract tumors in pancreas divisum

Background The present study was undertaken to evaluate the prevalence of pancreatic and biliary tract tumors in pancreas divisum (PD). Methods A retrospective single-center study was performed, and a total of 118 cases of complete PD and 7850 cases of fused pancreas were identified among the 8537 consecutive new endoscopic retrograde cholangiopancreatography (ERCP) examinations performed between 1980 and 2002. The prevalence of pancreatic cancer (PCA), intraductal papillary mucinous neoplasms (IPMNs), other pancreatic tumors, and biliary tract cancer in the patients with PD and the patients with a fused pancreas were compared. Results The prevalence of the pancreatic tumors in the PD patients was: PCA, 10%; IPMN, 5.1%; other pancreatic tumors, 2.5%. The prevalence of pancreatic tumors in the patients with a fused pancreas was: PCA, 4.8%; IPMN, 2.6%; and other pancreatic tumors, 1.1%. The prevalence of PCA was significantly higher in the patients with PD than in those with a fused pancreas (P = 0.008; OR, 2.24). The percentages of PD patients with PCA who had pancreatic-type pain and a serum pancreatic enzyme elevation were significantly higher than among the PD patients without PCA. The prevalence of biliary tract cancer was 0.8% in the PD group and 5.3% in the fused pancreas group, and it was significantly lower in PD than in fused pancreas (P = 0.031). Conclusions The results of this study showed a significantly higher prevalence of PCA in PD than in fused pancreas. We concluded that patients with PD, especially patients presenting with pancreatic-type pain and pancreatic enzyme elevation, should be carefully followed up because of the risk of developing PCA.     

心外科患者中心脏肿瘤的流行病学研究

目的:总结心脏肿瘤的流行病学特征,提高对心脏肿瘤的认识。方法:回顾性分析了自1996年10月～2005年3月我院行心脏手术治疗的242例心脏肿瘤患者的年龄分布、性别特征、肿瘤性质、生长部位和特点等。结果:在行心脏外科治疗的患者中,心脏肿瘤发生率为0.75%。良性肿瘤构成比为88.0%,以黏液瘤为主,高于恶性肿瘤(11.2%)(P<0.01)。不同年龄发生率也不同,40～49岁年龄段发生率最高,达30%,其次为50～59岁年龄段(26.8%)。黏液瘤女性发生率高于男性(P<0.01),这一现象在非黏液瘤患者中不明显。左心系统恶性肿瘤比例为5.3%,右心系统恶性肿瘤比例为28.6%,8例继发性心脏肿瘤均发生于右心系统,侵犯多房室的肿瘤恶性比例为75%。结论:经外科治疗的心脏肿瘤发生率占心脏外科患者的0.75%,多数为原发良性肿瘤。     

Patterns of lymph node metastasis in carcinoma of the distal bile duct.

BACKGROUND/AIMS: The aim of this study was to clarify the lymphatic spread in distal bile duct carcinoma in relation to local tumor extent (pT category). METHODOLOGY: The distribution and number of involved nodes were examined in 42 patients with distal bile duct cancer. RESULTS: Lymph node metastases were present in 25 of 42 patients (60%); 5 of 12 (42%) with pT2 tumors and 20 of 26 (77%) with pT3 tumors. Nodal involvement was not identified in 4 patients with pT1 tumors. The incidence of node positivity was higher in patients with pT3 tumors than in those with pT1 or pT2 tumors (p<0.01 or p<0.05). The total number of positive nodes was greater in patients with pT3 tumors than in those with pT2 tumors (mean: 3.08 vs. 0.75; p<0.01). All node-positive patients had involved nodes in the hepatoduodenal ligament or posterior pancreaticoduodenal region, or both. The number of positive nodes in the superior mesenteric and para-aortic region was greater in patients with pT3 tumors than in those with pT2 tumors (p<0.05). CONCLUSIONS: As tumor invades the pancreas from the distal bile duct, lymphatic spread extends from the hepatoduodenal ligament or posterior pancreaticoduodenal region to the superior mesenteric and para-aortic nodes.     

超声心动图对87例心脏肿瘤的诊断价值

目的：探讨彩色多普勒超声心动图诊断心脏肿瘤的临床价值。方法：回顾分析87例心脏肿瘤患者的临床资料,对其发病部位、临床表现、超声心动图特征进行分析。结果：87例心脏肿瘤均获得病理证实：良性心脏肿瘤73例（83.9％）,其中粘液瘤66例（90.4％）,其他类型良性心脏肿瘤7例;恶性心脏肿瘤14例（16.1％）。超声心动图所见：粘液瘤示多发生于左房（58例）,多数有蒂,活动度大;其他类型良性心脏肿瘤6例（86％）发生于心房或心室的心肌内,无蒂,回声较强;恶性肿瘤附着面广,可呈球状或菜花状,活动度差,无蒂,多数伴有心包积液。结论：超声心动图能动态地观察瘤体形态、大小、回声及血流动力学变化,诊断准确率高;心脏肿瘤以粘液瘤最为多见。