射频治疗前列腺增生症随访结果分析

自１９９２年１０月开始，应用射热疗仪治疗前列腺增生症８７例。结果：治疗后３个月；６个月、１年和２年时主观症状改善率分别为８３．９５％、８１．０８％、５４．０５％和３６．４９％；３个月和２年时最大尿充提高２ｍｌ／ｓ以上者分别为５１．８５％和２０．００％，残余尿减少５０％以上者为６８．５２％和２６．６７％。并对射频治疗前列腺增生症的机理、适应证和疗效不能持久的原因等进行了讨论。认为射频治疗前列腺增生是     

胃癌根治术中及术后早期腹腔热低渗灌注化疗32例报告

目的：总结利用温热和化疗的协同作用杀灭腹腔游离癌细胞和残存的微小癌灶的方法以减少术后转移和复发。方法：进展期胃癌44例,随机分成2组,32例接受术中、术后早期腹腔热低渗灌注化疗;12例作为对照组仅接受常温双蒸水冲洗腹腔1次和FM方案静脉化疗。分别作腹腔冲洗液脱落癌细胞检查,观察毒副反应、并发症和随访近期疗效。结果：热化疗结束后腹腔冲洗液未发现癌细胞,而对照组仍有1例发现癌细胞;热化疗组随访21±8．4个月,生存15例（46．9％）;对照组随访20±7．6个月,生存2例（16．7％）,热化疗组全身毒副反应较对照组轻,无严重并发症。结论：胃癌根治术后早期肿瘤负荷最小,癌细胞分裂增殖速度相应较快,对热化疗最敏感,适时开展（IPHP或IHCP）能延长进展期胃癌患者术后无瘤生存期。如何更好地维持和监测灌注液的恒温,有待进一步完善。     

射频组织间质热疗治疗腹腔肿瘤的研究现状

肿瘤热疗是近来肿瘤治疗学的一大热点，分为温热疗法和局部高温固化治疗。利用射频技术对腹腔深部肿瘤进行高温固化治疗是其中较有前途的方法之一，尤其在治疗肝脏肿瘤方面已取得了很大的进展。     

肝癌射频热疗

肝癌是一种常见恶性肿瘤 ,恶性程度高 ,预后差。射频治疗 (RFA )是近几年兴起的一种新的热疗方法 ,随着对其研究的不断深入 ,现在 RFA对肝癌的治疗已达到较为满意的效果。1　肝癌射频治疗机理RFA是通过一带鞘针 ,在超声、CT的引导下经皮、经腹腔镜、剖腹术中插入肝癌瘤体内 ,通过针尖的单个或多个弹头发出射频波 ,激发组织细胞中离子相互撞击 ,产生 80℃～10 0℃高温 ,从而杀灭肿瘤细胞。 RFA可使肿瘤周围的血管凝固 ,阻断肿瘤血供 ,防止肿瘤转移。局部肿瘤热疗还可刺激机体的免疫系统 ,抑制残留和原发肿瘤组织的生长 [1 ] 。 RFA作…     

射频热疗对前列腺组织病理变化和PSA、性激素受体表达的影响及其临床意义

为探讨前列腺增生症（ＢＰＨ）射频热疗机理，对射频热疗前后的人与实验犬前列腺标本，进行了病理组织学、细胞超微结构和前列腺特异抗原（ＰＳＡ）以及睾酮受体（ＡＲ）和雌、孕激素受体（ＥＲ、ＰＲ）表达的动态观察。结果显示，热疗后近期可见前列腺实质水肿、出血、坏死，远期见肉芽组织再生修复，大量纤维组织增生。电镜下见细胞器变性丧失功能，邻近坏死区域组织中可见明显的凋亡现象。人与犬前列腺标本射频组织ＰＳＡ、ＡＲ、ＥＲ和ＰＲ的阳性表达均明显低于各自的对照组（Ｐ＜０．０５）。研究表明，射频可使前列腺组织实质坏死、纤维组织修复，尿道内腔拉开，减轻机械性梗阻；破坏和阻断α受体，减轻动力性梗阻；破坏和阻断性激素受体，抑制ＢＰＨ的发展。但由于作用深度范围有限，射频的适应证及疗效有限。     

交变磁场感应肿瘤热疗设备的研究

随着热生物学、热生理学与电子技术的综合发展,肿瘤局部热疗成为近年国际肿瘤治疗的研究热点。肿瘤局部热疗(hyperthermia)希望能适形把癌瘤组织加热到46～70℃有效治疗温度范围,并维持一段时间,使癌细胞受到毁灭性的打击,并刺激机体免疫系统,增强机体对肿瘤的免疫力;同时要避免正常组织的过热损伤,减少患者不能忍受的各种创伤和威胁患者生命的并发症。与手术、放疗和化疗3种传统方法比较,肿瘤热疗处于辅助和次要地位,但有巨大开发和应用潜能。目前,用于肿瘤局部热疗的方法主要有射频加热、微波加热、超声波加热等[1],但这些方法各自存在一…     

关节镜结合高频热疗治疗膝关节骨性关节炎临床疗效观察及康复

目的:探讨关节镜微创手术结合高频热疗治疗膝关节骨性关节炎的临床疗效.方法:将212例我院住院诊断为膝关节骨性关节炎的患者分为对照组和治疗组,每组106例,两组均给予关节镜微创手术治疗,治疗组在此基础上加用高频热疗.结果:治疗组明显有效72例,有效26例,改善5例,无效3例,总有效率为97.17%;对照组明显有效52例,有效28例,改善11例,无效15例,总有效率为85.85%,两者比较差异有统计学意义(P<0.05).结论:关节镜结合高频热疗对膝关节骨性关节炎疗效肯定.     

结肠癌根治术后腹腔热化疗对T淋巴细胞亚群及细胞因子的影响

目的:探讨腹腔热化学治疗对机体细胞免疫水平的影响.方法:将135例结肠癌根治性切除术后分为A,B两组治疗.A组65例,采用卡铂、5-Fu以及丝裂霉素分次溶入加热至45～50℃的生理盐水中腹腔注射;B组65例将上述化疗药物溶入常温生理盐水中腹腔注射,C组62例为健康正常对照组且未行腹腔灌注化疗.分别观察3组病例外周血T淋巴细胞亚群和细胞因子(IL-4与IFN-γ)的变化.结果:A组热化疗后15 d时,CD4 水平较术后第7天明显增加(t=2.32,P≤0.05),CD8 水平明显低于B组同期水平(t=3.00,P≤0.05),IL-4水平较术后第7天明显下降(t=2.65,P≤0.05),而IFN-r水平明显增加(t=2.70,P≤0.05).CD4 百分比与IFN-r水平正相关,CD8 百分比与IL-4水平正相关.结论:结肠癌根治性切除术后热化疗,在杀灭肿瘤细胞的同时,可诱导机体产生抗肿瘤的细胞免疫应答.     

全身热疗法治疗晚期肝脏恶性肿瘤39例报告

目的 探讨全身热疗法（whole body hyperthermia，WBH）治疗肝脏恶性肿瘤的疗效及其对肝功能的影响。方法 采用WBH治疗肝脏恶性肿瘤患者39例，并对治疗前、后患者肝功能指标进行动态观察，分析该疗法对肝脏功能的影响，并通过分析治疗效果，初步评估该疗法的疗效。结果 ①WBH治疗不能手术切除的晚期肝脏恶性肿瘤患者的有效率为61．5％（24／39），60．0％（9／15）的患者AFP有不同程度下降，肿瘤疼痛缓解率达100％；存活期〉2年者占12．8％（5／39），〉1年者占59．0％（23／39），〉6个月者占76．9％（30／39）。②谷丙转氨酶于治疗后1～3d出现明显升高（P〈0．05），7d后下降并接近治疗前水平；谷草转氨酶于治疗后1d明显升高（P〈0．05），3～7d则下降并接近治疗前水平；白蛋白于治疗后1d出现下降（P〈0．05），但3d即已恢复；肝功能正常组总胆红素于治疗后第1～3d出现升高（P〈0．05），而肝功能异常组未观察到同样变化；转肽酶则无明显变化。结论 WBH能改善晚期肝脏恶性肿瘤患者的预后，提高生存质量，延长生存时间，但同时可造成患者肝功能一定程度的可逆性损害。     

前列腺特异性膜抗原和前列腺特异性抗原在前列腺癌组织中的表达

目的：观察并比较前列腺特异性膜抗原（PSMA）和前列腺特异性抗原（PSA）在不同前列腺为组织中的表达差异；比较组织PSMA与PSA对前列腺癌诊断和鉴别诊断的意义。方法：采用ABC三步法免疫组织化学染色方法，用PSMA和PSA单克隆抗体对70例前列腺癌（PCA）、21例前列腺上皮内瘤（PIN）、20例前列腺良性增生（BPH）组织进行染色。结果：PSMA在前列腺癌组织中明显高表达，PSA则在前列腺良性增生组织中高表达；组织PSMA对前列腺癌的阳性检出率明显高于PSA。结论：PSMA是较PSA更具特异性的前列腺癌瘤标，可望取代PSA成为诊断前列腺癌的新型瘤标，并在前列腺癌免疫治疗方面具有良好的应用前景。     

CD147在前列腺癌组织中阳性表达与PSA失败的相关性分析

目的探讨CD147在前列腺癌组织中的表达情况及其临床意义。方法应用免疫组化S—P法检测240例前列腺癌组织中CD147的表达情况,并对CD147与前列腺癌PSA失败的关系进行统计学分析。结果CD147在无PSA失败前列腺癌组织中的阳性率为27．6％．有PSA失败的阳性率为80．7％,具有显著差异（P〈0．05）。CD147的表达与PSA失败呈正相关。结论CD147检测有助于了解前列腺癌的恶性程度,评估其预后,对临床制定治疗方案有指导意义。     

检测前列腺癌病人外周血中PSA mRNA表达的临床意义

目的 探讨前列腺癌患者外周血中ＰＳＡ ｍＲＮＡ表达的临床意义。方法 运用敏感的巢式ＲＴ－ＰＣＲ方法检测３３例前列腺癌（ＰＣａ）患者和１０例前列腺增生（ＢＰＨ）患者外周血中ＰＳＡ ｍＲＮＡ的表达。结果 ＢＰＨ组外周血中ＰＳＡ ｍＲＮＡ均不表达。ＰＣａ组有１４例（４２％）ＰＳＡ ｍＲＮＡ表达阳性。１２例未行内分泌治疗者中有８例（６７％）阳性,２１例行分泌治疗者中有６例（２９％）阳性,二者差异有显著性（     

Secretion of prostate-specific antigen-suppressing activity by two human prostate carcinoma cell lines

The well-differentiated human prostatic carcinoma cell line LNCaP has often been used as a model to study the modulation of prostate-specific antigen (PSA) expression. In this study, we examined the effect of conditioned medium from two androgen-unresponsive, PSA-negative human prostatic carcinoma cell lines, PC-3 and DU-145, on PSA expression by the LNCaP cells. Our results show, for the first time, that the undifferentiated PC-3 and DU-145 cells secrete a factor that lowers PSA mRNA and protein levels in LNCaP cells. Further characterization of the PSA-suppressing activity indicated that it was trypsin as well as acid sensitive, heat-stable, and ammonium sulfate precipitable. The activity was present in the 30-100-kd fraction of PC-3 and DU-145 conditioned media. This PSA-suppression factor could act in an autocrine manner to render undifferentiated prostatic carcinoma cells PSA negative. It may also be responsible for the lack of increase in serum PSA levels observed in a subset of patients with hormone-resistant prostatic carcinoma.     

Variation of prostate-specific antigen expression in different tumour growth patterns present in prostatectomy specimens

Summary A series of 55 randomly chosen radical prostatectomy specimens was analyzed for expression of prostate-specific antigen (PSA) by immunohistochemical techniques. Tissue sections were selected in such a manner that in addition to glandular benign prostatic hyperplasia (BPH), one or more different prostatic tumour growth patterns were present. Four monoclonal antibodies, directed against three different PSA epitopes, and one polyclonal anti-PSA antiserum were used. Expression of PSA was compared with that of prostate-specific acid phosphatase (PAP), recognized by two different polyclonal antisera. A critical dilution aimed at a maximum of staining intensity on BPH tissue sections was chosen for all antibodies. Anti-PSA and anti-PAP antisera stained essentially all BPH samples (over 90%). Irrespective of the nature of the antibodies used, PSA expression was found to be decreased in prostatic carcinoma. A clear cut relationship was found between immunoreactivity for PSA and the degree of differentiation of the tumour area. Under the experimental conditions used the PSA monoclonal antibodies stained only 1 out of 10 undifferentiated carcinomas, whereas 50% to 70% of the well- and moderately-differentiated carcinomas showed immunoreactivity. This correlation was less pronounced with the PAP staining pattern. If the PSA antibody titer was raised the percentage of clearly staining undifferentiated carcinomas could be considerably increased (up to 60%–100%), indicating that PSA expression is not absent, but lowered in most (if not all) undifferentiated carcinomas.     

PSA"灰区"值时前列腺癌组织中Trp-p8的表达及意义

目的 研究Trp-p8蛋白在PSA"灰区"前列腺组织中的表达规律,探讨其在前列腺癌(PCa)早期诊断中的作用.方法 通过免疫组织化学的方法研究了28例PSA"灰区"前列腺组织中Trp-p8蛋白的表达情况,其中前列腺增生症(BPH)和PCa标本各14例,采用图文数据成像分析系统判定各组织中Trp-p8蛋白的表达强度,分析其差异性.结果 BPH中Trp-p8蛋白的表达强度较弱,呈不表达或微量表达.在PCa组织中Trp-p8蛋白均呈不同程度的阳性表达,这种表达差异具有统计学意义.结论 Trp-p8在PSA"灰区"前列腺组织中的表达存在差异,在PCa组织中Trp-p8蛋白的表达强度高于BPH组织,这种差异性表达对于早期PCa诊断具有重要意义.     

前列腺增生患者前列腺液白细胞数量与血清PSA含量的关系

目的探讨前列腺增生患者前列腺按摩液（EPS）中白细胞含量与血清前列腺特异性抗原（PSA）升高之间的关系。方法 ELISA法测定78例前列腺增生患者的血清PSA含量,术前通过前列腺按摩获取前列腺液,并行前列腺液中的白细胞计数。分析EPS中白细胞含量与血清PSA升高的相关性,并比较不同血清PSA水平间（〈4ng/mL、4~10ng/mL、≥10ng/mL）的EPS中白细胞含量差异。结果前列腺增生患者血清PSA与EPS中白细胞密度和总数呈正相关关系,血清PSA升高组EPS中白细胞含量明显高于血清PSA正常组。结论前列腺增生患者血清PSA与EPS中白细胞的含量呈正相关,前列腺增生患者的PSA值增高可能与前列腺液中的白细胞增高有关。     

Prostatic calculi do not influence the level of serum prostate specific antigen in men without clinically detectable prostate cancer or prostatitis

PURPOSE: Prostatic calculi are common but little is known of their effect on serum prostate specific antigen (PSA). We investigated whether prostatic calculi might influence serum PSA in men with clinically undetectable prostatic cancer or prostatitis. MATERIALS AND METHODS: Between November 1999 and November 2001, 581 consecutive patients underwent serum PSA determination and digital rectal examination. Of these patients 486 without detectable prostatic cancer, or a history or symptoms of prostatitis and with other specified exclusion criteria were included in the study. The detection and volume measurement of prostatic calculi, and the measurement of prostate volume were performed by transrectal ultrasonography. RESULTS: Prostatic calculi were detected in 198 of the 486 men (40.7%). Mean patient age, prostate volume and serum PSA were not significantly different in men with and without prostatic calculi. Prostate volume was significantly greater in patients with abnormally elevated serum PSA than in those with normal levels. However, no significant difference was found between the percent of men with prostatic calculi or the volumes of prostatic calculi in the 2 groups. Univariate logistic regression analysis indicated that the presence or volume of prostatic calculi was not a risk factor for elevated PSA. Multivariate analysis showed that age and prostate volume were associated with elevated PSA. CONCLUSIONS: The presence or volume of prostatic calculi had no significant effect on serum PSA. Our results suggest that the influence of prostatic calculi is irrelevant in men with elevated PSA.     

Adenoid cystic carcinoma of the prostate: A case report with immunohistochemical and in situ hybridization staining for prostate-specific antigen

A 43-year-old man with urinary outlet obstruction was referred to our hospital. A digital rectal examination revealed an elastic hard prostate. The serum prostate-specific antigen (PSA), serum prostatic acid phosphate and gamma-seminoprotein levels were found to be within the normal range, and transrectal ultrasound sonography provided normal findings. The patient underwent a subcapsular prostatectomy under a diagnosis of benign prostatic hyperplasia. Histopathologically, the lesion was diagnosed as an adenoid cystic carcinoma of the prostate. Because a further examination revealed a pathologic extension into the urinary bladder, a radical cystoprostatectomy was performed. The expression of PSA protein and PSA mRNA was studied by means of immunohistochemistry and an in situ hybridization technique. The adenoid cystic carcinoma in the patient did not show any positive signs for PSA protein or PSA mRNA.     

F/T比值在前列腺癌筛选中的应用价值

目的：评价F／T比值在前列腺癌筛选中的作用。方法：运用直肠指检、B超、PSA、PSA密度（PSAD）、F／T比值对389例行健康体检的50岁以上男性进行前列腺癌筛选，并对各项方法的准确性、特异性、敏感性进行比较。结果：共检出前列腺癌15例，其中F／T比值在敏感性不降低的情况下，其特异性明显优于PSA和PSAD，特别是在PSA的诊断灰区能很好地将良、恶性病变区分开来，使将近50％的可疑患者免受活检。结论：F／T比值是前列腺癌筛选的有效手段。