Co-immunotherapy with interleukin-2 and taurolidine for progressive metastatic melanoma

Background  

Recombinant interleukin-2(rIL-2) therapy in metastatic melanoma is limited by toxicities, particularly vascular leak syndrome(VLS). Taurolidine potentiates the anti-neoplastic effects of IL-2 while reducing its associated endothelial cell dysfunction in experimental settings. We hypothesized that co-administration of rIL-2 with taurolidine could enhance tolerability without weakening effectiveness.     

白细胞介素-2联合顺铂治疗肺癌所致恶性胸腔积液

胸腔积液是恶性肿瘤患者的常见并发症,常见于肺癌、乳腺癌、胸膜间皮瘤、淋巴瘤等。目前多采用引流胸腔积液后胸腔内注入药物来控制胸腔积液。近年来白细胞介素-2(IL-2)与化疗药物顺铂(DDP)联合治疗恶性胸腔积液取得较好疗效。我们自2003年9月-2006年8月,应用IL-2与DDP联合胸腔     

白细胞介素2联合顺铂治疗恶性胸腔积液有效性及安全性的Meta分析

目的：系统评价白细胞介素2联合顺铂治疗恶性胸腔积液的有效性及安全性,为临床治疗策略提供依据。方法系统检索中国生物医学文献数据库（BM）、中国学术期刊网络出版总库（CNKI）、维普（VIP）、万方、ISI、Pubmed、Embase 及 Co-chrane library 临床试验注册数据库,采用 Cochrane 协作网 RCT 质量评价标准评价纳入研究质量,Meta 分析提取数据。结果（1）纳入34个 RCT,2037例恶性胸腔积液患者,纳入研究质量一般;（2）与单独使用顺铂比较,Meta 分析合并相对危险度（RR）值：ORR[RR＝1．45,95％CI （1．36～1．54）,P ＜0．01]及发热[RR ＝2．37,95％CI （1．53～3．66）,P ＜0．05]比较差异有统计学意义;白细胞减少症[RR＝0．81,95％CI （0．61～1．07）,P ＝0．14];骨髓抑制[RR ＝0．83,95％CI （0．62～1．11）,P ＝0．21]及胸痛[RR＝1．04,95％CI （0．84～1．29）,P ＝0．69]在两组间差异无统计学意义。结论本研究表明 IL-2联合顺铂能显著改善恶性胸腔积液患者近期疗效,但存发热等不良反应,纳入研究质量一般。     

白细胞介素-2联合卡铂胸腔灌注治疗恶性胸水25例

目的研究白细胞介素-2(IL-2)联合卡铂治疗恶性胸腔积液的临床效果。方法将48例恶性胸水患者随机分为治疗组和对照组,治疗组25例应用IL-2加卡铂胸腔灌注,对照组23例单纯应用卡铂治疗,观察治疗前后胸水变化和副作用。结果治疗组控制胸水有效率(CR+PR)为96.0%,对照组为56.5%(P<0.01)。治疗组的副作用为轻度发热、胸痛,对照组为骨髓抑制、胃肠道反应及发热。结论IL-2联合卡铂胸腔灌注能有效地控制恶性胸腔积液,毒副作用小,疗效肯定。     

胸腔置管引流并灌注白细胞介素Ⅱ联合顺铂治疗肺癌恶性胸腔积液疗效观察

目的观察胸腔置管引流并灌注白细胞介素Ⅱ联合顺铂(PPD)治疗肺癌伴恶性胸腔积液的近期疗效和毒副反应。方法65例肺癌伴恶性胸腔积液患者,先用深圳市益心达医学新技术有限公司生产的一次性双腔中心静脉导管进行胸腔置管和闭式引流胸液,充分引流后给予胸腔内注药。观察组(n=25例)胸腔灌注顺铂(PPD)联合白细胞介素Ⅱ;对照组1(n=20例)胸腔灌注单用顺铂(PPD);对照组2(n=20例)胸腔灌注单用白细胞介素Ⅱ。顺铂每次注入40~60mg,白细胞介素Ⅱ每次注入40~60万U,1~2次/周,连续注射2、3周,1个月后观察两组的疗效及不良反应。结果白细胞介素Ⅱ联合顺铂对恶性胸腔积液的有效率为84.0%,明显优于单用顺铂组60.0%及单用白细胞介素Ⅱ组50.0%(P<0.05)。结论胸腔置管引流并灌注白细胞介素Ⅱ联合顺铂治疗肺癌恶性胸腔积液,疗效肯定,是控制恶性胸腔积液的有效方法。     

Surveillance testing in patients with primary malignant melanoma

There are, at this time, no fully published prospective randomized studies of follow-up strategies for patients with primary malignant melanoma. However, four recent retrospective studies indicated that greater than 90% of melanoma recurrences were detected by history and/or physical examination, and that detection of recurrent melanoma by blood tests, chest X-ray, or CT scan rarely led to long-term survival. Based on the results of the above studies, recommendations for follow-up as developed by the National Institute of Health Consensus Panel on Early Melanoma can be considered. These include: 1) history and physical examination (including total body skin examination) at regular intervals; 2) the consideration of initial screening for first degree family members of patients with melanoma; and 3) on-going education for patients to recognize the signs of local and regional recurrences.     

Reasons for poor prognosis in British patients with cutaneous malignant melanoma

One hundred and twenty five patients presenting in the west of Scotland with primary cutaneous malignant melanoma answered a detailed questionnaire to establish whether there was any evidence of inappropriate delay in receiving surgical treatment for a new or changing pigmented lesion. The survey was carried out because of the relatively high proportion of patients in Scotland with melanoma presenting with primary lesions categorised as "thick, poor prognosis" and the poor five year survival figures as compared with many other countries. Of the 125 patients questioned, only 20 (16%) had received appropriate surgical treatment within three months of becoming aware of a suspicious cutaneous pigmented lesion; 63 (50%) had received surgical treatment three to 12 months after first noticing such a change, and in 42 cases (34%) this interval was over one year. In 102 of 105 patients in whom the interval exceeded three months the patient alone was responsible for the delay; in only three cases was the family doctor partially at fault. No evidence of delay by the hospital service was identified. Because of these findings a public education campaign was launched in the west of Scotland in June 1985 with the aim of improving recognition of early malignant melanoma. In the next six months the proportion of patients in the west of Scotland with primary melanomas categorised as "thin, good prognosis" had risen from 38% to 62%, and the proportion with tumours categorised as "thick, poor prognosis" had fallen from 34% to 15%.     

280例肢体恶性黑色素瘤临床分析

目的:本文旨在对我院四肢的恶性黑色素瘤的临床和病理特征、治疗情况进行分析。方法:收集我院1998年至2009年11月就诊的四肢恶性黑色素瘤280例患者的临床资料,对其病历资料完整、接受系统治疗的146例病例、结合相关文献进行总结、分析。结果:回顾性资料分析显示:原发于肢体的恶性黑色素瘤95%发生于其末端,32%原发部位有外伤史、历经5～20年(平均16年),后被活检病理证实。中位随访39.9月,1年生存率99%,3年生存率58%。结论:恶性黑色素瘤是一类来源于黑色素细胞的恶性程度高、治愈难度大的恶性肿瘤。该病起病隐匿,加之人们对其认识不到位,经常在肿瘤进展后来院就诊,预后较差。依靠病理学早期明确诊断、及早手术、系统、规范化、个体化的治疗可延长生存期、提高生存率。     

Regression of ocular melanoma metastatic to the liver after hepatic arterial chemoembolization with cisplatin and polyvinyl sponge

Thirty patients with ocular melanoma metastatic to the liver were treated by hepatic arterial chemoembolization using an admixture of cisplatin and polyvinyl sponge. Tumor regression was complete in one patient and partial (greater than 50%) in 13 patients. The total response rate was 46%. The median survival for the entire group was 11 months (95% confidence interval, nine to 18 months). Treatment-related morbidity was short-lived and included primarily severe upper right quadrant abdominal pain, transient paralytic ileus, and nonicteric hepatitis. Hepatic arterial chemoembolization provided effective palliation, with good-quality survival among 46% of patients with ocular melanoma metastatic to the liver.     

43例肛管直肠恶性黑色素瘤临床分析

【目的】探讨原发性肛管直肠恶性黑色素瘤的生物学特性、临床表现、诊断、治疗及预后。【方法】回顾性分析我院1980-2002年收治的43例原发性肛管直肠恶性黑色素瘤的临床资料,并复习文献。【结果】本组43例,占同期收治的大肠恶性肿瘤的0.7%,男性17例,女性26例;平均发病年龄54岁;主要临床表现为:便血60.5%、肛门口肿物53.5%、肛门疼痛或不适34.9%等;首次就诊误诊率46.5%;43例中29例行腹会阴联合切除术,12例行经肛门局部扩大切除术,2例行乙状结肠造瘘术;全组病例5年生存率为9.3%。【结论】肛管直肠恶性黑色素瘤恶性程度极高,提高生存率的关键是早期发现,早期治疗。     

重组人白介素-2联合顺铂治疗恶性胸腔积液的疗效观察及护理

目的:探讨重组人白介素-2联合顺铂治疗恶性胸腔积液的临床疗效及护理。方法:将68例恶性胸腔积液患者随机分为治疗组和对照组各34例,两组均采取综合护理措施,在此基础上治疗组胸腔内灌注重组人白介素-2及顺铂,对照组仅灌注顺铂,分析比较两组患者的治疗效果。结果:治疗组总有效率显著高于对照组(x2=4.43,P<0.05)。结论:重组人白介素-2联合顺铂治疗恶性胸腔积液能显著提高疗效,综合护理措施是提高疗效的基础。     

胸腔闭式引流后注入顺铂与IL-2治疗恶性胸腔积液

目的 观察胸腔置管引流并注入顺铂与IL-2联合治疗恶性胸腔积液的近期疗效和毒副反应.方法 23 例恶性胸腔积液患者,进行胸腔闭式引流胸液,并给予胸腔内注药,治疗组(n=12例)胸腔灌注IL-2联合顺铂;对照组(n=11例)单纯胸腔闭式引流.IL-2每次注入100 万U,顺铂每次注入40～60 mg,每5～7 d注射1次,连续注射2、3周,1个月后观察两组的疗效及不良反应.结果 治疗组有效率为75%,明显优于单用对照组45.45%(P<0.05).结论 胸腔置管引流并灌注顺铂与IL-2联合治疗恶性胸腔积液,疗效肯定,有利于恶性胸腔积液的控制.     

银屑病患者IL-2、sIL-2R、IL-6和TNF-α的表达

目的：探讨银屑病患者外周血单个核细胞（PBMC）分泌白细胞介素2（IL-2）、可溶性白细胞介素2受体（sIL-2R）、白细胞介素6（IL-6）和肿瘤坏死因子α（TNF-α）的水平及意义。方法：选取32例银屑病患者和15例正常人,分别作为病例组和对照组,分离培养其外周血PBMC,并用植物血凝素（PHA）诱导,酶联免疫吸附法（ELISA）检测诱导前后PBMC分泌IL-2、sIL-2R、IL-6和TNF-α的水平。结果：①病例组PBMC培养上清液中IL-2水平在PHA刺激前低于对照组（P〈0.05）,刺激后则明显低于对照组（P〈0.01）;②sIL-2R水平在刺激前与对照组间无显著性差异（P〉0.05）,刺激后明显高于对照组（P〈0.01）;③TNF水平在刺激前高于对照组（P〈0.05）,刺激后显著高于对照组（P〈0.01）;④IL-6水平在刺激前明显高于对照组（P〈0.05）,刺激后虽稍高于对照组,但无统计学意义（P〉0.05）;⑤sIL-2R和TNF-α的水平与银屑病面积和严重程度指数（PASI）均呈显著正相关（r分别为0.53、0.68）,IL-2的水平与PASI呈显著负相关（r=-0.46,P〈0.05）;⑥IL-6的水平与PASI不相关（r=0.30,P〉0.05）。结论：IL-2、sIL-2R、IL-6和TNF-α在银屑病的发病过程中发挥一定的作用。     

银屑病患者IL-2、sIL-2R、IL-6和TNF-α的表达

目的:探讨银屑病患者外周血单个核细胞(PBMC)分泌白细胞介素2(IL-2)、可溶性白细胞介素2受体(sIL-2R)、白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)的水平及意义。方法:选取32例银屑病患者和15例正常人,分别作为病例组和对照组,分离培养其外周血PBMC,并用植物血凝素(PHA)诱导,酶联免疫吸附法(ELISA)检测诱导前后PBMC分泌IL-2、sIL-2R、IL-6和TNF-α的水平。结果:①病例组PBMC培养上清液中IL-2水平在PHA刺激前低于对照组(P<0.05),刺激后则明显低于对照组(P<0.01);②sIL-2R水平在刺激前与对照组间无显著性差异(P>0.05),刺激后明显高于对照组(P<0.01);③TNF水平在刺激前高于对照组(P<0.05),刺激后显著高于对照组(P<0.01);④IL-6水平在刺激前明显高于对照组(P<0.05),刺激后虽稍高于对照组,但无统计学意义(P>0.05);⑤sIL-2R和TNF-α的水平与银屑病面积和严重程度指数(PASI)均呈显著正相关(r分别为0.53、0.68),IL-2的水平与PASI呈显著负相关(r=-0.46,P<0.05);⑥IL-6的水平与PASI不相关(r=0.30,P>0.05)。结论:IL-2、sIL-2R、IL-6和TNF-α在银屑病的发病过程中发挥一定的作用。     

23例恶性黑色素瘤患者的临床特点及预后分析

目的 分析恶性黑色素瘤患者的临床特点及预后,为临床诊疗提供参考。方法 选取2020年5月至2022年1月于宁波大学医学院附属医院住院治疗的23例恶性黑色素瘤患者为研究对象,收集患者的临床表现、皮肤镜特征、病理结果、治疗及随访情况。结果 23例患者中男15例,女8例;平均年龄（65.36±10.69）岁;平均体质量指数（22.29±1.10）kg/m2;发病时间2个月~2年,中位发病时间6个月;病变部位在肢端15例（65.22%）,四肢5例（21.74%）,腹部2例（8.70%）,腋下1例（4.35%）;黑色素瘤直径0.3~3.5cm,最大直径≤2cm 15例,>2cm 8例;TNM分期Ⅰ期3例（13.04%）,Ⅱ期10例（43.48%）,Ⅲ期9例（39.13%）,Ⅳ期1例（4.34%）。23例患者共70处皮损,其中溃疡14处（20.00%）,不规则色素球13处（18.57%）,蓝白幕12处（17.14%）,不典型血管11处（15.71%）,不规则色素条纹9处（12.86%）,多种色调9处（12.86%）,粉红色无结构2处（2.86%）。病理结果显示,镜下可见大量的癌细胞,癌细胞体积大,呈圆形、椭圆、异型、梭形,边界清楚,核仁明显,胞质丰富,腺泡状或片状结构,核大深染,细胞可见色素,其中结节性黑色素瘤17例（73.91%）,肢端雀斑样黑色素瘤6例（26.09%）。所有患者均接受手术治疗,术后随访6~18个月,无死亡或复发病例。结论 恶性黑色素瘤起病隐匿,病理特征复杂,皮肤镜在恶性黑色素瘤诊断中具有较高价值,手术治疗具有一定的疗效。     

吉西他滨联合顺铂治疗蒽环类及紫杉类耐药转移性乳腺癌的临床观察

目的:观察吉西他滨(Gemcitabine)联合顺铂(Cisplatin)治疗蒽环类及紫杉类耐药转移性乳腺癌的疗效及耐受性。方法:应用Gemcitabine 1000mg/m2静脉滴注d1d8,Cisplatin 20mg/m2,静脉滴注,d2～5,21d为一周期。结果:全组24例,其中CR1例、PR9例、SD9例、PD5例,总有效率41.7%。结论:吉西他滨联合顺铂治疗蒽环类及紫杉类耐药转移性乳腺癌疗效肯定,毒副反应能耐受。