高剂量化疗和自体外周血干细胞移植治疗5例晚期肺癌

高剂量化疗和自体外周血干细胞移植较多应用在乳腺癌、小细胞肺癌、生殖细胞瘤、淋巴瘤等敏感实体肿瘤中。本院自 1998年 1月— 1999年 1月对 5名晚期肺癌患者作了高剂量化疗和自体外周血干细胞移植尝试 ,收到了一定效果。现报道如下。材料与方法一　研究对象5例晚期肺癌 ,男性 3例 ,女性 2例。年龄 39— 6 6岁。病理 :3例小细胞肺癌 ,2例腺癌。入院前都是以往多次化疗后病情未得到控制有广泛转移的晚期病人。经病人和家属同意 ,自愿接受高剂量化疗。二　治疗方法入院化疗前对患者一般情况作了评估。并测肝肾功能、血常规、心电图、Ｂ超、免…     

高剂量化疗对小细胞肺癌治疗的分(附6例长期随访的结果)

目的研究病理明确诊断的小细胞肺癌采用自体外周血干细胞移植支持下的高剂量化疗的疗效。方法6例患者选自常规化疗达到CR、PR或手术切除原发灶的小细胞肺癌,对其采用自体外周血干细胞移植支持下的高剂量环磷酰胺(CTX)、足叶乙甙(VP-16)、卡铂(CBP)的化疗(CTX 6 000mg/m     

高剂量化疗并自体外周血干细胞移植治疗实体瘤九例分析

目的 探讨高剂量化疗并自体外周血干细胞移植治疗高危实体瘤的可行性及疗效,了解外周血干细胞动员及采集时机、造血功能重建等问题.方法 9例经病理组织学确诊的高危乳腺癌2例,非霍奇金淋巴瘤(NHL)3例及4例小细胞肺癌经过诱导化疗后,进行了高剂量化疗并自体外周血干细胞的移植.结果 随访7(1.6～13.8)个月,9例全部生存,7例无瘤生存.回输的单个核细胞(MNC)＞1.5×108/kg时,中性粒细胞(ANC)恢复≥0.5×109/L和血小板20×109/L所需的天数分别为9天和9.4天,无1例骨髓功能重建不全.结论 高剂量化疗并自体外周血干细胞移植对化疗敏感的乳腺癌、NHL及小细胞肺癌具有较好疗效且较安全,回输足够数量的造血干细胞,可使造血功能快速重建.     

以硼替佐米为基础的联合化疗序贯自体外周血造血干细胞移植治疗原发性浆细胞白血病一例并文献复习

目的：探索以硼替佐米为基础的联合化疗序贯自体外周血干细胞移植治疗原发性浆细胞白血病（pPCL）的效果。方法报道1例经硼替佐米为基础的联合化疗序贯自体外周血干细胞移植治疗pPCL,并进行相关文献复习。结果该例患者经硼替佐米为基础的联合化疗达到非常好的部分缓解（VGPR）,进行自体外周血干细胞移植后达到完全缓解（CR）,无进展生存达33个月。结论以硼替佐米为基础的联合化疗及自体造血干细胞移植可能会改善pPCL患者的预后,减少复发。     

《中国肿瘤临床》文章推荐:普乐沙福用于外周血干细胞动员的研究进展

大剂量化疗联合自体外周血干细胞(PBSC)移植是淋巴瘤和多发性骨髓瘤(MM)的有效治疗手段。PBSC的常规动员方案包括粒细胞集落刺激因子(G-CSF)单用或联合化疗。部分患者使用常规动员方案无法采集到目标剂量的CD34+细胞,无法进行造血干细胞(HSC)移植治疗。因此,针对动员不佳患者以及降低具有危险因素患者动员失败的风险,根据个体情况有效调整动员策略十分必要。     

《中国肿瘤临床》文章推荐:普乐沙福用于外周血干细胞动员的研究进展

大剂量化疗联合自体外周血干细胞(PBSC)移植是淋巴瘤和多发性骨髓瘤(MM)的有效治疗手段。PBSC的常规动员方案包括粒细胞集落刺激因子(G-CSF)单用或联合化疗。部分患者使用常规动员方案无法采集到目标剂量的CD34+细胞,无法进行造血干细胞(HSC)移植治疗。因此,针对动员不佳患者以及降低具有危险因素患者动员失败的风险,根据个体情况有效调整动员策略十分必要。     

利妥昔单抗联合高剂量治疗和自体外周血干细胞移植治疗侵袭性B细胞淋巴瘤的多中心前瞻性研究

目的 探讨在高剂量治疗联合自体外周血干细胞移植的基础上,加用利妥昔单抗治疗侵袭性B细胞淋巴瘤的可行性和疗效.方法 12个癌症研究中心共入组28例侵袭性B细胞淋巴瘤患者,其中22例为新诊断患者,6例为复发患者.每例患者共接受4次利妥昔单抗静脉输注,即在外周血干细胞动员化疗的前1天、动员化疗的第7天、干细胞回输的前1天和回输后的第8天各给予1次,每次375 mg/m2,共1500 mg/m2结果 高剂量治疗后,所有患者均达到完全缓解.中位随访37个月时,全组患者的4年总生存率和无进展生存率分别为75.0%和70.3%,新诊断患者的4年总生存率和无进展生存率均为72.7%.全组患者对利妥昔单抗治疗的耐受性较好,不良反应多为1、2度.结论 在高剂量治疗联合自体造血干细胞移植的基础上加入利妥昔单抗治疗侵袭性B细胞淋巴瘤是可行的,并且可能使患者的生存获益.     

自体外周血干细胞支持下高剂量化疗与常规化疗治疗小细胞肺癌的比较

比较自体外周血干细胞支持下高剂量化疗（ｈｉｇｈ－ｄｏｓｅ ｃｈｅｍｏｔｈｅｒａｐｙ,ＨＤＣＴ）与常规剂量化疗（ｃｏｎｖｅｎｔｉｏｎａｌ ｄｏｓｅ ｃｈｅｍｏｔｈｅｒａｐｙ,ＣＤＣＴ）治疗小细胞肺癌（ＳＣＬＣ）的疗效,生存期,并评价与高剂量化疗相关的毒性。方法本试验观察了２７例经病理证实的ＳＣＬＣ患者,其中１３例为例自体外周血干细胞支持下高剂量化疗,１４例为常规剂量化疗。高剂量化疗组先行１－３个周期     

化疗序贯自体造血干细胞移植治疗淋巴瘤的疗效评价及影响因素分析

目的:探讨化疗序贯自体造血干细胞移植(auto-HSCT)对淋巴瘤患者的疗效及影响因素.方法:回顾性分析2015年09月至2020年12月于我科接受大剂量化疗(HDC)序贯自体外周血造血干细胞移植治疗的患者,并进行疗效及不良反应评价.结果:40例患者,其中非霍奇金淋巴瘤34例,霍奇金淋巴瘤6例;男性27例,女性13例,...     

自体外周血干细胞支持高剂量化疗治疗小细胞肺癌的研究

目的：比较自体外周血干细胞支持下高剂量化疗与常规剂量化疗治疗小细胞肺癌的疗效、中位生存期、累计生存率的差异，并评价与高剂量化疗有关的毒性。方法：小细胞肺癌３９例中１９例为自体外周血干细胞支持下高剂量化疗，２０例为常规剂量化疗。化疗方案以ＩＶＰ、ＣＶｐＰ为主，高剂量为常规剂量的３倍，造血因子Ｇ－ＣＳＦ动员干细胞，高剂量化疗及常规化疗组２疗程后，除Ⅲｂ、Ⅳ期外均给予手术或放疗。结果：高剂量化疗后缓解率     

生殖细胞肿瘤治疗的研究进展--2004年ASCO文献综述

生殖细胞肿瘤是15～35岁男性最常见的恶性肿瘤.目前的多学科综合治疗使大多数患者得到了治愈,人们正试图如何进一步提高疗效,减少治疗带来的远期毒性.2004年ASCO年会收录的关于男性生殖细胞肿瘤的研究报告主要集中在以下几个方面:术后辅助化疗的地位、基于预后因素的个体化治疗、新药和新的化疗方案、自体造血干细胞移植的治疗策略和长期生存者生活质量的影响因素.本文就这些方面的研究进展作一综述.     

Oat cell carcinoma of esophagus: a report of six british patients with a review of the literature

This paper presents 6 British patients with a diagnosis of oat cell carcinoma of the esophagus. Sixty-six patients have previously been reported in the literature, the majority (30) being British. Approximately two-thirds of these tumors have been reported as pure oat cell carcinoma of the esophagus. Four other histological patterns have been described: oat cell carcinoma with squamous carcinoma in situ; oat cell carcinoma with squamous carcinoma; oat cell carcinoma with adenocarcinoma; and oat cell carcinoma with carcinoid differentiation. A preponderance of males has also been noted, although this series shows a 2;1 female: male ratio. The tumor arises most commonly in the mid or lower esophagus. The cell of origin of these tumors in considered to be the Kulchitsky or APUD cell of neuroectodermal derivation. They may show neurosecretory granules on electron microscopy. Polypeptides have been identified within the tumor cells. One previous report describes a patient with primary oat cell carcinoma of the esophagus and hypercalcemia. A patient with the syndrome of inappropriate anti diuretic hormone secretion is described in this paper. Survival is poor following radiotherapy, with a median survival of 3 months in this series. On reviewing the records of the Radiation Oncology Unit in Edinburgh, no patient with oat cell carcinoma of the esophagus was reported before 1972. This suggests that awareness of this tumor is increasing and, although rare, its incidence is greater than previously reported.     

代谢综合征与肾透明细胞癌相关性研究

目的 代谢综合征(metabolic syndrome,MS)是一组临床症候群,MS及其相关组分与癌症发生发展及病理特征具有密切关系.本研究旨在分析MS及其相关组分与肾透明细胞癌(clear cell cenal cell carcinoma,CCRCC)分期、分级及肿瘤大小的相关性.方法 回顾性分析2013-01-01-2015-12-30于山西医科大学第一医院就诊且病理诊断为CCRCC的375例患者的临床资料,包括年龄、性别、身高、体质量、血压、空腹血糖、生化结果、病理分期分级和肿瘤大小等.计数资料采用x2检验,计量资料以(x)±s表示,组间比较采用t检验,多因素分析采用Logistic回归分析.结果 MS组56例患者,其中男性患者32例,女性患者24例;非MS组319例患者,其中男性患者206例,女性患者113例.男女患者比较,差异无统计学意义,P=0.287.MS组与非MS组相比,年龄、吸烟、饮酒等差异无统计学意义,P值分别为0.100、0.691和0.269;而BMI指数、收缩压、空腹血糖、TG、HDL-C等差异均有统计学意义,均P＜0.001.在病理特点方面,MS与非MS相比,CCRCC病理分期(P=0.018)、分级(P=0.026)及肿瘤大小(P=0.026),差异均有统计学意义.MS相关疾病与CCRCC分期分析,糖尿病(P＜0.001)、高血压(P=0.015)、血脂紊乱(P=0.006)与CCRCC的分期有关.结论 CCRCC合并MS者病理分期较高、分级较低、肿瘤更大,糖尿病、高血压和血脂紊乱都可增加CCRCC的病理分期.     

吉非替尼治疗31例男性晚期非小细胞肺癌临床观察

目的：观察吉非替尼（Iressa）对男性晚期非小细胞肺癌（NSCLC）患者疗效及毒副反应。方法：31例经病理组织学或细胞学确诊的男性晚期NSCLC口服Iressa250mg/d,直至病灶进展或出现不可耐受的副反应,每月CT扫描,评价疗效,同时记录不良反应。结果：31例入选患者中,30例可评价疗效,无完全缓解（CR）,部分缓解（PR）6例,均为肺腺癌,稳定（SD）12例,其中鳞癌1例,12例病情进展（PD）,有效率（RR）为20%（6/30）,疾病控制率（CR＋PR＋SD）为60%（18/30）,中位肿瘤进展时间5个月,1年生存率40%。最常见的毒副反应为皮疹和腹泻。结论：对于无法耐受化疗或化疗失败的亚洲男性晚期NSCLC患者,尤其是肺腺癌患者,持续口服吉非替尼同样是较理想的方案。     

Lung carcinoma with spindle and/or giant cell： a clinicopathological analysis of 17 cases

Objective: Lung carcinoma with spindle and (or) giant cell (LCSG) is a rare epithelial malignant tumor. The aim of our study is to investigate the clinicopathological and prognostic characteristics of 17 cases of LCSGs. Methods: Among 421 patients underwent resection of lung carcinomas, 17 cases of LCSG were studied for clinical, gross and histological parameters. Follow-up information was obtained and analyzed to clarify prognostically significant parameters. Results: The LCSG patients consisted of 15 males and 2 females, with the age ranging from 45 to 78 years (median, 58 years); 5 cases of stage Ⅰ, 3 of stage Ⅱ, 9 of stage Ⅲ by pathological TNM staging; 2 cases of exclusively spindle cell carcinoma, 5 cases of lung carcinoma with spindle cell, 10 cases of lung carcinoma with giant-cell carcinoma. Cough, chest distress, or chest pain were the most common presenting symptoms, occurring in 15 patients (88.2%). Of 5 patients in stage Ⅰ, 4 were alive and free of relapse for more than 5 years. The difference in survival was statistically significant between LCSG and squamous cell carcinoma patients (median survival, 36 vs. 61 months; P = 0.027). Lymph node metastasis and carcinoma with giant cell were the hazardous factors impacting postoperative prognosis of LCSG patients. Conclusion: LCSG patients in early stage may have an optimistic outcome. Lung carcinomas with giant cell displayed multiple cell components in histopathology, and poor outcome due to more lymph node involved.     

Prognostic value of tumor thickness in patients with Merkel cell carcinoma

BACKGROUND AND OBJECTIVES: Merkel cell carcinoma is an aggressive skin malignancy that often presents with tumor metastases. We hypothesized that tumor thickness might correlate with both regional and metastatic tumor spread and could, therefore, be used as an independent prognostic variable. The purpose of this study was to see if depth of tumor invasion would predict prognosis independent of tumor stage. METHODS: Data pertaining to clinical presentation, pathology, treatment, and survival were collected for patients diagnosed with Merkel cell carcinoma from 1972 to 2005. Patients were staged according to AJCC guidelines. Pathologic specimens were evaluated for tumor thickness. The relationship between tumor thickness and disease-free survival or overall survival was analyzed using Kaplan-Meier survival analyses. RESULTS: Sixty patients were identified. Five-year disease-free survivals for Stages 1, 2, and 3 patients were 20%, 33%, and 0%, respectively. Five-year overall survivals for Stages 1, 2, and 3 patients were 33.3%, 60%, and 16.7%, respectively. There was no correlation between tumor thickness and either disease-free survival or overall survival. CONCLUSIONS: This study suggests that tumor thickness is not an independent risk factor for survival. Mean tumor thickness did increase with the AJCC stages, but this most likely represents more advanced stage of disease.     

无功能胰岛细胞肿瘤的诊断与治疗

目的分析无功能胰岛细胞肿瘤(NFICCs)的临床病理特征,探讨其临床诊治方法。方法回顾性分析43例无功能胰岛细胞肿瘤的临床、病理及预后资料。采用Kaplan-Meier生存曲线分析及Log rank统计分析。结果43例无功能胰岛细胞肿瘤患者中,无功能胰岛细胞癌(NFICC)28例,无功能胰岛细胞瘤(BNFICTs)15例。临床症状以腹痛、恶心、呕吐、乏力及腹部肿块多见。术前B超及CT均能确定胰腺肿块。肿瘤位于胰头部21例,胰尾部10例,胰体部6例,体尾部5例,多发性1例。全组总的手术切除率为90.7%,根治切除率为69.8%,姑息手术20.9%。NFICC患者手术切除率及根治性切除率分别为78.6%和60.7%。NFICC患者的5年及10年生存率分别为58.1%和29.0%。女性、30岁以下、根治性手术以及肿瘤直径<10 cm的患者预后较好。多因素回归分析证实,手术方法是惟一的预后影响因素(P=0.007)。结论无功能胰岛细胞肿瘤好发于年轻女性,手术切除率较高。患者采取手术治疗、特别是根治性手术,可以获得较理想的远期疗效。     

Giant cell fibroblastoma

A report of a 1¹/₂-year-old male child diagnosed as a case of giant cell fibroblastoma is described and the available literature on this neoplasm is reviewed. The tumor consists of a mixture of spindle cells and multinucleated giant cells in a myxoid or collagenous background. The pathological findings and clinical course suggest that these tumors be classified with fibromatoses of childhood. Removal of the tumor with wide excision is sufficient and these patients do not require any form of chemotherapy. © 1993 Wiley-Liss, Inc.     

Changes in the expression and subcellular distribution of galectin-3 in clear cell renal cell carcinoma

Background

Clear cell renal cell carcinoma, a solid growing tumor, is the most common tumor in human kidney. Evaluating the usefulness of β-galactoside binding galectin-3 as a diagnostic marker for this type of cancer could open avenues for preventive and therapeutic strategies by employing specific inhibitors of the lectin. To study a putative correlation between the extent of galectin-3 and the development of clear cell renal cell carcinoma, we monitored the quantity and distribution of this lectin in tissue samples from 39 patients.

Methods

Galectin-3 concentrations in normal, intermediate and tumor tissues were examined by immunofluorescence microscopy and on immunoblots with antibodies directed against galectin-3 and renal control proteins. The cell nuclei were isolated to determine quantities of galectin-3 that were transferred into this compartment in normal or tumor samples.

Results

Immunofluorescence data revealed a mosaic pattern of galectin-3 expression in collecting ducts and distal tubules of normal kidney. Galectin-3 expression was significantly increased in 79% of tumor samples as compared to normal tissues. Furthermore, we observed an increase in nuclear translocation of the lectin in tumor tissues.

Conclusions

Our data indicate that changes in the cellular level of galectin-3 correlate with the development of clear cell renal cell carcinoma, which is in line with previously published data on this specific type of tumor. In most of these studies the lectin tends to be highly expressed in tumor tissues. Furthermore, this study suggests that the increase in the proportion of galectin-3 affects the balance from a cytosolic distribution towards translocation into the nucleus.     

Granular cell tumor: a clinicopathologic study of 110 patients

The clinicopathologic features of 118 granular cell tumors (GCT) encountered at two affiliated hospitals were reviewed. A total of 110 patients were affected over this 32-year period of study (71 men, 39 women), and in 5% GCT were multiple. Patients ranged in age from 16 to 58 years (average 32 years) and were symptomatic for an average duration of 11 months prior to diagnosis. There was a greater than expected frequency of GCT among black patients (29%). Although tongue was the single most common anatomic site involved, relatively more GCT (44%) occurred in skin or subcutaneous tissue. Less common locations were breast parenchyma (10 cases), rectal mucosa and anus (6), vulva (4), esophagus and larynx (2 cases each). The correct preoperative diagnosis of this protean tumor was made in only three patients. GCT were surgically treated with the average diameter of resected tumor being 1.2 cm (range 0.2--3.5 cm). Pseudoepitheliomatous hyperplasia was noted in 11 tumors and in one vulvar GCT there was overlying in situ squamous cell carcinoma. Tumors were incompletely excised in 24 of 56 patients having adequate followup; only five of these 24 patients experienced a local recurrence of tumor. Malignant behavior was not observed. Results of histochemical and ultrastructural study are briefly discussed. The precise histogenesis of GCT is uncertain but Schwann cell origin is favored in most cases.