微波消融术对原发性肝癌肝纤维化指标的影响

目的探讨微波消融（PMCT）治疗中晚期肝癌对肝纤维化五项指标的影响。方法49例微波消融的原发性肝癌患者,观察治疗前后血清HA、LN、PC-Ⅲ、Ⅳ-C、TGF-β1五项肝纤维化指标水平。结果PMCT治疗后与PMCT治疗前相比,HA、LN、PC-Ⅲ、Ⅳ-C差异无统计学意义,TGF-β1每次均有下降（P＜0.05）。结论PMCT治疗原发性肝癌对HA、LN、PC-Ⅲ、Ⅳ-C无影响,且对肝纤维化有一定抑制作用。     

血清PINP和ICTP及PCⅢ检测对肝病诊断价值的研究

目的:1)了解Ⅰ型前胶原氨端肽原(PINP)、Ⅰ型胶原羧端交联肽原(ICTP)和Ⅲ型前胶原(PCⅢ)三项肝纤维化指标在原发性肝癌、转移性肝癌和肝硬化血清中的变化。2)了解PINP、ICTP和PCⅢ三项肝纤维化指标、肝肿瘤指标和肝功指标之间的关系。方法:实验分四组:正常对照组30例,73例患者中原发性肝癌组28例,转移性肝癌组23例,肝硬化组22例。测定PINP、ICTP、PCⅢ、甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原(CA-199)、谷丙转氨酶(AST)、谷草转氨酶(ALT)和谷氨酰氨转酞酶(γ-GT)九项指标。结果:1)73例患者PINP、ICTP和PCⅢ水平均明显高于正常对照组,P<0·01;但PINP、ICTP和PCⅢ在原发性肝癌组和转移性肝癌组比较差异无统计学意义,P>0·05。2)AFP和肝功能指标在原发性肝癌组明显升高,和转移性肝癌组比较差异有统计学意义,P<0·01;CEA和CA-199在转移性肝癌组明显升高,和原发性肝癌组比较差异有统计学意义,P<0·05。3)PINP、ICTP和PCⅢ与肝肿瘤指标和肝功能指标之间的相关分析无相关关系,P>0·05。结论:1)PINP、ICTP和PCⅢ对了解肝内占位性病变的纤维化程度有一定的帮助;2)原发性肝癌和转移性肝癌的九项指标有一定差异;3)PINP、ICTP和PCⅢ与肝肿瘤指标和肝功能指标之间无相关关系。     

肝脏恶性肿瘤患者血清4项肝纤维化指标的检测及其临床意义

透明质酸 (ＨＡ)、Ⅲ型前胶原肽 (ＰⅢＰ )、层黏蛋白 (ＬＮ )和Ⅳ型胶原 (Ⅳ -Ｃ)均为重要的细胞外间质成份 ,其血清水平的高低与肝纤维化及肝细胞损伤的程度有关。为探讨血清上述 4项肝纤维化指标与原发性肝癌和继发性肝癌的关系 ,从 2 0 0 0年起 ,我们对收治的原发性肝癌、继发性肝癌及肝外恶性肿瘤患者进行 4项指标的检测 ,现报告如下。1　材料与方法1.1　对象1.1.1　正常对照组　本院健康体检者 5 1例 ,男性 3 0例 ,女性2 1例 ,年龄 2 1～ 5 9岁。各项体检指标均正常 ,无肝脏疾病史 ,甲、乙、丙、丁、戊、庚型肝炎病毒检测均阴性 ,肝功…     

原发性与转移性肝癌患者血清学检测的临床应用

  目的  探讨血清学检测指标在鉴别原发性与转移性肝癌时的临床应用价值。  方法  分别测定125例原发性肝癌患者组,135例转移性肝癌患者组及135例无肝转移的癌症患者组血清中ALT、AST、ALP、TBIL、DBIL、GGT、CHE、5'-NT、AFP、CEA、CA199的水平,采用方差析和Scheffe检验进行统计学分析。应用ROC曲线分析AFP、CEA和CA199对原发性肝癌及转移性肝癌的诊断价值。  结果  1）原发性肝癌组与转移性肝癌组之间血清AST、ALP、GGT、5'-NT、AFP及CEA水平差异有统计学意义（P < 0.05）。2）根据原发性肝癌组和转移性肝癌组AFP、CEA和CA199的ROC曲线下面积（Area under the ROC curve,AUC）判断,AFP对原发性肝癌诊断有一定的准确性,CEA、CA199对鉴别原发性肝癌与转移性肝癌有一定诊断价值。  结论  检测血清AST、GGT、5'-NT、AFP、CEA、CA199水平可对恶性肿瘤是否发生肝转移进行初步诊断,亦可对原发性肝癌与转移性肝癌的鉴别诊断提供佐证。      

肿瘤相关物质与甲胎蛋白联合检测在原发性肝癌诊断中的应用

目的探讨肿瘤相关物质(TSGF)与甲胎蛋白(AFP)联合检测在原发性肝癌诊断中的价值.方法设原发性肝癌组、继发性肝癌组、肝硬化组、肝炎组及正常对照组共5组,分别行TSGF与AFP联合检测及相关性统计.结果原发性肝癌组TSGF与转移性肝癌组相比无显著性差异,但与其他3组比较,有显著性差异(P＜0.05).原发性肝癌组AFP与其他各组比较,均有显著性差异(P<0.05).结论 TSGF是原发性肝癌的灵敏检测指标,与AFP联检可显著提高原发性肝癌的诊断率.     

荧光检测外周血AFP mRNA的表达与肝癌的相关性研究

目的：研究定量检测原发性肝癌患者外周血单个核细胞（PBMC）甲胎蛋白信使核糖核酸（AFP mRNA)表达的意义。方法：应用荧光定量聚合酶链反应（FQ－PCR）定量检测51例原发性肝癌，10例转移性肝癌，18例非肝癌的恶性肿瘤，16例慢性肝病患者的外周血单个核细胞（PBMC）甲胎蛋白mRNA。结果：AFP mRNA在非肝癌的恶性肿瘤患者无异常表达，在转移性肝癌（20％，2／10），慢性肝病（6．3％，1／16），原发性肝癌（37．3％，19／5）、AFP mRNA的基因拷贝数和肝癌TNM分期[1]，门静脉癌栓，肝外转移显著相关，而与肿瘤大小及血清AFP值无相关性。结论：巢式FQ－PCR检测肝癌患者外周血AFP mRNA异常预示有血源性转移的可能，可作为肝癌的诊断，肿瘤分期和有无肝外转移及愈合的指标。     

多项肿瘤标志物联合应用对肝癌的诊断价值

目的 探讨甲胎蛋白(AFP)、α-L-岩藻糖苷酶(AFU)、癌胚抗原(CEA)和糖链抗原19-9(CA19-9)四种肿瘤标志物对肝癌的诊断价值.方法 收集70例肝癌患者(肝癌组)、80例慢性肝病患者(慢性肝病组)和80例健康体检者(对照组)的临床资料,比较3组研究对象的血清AFP、AFU、CEA和CA19-9水平及其阳性率,比较原发性肝癌与转移性肝癌患者的血清AFP、AFU、CEA和CA19-9水平,分析多指标联合应用对乙肝表面抗原(HB-sAg)(+)肝癌与HBsAg(-)肝癌患者的诊断价值.结果 肝癌组患者的血清AFP、AFU、CEA、CA19-9水平及阳性率均高于对照组和慢性肝病组(P﹤0.05).原发性肝癌患者的血清AFP和AFU水平明显高于转移性肝癌患者(P﹤0.01),血清CEA水平明显低于转移性肝癌患者(P﹤0.01).不同的筛查组合对HBsAg(+)肝癌患者的诊断灵敏度均高于HBsAg(-)肝癌患者,其中AFP+AFU+CEA筛查对HBsAg(+)肝癌患者的灵敏度和约登指数最高,分别为91.11%和0.80.结论 应用AFP+AFU+CEA进行肝癌筛查的诊断效率较好,适合作为HBsAg(+)肝癌高危人群的筛查项目,且有助于区别原发性肝癌和转移性肝癌.     

多种血清肿瘤标记物联合检测在原发性肝癌临床诊断中的价值

目的:探讨血清中甲胎蛋白（alpha fetoprotein,AFP）、α-L-岩藻糖苷酶（α-L-fucosidase,AFU）、癌胚抗原（carcinoembryonic antigen,CEA）、癌抗原199（cancer antigen 199,CA199）的联合检测在原发性肝癌临床诊断中的价值。方法:选取97例原发性肝癌患者作为肝癌组,同期收治的65例肝良性疾病患者作为良性组,50例体检健康者作为健康组,采用电化学发光法对三组受检者血清中的AFP、AFU、CEA、CA199的水平进行检测,并比较三组血清肿瘤标记物的检测结果,血清肿瘤标记物单独检测和联合检测的敏感性与准确性。结果:肝癌组血清中AFP、AFU、CEA、CA199的水平显著高于良性组和健康组,差异有统计学意义（P＜0.05）。与高分化和中分化的原发性肝癌患者相比,未分化和低分化患者血清肿瘤标记物水平显著提高,差异有统计学意义（P＜0.05）;与未发生肿瘤转移组相比,出现原发性肝癌转移组的血清标记物水平明显升高,差异有统计学意义（P＜0.05）;HBV感染组与HBV未感染组的血清肿瘤标记物水平比较,差异无统计学意义（P＞0.05）。四项血清肿瘤标记物联合检测诊断原发性肝癌的敏感性达90.72%,准确性达87.65%,与单项肿瘤标记物检测相比,差异有统计学意义（P＜0.05）。结论:血清中上述四项肿瘤标记物的检测均可作为原发性肝癌诊断的指标,四项肿瘤标记物联合检测有助于提高原发性肝癌诊断的敏感性和准确性。     

IGF-2、AFP、ALP、r-GT在原发性肝癌模型小鼠血清中的表达水平

目的:研究胰岛素样生长因子-2（insulin like growth factor,IGF-2）、甲胎蛋白（alpha fetoprotein,AFP）、碱性磷酸酶（alkaline phosphatase,ALP）、r－谷氨酰转肽酶（r-glutamyl transferase,r-GT）在原发性肝癌模型小鼠血清中的表达水平。方法:选择SD健康雄性小鼠35只,按照随机数字法分为正常组和原发性肝癌组两组,分别有10只和25只小鼠。正常组小鼠不做任何处理,原发性肝癌组小鼠制成原发性肝癌模型,造模成功的共22只小鼠。免疫透射比浊法检测IGF-2、电化学发光免疫分析检测AFP的血清水平、双抗体夹心法检测ALP、r-GT水平表达、荧光定量RT-PCR技术检测IGF-2 mRNA、AFP mRNA、ALP mRNA、r-GT mRNA表达水平。结果:正常组小鼠肝组织细胞大小均匀,形态一致;原发性肝癌组小鼠肝组织细胞大小不等,细胞核形态多样,多有核分裂现象。原发性肝癌组小鼠的血清中IGF-2和IGF-2 mRNA水平均显著高于正常组的健康小鼠（P＜0.05）;原发性肝癌组小鼠的血清中AFP和AFP mRNA水平均显著高于正常组的健康小鼠（P＜0.05）;原发性肝癌组小鼠的血清中ALP和ALP mRNA水平均显著高于正常组的健康小鼠（P＜0.05）;原发性肝癌组小鼠的血清中r-GT和r-GT mRNA水平均显著高于正常组的健康小鼠（P＜0.05）。结论:原发性肝癌模型小鼠血清中IGF-2、AFP、ALP、r-GT水平都呈高水平表达,检测其血清中的水平对原发性肝癌的诊断有重要价值。     

卵巢癌患者围手术期血清bFGF、ColⅣ、HA的变化及临床意义

目的 探讨卵巢癌患者围手术期血清碱性纤维母细胞生长因子(bFGF)、Ⅳ型胶原(ColⅣ)和透明质酸(HA)的变化及其临床意义.方法 用分别采用双抗体夹心酶联免疫法(ELISA)和放射免疫法测定77例卵巢癌患者手术前后血清bFGF、ColⅣ和HA的含量,并与健康对照组比较分析.结果 卵巢癌组治疗前bFGF、ColⅣ和HA均增高,与对照组比较有显著性差异(P＜0.01);且与淋巴结转移和卵巢癌临床分期有明显相关性.行根治性手术组术后bFGF、ColⅣ和HA均有显著性降低(P＜0.05),而姑息性手术组bFGF、ColⅣ和HA则无显著性降低(P＞0.05).结论 卵巢癌患者血清bFGF、ColⅣ和HA的水平与肿瘤的浸润转移和病程有关,检测卵巢癌患者血清bFGF、ColⅣ和HA的变化,有助于估计患者的预后.     

Pathogenesis and Prevention of Radiation-induced Myocardial Fibrosis

Radiation therapy is one of the most important methods for the treatment of malignant tumors. However, in radiotherapy for thoracic tumors such as breast cancer, lung cancer, esophageal cancer, and mediastinal lymphoma, the heart, located in the mediastinum, is inevitably affected by the irradiation, leading to pericardial disease, myocardial fibrosis, coronary artery disease, valvular lesions, and cardiac conduction system injury, which are considered radiation-induced heart diseases. Delayed cardiac injury especially myocardial fibrosis is more prominent, and its incidence is as high as 20–80%. Myocardial fibrosis is the final stage of radiation-induced heart diseases, and it increases the stiffness of the myocardium and decreases myocardial systolic and diastolic function, resulting in myocardial electrical physiological disorder, arrhythmia, incomplete heart function, or even sudden death. This article reviews the pathogenesis and prevention of radiation-induced myocardial fibrosis for providing references for the prevention and treatment of radiation-induced myocardial fibrosis.     

A Digital Cephalometric Study on The Morphometric Evaluation of Soft Palate in Oral Submucous Fibrosis

Objective: Oral submucous fibrosis (OSMF) is a chronic precancerous condition affecting the oral cavity, which is progressive and characterised by burning sensation and fibrotic change leading to restriction of mouth opening. This study evaluated the morphology of soft palate in different stages of OSMF patients using digital lateral cephalogram and compare it with healthy individuals. Methods: The study included 60 subjects, who were grouped as 30 OSMF and 30 healthy subjects from the same geographic population. Digital lateral cephalograms were taken with Planmeca Proline XC (Oy, Helsinki, Finland). Soft palate morphology was evaluated using Lateral Cephalogram, and the results were analysed statistically. Results: Leaf-shaped (Type 1) soft palate was commonly seen in the control group and stage I and II OSMF. Stage III OSMF patients presented with a butt-shaped (Type 3) soft palate. As the disease progressed, there was a conversion of Type 1 variety of soft palate to Type 3 variety. There was a gradual reduction in the length of the soft palate in the anteroposterior direction in OSMF patients compared to the control group. Conclusion: Early cephalometric diagnosis of soft palate changes may play a pivotal role in the overall management of OSMF.     

Fibrosis in immune control of mammary-tumor growth.

In malignancies, an interruption of growth (dormancy) is sometimes observed. In the immunogenic mammary carcinoma MC2, dormancy followed by regression after a period of growth was observed in 18% of s.c. implants in normal mice. Dormant implants removed for histologic examination were invariably found to be completely surrounded by a highly fibrous stroma. Fibrosis was enhanced in immunized mice, and reduced in immuno-deficient mice. Surgical disruption of the fibrous capsule around dormant tumors early (19 +/- 3 days) in the immune response led more frequently to resumed growth, while later (32 +/- 3 days) disruption of the capsule led more frequently to complete regressions. This showed that fibrous capsules that could destroy tumors could also shield them against well-developed systemic immune mechanisms.     

Decoding Bone Marrow Fibrosis in Myelodysplastic Syndromes

BackgroundBone marrow fibrosis (BMF), a poor prognostic factor in myelodysplastic syndromes (MDS), in the context of new risk stratifications of MDS has not been fully explored. We examined the relationship between BMF in MDS and survival outcomes, and explored the landscape of somatic gene mutations in the setting of BMF.Patients and MethodsWe retrospectively evaluated 2624 MDS patients for BMF who were divided into 2 groups: grade 0-2 BMF (96%) and severe/grade 3 BMF (4%) based on analysis presented. Commonly MDS tested acquired somatic mutations were also compared between those 2 groups of patients with available next-generation sequencing data.ResultsOnly grade 3 BMF was associated with worse overall survival independent from the Revised International Prognostic Scoring System (IPSS-R) (hazard ratio = 1.6; 95% confidence interval, 1.2-1.9; P < .005). More patients with severe BMF were classified as MDS-EB1 and -EB2 by the World Health Organization 2016 classification, a higher-risk International Prognostic Scoring System score, and a high/very high IPSS-R risk category than patients with grade 0-2 BMF. A complex karyotype, higher bone marrow myeloblasts, lower platelets, and higher rate of elevated lactate dehydrogenase were observed more often in patients with severe BMF. No differences in response to hypomethylating agents or lenalidomide were observed. Among somatic gene mutations tested in MDS, TP53 mutation and SETBP1 were more frequent in patients with grade 3 BMF.ConclusionThe presence of grade 3 BMF is associated with reduced overall survival independent from IPSS-R; however, BMF grade did not affect response to hypomethylating agent or lenalidomide treatment. TP53 and SETBP1 mutations occurred with greater frequency among patients with severe fibrosis.     

Fibrin producing factor in Oral Sub-Mucous Fibrosis

When the saliva of the patient suffering from Oral Submucous Fibrosis (O.S.M.F.) was mixed with the plasma of the same patient and plasma of two other control persons, and incubated at 37°C, strong fibrin producing factor was detected in the saliva of OSMF patient, with an elevated plasma fibrinogen level, precipitable fibrinogen at 37°C and cryoprecipitate containing fibrinogen and immunoglobulin IgG. The presence of elevated fibrinogen level and precipitable fibrinogen at 37°C and 4°C is also found in other patients suffering from OSMF (unpublished data).     

Myelodysplastic Syndrome Associated with Bone Marrow Fibrosis

Bone marrow biopsy (BMB) in myelodysplastic syndrome (MDS) frequently reveals a slight alteration in the reticulin stroma which does not have any clinical significance. However, in a minority of cases, full-blown bone marrow fibrosis (BMF) can be found.

Primary MDS patients with BMF show distinct clinico-pathological features and an unfavourable prognosis mainly attributable to complications deriving from pancytopenia and continuous transfusions, while leukemic transformation occurs only rarely. Since BMF may characterize other hematological disorders, primary MDS with BMF should be included in the differential diagnosis particularly with malignant myelofibrosis (MM) and idiopathic myelofibrosis (IMF).

Secondary MDS with BMF represent a variety of preleukemic conditions in subjects treated for previous neoplasias. Unlike the primary forms, they do not form a clearcut clinico-pathological entity.     

Pentoxifylline Therapy in the Management of Oral Submucous Fibrosis

Objectives: Oral submucous fibrosis is a common premalignant condition in the Indian subcontinent andis caused by chewing areca nut and other irritants in various forms. Its medical treatment is not yet fullystandardized. In this study we compared the efficacy of Pentoxifylline as compared to placebo. Materials andmethods: 75 patients suffering from oral submucous fibrosis were randomly divided into two groups A and B.Group A patients received placebo, while Group B patients received 400 mg. Pentoxifylline for a period of 7months. Treatment outcome was evaluated on the basis of improvement in symptom and sign scores. Student’s‘t’ test was applied for comparing the results. Results: The improvement in total (i.e. symptoms + sign) scorewas 25% in group A and 49.15% in group B. This difference was found to be statistically significant. (p < 0.05)Conclusion: Treatment regimen of group B was more effective. No significant side effects were seen. A follow upstudy is required to assess long term outcome of this therapy.     

Radioisotopic Assessment on Development of Radiation Pneumonitis and Fibrosis

For a prospective study of earlier detection of radiation pneumonitis than by chest radiography, the sequential pulmonary arterial perfusion rate in irradiated upper lung regions was investigated with patients who received incidental pulmonary irradiation for post-operative cobalt 60 teletherapy of breast cancer.     

Superior Vena Cava Syndrome Caused By Chemotherapy-Induced Fibrosis

Abstract

We report a case of a 51-year old man with small cell lung cancer who developed superior vena cava syndrome due to obstruction of the superior vena cava at the junction of the brachiocephalic vein by a fibrotic band, 2 months after completing six cycles of chemotherapy with cisplatin and etoposid. Superior vena cava syndrome caused by chemotherapy-induced pulmonary fibrosis should be kept in mind during follow-up.