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1.
72例新月体肾炎的临床分析 总被引:5,自引:2,他引:3
本文分析经肾活检确诊的72例新月体肾炎,占全部肾活检的1.37%,按免疫病理分型,Ⅰ型9例(12.5%),Ⅱ型48例(66.7%),Ⅲ型15例(20.8%),原发病因以狼疮性肾炎最多见(25例),急进性肾炎次之(18例),血管炎居第三(10例),在贫血,高血压及肾功能损害程度上Ⅰ型重于Ⅱ型和Ⅲ型,而大量蛋白尿,肉眼血尿Ⅲ型多于Ⅰ和Ⅱ型,Ⅲ型新月体肾炎中ANCA,MPO-ANCA,AECA阳性率分别 相似文献
2.
肺大细胞癌的临床与病理分析 总被引:8,自引:0,他引:8
目的探讨肺大细胞癌临床特点和病理分型。方法对1978~1997年手术切除的54例肺大细胞癌的病理资料与临床资料进行了分析。结果54例大细胞癌中有透明细胞癌6例,巨细胞癌1例。男女之比为5∶1(45/9),男性明显多于女性;肺大细胞癌占肺癌切除病例的128%;平均存活时间为23个月,P53蛋白过度表达,阳性率为65%(13/20),介于鳞癌、腺癌与小细胞癌之间,增殖细胞核抗原(PCNA)免疫组化染色阳性率为100%(20/20)。结论肺大细胞癌作为一种病理类型,已不利于临床的诊断及治疗,建议将肺大细胞癌分成鳞分化型、腺分化型、神经内分泌型、未分化型。 相似文献
3.
bcl—2蛋白在肝肿瘤组织的表达及意义 总被引:1,自引:0,他引:1
目的 探讨抗凋亡基因bcl-2蛋白在常见肝肿瘤发生中的作用。方法 应用bcl-2癌蛋白单克隆抗体对64例四种类型的肝恶性肿瘤进行LSAB免疫组织化学标记。结果 16.2%(6/37)的肝细胞癌,69.2%(9/13)的胆管细胞癌,20.0%(1/5)的肝母细胞瘤和22.2%(2/9)肝转移癌呈bcl-2癌蛋白阳性表达,其中胆管细胞癌的阳性率显著高于其癌旁组织(P值〈0.05)和肝细胞癌(P值〈0. 相似文献
4.
目的 通过检测nm23-H1与CD44V6在NSCLC中的表达,探讨抑癌基因与转移相关基因在NSCLC中的表达及临床意义。方法 采用免疫组化法检测147例NSCLC nm23-H1、CD44V6的表达情况。结果 nm23-H1阳性92例(62.6%)。Ⅰ、Ⅱ期阳性率65.3%(62/95),Ⅲ、Ⅳ期为57.7%(30/52),两组比较x^2=0.20。P〉0.05。高、中分化组阳性83例(68.6%),与低分化组阳性(34.6%)比较x^2=10.55,P〈0.01。腺癌中nm23-H1阳性52例(78.8%),鳞癌中阳性32例(50.8%),两类型肺癌比较x^2=11.12,P〈0.01。CD44V6阳性率64.6%(95/147)。在Ⅰ、Ⅱ期中阳性表达率66.3%(63/95),Ⅲ、Ⅳ期阳性表达59.6%( 相似文献
5.
我院自1994年1月至1999年6月期间,经胃镜检查并手术后病理检查确诊早期胃癌33例,现将其手术后病理检查的TNM分期情况作一回顾性分析。 一、胃镜检查:根据1962年日本内镜学会提出分型的标准,本组33例早期胃癌中I型3例(9.0%);Ⅱ型15例(45.5%),Ⅱ型中Ⅱa型5例、Ⅱb型3例、Ⅱc型6例、Ⅱa+Ⅱc型1例;Ⅲ型15例(45.5%)。早期胃癌部位,胃窦18例(54.5%),胃角 7例(21.2%),胃体6例(18.2%),贲门2例(6.1%). 二、手术所见:33例病人手术前均常规… 相似文献
6.
分析40例手术切除小肝癌的临床病理学特征,其中32例随访1-18年(中位数9年)1,3,5,10年生存率,≤5cm(18例)为88.9%,44.4%,22.2%及5.6%,≤3cm(9例)为100%,66.7%,33.3%及22.2%,≤2cm(5例)为80.0%,40.0%,40.0%及20.0%,总体生存率为90.0%,56.3%,28.1%及12.5%,1,3,5年复发率为:≤5cm为22. 相似文献
7.
探讨抗凋亡基因bcl-2蛋白在常见肝肿瘤发生中的作用。方法应用bcl-2癌蛋白单克隆抗体对64例四种类型的肝恶性肿瘤进行LSAB免疫组织化学标记。结果16.2%(6/37)的肝细胞癌,69.2%(9/13)的胆管细胞癌,20.0%(1/5)的肝母细胞瘤和22.2%(2/9)的肝转移癌呈bcl-2癌蛋白阳性表达,其中胆管细胞癌的阳性率显著高于其癌旁组织(P值<0.05)和肝细胞癌(P值<0.01)。癌旁组织中的阳性细胞主要为增生的小胆管上皮细胞,而在肝细胞不典型增生中阳性率颇低(15.4%,2/13)。结论bcl-2基因可能在胆管细胞癌的发生中起重要作用,而不参与肝细胞的分裂、增殖。 相似文献
8.
为了解胃粘膜癌变过程中多基因蛋白的表达及意义,应用免疫组化技术检测107例内镜活检胃粘膜组织中增殖细胞核抗原(PCNA)及p53、K-ras、bc1-2基因蛋白。结果各基因蛋白阳性率随病变程度加重而增加。Ⅲ型肠化生者增殖细胞核抗原标记指数(PCNALI)及K-ras、bc1-2基因蛋白阳性率较之Ⅰ、Ⅱ型肠化亦有增高趋势但未见统计学差异(P≥0.05)。12例Ⅲ型肠化中有9例出现K-ras或bc1-2蛋白异常表达(75.0%),显著高于Ⅰ、Ⅱ型肠化(23.8%)(P<0.05)。在肠型及胃型胃癌p53表达率为53.3%、37.0%(P>0.05);K-ras为40.0%、7.4%(P<0.05);bc1-2为93.3%、59.3%(P<0.05)。15例肠型胃癌中有9例同时存在2种或2种以上蛋白异常表达(3例p53与bc1-2表达异常,2例bc1-2与K-ras表达异常,4例p53与bc1-2、K-ras异常表达),高于胃型胃癌(P<0.05)。结果提示以上基因产物的表达异常与胃粘膜癌变相关,Ⅲ型肠化属于胃癌癌前病变范畴,肠型胃癌发生发展的分子机制与胃型胃癌显著不同。 相似文献
9.
血脂康对Ⅱ型糖尿病糖、脂代谢的影响 总被引:30,自引:0,他引:30
目的验证血脂康对Ⅱ型糖尿病患者糖、脂代谢的影响。方法100例Ⅱ型糖尿病在原降糖措施的基础上分为四组,不合并(A组)和合并(B组)高脂血症各30例加服血脂康,不合并(C组)和合并(D组)高脂血症各20例不服血脂康为对照组,疗程2个月。结果A、B两组分别降低空腹血糖76%±77%和108%±96%,餐后2小时血糖141%±90%和122%±105%,糖化血红蛋白A1c11.0%±5.4%和63%±78%,总胆固醇9.0%±9.0%和15.0%±9.0%,甘油三酯4.0%±13.0%和21.0%±26.0%,与治疗前相比,差异有非常显著性(P值分别<0.05和<0.01),C、D组在观察前后各项指标无明显变化(P值均>0.05)。未见副作用。结论血脂康对Ⅱ型糖尿病除可调节异常血脂外,尚有一定降低血糖的作用。 相似文献
10.
术后残胃病变633例临床分析 总被引:16,自引:0,他引:16
术后残胃作为一种特殊的癌前状态,已越来越引起人们的重视。我院自1979年5月至1999年6月对胃大部切除术后患者633例进行了胃镜检查,现将结果报告分析如下。1.一般资料:本组633例残胃病变中,男550例,女83例,男女之比为6.6:1;年龄19~83岁,平均47.8岁。胃镜检查距手术时间3个月~30年。手术方式:BillrothⅠ(BⅠ)式330例(52.1%),BillrothⅡ(BⅡ)式303例(47.9%)。主要症状有上腹痛(63.5%)、腹胀(58.9%)、纳差(16.6%)、黑便(… 相似文献
11.
Factors affecting the yield of percutaneous cholangioscopic biopsy in patients with bile duct cancer
Ju Sang Park Dong Wan Seo Sung Koo Lee Yeon‐Ho Joo Myung Hwan Kim Young Il Min 《Digestive endoscopy》2001,13(3):142-145
Background: This study analyzed the factors associated with the yield of percutaneous transhepatic cholangioscopic biopsies in patients with bile duct cancer. Methods: One‐hundred‐and‐sixteen patients who had received percutaneous transhepatic cholangioscopy and who had been confirmed as having bile duct cancer were enrolled in this study. Multiple targeted biopsies were taken under direct cholangioscopic view. Results: When the location of the tumor was divided into intrahepatic duct (IHD), hilar duct and common bile duct (CBD), the biopsy yield was significantly higher in IHD cancer (93.7%) than in cases of hilar cancer (69.6%) (P < 0.05). After a bile duct cancer had been classified as a nodular type (n = 31), papillary type (n = 27) or infiltrative type (n = 58) cancer upon cholangioscopic findings, the biopsy yields from nodular (96.8%) or papillary types (96.3%) were significantly higher than from infiltrative types (58.6%; P < 0.01). The positive rate for malignant cells was not influenced by the presence of tumor vessels or the number of biopsy samples taken. However, the sensitivity of the combination of cholangioscopic biopsy and tumor vessel in overall bile duct cancer, especially in the infiltrative type, was significantly increased when it was compared with that of cholangioscopic biopsies (P < 0.01) or tumor vessels alone (P < 0.01). Conclusions: Cholangioscopic biopsy provides a high positive yield of malignant cells in those patients with IHD, nodular‐type and papillary‐type cancers. The cholangioscopic classification of bile duct tumors might thus provide important clues to predict biopsy yield. 相似文献
12.
胃肠道原发恶性淋巴瘤的内镜诊断探讨 总被引:1,自引:0,他引:1
本文报告经手术及病理检查证实的胃肠道原发恶性淋巴瘤20例,对其中13例行内镜检查者作了较细致观察与记录。肿瘤形态呈隆起型4例,溃疡型5例,局部浸润型1例,弥漫型3例。内镜确诊率为15.4%,确诊加疑诊率为53.8%。文中重点讨论了本病胃镜、肠镜的表现特点及活检取材的方法,提出了早期诊断的必要性和可能性。 相似文献
13.
Miwako ARIMA 《Digestive endoscopy》1999,11(1):12-23
Abstract: A questionnaire-based survey of cases of superficial esophageal cancer with histological features other than squamous cell carcinoma (SCC) was conducted prior to The 37th Conference of the Japanese Research Society for Early Esophageal Cancer and Chromoendoscopy. The data of cases resected between 1986 and 1996 at 25 Japanese institutions were evaluated. Among 2,381 cases of superficial esophageal cancer, 93 patients (3.9%) were diagnosed with histological features other than SCC. These included 6 cases of mucosal cancer and 87 cases of submucosal cancer, and were referred to as superficial nonsquamous cell carcinoma (NSCC). Most cases were grossly classified as O-I type. Elevated tumors, which included O-I and O-lla types, accounted for 80% of all lesions. Many cases of adenoid cystic carcinoma (ACC), adenosquamous carcinoma (ASC), basaloid carcinoma (BSC) and undifferentiated carcinoma (UND) were classified as O-lpl or O-lsep types. Almost all cases of carcinosarcoma (CASA) and malignant melanoma (MM) were classified as O-lp type. A small number of O-llc type tumors were observed and diagnosed as adenocarcinoma (AC), ACC ASC and BSC. All cases of AC were classified as unilocular tumor, and many cases were observed at the abdominal esophagus. However, the superficial esophageal tumors could not be differentiated by endoscopic features. The frequency of lymph node metastasis was slightly higher in UND and MM (60%), while the other histological types of esophageal cancer had an equivalent frequency to SCC (20–40%). Although the frequency of tumor recurrence was usually approximately 20%, the frequency of recurrent UND and MM was as high as 50–60%. Distant organ metastasis was the most commonly observed pattern of tumor metastasis. The five-year survival rate was approximately 60%, and there were no significant differences in the survival rate among the patients. However, the prognosis of UND and MM tended to be poor. (Dig Endosc 1999; 11: 12–23) 相似文献
14.
Makiyo MACHIDA Yoshiharu SATAKE Shigehiro KATAKURA Yoshio TSUBOMIZU Hiroshi MASUMITSU Norihiro KAMINAGA Yutaka ENDO Rikiya FUJITA 《Digestive endoscopy》1996,8(4):269-275
Abstract: Out of a total of 466 cases of early colorectal cancer, we analyzed 139 cases with submucosal invasion (sm cancer) according to tumor size, gross appearance, depth and degree of invasion, and the presence of adenoma components. Early colorectal cancers 11 -20 mm in diameter were the most common lesion in this group, and the percentage with sm cancer increased with tumor size. More than 70% of relatively small sm cancers, 6-10 mm in diameter, had moderate or massive submucosal invasion similar to that found in large sm cancers. Only 35% of 6-10 mm cancers had an adenoma component; the majority (65%) had no adenoma component. In marked contrast, 63% of sm cancers 11 -20 mm in diameter had an adenoma component and in sm cancer the percentage of tumors composed solely of cancerous tissue without an adenoma component was low. Similar results were obtained when only protruding type sm cancers, which accounted for the majority of sm cancer cases, were included in the analysis. Therefore, we believe that the protruding type sm cancer 6-10 mm in diameter is at a stage close to advanced cancer. It is possible that many 6-10 mm sm cancers have a histogenesis different from that of large sm cancers. 相似文献
15.
Value of biopsy and brush cytology in the diagnosis of gastric cancer. Shanghai Gastrointestinal Endoscopy Cooperative Group, People's Republic of China.
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《Gut》1982,23(9):774-776
This report presents the diagnostic value of brush cytology in gastric cancer. Gastric biopsies and brush cytology were performed in 155 patients with gastric cancer and 48 with benign gastric disease. The positive rate for biopsy and brush cytology in cancer patients (including 11 cases of early gastric cancer) was 74.2% and 76.8% respectively. The positive rate of biopsy with concomitant brush cytology was 87.7, which was superior to that of biopsy or brush cytology alone (p less than 0.01). In 29 cases of gastric cancer involving the cardiac region. 20 were biopsy positive (69%) and 22 were brush cytology positive (75.9%). Biopsy with brush cytology was positive in 27 cases (93.1%) and gave better results than biopsy alone (p less than 0.01). The positive rate of biopsy with concomitant brush cytology in Borrmann type I, II, and III lesions (89.7%) was significantly higher than in Borrmann type IV lesions (50%). In the 48 patients with benign gastric lesion, biopsy and brush cytology each provided two false positives. The study shows that the combination of biopsy and brush cytology increases diagnostic accuracy for gastric cancer. 相似文献
16.
Factors associated with pN3 stage tumors according to the TNM classification in advanced gastric cancer 总被引:5,自引:0,他引:5
Kikuchi S Katada N Sakuramoto S Koabayashi N Shimao H Sakakibara Y Kakita A 《Hepato-gastroenterology》2003,50(53):1723-1726
BACKGROUND/AIMS: The aim of the present study was to analyze factors associated with pN3-stage tumors, as classified according to the TNM Classification of Malignant Tumors, in patients who undergo curative resection for advanced gastric cancer. METHODOLOGY: A total of 391 patients with advanced gastric cancer (247 males and 144 females; average age, 59.2 years) were enrolled in the present study. The numbers of dissected regional lymph nodes and positive nodes were assessed, and node stage was determined according to TNM. Patient survival and factors associated with pN3-stage tumors were then analyzed. RESULTS: The 5-year survival rate was 82.9% for the 132 N0 patients, 66.4% for the 154 N1 patients, 41.1% for the 64 N2 patients and 21.1% for the 41 N3 patients. A significant difference was found between some of the curves (N0 and N1, p = 0.0012; N1 and N2, p = 0.0007; N2 and N3, p = 0.0055). In logistic regression analysis, independent factors associated with advanced gastric cancers with a pN3-stage tumor were tumor diameter (> 6 cm vs. < or = 6 cm, p = 0.0037), number of dissected nodes (> 30 vs. < or = 30, p = 0.0143), depth of invasion (T3 or T4 vs. T2, p = 0.0028) and microscopic type (undifferentiated vs. differentiated, p = 0.0147). CONCLUSIONS: The results of the present study suggest that tumor diameter (> 6 cm), depth of invasion (T3 or T4) and microscopic type (undifferentiated type) are the most reliable indicators of pN3-stage tumors in patients who undergo curative resection for advanced gastric cancer. 相似文献
17.
Significance of post-chemoradiation biopsy in predicting residual esophageal carcinoma in the surgical specimen 总被引:1,自引:0,他引:1
Q. Yang K. R. Cleary J. C. Yao S. G. Swisher J. A. Roth P. M. Lynch R. Komaki J. A. Ajani A. Rashid S. R. Hamilton T.-T. Wu 《Diseases of the esophagus》2004,17(1):38-43
Pathologic complete response in the resected esophagus can be achieved in approximately 30% of patients with locally advanced esophageal or gastroesophageal junction carcinoma after preoperative chemoradiation therapy. These patients tend to have a longer survival than those who have less than pathologic complete response. Post-chemoradiation esophageal biopsy (PCEB) is used to check for the presence of residual tumor before a definitive resection is performed, but the clinical significance of PCEB findings is not clear due to the possibility of sampling bias and the superficial nature of the specimen obtained. We evaluated the use of PCEB (defined as biopsy taken within 30 days before esophagectomy) in predicting residual cancer in post-treatment esophagectomy specimens. PCEB was performed in 65 of 183 (36%) patients with locally advanced esophageal or gastroesophageal junction carcinoma, who received preoperative chemoradiation therapy. The cancer status in PCEB was correlated with the residual cancer in the esophagectomy specimens. PCEB had no cancer in 80% (52 of 65) of patients (Bx-negative) and cancer in 20% (13 of 65) of patients (Bx-positive). There was no difference in the presence of residual cancer (either in esophagus or lymph node) in esophagectomy specimens between Bx-negative patients (77%, 40 of 52) or Bx-positive patients (92%, 12 of 13), P = 0.44. The positive predictive value of biopsy was 92% (12 of 13), negative predictive value 23% (12 of 52), sensitivity 23% (12 of 52) and specificity 92% (12 of 13). There was no difference in the residual cancer staging in the esophagectomy specimen between Bx-positive and Bx-negative patients. In contrast, residual metastatic carcinoma in lymph nodes was more frequent in Bx-positive patients (69.2%, 9 of 13) than in Bx-negative patients (28.8%, 15 of 52), P = 0.01. Our data suggest that PCEB is a specific but not a sensitive predictor of residual cancer following esophagectomy. Bx-positive patients tend to have more frequent residual tumor in lymph nodes. The utility of PCEB in predicting residual cancer in the lymph nodes needs to be explored further along with molecular predictors of response to preoperative therapy. 相似文献
18.
原发性大肠恶性淋巴瘤临床、内镜与病理特点 总被引:12,自引:0,他引:12
目的 搪塞原发性大肠恶性淋巴瘤(PCML)的临床表现、内镜和病理特点。方法 采用血常规及血型检测,X线检查、内镜检查,最终均得到手术和病理证实。结果 24例PCML中临床表现以腹痛、体重下降、发热、腹块、便血和大便习惯改变为主。病变位迂回在盲部9例(37.5%),直肠1例(4.2%)。内镜下表现为隆起9/16例(56.2%)、浸润型4/16型(25.0%),溃疡型3/16例(18.8%),与术后分 相似文献
19.
Dye Spraying and Magnifying Endoscopy for Dysplasia and Cancer Surveillance in Ulcerative Colitis 总被引:5,自引:1,他引:4
Sada M Igarashi M Yoshizawa S Kobayashi K Katsumata T Saigenji K Otani Y Okayasu I Mitomi H 《Diseases of the colon and rectum》2004,47(11):1816-1823
PURPOSE The aim of this study was to investigate detection of dysplasia or colitic cancer with ulcerative colitis by use of magnifying endoscopic observation.METHODS From 1986 through 2000, ulcerative colitis was diagnosed and treated in 886 patients at Kitasato University East Hospital. Of the total, we studied 25 patients in depth: 14 who had dysplasia alone, 5 in whom cancer was diagnosed during follow-up after the detection of dysplasia, and 6 who had colitic cancer.RESULTS Dysplasia was detected in 11 (3.2 percent) of 345 patients with extensive colitis and in 8 (3.7 percent) of 217 with left-sided colitis. Colorectal cancer was diagnosed in nine patients (2.6 percent) with extensive colitis and in two (0.9 percent) with left-sided colitis. Neither dysplasia nor colitic cancer was found in patients with proctitis-type colitis. Endoscopically, dysplasia and early cancer were characterized by granular or nodular protruding mucosa or by lowly protruding or flat mucosa, often associated with redness. Dye-spraying endoscopy was useful for detection. Magnifying endoscopy of ten regions of dysplasia (7 patients) and five early cancers (4 patients) showed IIIS to IIIL type pits or IV type pits. Biopsy of sites showing tumorous pits on magnifying endoscopy revealed dysplasia and early cancer. Observation of the pit pattern was found to be diagnostically useful.CONCLUSIONS Dye spraying and magnifying endoscopy are useful for the detection, targeted biopsy, and diagnosis of dysplasia and colitic cancer in patients with ulcerative colitis. 相似文献
20.
Congenital expression of mdr-1 gene in tissues of carcinoma and its relation with pathomorphology and prognosis 总被引:2,自引:1,他引:1
NTRODUCTIONMultidrugresistance(MDR)ofmalignanttumorcelhasarousedwidespreadinterest.IthasbeenshownthatMDRispresentinmanymalign... 相似文献