CLINICAL SIGNIFICANCE OF THE DETECTION OF MINIMAL RESIDUAL DISEASE IN CHILDHOOD B-ALL BY FLOW CYTOMETRY

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A COMPARATIVE STUDY OF DNA FLOW CYTOMETRY AND MICROSPECTROPHOTOMETRY IN GASTRIC CARCINOMAS

Flow cytometric (FCM) and microspectrophotometric (MSP) measurements of cell nuclear DNA content were made in 53 fresh gastric carcinoma specimens and in 30 gastric mucosal specimens with chronic gastritis. DNA aneuploidy was found in 32/53 (60%) of gastric carcinomas, and appeared more frequently in wellor moderately differentiated tubular adenocarcinomas (90%) than in undifferentiated and mucousa cell carcinomas (23.6%) (P<0.001). No aneuploidy was found in chronic gastritis samples, but their proliferative cell fractions were higher than in normal control gastric mucosa samples (P<0.01). A comparison was made between FCM and MSP analyses of DNA content in 29 cases of gastric carcinoma, a high correlation rate (r=0.90) was found. The advantages and limitations of both methods are discussed, they may be used in combination for more precise cytochemical analysis.     

EMG STUDY IN THE DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS OF LIPID STORAGE MYOPATHY

Clinical, electromyographic and pathological features were studied in 18 patients with lipid storage myopathy （group I ) and 18 patients with polymyositis and dermatomyositis (group Ⅱ ). The results showed a remarhable lower stxmtaneous activity(SA) incidence (14%) in group I than that (55%) in group Ⅱ ;46% and 34% short-duration motor unit potentials(MUAPs) with polyphasic potentials and 74% and 71% short-duration MUAPs without polyphasie potsntials respectively； the percentages of increased polyphasic MUAPs wre same in the Vwo groupa. The reduced or pathologic interfereuce palms accmmted for 61% in the group I and 50% in group Ⅱ. Increased CPK, LDH and HBD were also found in both of them. It is suggested that the lipid storage myopathy may be diagnosed when patients have muscle weakness and myalgia with short-duration and low-amplitude and polyphasic MUAPs without or with occasional spoataneous activitie*, and increased CPK, LDH and HBD.     

IMAGING TECHNIQUES FOR THE DIAGNOSIS OF RENAL TUMORS

In recent years.diagnostic imaging techniques,especially ultrasonography (US) and CTscanning,have been widely adopted in clinical practice,making early accurate diagnosisof renal tumors possible.A total of 452 cases of renal tumors have been admitted to theinstitute since 1951,of which 220 were seen from 1951 to 1979 and 232 in the past 9years (1980-1988).The frequency of renal parenchymal tumors was obviously higher in thelatter group,including asymptomatic renal carcinoma in 20.2% and hamartoma in 38.1%.All these were discovered on routine physical check-up by ultrasonography and/or CTscanning and would otherwise have gone undiagnosed on conventional urography.Ultra-sonography and CT can also reveal the nature and the extent of the tumor.The idea that“a renal tumor should be considered malignant unless pathologically proven otherwise”isno longer valid.However,general manifestations of renal carcinoma,such as elevatederythrocyte sedimentation rate (ESR),hypertension,malaise,anemia,fever and hypercalcemia,still deserve proper attention.We suggest that ultrasonography of both kidneys should bemandatory in routine physical check-up,as far as the urinary system is concerned,in orderto discover asymptomatic renal tumors.     

DIAGNOSIS AND TREATMENT OF THE MIRIZZI SYNDROME

Objeetves. The aim of this paper is to describe the clinical characteristics, diagnostie procedure andoperative management of Mirrizi syndrome. Methods. Sixteen cases of Mirrizi syndrome were selected and reviewed from 1987 to 1997. Results. In the 16 eases, 6 cases were male, 10 eases were female, the average age was 62. 7 years old. Ten eases were diagnosed to be Mirrizi syndrome preoperativaly(62. 5 ％ ) ; 3 cases were considered to bile duct tumor, the other 3 eases were emergency, they were confirmed the diagnosis after the operation. Conclusions. Ultrasound is recommended as the first choice of screening method, while ERCP may confirm the diagnosis. Surgical approach is considered to be the choice and technical procedures are sug-gested to prevent intraoperative injury and to repair defects of the common bile duct.     

DETECTION OF PLATELET-DERIVED MICROPARTICLES USING FLOW CYTOMETRY AND ITS CLINICAL APPLICATION

Objective. To establish a flow cytometric internal standard method for counting platelet-derived microparti-cles (PMPs) and to study its clinical significance.Methods. PMPs suspension (platelet poor plasma, PPP) was extracted by gradual centrifugation. According to the size of PMPs, 3 μm and 0. 8μm latex beads were used as internal standards for the quantitation. PMPs were counted by adjusting flow cytometric discrimination and voltage of forward scatter and side scatter.Results. In 30 healthy donors, the average concentration of resting PMPs was (1. 2×105±5.7×104 ) /ml and that of activated PMPs was (1. 6×106±9. 1×105) /ml. Compared with healthy donors, PMPs mean value was significantly higher ( P < 0. 001) in 18 patients with coronary artery disease, 12 with acute cerebral infraction and 23 with chronic renal failure [the average PMPs concentration, ( 6. 1×105±2. 5×105 )/ml, ( 6. 8×105±3. 4×105) /ml and (5. 9×105±3. 1×105) /ml respectively]. However, no significant difference in PMPs     

THE USE OF SLEEP EEG IN EPILEPTIC DIAGNOSIS

Sleep and waklng EEG of 522 patients with epilepsy and various disease with attack nature were studled, EEG showed paroxysmal activities(PA) in 2]7 cases. PA appeared only during sleep in 96 cases, posirive rate of EEG diagnosis increased from 23.2 percent in waking recordings to 41.6 percent, Fifty of 97 benign childhood epilepsy with centrotemporal spike(5l.6%) had focal PA only during sleep. Two of 6 cases with Lennox-Gastaut syndrome showed tonic seizure and/or generalized paroxysmal fast activities,Seizure types of 15 patients were deigned hy interictal PA and ictal EEG during sleep. There was no corresponding relationship between seizure time(waking or sleep) and PA sensitivity to state of vigilance.     

DIAGNOSIS AND TREATMENT OF IDIOPATHIC NECROSIS OF THE FEMORAL HEAD

Fifteen cases,27 hips,of idiopathic necrosis of the femoral head (INFH) were included iour series.The role of radiography,isotopic bone scanning,intraosseous pressure measure-ment and intraosseous venography in the diagnosis of INFH were evaluated.Radiologicalexamination could not reveal early cases,while isotopic bone scanning was more sensitive.There was an increase of intraosseous pressure in most of the diseased hips.and intraos-seous venography showed abnormalities in all examined hips.The latter two tests couldtherefore detect early INFH.Core decompression was performed in 23 hips,21 of whichwere followed for 7 to 27 months.Functional evaluation was good or excellent in 18 hips.Radiological re-examination remained unchanged in 19 hips.Postoperative intraosseouspressure measurement and intraosseous venography revealed a decrease of intraosseous pres-sure and improvement of venous drainage.Core decompression is therefore an ideal methodof treatment for early INFH.     

膀胱肿瘤抗原检测试验在膀胱癌无创诊断中的应用

目的：探讨无创早期诊断膀胱癌的有效方法：对膀胱癌患者进行尿液中膀胱肿瘤抗原（ＢＴＡ）测定与分析。方法：对６４例膀胱癌及２８例非膀胱癌患者的尿进行ＢＴＡ测定及尿脱落细胞学检查，比较这两种方法的敏感度、特异度、准确度、阳性及阴性似然比。结果：ＢＴＡ测定的敏感度、准确度、特异度、阳性及阴性似然比分别为９０６％、８９３％、９０２％、８５及０１；尿脱落细胞学检查这些指标分别为４６９％、９２９％、６０９％、６６及０５７。ＢＴＡ测定的敏感度、准确度、阴性似然比与尿脱落细胞学检查指标比较存在显著性差异（Ｐ＜００５）；阳性似然比高于脱落细胞学检查，但无统计学意义（Ｐ＞００５）；特异度在二者也无差异性（Ｐ＞００５）。ＢＴＡ敏感度随肿瘤的分级、分期的增高而呈升高趋势，但差异并无统计学意义（Ｐ＞００５）。结论：ＢＴＡ测定是无创、快速诊断及监测膀胱癌的方法，有较高的敏感度及准确性。     

RhoGDI2蛋白在膀胱癌组织中的表达及意义

目的:研究RhoGTP酶GDP解离抑制因子2(rho GDP dissociation inhibitor 2,RhoGDI2)蛋白在膀胱癌组织中的表达情况及意义.方法:收集来自广西医科大学附属肿瘤医院2010年10月至2014年6月的膀胱癌组织标本44例.用免疫组织化学的方法定位、定量检测膀胱癌组织中RhoGDI2蛋白的表达情况,按不同病理参数对膀胱癌组织进行分组并比较各分组RhoGDI2蛋白的表达是否有统计学差异.结果:全部膀胱癌组织标本均可见RhoGDI2蛋白阳性表达,不同性别和不同年龄分组的RhoGDI2蛋白表达无差异(P＞0.05).在Ta～T3期,RhoGDI2蛋白表达与分期相关(P＜0.05),随着分期增高表达降低,T3与T4期比较无差异(P＞0.05);RhoGDI2蛋白表达与分化相关(P＜0.05),分化程度越高,表达越低;原发与复发、非转移与转移组之间比较有差异(P ＜0.05),复发组和转移组的RhoGDI2蛋白表达降低.结论:膀胱癌组织中RhoGDI2蛋白可能抑制膀胱癌的浸润、转移,在蛋白水平上可能是膀胱癌转移抑制因子.     

膀胱癌细胞癌基因ras产物P_(21)的表达及其临床意义

本文用癌基因ras产物P_(21)的单克隆抗体SCI-oncogema 1及ABC免疫酶标染色法对53例膀胱癌和7例泌尿系非肿瘤病人的膀胱粘膜石蜡切片进行染色,结合肿瘤的病理学分级和分期以及病人随访结果进行分析,表明弱例膀胱癌中P_(21)阳性者达32例(60.4％),而7例泌尿系非肿瘤病人的膀胱粘膜标本其P_(21)均为阴性。还发现在膀胱癌P_(21)的阳性率随着病理分级和分期的上升而明显下降,P_(21)阳性膀胱癌其复发率为17.6％,而P_(21)阴性膀胱癌的复发率则高达82.4％。经分析还发现P_(21)表达与膀胱癌预后有密切的相关性,32例P_(21)阳性膀胱癌患者中死于肿瘤者仅3例(9.4％),而21例P_(21)阴性膀胱癌患者中死于肿瘤者多达17例(81％)。提示P_(21)阳性可考虑作为膀胱癌预后较好的客观依据之一。     

三维超声显像在膀胱疾病诊断中的应用

①目的　探讨三维超声显像在膀胱疾病诊断中的应用。②方法　采用GEVoluson 730三维超声成像系统对 31例膀胱疾病病人进行了二维与三维超声表面模式重建。③结果　三维超声图像清晰、直观、立体感强 ,能清楚地显示病变的位置、大小、数目、形态、回声特点、与膀胱壁的关系、基底的宽窄及有无蒂等。三维超声对膀胱疾病的诊断符合率高于二维超声 (χ2 =5 .72 6 ,P <0 .0 5 )。④结论　三维超声较二维超声能够提供更为丰富的图像信息 ,有助于膀胱疾病的诊断及鉴别诊断     

流式细胞术检测DNA含量在胃癌早期诊断中的价值

肿瘤的发生与发展是一个多基因、多因素的过程,胃癌亦是如此,它的发生与发展是一个极其复杂的过程,有众多复杂的分子生物学变化.用流式细胞术(FCM)测定细胞核DNA含量,可反映细胞的增殖能力,并可根据异倍体的出现,判断组织的良性与恶性.由于细胞核DNA含量的变化出现在细胞形态和组织结构改变之前,因此,检测胃黏膜癌前病变和胃癌细胞核内DNA含量,对分析癌前病变发展趋势,发现早期胃癌有一定价值.FCM检测细胞DNA倍体在胃癌的研究中虽然取得了一定成果,但能否同病理形态学一样作为胃癌诊断依据尚不明确.随着研究的不断深入,人们对它的了解越来越多,应用于胃癌早期诊断的前景更为广阔.     

尿液流式细胞DNA分析术对膀胱肿瘤的诊断价值

对68例膀胱肿瘤病人和34例泌尿系非肿瘤病人的尿液和膀胱冲洗液流式细胞分析术(FCM)检测结果作了比较。结果所有的膀胱冲洗液和63.7％尿液标本FCM检测结果满意,36.3％尿液标本虽然不能得到有关细胞动力学数据,但仍然可以进行DNA倍体分析,表明膀胱冲洗液和尿液均适用于FCM检测,但前者优于后者。在早期和晚期膀胱肿瘤诊断上本组膀胱冲洗液和尿液的FCM阳性率分别为79.3％和97.4％及55％和89.7％,而尿细胞学检查仅为13.7％和71.8％。结果显示尽管尿液FCM阳性率低于膀胱冲洗液FCM阳性率,但尿液标本留取方便,并能多次重复,在高危人群普查和术后随访监测中更有它的优点。故不失为较理想的膀胱肿瘤的辅助诊断方法。     

实时三维超声对膀胱肿瘤的诊断及术前分期的研究

目的:探讨实时三维超声对膀胱肿瘤诊断及术前分期的临床应用价值.方法:应用二维超声与三维超声对68例膀胱肿瘤患者进行诊断并术前分期,并与手术结果进行对照.结果:68例膀胱肿瘤患者共检出瘤体98个,二维超声检出符合率为82.7%,术前分期准确率为79%.三维超声栓出符合率为94.9%,术前分期准确率为90%.结论:三维超声对膀胱肿瘤的空间位置、形态及分期较二维超声准确率高.三维超声能更直观立体的反映肿瘤的结构,能提高膀胱肿瘤诊断及术前分期的准确率.     

超声显像与膀胱镜对膀胱肿瘤的诊断价值

对经手术和病理证实的８３例膀胱肿瘤进行超声显像和膀胱镜检查的对比性分析。结果表明，膀胱镜对膀胱肿瘤的诊断符合率为９７．５％，略高于超声显像符合率的９５．２％；但对膀胱肿瘤的术前分期，膀胱镜检查尚存在局限性，而超声显像可弥补膀胱镜检查的不足。本文超声显像对膀胱肿瘤的术前分期准确率达８９．５％。超声显像对小于０．５ｃｍ的小膀胱肿瘤之检出率不如膀胱镜高。因此在常规检查以及对肿瘤的术前分期时，应以超声显像作为首选，同时结合膀胱镜检查，可进一步提高膀胱肿瘤的术前诊断正确率。     

尿液乳酸脱氢酶活力及其同工酶对膀胱癌诊断价值的探讨

11名健康成人尿液LDH活力为16.8±9.7u/8h尿量,LDH同工酶以LDH_1最多,为81％,LDH_218.6％,LDH_3,LDH_4和LDH_5之和只为0.30％。膀胱癌患者尿液LDH活力增加5.6倍,同工酶中LDH_1降低51.7％,LDH_2增高近一倍,LDH_3、LDH_4和LDH_5之和达26.4％。由于肾盂肾炎和肾盂癌患者尿液LDH活力和LDH同工酶也有类似改变,可以断定尿液LDH活力及其同工酶对泌尿系统疾病有一定诊断价值,但对膀胱癌的诊断并无特异性。     

儿童侧脑室肿瘤的诊断和外科治疗

目的:探讨儿童侧脑室肿瘤的诊断和外科治疗及临床效果.方法:回顾性分析26例儿童侧脑室肿瘤的临床表现、病理分型、手术入路的选择及预后,所有病例均行手术治疗.结果:26例儿童侧脑室肿瘤中,所有肿瘤均经手术和病理证实,肿瘤全切除20例,近全切除3例,大部切除2例,部分切除加外减压1例.15例获得随访6～20月,其中9例生活基本上能自理或参加学习,随访期内复发4例.结论:早期诊断,选择适当的手术入路进行显微手术能有效地降低手术创伤,提高治愈率.