顺铂联合香菇多糖治疗恶性胸腔积液32例疗效观察

目的 探讨顺铂联合香菇多糖治疗恶性胸腔积液的疗效及机制。方法 将64例恶性胸腔积液患者随机分为观察组(32例)和对照组(32例)。观察组32例患者放尽胸水后经胸腔内注入顺铂加香菇多糖进行治疗；对照组32例患者放尽胸水后经胸腔内注入顺铂进行治疗。结果 观察组有效率(84．4％)高于对照组(50.0％)具有显著性差异(P＜0．05)。结论 顺铂联合香菇多糖治疗恶性胸腔积液患者有确切疗效。明显提高化疗药敏感性，提高患者生存期及生活质量。     

力尔凡联合顺铂治疗恶性胸水55例疗效分析

目的观察力尔凡联合顺铂对恶性胸水的抑制作用。方法 55例胸腔积液患者均采用常规胸穿刺抽胸腔积液,随机分为力尔凡＋顺铂组和顺铂组,观察Karnofsky评分、治疗副作用及胸水量。结果力尔凡＋顺铂组有效率为80.65%,明显高于顺铂组的45.83%（P〈0.01）。结论力尔凡加顺铂配合常规胸穿刺抽胸腔积液可以有效控制恶性胸水,提高患者生存质量,减轻化疗副反应,值得推广。     

顺铂联合高聚生腹腔灌注治疗37例恶性腹水的体会

目的　评价顺铂 (DDP)联合高聚生 (HASL)腹腔灌注治疗恶性腹水的效果。方法　将49例恶性腹水病人随机分为治疗组 (顺铂联合高聚生腹腔灌注 ) 37例和对照组 (单一顺铂腹腔灌注 )12例 ,治疗出院后分别随访 ,比较两组的治疗效果及生存期限。结果　治疗组完全有效 (CR) 2 8例 ,部分有效 (PR) 7例 ,无变化 (NC) 2例 ,总有效率 94.6 % (35 / 37) ,对照组CR2例 ,PR3例 ,NC7例 ,总有效率 41.7% (5 / 12 )。治疗组生存 4～ 2 2个月 ,平均生存 12 .3个月 ;对照组生存 2～ 7.5个月 ,平均生存4.5个月。结论　顺铂联合高聚生腹腔灌注治疗恶性腹水疗效确切 ,安全可靠 ,可明显改善病人生活质量 ,提高病人生存期限。     

化疗联合腹腔灌注治疗直肠癌恶性腹水的临床观察

目的 评价化疗联合顺铂腹腔灌注治疗直肠癌恶性腹水的疗效以及腹水癌细胞凋亡和Trail的表达情况.方法 将2010年1月至2012年12月福建医科大学附属协和医院收治的伴有恶性腹水的83例晚期直肠癌患者,随机分为单纯化疗组（37例,伊立替康＋5-氟尿嘧啶的FOLFIRI方案）和综合治疗组（46例,FOLFIRI方案化疗十顺铂腹腔灌注）,比较两组患者临床疗效、腹腔积液中癌细胞凋亡和Trail的表达.结果 与单纯化疗组相比,综合治疗组患者腹水明显减少,腹水控制率DCR更高（80.43％比72.97％.P＜0.05）.与腹腔灌注前比较,腹腔灌注后,Trail表达和癌细胞凋亡增加（P＜0.05）.结论 与单纯化疗相比,综合治疗组对直肠癌腹水患者取得更好疗效,同时促进癌细胞凋亡.     

力尔凡胸腔内给药治疗肺癌胸腔积液疗效观察

目的探讨力尔凡胸腔内给药治疗肺癌恶性胸腔积液的效果。方法将83例肺癌恶性胸腔积液患者随机分成两组,对照组(42例)胸腔内注入化疗药物,观察组(41例)胸腔内注射力尔凡。结果两组药物疗效比较,差异无显著性意义(P>0.05);不良反应比较,差异有显著性意义(P<0.05)。结论力尔凡胸腔内给药治疗恶性胸腔积液不良反应少,效果显著。     

胸腺肽联合顺铂胸腔灌注治疗恶性胸腔积液效果观察

目的观察胸腺肽联合顺铂胸腔灌注治疗恶性胸腔积液的效果。方法随机将68例晚期肺癌伴恶性胸腔积液患者分为2组,每组34例。胸腔闭式引流后对照组经引流管缓慢将顺铂注射液20 mg注入胸腔,夹闭引流管48 h。观察组联合胸腺肽200mg胸腔灌注。比较2组近期疗效、治疗期间不良反应及治疗前后Karnofsky功能状态评分(KPS)。结果观察组总有效率和治疗后KPS评分均明显高于对照组,差异有统计学意义(P0.05)。2组不良反应发生率比较差异无统计学意义(P0.05)。结论胸腺肽联合顺铂胸腔灌注治疗恶性胸腔积液,能有效抑制胸腔积液的生成,改善患者生活质量。     

奈达铂胸腔灌注治疗恶性胸腔积液的临床观察

目的观察胸腔内注射奈达铂治疗恶性胸腔积液的临床疗效及安全性。方法 59例恶性胸腔积液患者,应用1次性单腔中心静脉导管行胸腔穿刺置管和闭式引流术排尽胸水后,行胸腔内药物注射。随机分治疗组和对照组：治疗组34例奈达铂100mg/次,0.9氯化钠注射液40mL稀释;对照组25例,顺铂80mg/次,0.9氯化钠注射液40mL稀释注入胸腔。1周后再次注药,共计不超过3次。结果治疗组CR12例,PR14例,有效率为76.5;对照组CR4例,PR9例,有效率为52.0。两组比较差异有统计学意义（P〈0.05）。两组患者腔内治疗均无气胸、胸腔感染、胸壁种植等严重并发症发生。结论胸腔置管闭式引流后注入奈达铂,是一种治疗恶性胸腔积液有效、安全的方法。     

顺铂化疗辅助治疗胃癌术后的疗效分析

目的探讨顺铂化疗辅助治疗胃癌术后的临床疗效和毒副反应。方法将60例胃癌术后患者随机分为观察组和对照组,各22例,观察组给予去甲长春花碱（NVB）、顺铂（DDP）静脉滴注联合顺铂腹腔灌注化疗,对照组仅给予甲长春花碱、顺铂静脉滴注治疗。结果观察组有效率（CR＋PR）30.0%,3年内疾病进展率为16.7%,5年总生存时间为83.3%,对照组有效率为20.0%,3年内疾病进展率为30.0%,5年总生存时间为70.0%,P〈0.05,差异有统计学意义。两组间毒副反应无显著差异性。结论顺铂化疗辅助治疗胃癌术后能改善疗效,值得推广。     

力尔凡胸腔内给药治疗肺癌胸腔积液疗效观察

目的探讨力尔凡胸腔内给药治疗肺癌恶性胸腔积液的效果。方法将83例肺癌恶性胸腔积液患者随机分成两组，对照组（12例）胸腔内注入化疗药物，观察组（41例，胸腔内注射力尔凡。结果两组药物疗效比较．差异无显著性意义（P〉0.05）；不良反应比较．差异有显著性意义（P〈0．05）。结论力尔凡胸腔内给药治疗恶性胸腔积液不良反应少．效果显著。     

顺铂腹腔循环热灌注治疗胃肠道肿瘤腹水的疗效观察

目的:对比不同剂量顺铂循环热灌注治疗胃肠道肿瘤腹水的近期疗效及副反应,并对其安全性进行评估.方法:同期胃肠道肿瘤腹水患者102例,随机分为两组,通过腹腔内穿刺置双管建立循环双通路,先行单向灌洗放出腹腔积液,再行循环热灌注.观察组于灌注液中加入顺铂120mg,并静脉给予硫代硫酸钠解救,对照组于灌注液中加入顺铂40mg,两组同时常规水化、利尿、止吐,两周期后对其疗效及副反应进行比较.结果:两组102例患者两个疗程后全部可评价疗效,观察组有效率90.7％,明显高于对照组,两组间差异有统计学意义(P＜0.01),毒副反应均较轻微,经对症处理,很快恢复正常,差异无统计学意义(P＞0.05).结论:大剂量顺铂腹腔内循环热灌注加硫代硫酸钠治疗胃肠道肿瘤腹水近期疗效明显,创伤性小,不良反应少而轻     

侵袭性骨肿瘤端粒酶活性检测及其意义

目的：检测端粒酶在侵袭性骨肿瘤中的活性及评估其作为骨肿瘤恶性诊断的意义。方法：采用非放射性同位素ＴＲＡＰ－银染方法从侵袭性骨肿瘤组织及骨源细胞系／株两方面进行端粒酶活性检测，并将此方法与ＴＲＡＰ－ＥＢ染色进行了比较。结果：５３例侵袭性骨肿瘤组织端粒酶活性检出率８３．０％（４４／５３）；同时检测的１９例同一病人的肿瘤旁对照组织和１例骨的瘤样病变—动脉瘤样骨囊肿均未检测到端粒酶活性；３例正常的骨膜培养细胞，１例已经３次化学致癌剂４－ＮＱＯ处理，传至１０２代的动脉瘤样骨囊肿细胞及１例人骨肉瘤细胞株（ＯＳ７３２）未能检出端粒酶活性，但另１例人骨肉瘤细胞株（ＨＯＳ）却表达有端粒酶活性。结论：端粒酶活性可能是骨肿瘤恶性的一种潜在生化标志物，并在骨肿瘤的发生发展过程中可能起到重要的作用。结果还表明非放射性同位素ＴＲＡＰ－银染方法是一种简便、安全、快速而有效的检测端粒酶活性的方法     

端粒酶活性与膀胱肿瘤T24细胞的诱导分化研究

目的：探讨人膀胱肿瘤T24细胞诱导分化治疗与端粒酶活性改变的关系。方法：用全反式维甲酸（ATRA）诱导分化人膀胱肿瘤T24细胞，用聚合酶链反应-酶联免疫吸附试验（PCR-ELISA）法检测T24细胞诱导分化后端粒酶活性变化，用流式细胞术检测细胞周期动力学改变。结果：T24细胞经ATRA诱导分化后，细胞周期动力学发生改变：S期细胞所占比例逐渐降低，G0/G1期细胞所占比例逐渐增加；端粒酶活性被明显抑制，与对照组比较，ATRA处理后1、3、5、7d端粒酶活性抑制率分别为10.9％、34.7％、81.2％、92.5％；端粒酶活性的高低与细胞所处的分化状态有关。结论：人膀胱肿瘤T24细胞诱导分化后，其细胞周期动力学发生改变，端粒酶活性被抑制，这可能为膀胱肿瘤的诱导分化治疗提供理论依据。     

Expression of telomerase activity in thymoma and thymiccarcinoma tissues; a clinicopathological study

BACKGROUND: Telomerase is a nucleoprotein complex that caps the physical termini of all eukaryotic chromosomes. It is suggested that telomerase play important roles in unlimited cell division acquisition of the malignant phenotype. We studied the relation of telomerase activity in thymoma and thymic carcinoma to the clinicopathological features of these lesions. METHODS: Tissue specimens were surgically resected from patients with thymoma and thymic carcinoma. Telomerase activity was evaluated according to a modified telomeric repeat amplification protocol (TRAP) assay. RESULTS: Telomerase activity was detected in all thymic epithelial tumors. The activity (mean +/- SD: unit/microgram.protein) in thymoma (n = 17) was significantly higher than that in thymic carcinoma (n = 7) [431.8 +/- 400.1 vs. 68.8 +/- 39.8: p < 0.01]. Telomerase activities in thymoma and thymic carcinoma were significantly higher than that in primary lung adenocarcinoma (33.5 +/- 39.2: n = 47), studied as control (p < 0.01). In patients with thymoma, telomerase activity did not correlate with tumor stage according to Masaoka classification (p = 0.776). In patients with thymic carcinoma, however, telomerase activity positively correlated with tumor stage (p = 0.02). In thymoma, telomerase activity positively correlated with the ratio of induced lymphocytes according to Rosai's classification (p = 0.045). CONCLUSION: In thymoma, telomerase activity reflects the presence of immature T-cell lymphocytes in tumor tissue rather than tumor stage or malignant phenotype. In thymic carcinoma, telomerase activity derived directly from cancer cells may relate to tumor stage.     

Telomerase activity in skeletal sarcomas

Background: Telomerase is a ribonucleoprotein that adds TTAGGG nucleotide repeats onto the ends of eukaryotic chromosomes to maintain telomere integrity. Somatic cells do not express telomerase and stop dividing when the chromosomal ends are shortened critically after many cell divisions. Immortal cell lines and cancer cells apparently have telomerase activity that contributes to an unlimited number of cell cycles. The purpose of our study is to investigate whether telomerase activity is expressed in primary malignant tumors of the skeletal system when compared to adjacent normal tissue. Methods: Fresh tumor and normal tissue was collected from 14 patients (10 males, 4 females; age range, 8 to 76 years) and protein extraction performed. The tumors included seven osteosarcomas (three examined before and after chemotherapy), two chondrosarcomas, two spindle cell tumors, one hemangiopericytoma, one chordoma, and one adamantinoma. Telomerase activity was analyzed by using a highly sensitive polymerase chain reaction (PCR)-based assay (telomere repeat amplification protocol [TRAP]). Results: Telomerase activity was found in 8 of 14 sarcoma patients (57%) using the TRAP assay. Compared to HeLa cell extract (positive control), telomerase activity in the tumor specimen ranged from 0 (in osteosarcoma) to 11.7% (in hemangiopericytoma). There was variation in the number of telomeric repeats generated by telomerase. At least five telomeric bands (e.g. 50, 56, 62, 68, 74 bp) in a ladder pattern had to be present before telomerase activity was considered positive in our analysis. Conclusions: Telomerase activity may be an oncogenic sustaining event helping to maintain the transformed phenotype seen in malignant tumors of the bone. The degree of telomerase activity varies among skeletal malignancies, but was less than that observed in HeLa cells. The majority of osteosarcomas showed no telomerase activity.     

Telomerase activity is correlated with lower grade and lower stage bladder carcinomas

BACKGROUND: Telomerase is a ribonucleoprotein enzyme that compensates for the progressive erosion of telomeres. The increasing interest in telomerase is motivated by the demonstration that most human carcinomas are telomerase positive. The potential use of telomerase activity in bladder carcinomas using a urine sample has been reported in several studies. However, little is known about the detection of telomerase activity in bladder carcinoma tissues. Herein, we investigate telomerase activity in bladder carcinoma tissues according to grade (G) and stage. MATERIAL AND METHODS: Telomerase activity was assayed by polymerase chain reaction enzyme-linked immunosorbent assay methods. Malignant lesions were assessed in 37 patients with bladder carcinoma and no malignant lesions were assessed in five patients with dysplasia or inflammatory bladder lesions. RESULTS: Twenty-three out of 37 carcinoma samples were telomerase-positive and one out of five control samples without carcinoma was telomerase-positive. The positive rates according to stage and grade were 83.3% for superficial and 42.1% for invasive stages and 83.3% for G1, 66.7% for G2 and 40.0% for G3. Telomerase activity was correlated with lower grade and lower stage bladder carcinomas. CONCLUSION: These results strongly suggest that reactivation of telomerase may differ between superficial and invasive bladder carcinomas and also between low grade and high grade bladder carcinomas.     

Telomerase activity in malignant and benign renal tumors

OBJECTIVES: An important characteristic of malignant cells is their unlimited replicative potential, their immortality. In conferring this immortality, the enzyme telomerase is believed to play a crucial role. The detection of telomerase activity provides new knowledge regarding the biologic growth behavior of tumors and offers new diagnostic and therapeutic tools. METHODS: In the present study the sensitive TRAP assay (telomeric repeat amplification protocol) was used to examine 44 malignant renal tumors and 8 benign tumors of the kidney and 52 specimens of normal renal tissue for telomerase activity. RESULTS: Telomerase activity was detected in 63% of tissue samples obtained from histologically confirmed renal cell carcinomas. In cases of renal cell carcinoma restricted to the kidney, telomerase activity was detected in 58%. In cases in which tumor growth has progressed beyond the limits of the organ, telomerase activity was found in 69%. This stage dependence, however, did not reach statistical significance. No correlation to tumor grading was observed. Telomerase activity was found less frequent in chromophobe renal cell carcinomas. Neither the 8 benign renal tumors (4 oncocytomas and 4 angiomyolipomas) nor the specimens of normal kidney showed any evidence of telomerase activity. CONCLUSIONS: The proportion of remarkable slow-growing renal cell carcinomas showing telomerase activity is less than in other malignancies and may correlate with biologic growth behavior. Possible explanations include the presence of an alternative pathway, called ALT (alternative lengthening of telomeres) and an association with the loss or presence of the telomerase suppressor on the short arm of chromosome 3. Prolonged follow-up will be of special interest to determine whether lack of telomerase activity predicts favorable outcome.     

FOCAL INTRATUMORAL HETEROGENEITY FOR TELOMERASE ACTIVITY IN HUMAN PROSTATE CANCER

PURPOSE: The value of telomerase activity as a marker in clinical decision-making is closely related to how representative the analysis of a small tumor sample is for the whole tumor. We therefore evaluated the intratumoral distribution pattern of telomerase activity in prostatic carcinomas. MATERIALS AND METHODS: From 50 prostate cancer patients treated with radical prostatectomy, telomerase activity was determined using the telomeric repeat amplification protocol (TRAP assay). Comparative analysis of at least two separate cancer areas from a single tumor was performed in 42 cases. RESULTS: Telomerase activation has been demonstrated in 90% of the prostatic carcinomas. Focal intratumoral heterogeneity was found in 38.1% of the tumors with at least two different areas examined. Telomerase positivity of all samples from one given tumor was detected in 50%, telomerase negativity of all samples in 11.9%. A heterogeneous telomerase activity pattern was more frequently detected in tumors with a Gleason score < or = 7 than in those with a Gleason score > 7. Furthermore, there was an increase in the proportion of homogeneously telomerase-positive tumors with increase in severity of the Gleason score. The differences reached statistical significance. Telomerase activity was also detected in non-cancerous prostatic tissue samples. CONCLUSIONS: Telomerase activation is nearly ubiquitous in prostatic carcinomas, although a heterogeneous telomerase activity pattern within tumors might produce a false-negative result in the telomerase activity assay. This limits the value of telomerase activity assays for diagnostic means. There is evidence for a shift from telomerase-negative prostate cancer tissue toward telomerase positivity during the progression process of prostate cancer. The relatively high proportion of telomerase-positive nonmalignant prostatic tissue samples argues against cancer-specificity of telomerase activation.     

Prognostic impact of telomerase activity in non-small cell lung cancers

OBJECTIVE: To evaluate the clinical significance of telomerase activity, particularly in terms of prognostic impact, in non-small cell lung cancer (NSCLC). SUMMARY BACKGROUND DATA: Telomerase activity has been found in various tissues. The activation of telomerase is considered necessary for the immortalization of human tumor cells, including NSCLC. METHODS: The authors studied 103 NSCLC specimens using a polymerase chain reaction based on a telomeric repeat amplification protocol assay. RESULTS: Telomerase activity was detected in 85 (82.5%) of 103 NSCLC specimens but in none of the paired normal lung tissue specimens. More cases of positive telomerase activity were observed in the group with advanced disease and in the group with poorly differentiated tumors. Such factors as the mean age at surgery, sex, smoking, histologic type, and size of tumor extension did not correlate with the telomerase activity. The Kaplan-Meier survival curves in all patients with NSCLC demonstrated that patients with telomerase-positive tumors survived for a significantly shorter period than those with a telomerase-negative tumor (p = 0.0058). According to a multivariate analysis, telomerase activity was identified as an independent prognostic factor (RR = 8.62, p = 0.035). CONCLUSIONS: Telomerase activity was one of the most important prognostic factors in patients with NSCLC, and its potential prognostic implication was independent of tumor stage.