武威市胃癌家族聚集性研究

目的 :探讨胃癌家族聚集现象。方法 :用二项分布 (p +q)n数学模型拟合 ,用 χ2 进行配合适度检验。结果 :武威市 4 4个家族中的胃癌分布超过了二项分布的概率范围 (χ2 =15 81,P <0 0 0 5 )。结论 :高发家族的胃癌发病存在家族聚集性     

104例女性肝细胞癌的临床病理学研究

以900例男性肝癌作对照,探讨了同期104例女性肝癌的临床病理学特点。结果提示:(1)女性肝癌患者的发病年龄较男性提前;(2)不合并肝硬变的肝癌患者的发病年龄较合并肝硬变者提前;(3)女性肝癌的发生多不经过肝硬变阶段,而男性肝癌多在肝硬变的基础上发生;(4)女性肝癌患者的血清AFP含量多高于男性;(5)女性肝癌患者的术后5年生存率高于男性肝癌患者。本文还讨论了与国外肝癌发病情况的差异。     

广西贵港地区乙型肝炎病毒感染及肝细胞性肝癌家族史与肝细胞性肝癌患者住院年龄的相关性分析

目的通过对肝细胞性肝癌（hepatocellularcarcinoma,HCC）住院病例的调查,探讨广西贵港地区乙型肝炎病毒（简称乙肝）感染及HCC家族史与HCC患者住院年龄的关系。方法应用临床流行病学横断面的研究方法,以2004~2008年贵港市人民医院首次住院的HCC患者1365例为研究对象。回顾性构建调查表的数据库,对贵港地区乙肝感染及HCC家族史与HCC患者住院年龄进行相关性分析。结果HCC家族史（＋）者住院年龄较HCC家族史（-）者小（P〈O．05）;HCC病例中乙肝（-）者住院年龄与乙肝（＋）者的差异无统计学意义（P=0．738）;以乙肝（-）且HCC家族史（-）者作为参照组,乙肝（＋）且HCC家族史（-）组与之比较,患者住院年龄的差异无统计学意义（聘0．443）,乙肝（-）且HCC家族史（＋）者及乙肝（＋）且HCC家族史（＋）者的住院年龄均偏小（尸均〈0．05）。结论①无论是否有乙肝感染,HCC家族史（＋）的肝癌患者住院年龄均较HCC家族史（-）者小;@HCC家族史及乙肝感染史与贵港地区HCC患者的住院年龄有关系。     

肝细胞癌周围微小转移分布的研究

目的研究肝癌微转移的分布规律,为手术切除范围提供参考.方法选择无临床转移灶的肝细胞癌病例,取切缘较充分的手术切除标本36例,将其瘤周组织划分为近端区域和远端区域,制成病理大切片.在距原发灶边缘0.5,1.0,2.0 cm分别做3条分界线(L0.5、L1.0、L2.0),把近端和远端区域的瘤周组织由内向外划分出6组条带(Zp0.5、Zp1.0、Zp2.0和Zd0.5、Zd1.0、Zd2.0).分析微转移的扩散距离和各组条带的微转移密度(Dp0.5、Dp1.0、Dp2.0和Dd0.5、Dd1.0、Dd2.0).结果检出的微转移72.5%(111/153)是门静脉微癌栓.在66.7%(24/36)的标本中检出了微转移,其中91.7%(22/24)的标本远端最大扩散距离<3 cm.在近端区域的特定分析中,92.3%(12/13)的标本近端最大扩散距离<1.5 cm.微转移密度比较Dp0.5>Dp1.0>Dp2.0,Dd0.5>Dd1.0>Dd2.0,Dd1.0>Dp1.0,Dd2.0>Dp2.0,差异有显著性.结论 (1)肝癌微转移主要以门静脉微癌栓的形式存在;(2)距原发灶越远,微转移发生率越低;(3)在距原发灶0.5 cm以外的范围,微转移在近端区域的发生率比在远端区域的低;(4)对于无临床转移灶的患者,在远端切除瘤周组织范围达到3 cm,在近端切除范围达到1.5 cm,可能有助于降低术后复发率.     

无伴有肝硬变肝细胞癌52例临床与病理分析

收集1980～1991年间收治的原发性肝细胞癌(PHCC)482例,其中根据临床表现、尸检大体标本(或死后肝穿组织)及镜下观察,病理确定为癌前无肝硬变表现的 PHCC52例,分析如下。临床资料无伴有肝硬变的 PHCC 组52例患者中,男45例,女7例,男女之比为6.4:1。年龄为18～55岁,平均42.5岁。其中<40岁者,男性22例(48.9％),女性3例(42.9％);伴肝硬变的 PHCC 组430例中,男394例,女36例,男女之比为10.9:1。年龄为19～73岁,。平均47.5岁。其中<40岁者,男性87例(22.1％),女性7例(19.4％)。     

1000例肝细胞癌的临床病理研究

 本文对八十年代以来1000例手术切除肝细胞癌的临床病理特点进行了分析。结果:(1)男性肝癌患者的年龄高峰在50岁,女性肝癌患者在40岁,但均从30岁起急剧增多,(2)无肝硬变肝癌中75.3%呈血清HBsAg阳性,提示此类肝癌仍以HBV为主要致癌因素,但感染方式可能不同于肝硬变肝癌;(3)肝癌患者血清AFP含量呈哑铃型分布特征,与瘤体大小、有无肝硬变以及肝癌分化程度无明显关系;(4)肝癌术后复发与首次切除肝癌的瘤体大小有关,与是否伴肝硬变无关;(5)3cm以下小肝癌仅占肝癌的10.2%,术后5年生存率为82.4%,高于总体肝癌的27.5%。认为提高肝癌患者生存率的关键是提高3cm以下小肝癌的诊治率。     

479例甲状腺结节的临床分析

４７９例甲状腺结节的临床分析浙江省诸暨市人民医院（３１１８００）金万炳我院１９９０年１月至１９９２年１２月经手术和病理证实的４７９例甲状腺结节进行临床分析，报道如下。临床资料一、一般情况本组男性８２例，女性３９７例，男女之比为１：５。年龄１５～７６岁...     

肝癌的蛋白质组学研究进展

蛋白质组学以其高通量和整体识别的特点已成为肿瘤研究中的重要工具.近年来对肝癌的研究主要集中于复发转移的机制及干预和寻找理想的肿瘤标记物以求早诊早治.研究者们找到了多种肝癌相关的蛋白,但其特异性和临床应用价值都还有待进一步的研究.     

Familial aggregation of urothelial cell carcinoma

Urothelial cell carcinoma (UCC) is not considered to be a familial disease. Familial clustering of UCC was described in several case reports, however, some with an extremely early age at onset suggesting a genetic component. Epidemiological studies yielded inconsistent evidence of familial UCC, possibly because of low power and the inability to adjust for strong confounding. In our study the existence of a familial subtype of UCC was evaluated, as well as familial clustering of UCC with other types of cancer. A population-based family case-control study was performed including patients newly diagnosed with UCC of the bladder, ureter, renal pelvis or urethra, between January 1995 and December 1997, in the southeastern part of the Netherlands. Information on the patients' first-degree relatives was collected by postal questionnaire and subsequent telephone calls. The patients' partners filled out a similar questionnaire on their relatives. All reported occurrences of UCC were verified using medical records. Disease occurrence among case-relatives and control-relatives was compared to obtain the familial risk. Random effect proportional hazards regression analyses were used to calculate this familial risk while adjusting for age, gender and smoking behavior. In 95 families of the 1,193 patients and in 36 families of the 853 partners at least 1 relative was diagnosed with UCC. This yielded an adjusted hazard ratio (HR) of 1.8 (95% CI: 1.3-2.7). An increased risk was also found for cancer of the hematolymphopoietic system (hazard ration = 1.9, 95% CI: 1.2-3.1) among case-relatives. These results indicate that UCC has a familial component with an almost 2-fold increased risk among first-degree relatives of patients with UCC, which cannot be explained by smoking. Future segregation analyses may indicate whether this clustering can be attributed to genetic susceptibility.     

铜锌-超氧化物歧化酶在肝癌组织中的异常表达及意义

目的：观察铜锌-超氧化物歧化酶（CuZn-SOD）mRNA和蛋白在黄曲霉毒素B1（AFB1）诱发树的肝细胞癌（HCC）形成过程中的表达变化，并对其在人肝癌组织中的表达情况进行验证和对比，探讨CuZn-SOD在肝癌形成中的作用。方法：应用逆转录多聚酶链反应（RT-PCR）和免疫组化方法检测35例AFB1诱发的树鼩肝癌、癌旁以及这些动物癌发生前自身的活检肝组织和相应对照组织中CuZn-SOD基因在mRNA水平和蛋白水平的表达情况，并且在35例人肝癌和癌旁组织进行验证。结果：CuZn-SOD mRNA和蛋白在树鼩肝癌组织的表达水平不仅明显低于癌旁及癌前组织，也明显低于实验组虽经AFB。处理但最终未发生肝癌的动物以及正常对照动物的同期活检肝组织。人肝癌组织的CuZn-SOD mRNA和蛋白表达情况与树鼩相似，癌组织的阳性表达率和表达水平均明显低于癌旁组织，并且分化较低的肝癌组织的蛋白表达水平下调更显著。结论：CuZn-SOD可能是肝癌发生的相关基因之一，它在mRNA水平和蛋白水平的表达下降与肝癌的发生发展可能互为因果。     

纤维板层型肝癌的影像学表现

目的 观察纤维板层型肝癌（ＦＬ－ＨＣＣ）的影像学表现。方法 １１例ＦＬ－ＨＣ互病理证实。做超声波（ＤＳ）检查１０例,ＣＴ扫描１１例,ＭＲＩ８傲因管造影９例。结果 ＵＳ显示肿瘤呈高回声４例,混杂回声６例,４例有大小不一的囊性区,ＤｏｐｐｌｅｒＵＳ提示肿瘤实性部分血供丰富。ＣＴ显示肿瘤单发９例,多个结节融合２例,平扫均为低密度,７例肿块中心区见放射状更低密度区,病理检查为致密胶原瘢痕,４例见点状钙化,     

雌激素受体与原发性肝癌生物学特性的关系

目的　为了探讨雌激素受体在原发性肝癌中的临床病理意义 ,对原发性肝癌的雌激素受体表达和原发性肝癌的生物学特性的关系作了研究。方法　用葡聚糖包裹活性炭吸附法检测了 62例原发性肝癌的雌激素受体表达 ,经大体和显微镜检查了这些原发性肝癌的病理特征 ,并用单克隆抗体PC- 10检测了这些肝癌的细胞增殖性核抗原 ( PCNA)。结果　雌激素受体阳性的肝癌 83.3%为单结节 ,58.3%有完整包膜 ,其构成比高于雌激素受体阴性肝癌的 4 2 .1%和 2 1.0 % ,统计学差异有显著性。小肝癌的雌激素受体阳性率 62 .5% ,显著高于大肝癌的 30 .4 % ( P<0 .0 5)。雌激素受体阳性肝癌的 PCNA标记指数为 ( 2 6.2± 18.7) % ,低于雌激素受体阴性肝癌的 ( 4 3.6± 32 .0 ) % ,统计学差异有显著性。结论　结果表明 ,雌激素受体阳性的肝癌与雌激素受体阴性的肝癌相比 ,前者的生物学行为和预后较好。     

ALK基因在肝细胞癌中的表达及临床意义

目的 探讨间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)基因在肝细胞癌(hepatocellular carcinoma,HCC)组织中的表达及其临床意义。方法 采用荧光原位杂交法(fluorescent in situ hybridization,FISH)检测ALK在213例HCC组织中的表达,并分析其与患者临床病理特征及预后的相关性。结果 213例HCC中无ALK基因重排阳性,28例存在ALK基因拷贝数增加(ALK gene copy number gain,ALK-CNG)现象。ALK-CNG阳性表达与HCC患者年龄。性别。AJCC分期。Child-Pugh评分及复发情况均无明显相关性(P>0.05),与HCC患者预后相关(P=0.048),晚期患者中ALK-CNG阳性组与阴性组的无进展生存率差异有统计学意义(P=0.007)。单变量和多变量Cox回归分析显示,ALK-CNG阳性是HCC患者的独立预后预测指标(P=0.046)。结论 HCC患者ALK基因重排阳性少见,但存在ALK基因拷贝数增加现象,且可能是影响HCC患者预后的不良因素。     

原发性肝癌术后辅助治疗的研究进展

原发性肝细胞癌(肝癌)是高发病率高死亡率的恶性肿瘤,手术切除是其最主要的根治性治疗,但术后5年生存率仅约50%,5年复发率可达60%～70%。对于预后不良的患者,明确最佳的辅助治疗手段是降低术后复发和转移率进而提高术后患者生存的关键。然而,目前尚未明确术后标准治疗模式,多种术后治疗手段包括经导管动脉化疗栓塞术、放疗、靶向治疗等均在研究和探讨中。本文就肝癌术后辅助治疗的研究进展进行综述,以指导临床进一步研究和应用。     

肝癌的靶向治疗

肝癌（HCC）是全球最富有挑战性的恶性肿瘤之一。HCC需要综合治疗，目前尚无特效的治疗药物。分子靶向药物的发展，使HCC的全身治疗有了新的希望。阐述了分子靶向药物的现状，多激酶抑制剂、抗血管生成和抗表皮生长因子受体药物在临床上的进展，认为索拉芬尼是晚期HCC的新的标准治疗药物。     

Familial papillary carcinoma of the thyroid: a report of nine first-degree relatives of four families

The authors report the occurrence of papillary carcinoma of the thyroid in nine first-degree relatives of four families among a consecutive series of 97 patients with papillary carcinoma of the thyroid who were operated on from 1991 to 1998. Total thyroidectomy was performed in all cases. All patients are alive without evidence of disease after a mean follow-up period of 43 months. Since in our series familial papillary carcinoma of the thyroid was found in 9.3% of patients, we suggest an adequate screening among first-degree relatives of all patients with papillary thyroid carcinoma. Because of reported aggressive behaviour of familial papillary carcinoma of the thyroid, aggressive surgical treatment plus post-operative thyroid remnant ablation with radio-iodine should be warranted in all patients.     

Risk of malignancy in first-degree relatives of patients with pancreatic carcinoma

BACKGROUND: Approximately 5-10% of pancreatic carcinoma (PC) patients report a family history of the disease. In some families, mutations of tumor suppressor genes have been elucidated, but for most the causative gene remains unidentified. Counseling the families of PC patients regarding their risk of cancer remains problematic because little information is available. METHODS: The authors analyzed family history questionnaires completed by 426 unselected, sequential Mayo Clinic patients with PC. The prevalence of malignancy reported among 3355 of their first-degree relatives was compared with the Surveillance, Epidemiology, and End Results Project (SEER) 9 (2000) registry. Age-adjusted and gender-adjusted standardized incidence ratios (SIRs) were generated. RESULTS: Greater than 130,000 person-years at risk for cancer among the first-degree relatives were analyzed. The risk of PC was found to be increased among the first-degree relatives of patients with PC (SIR of 1.88; 95% confidence interval [95% CI], 1.27-2.68), as was the risk of liver carcinoma (SIR of 2.70; 95% CI, 1.51-4.46). Lymphoma (SIR of 0.28; 95% CI, 0.12-0.55), bladder carcinoma (SIR of 0.55; 95% CI, 0.31-0.89), breast carcinoma (SIR of 0.73; 95% CI, 0.57-0.92), lung carcinoma (SIR of 0.62; 95% CI, 0.47-0.80), and prostate carcinoma (SIR of 0.71; 95% CI, 0.54-0.92) were found to be underrepresented. When the proband was age < 60 years, the risk of PC to first-degree relatives was found to be increased further (SIR of 2.86; 95% CI, 1.15-5.89). In this subgroup, no other malignancies were found to be significantly increased, although the risks of melanoma (SIR of 1.73; 95% CI, 0.70-3.57), ovarian carcinoma (SIR of 2.20; 95% CI, 0.72-5.12), and colon carcinoma (SIR of 1.37; 95% CI, 0.80-2.19) were suggestive. CONCLUSIONS: There was a nearly twofold increased risk of PC in the first-degree relatives of PC probands. This risk was found to increase nearly threefold when patients were diagnosed before age 60 years. At the current time, in the absence of a pedigree suggestive of known familial cancer syndromes, the current study results do not support targeted screening for other malignancies in the first-degree relatives of patients with sporadic PC.