B超引导下穿刺注射化疗药物与无水乙醇联合治疗肝癌临床研究

为了探讨B超引导下穿刺注射化疗药物与无水乙醇联合治疗肝癌的可行性及疗效,对52例肝癌患者行B超引导下穿刺注射化疗药物与无水乙醇联合治疗,均给予2个周期治疗。结果示52例患者中CR8例,彩色超声显示瘤内无彩色血流,AFP降至正常,穿刺活组织检查无肿瘤细胞残留;PR20例,活组织检查有少量肿瘤细胞残留,但AFP降至正常;NC16例。初步研究结果提示,B超引导下穿刺注射化疗药物与无水乙醇联合治疗肝癌方法简便、安全、疗效满意,是一种较为理想的治疗方法。     

草酸铂与5-FU联合西妥昔单抗治疗结肠癌术后肠梗阻1例报道

患者,女性,65岁。于2009年1月17日行右半结肠癌切除术,术后病理诊断：右半结肠弥漫性浸润型低分化腺癌,侵及浆膜层,部分为印戒细胞癌,淋巴结未见癌转移,病理分期DukesB期。KRAS基因检测为野生型。患者术后二十余天出现恶心,呕吐,腹胀,停止排便排气。     

肾癌中miR-363的表达及其临床意义

目的:探讨miR-363在肾癌中的表达及其临床意义.方法:在大规模平行测序基础上,应用实时荧光定量PCR检测51例肾癌及其癌旁组织样本中miR-363的表达水平,并应用RT-PCR检测进行验证,分析miR-363的表达水平与肾癌患者的临床病理特征之间的关系.结果:与相应的癌旁组织比较,肾癌组织中miR-363的表达水平明显下调,平均下调约11.49％,且miR-363的表达水平与患者的年龄、病理分型及TNM分期有关(P＜0.05).结论:miR-363可能与肾癌的进展有密切关系,进行miR-363表达意义的研究可能对肾癌早期诊断及治疗具有潜在的临床意义.     

HEP方案治疗难治性晚期乳腺癌的临床观察

目的:观察国产羟基喜树碱(HCPT)为基础组成的HEP方案对多次化疗失败晚期乳腺癌患者的疗效及耐受性。方法:HEP方案(HCPT6mg/m2,静脉滴入,d1~d5;依托泊苷100mg,静脉滴入,d1~d5,或50mg/d,口服d1~d14;顺铂20mg,静脉滴入,d1~d5)治疗复发或转移后经至少一种化疗方案治疗失败的晚期乳腺癌患者,4周重复,治疗2~6个周期。结果:共25例患者接受治疗,其中25例可评价毒副反应,23例可评价疗效。有效率17·4%(4/23),临床受益率为56·5%(13/23),中位疾病进展时间(TTP)为7·0个月。主要不良反应为恶心、呕吐、脱发及骨髓抑制,其中Ⅲ~Ⅳ度白细胞下降占20·0%(5/25)。结论:HEP方案对先前反复化疗失败的晚期乳腺癌有一定疗效,是可选择的治疗方案之一。     

结肠癌患者手术前后血浆miR-21表达水平变化及其临床意义

目的 探讨结肠癌患者手术前后血浆miR-21表达水平变化及其临床意义。方法 实时荧光定量聚合酶链反应法（real-time quantitative PCR, qRT-PCR）检测结肠癌患者与健康对照组血浆中miR-21 的表达情况,以及与临床病理参数的关系;另外检测结肠癌患者手术前一周、手术后一周和术后一月血浆中miR-21的表达水平变化。 结果 40例结肠癌患者手术前血浆中miR-21表达水平较对照组差异具有统计学意义（P<0.05）;并与肿瘤的分化程度、临床分期、淋巴结转移及远处转移有关（P <0.05）,而与年龄和性别无相关性（P>0.05）;与术前相比,术后一周和一月血浆中miR-21的表达明显降低,差异有统计学意义（P<0.05）。 结论 结肠癌患者血浆中miR-21的表达情况,可作为结肠癌潜在的生物标志物,有望成为一种新的有效辅助诊断结肠癌及判断预后的方法。     

草酸铂为主联合化疗治疗晚期胃肠道肿瘤54例疗效观察

为观察草酸铂和羟基喜树碱、5-氟尿嘧啶（5-FU）联合化疗方案治疗晚期胃癌结肠癌的近期疗效和不良反应,制定化疗方案如下：草酸铂130 mg/m^2,静脉滴入2 h,d1;羟基喜树碱6～8 mg/m^2,静脉滴入,d1～d5;甲酰四氢叶酸钙200 mg/m^2,静脉滴入,d1～d5.5-FU 500 mg/m^2,静脉滴入,d1～d5.21 d为1个周期,完成3个周期后判定疗效.全组病例54例,胃癌36例有效率为50.0%（18/36）,结肠癌18例有效率为44.4%（8/18）,胃癌和结肠癌总的有效率48.1%（26/54）.主要不良反应为轻度的血液学毒性,恶心、呕吐和外周感觉神经异常.初步观察结果显示,草酸铂、羟基喜树碱和5-FU是治疗晚期胃肠道肿瘤有效且毒性较少的联合化疗方案.     

氟康唑治疗恶性血液病化疗后真菌感染21例

目的观察氟康唑治疗恶性血液病化疗后合并真菌感染的疗效。方法对1998年7月至2006年6月收治的21例恶性血液病化疗后合并真菌感染的患者作回顾性分析。结果总有效率为76．19％（16／21）,确诊病例为71．43％（5／7）,临床诊断病例为90．91％（10／11）,拟诊病例66．66％（2／3）。结论氟康唑对恶性血液病化疗后合并真菌感染的患者疗效确切,价格较低,可作为一线治疗推荐药物。     

药物相关酶的表达或活性对结直肠癌化疗的预测作用

结直肠癌是常见的恶性肿瘤之一,随着新药物的应用,使其化疗效果取得了较大的进步,但是耐药仍然是结直肠癌患者化疗过程中面临的主要问题。研究显示,不同患者的肿瘤组织中药物代谢相关酶的表达及活性也不尽相同,这可能是影响化疗疗效和预后的关键因素之一。本文就此作一综述,探讨药物相关酶对结直肠癌化疗疗效和预后的预测作用。     

西妥昔单抗联合化疗治疗晚期结直肠癌的临床观察

目的:观察西妥昔单抗联合化疗治疗晚期结直肠癌的有效性、安全性和对生活质量的影响.方法:2006-11-2009-02,我院共有11例患者,均经病理组织学确诊为晚期转移性结直肠癌,联合FOLFIRI或FOLFOX方案治疗,西妥昔单抗首剂400 mg/m2,以后每周250 mg/m2维持.结果:11例患者治疗后3例CR,1例PR,6例SD,1例PD,有效率36.4%,疾病控制率90.9%.主要的不良反应为痤疮样皮疹,治疗后生活质量改善较好.结论:西妥昔单抗联合化疗治疗晚期转移性结直肠癌有效,除皮疹外,并未增加化疗的毒副反应,治疗后生活质量较好.     

紫杉醇联合化疗治疗晚期胃癌的临床分析

回顾分析我科以紫杉醇为主的联合化疗方案治疗晚期胃癌患者56例的临床资料,探讨紫杉醇为主的联合化疗方案在晚期胃癌患者中的治疗价值。1临床资料1.1一般资料2000年1月～2004年6月我科应用紫杉醇为主联合化疗治疗晚期胃癌56例,均为手术后复发转移经一线化疗失败患者。男31例,女     

Expression of thymidylate synthase in relation to survival and chemosensitivity in gastric cancer patients

Expression of thymidylate synthase (TS) has been studied as a prognostic factor and mechanism of drug resistance in gastric cancers. The relationship between TS expression in surgically resected specimens and clinicopathological factors was examined in 216 gastric cancer patients. Immunohistochemical demonstration of the protein was achieved using an anti-TS polyclonal antibody. Positive TS staining was observed in 50 patients (23.1%). Lymph node metastasis was more frequent in patients with TS-positive tumors than in those with TS-negative tumors (P<0.01). Patients were followed for more than 5 years and survival was examined. In 163 patients who received fluorouracil (FU)-based chemotherapy, the overall 5-year survival rate was 41.8% for patients with TS-positive tumors and 57.0% for patients with TS-negative tumors (P<0.01). In the 53 patients who did not receive chemotherapy, these figures were 25.6% and 79.5%, respectively (P<0.05). In patients with T3 gastric cancer who were treated with curative gastrectomy, however, FU-based chemotherapy did not affect survival of either patients with TS-positive tumors or with TS-negative tumors. Multivariate analysis also revealed TS expression to be a significant variable for predicting postoperative survival (P<0.05). These results indicate that TS expression can be used as an independent prognostic factor for patients with gastric cancer. However, TS expression is not a major predictor of the efficacy of FU-based chemotherapy.     

结肠癌患者循环miR-630的表达及其临床意义

目的:探讨结肠癌患者外周血中microRNA-630(miR-630)的表达,进一步分析其表达对评估结肠癌进展及预后的价值。方法:使用实时荧光定量PCR（Real time PCR）检测55例结肠癌及21例正常对照者外周血中miR-630的表达,采用统计学方法分析miR-630在结肠癌外周血中的表达及其与肿瘤进展和预后的关系。结果:分析Real time PCR检测结果发现,结肠癌患者外周血中miR-630的表达显著高于正常对照（P<0.05）,外周血中miR-630表达与结肠癌的侵袭、转移和分期显著相关（P<0.05）,单因素和多因素生存分析发现外周血中miR-630的表达上调与结肠癌预后不良显著相关（P<0.05）。结论:结肠癌患者循环miR-630表达显著上调,与结肠癌侵袭和转移密切相关,并可作为结肠癌的独立预后标记分子。     

结肠癌患者血清中miR-30a、miR-106b的表达及其临床意义

目的:探讨结肠癌患者血清miR-30a、miR-106b的表达及其在结肠癌进展及预测患者预后中的价值.方法:选取2012年06月至2013年02月本院收治的接受结肠癌手术治疗的患者80例为研究对象,20例同期健康人群作为对照组.逆转录PCR法检测外周血血清中miR-30a、miR-106b的表达水平,分析患者血清miR...     

p-MTOR在结肠癌中的表达及与患者病理学特征的关系

目的 探讨结肠癌组织中磷酸化雷帕霉素靶蛋白(p-MTOR)表达的变化及其对患者预后的影响.方法 选取结肠癌组织标本110例及其对应的癌旁组织110例,采用免疫组化染色法检测两组标本中的p-MTOR蛋白表达水平,分析p-MTOR蛋白表达与患者临床病理特征及远期预后的关系.结果 结肠癌组织中p-MTOR蛋白阳性表达率为54.55%,明显高于癌旁组织的10.00%,差异有统计学意义(P﹤0.01);不同TNM分期、浸润深度及是否有淋巴结转移患者结肠癌组织中p-MTOR蛋白阳性表达率比较,差异有统计学意义(P﹤0.01);结肠癌组织中p-MTOR蛋白阳性表达患者的3年生存率(28.33%)明显低于p-MTOR蛋白阴性表达患者(55.00%),差异有统计学意义(χ2=8.364,P=0.004);TNM分期增高、发生淋巴结转移、浸润肌层、p-MTOR蛋白阳性表达是结肠癌患者不良预后的独立危险因素(P﹤0.05).结论 结肠癌组织中p-MTOR蛋白的表达水平上调,并且与患者的TNM分期、淋巴结转移及浸润深度有关,是患者不良预后的独立危险因素.     

miR-21的功能分析及其在结肠癌中的临床意义

目的:分析miR-21的功能及其在结肠癌中的临床意义。方法:采用miRWalk在线工具预测和筛选miR-21的靶基因,并使用DAVID分析靶基因的功能和信号通路;检测结肠癌患者和健康对照人群血清以及癌组织和癌旁组织标本的miR-21的表达水平;使用TCGA数据库中结肠癌的数据,分析miR-21表达水平与临床病理参数的关系以及与患者预后的关系。结果:共筛选出429个miR-21的靶基因,靶基因功能分析提示这些基因主要参与了正性调节代谢过程、蛋白结合等。结肠癌患者血清miR-21表达水平显著高于健康对照人群,差异有统计学意义（P<0.05）。TCGA数据显示,结肠癌组织中的miR-21表达水平与肿瘤的临床分期、肿瘤侵袭程度、淋巴结转移分期、远处转移分期无显著差异（P>0.05）。生存分析显示组织中高表达miR-21的患者其生存时间较低表达者短（P<0.05）。结论:miR-21调控多个肿瘤发生相关的基因,在结肠癌发生过程中具有重要的调控作用。结肠癌患者miR-21表达水平显著高于健康人群,且miR-21高表达的患者预后差。     

Timing of adjuvant chemotherapy and its relation to survival among patients with stage III colon cancer

BackgroundCurrently available data suggest that delaying the start of adjuvant chemotherapy in colon cancer patients has a detrimental effect on survival. We analysed which factors impact on the timing of adjuvant chemotherapy and evaluated the influence on overall survival (OS).Patients and methodsStage III colon cancer patients who underwent resection and received adjuvant chemotherapy between 2008 and 2013 were selected from the Netherlands Cancer Registry. Timing of adjuvant chemotherapy was subdivided into: ⩽4, 5–6, 7–8, 9–10, 11–12 and 13–16 weeks post-surgery. Multivariable regressions were performed to assess the influence of several factors on the probability of starting treatment within 8 weeks post-surgery and to evaluate the association of timing of adjuvant chemotherapy with 5-year OS.Results6620 patients received adjuvant chemotherapy, 14% commenced after 8 weeks. Factors associated with starting treatment after 8 weeks were older age (Odds ratio (OR) 65–74 versus <65 years 1.3 (95% confidence interval (CI): 1.14–1.58); OR ⩾75 versus <65 years 1.6 (1.25–1.94)), emergency resection (OR 1.8 (1.41–2.32)), anastomotic leakage (OR 8.1 (6.14–10.62)), referral to another hospital for adjuvant chemotherapy (OR 1.9 (1.36–2.57)) and prolonged postoperative hospital admission (OR 4.7 (3.30–6.68)). Starting 5–8 weeks post-surgery showed no decrease in OS compared to initiation within 4 weeks (Hazard ratio (HR) 5–6 weeks 0.9 (0.79–1.11); HR 7–8 weeks 1.1 (0.91–1.30)). However, commencing beyond 8 weeks was associated with decreased OS compared to initiation within 8 weeks (HR 9–10 weeks 1.4 (1.21–1.68); HR 11–12 weeks 1.3 (1.06–1.59); HR 13–16 weeks 1.7 (1.23–2.23)).ConclusionOur data support initiating adjuvant chemotherapy in stage III colon cancer patients within 8 weeks post-surgery.     

Investigation of miR-21, miR-141, and miR-221 in blood circulation of patients with prostate cancer

In addition to their potential as tissue-based markers for cancer classification and prognostication, the study of microRNAs (miRNAs) in blood circulation is also of interest. In the present study, we investigated the amounts of three cancer-related miRNAs, miR-21, -141, and -221 in blood plasma of prostate cancer (PCa) patients. A cohort of 51 patients with PCa was enrolled into the study, and miRNAs were measured in two subgroups, with localized/local advanced or metastatic PCa. A group of 20 healthy individuals served as the control group. miRNAs were quantified from the total RNA fraction using 200 μl plasma and the small RNA molecule RNU1A as a control for normalizing the miRNA amounts in circulation. We found similar levels of three miRNAs in healthy subjects with median values of 0.039, 0.033 and 0.04, respectively; (p = n.s.). In the patients, the miRNA levels were higher, with miR-21 being the highest (median, 1.51). The miR-221 levels were intermediate (median, 0.71) while the miR-141 displayed the lowest levels (median, 0.051). The differences between the control group and the patients were highly significant for the miR-21 (p < 0.001; area under the curve (AUC), 88%) and -221 (p < 0.001; AUC, 83%) but not for the miR-141 (p = 0.2). In patients diagnosed with metastatic PCa, levels of all three miRNAs were significantly higher than in patients with localized/local advanced disease where the difference for the miR-141 was most pronounced (p < 0.001; AUC, 75.5%). In conclusion, analysis of miR-21, -141, and -221 in blood of PCa patients reveals varying patterns of these molecules in clinical subgroups of PCa.     

转胶蛋白在结肠癌中的表达及与患者临床特征和预后的关系

目的 探讨转胶蛋白(transgelin)在结肠癌中的表达及与患者临床特征和预后的关系.方法 选取475例结肠癌患者的结肠癌组织及50例距病灶5 cm以外的癌旁组织,免疫组化法检测transgelin蛋白的表达情况,并分析其与患者临床特征的关系.随访时间16～51个月,记录患者的总生存期(OS)和无进展生存期(PFS)...     

LncRNA ITGA9-AS1在卵巢癌中的表达及与顺铂化疗敏感性的关系

目的:观察长链非编码RNA(LncRNA)ITGA9-AS1在卵巢癌中的表达水平,探究其与顺铂化疗敏感性的关系.方法:选取2017年01月至2019年01月本院收治的64例卵巢癌患者,卵巢摘除手术中采集卵巢癌组织,另收集因卵巢囊肿需作手术切除但已证实无瘤细胞的正常卵巢组织标本,采用实时定量PCR(RT-qPCR)检测卵...