Childhood Cancer Incidence and Survival 1985-2009, Khon Kaen,Thailand

Background: The Khon Kaen Cancer Registry (KKCR) was established in 1984. Previous population-basedincidences and survivals of childhood cancer in Thailand were determined using a short cancer registration period.Materials and Methods: Data were retrieved of all children residing in Khon Kaen, between 0–15 years, diagnosedas having cancer and registered in the KKCR (1985-2009). The follow-up censored date was December 31, 2012.The childhood cancers were classified into 12 diagnostic groups, according to the International Classificationof Childhood Cancer. The incidence was calculated by the standard method. Survival of childhood cancer wasinvestigated using the KKCR population-based registration data and overall survival calculated using the KaplanMeier method. Results: In the study period, 912 newly diagnosed cases of childhood cancer were registered.The respective mean and median age was 6.4 (SD=4.6) and 6 (0-14) years. The age-peak for incidence was 0–4years. The age-standardized rate (ASR) was 83 per million. Leukemia was the most common cancer (N=360,ASR 33.8) followed by neoplasms of the central nervous system (CNS, N=150, ASR 12.8) and lymphoma (N=79,ASR 7.0). The follow-up duration totaled 101,250 months. The death rate was 1.11 per 100 person-months(95%CI: 1.02 -1.20). The 5-year overall survival was 52% (95%CI: 53-56.9) for all cancers. The respective 5-yearoverall survival for (1) acute lymphoblastic leukemia (ALL), (2) acute non-lymphoblastic leukemia (ANLL), (3)lymphoma, (4) germ cell tumors, (5) renal tumors, (6) retinoblastoma, (7) soft tissue tumors, (8) CNS tumors,(9) bone tumors, (10) liver tumors, and (11) neuroblastoma was (1) 51%, (2) 37%, (3) 63%, (4) 74%, (5) 67%,(6) 55%, (7) 46%, (8) 44%, (9) 36%, (10) 34%, and (11) 25%. Conclusions: The incidence of childhood canceris lower than those of western countries. Respective overall survival for ALL, lymphoma, renal tumors, livertumors, retinoblastoma, soft tissue tumors is lower than that reported in developed countries while survival forCNS tumors, neuroblastoma and germ cell tumors is comparable.     

卵巢交界性浆液、粘液性肿瘤病理诊断新概念

本文总结近年有关卵巢交界性浆液、小数点 液性肿瘤文献论述病理诊断的新概念。分别为：（1）卵巢交界性肿瘤基本诊断标准;（2）卵巢交界性浆液性肿瘤概括Piura(1992),Russel(1994)、Silva(1996),Eichhorn(1999),Scully(1999)病理诊断标准;（3）卵巢交界性粘液肿瘤概括Piura(1992),Kuman(1996),Riopel(1999),Scully(1999)病理诊断标准。（4）腹膜假粘液瘤;（5）上皮内癌;（6）微浸润;（7）种植;（8）淋巴结转移;（9）多中心性;（10）命名;（11）预后。     

Pharmacokinetics of KRN 8602 in cancer patients]

The pharmacokinetic properties of KRN 8602, an anthracycline compound, was studied by HPLC following intravenous administration of KRN 8602 to cancer patients. The results were as follows. (1) The plasma concentration-time curve declined as a triphasic function (alpha, beta, gamma) (t1/2 (alpha) = 0.02910, +/- 0.0054 hr, t1/2 (beta) = 0.704 +/- 0.319 hr, t1/2 (gamma) 8.37 +/- 1.37 hr). The blood cell concentration was higher than that in plasma. (2) The distribution volumes of the tissue compartment were larger than those of the central compartment. This result suggested that KRN 8602 would be easily transferred into the tissues. (3) The area under the curve (AUC) of KRN 8602 increased in proportion to the increase of dosage. (4) The metabolites of KRN 8602 were detected in plasma, blood cell and urine. (5) Urinary excretion of KRN 8602 and its metabolites were extremely low.     

PYM-BAG5和131I-BAC5联合导向治疗鼻咽癌的实验研究

背景与目的:现代的肿瘤治疗提倡综合治疗,肿瘤的导向综合治疗具有研究价值.本实验在研究鼻咽癌放射免疫治疗的基础上,观察平阳霉素(pingyangmycin,PYM)和131 I与鼻咽癌单抗BAC5的偶联物PYM-BAC5和131 I-BAC5对鼻咽癌细胞CNE2的联合抑制效果.方法:用葡聚糖T-40作中间载体偶联PYM和BAC5,用测定抑菌活性和免疫活性的方法鉴定偶联物.用氯胺T法制备131 I-BAC5.设置单独用药组(游离PYM,131 I-mIgG)、单独导向用药组(PYM-BAC5,131 I-BAC5)以及联合导向用药组(PYM-BAC5+131 I-BAC5)共5个实验组,用MTT法测定各药物组的抑制作用.结果:PYM-BAC5和游离PYM对CNE2的半数抑制浓度(IC50)分别为46.57 μg/ml和316.70 μg/ml;131 I-BAC5和131 I-mIgG对CNE2的IC50分别为4.42×105 Bq/ml和＞11.10×105 Bq/ml;联合用药组中PYM-BAC5的IC50为7.01 μg/ml,131 I-BAC5的IC50为0.54×105Bq/ml.结论:(1)导向用药组的抑瘤效果明显高于非导向组;(2)联合导向用药组的抑菌效果明显高于单独导向用药组.     

~(11)C-鬼臼毒素和~(18)F-脱氧葡萄糖示踪剂在小鼠肺癌模型PET影像学检查中的应用

目的 对比~(11)C-鬼臼毒素(PDT)和~(18)F-脱氧葡萄糖(FDG)在荷肺腺癌小鼠体内的生物学分布及在PET中的显像,评价_(11)C-PDT作为新型示踪剂在肺癌显像中的作用.方法 24只荷肺腺癌小鼠随机分为2组,每组12只,分别经尾静脉注入~(11)C-PDT和~(18)F-FDG,于注药60 min后用井型探测仪测量~(11)C-PDT和~(18)F-FDG在小鼠各脏器内的生物学分布,并行 PET 显像.结果 ~(11)C-PDT和~(18)F-FDG在肿瘤组织中均有较高的放射性摄取,但是~(11)C-PDT组肿瘤组织的放射性摄取值[(0.65±0.20)%ID/g]明显低于~(18)F-FDG组[(7.44±1.56)%ID/g,P<0.01].~(11)C-PDT组放射性摄取最高的部位依次为肝、肾和血液,而~(18)F-FDG组放射性摄取最高的部位依次为心脏、肿瘤和肾.~(11)C-PDT组中,肿瘤组织对肌肉组织的T/NT值相对较高,达2.02±0.56,但仍低于~(18)F-FDG组(2.95±0.49,P<0.01).~(11)C-PDT组中,肿瘤组织对其他脏器的T/NT值均<2.~(11)C-PDT组荷肺腺癌小鼠PET显像可见腹腔脏器及肿瘤部位有放射性热区,~(18)F-FDG组可见心脏、肿瘤及腹腔脏器放射性浓聚明显,两种示踪剂的肿瘤显像均较清晰.结论 ~(11)C-PDT在肺癌组织中的摄取高于肌肉组织,通过PET显像可以显示肺部肿瘤.~(11)C-PDT可以作为肺癌显像的示踪剂.     

EXPRESSION OF IL-2R ON PERIPHERAL BLOOD LYMPHOCYTES OF PATIENTS WITH COLORECTAL CANCER AND ITS CLINICAL SIGNIFICANCE

In recent years it has been noted that the levels of serum soluble interleukin-2 receptor (sIL-2R) in patients with malignancy were abnormally elevated and the levels of sIL-2R might be considered as an index to monitor patient's condition and assess treatment effects. But in medical literature it was reported that the levels of membrane interleukin-2 receptor (CD25) in peripheral blood lymphocytes (PBL) in patients with malignancy were various, some were elevated, some were dropped.[1] Th…     

LFH或LFPH方案治疗胃贲门癌及结直肠癌疗效评价

目的 回顾性分析羟基喜树碱(HCPT)、醛氢叶酸(LV)、5-氟脲嘧啶(5-Fu)及顺铂(DDP)联合化疗方案治疗胃贲门癌及结直肠癌的近期疗效和耐受性。方法 65例胃贲门癌及大肠癌患者均接受了LFH或LFPH全身化疗,21d为一周期,中位治疗周期为4周期。结果 部分缓解(PR)17例,稳定(SD)3l例,进展(PD)17例,总有效率(RR)为26．2％(17／65),临床受益率(CR PR SD)为73．8％(48／65)。其中初治患者有效率(RR)为32．3％(10／31),复治患者有效率为20．6％(7／34),稳定率为47．7％(3l／65)。胃贲门癌初治患者有效率为33．3％(5／15),而复治患者有效率仍可达29．4％(5／17)。中位生存时间(MST)为10个月,中位进展时间(MTTP)为8个月。主要毒性反应表现为口腔炎、恶心呕吐和白细胞下降,Ⅲ度以上毒性反应分别为10．8％、12．3％和6．2％。80％的患者有脱发,但无Ⅲ度以上脱发。结论 HCPT联合LV、5-Fu及DDP治疗晚期胃贲门癌及结直肠癌虽然疗效不高,但稳定率较高,且复治患者仍有较好疗效,特别是对胃贲门癌的疗效较好,毒性反应小,生活质量高,值得临床进一步研究。     

Transient absorption spectra and kinetics of folic acid (vitamin B11) and some kinetic data of folinic acid and methotrexate

Folic acid (FA; vitamin B11) exhibits antitumor properties. Its transients, resulting from reaction with OH radicals, are of special interest and were studied by pulse radiolysis. The complex composition of FA offers the formation of numerous transients having different electronic structure stability (lifetime). Investigating their kinetic profiles of decay at various wavelengths, it was established that transients with very unstable electron structure (very short-lived radicals) tend to convert into more stable electronic structures (longer lived) by intramolecular electron transfer process. The biological importance of a FA radical depends on its concentration and on its specific reaction rate constant (k value) for a given process. The rate constant for the OH attack is k(OH + FA) = 1.1 x 10(10) L mol(-1) s(-1). Superimposed absorption spectra of FA radicals as well as formation and decay rate constants of total processes are presented. The primary spectrum is characterized by lambda = 425 nm, epsilon = 1.64 x 10(4) L mol(-1) s(-1). The chemical structure of FA is similar to that of folinic acid (FNA) and of methotrexate (MTX), but their biological properties are different. Therefore, their rate constants for the reactions with e-aq and OH were also determined for comparison: k(FNA + e-aq) = 3.1 x 10(10) L mol(-1) s(-1), k(FNA + OH) = 0.8 x 10(10) L mol(-1) s(-1), k(MTX + e-aq) = 1 x 10(10) L mol(-1) s(-1); k(MTX + OH) = 2.3 x 10(10) L mol(-1) s(-1), and k(FA + e-aq) = 1.9 x 10(10) L mol(-1) s(-1).     

伊马替尼治疗慢性粒细胞白血病135例远期疗效观察

  目的　对伊马替尼治疗慢性粒细胞白血病（CML）的疗效及安全性进行分析,并初步探讨影响CML患者生存的因素。方法　135例CML患者应用伊马替尼治疗,监测其血常规、染色体核型、bcr-abl p210转录本表达及不良反应。结果　中位随访20（3～67）个月。慢性期患者累积获得的完全血液学缓解（CHR）率为97.9 ％,主要细胞遗传学缓解（MCyR）率为78.3 ％,完全细胞遗传学缓解（CCyR）率为72.2 ％,完全分子学缓解（CMoR）率为35.1 %,均显著高于加速期及急变期（P ＜0.001）。慢性期低危组与高危组之间CCyR率有差异（P＝0.048）。慢性期患者1、3和5年总生存（OS）率分别为：（97.8±1.5）%、（95.2±2.4）%、（91.9±3.2）%,疾病无进展生存（PFS）率分别为（92.6±2.7）%、（85.5±3.7）%、（81.3±4.3）%;加速期患者6个月、1、2年OS率分别为：（93.8±6.1）%、（72.5±11.8）%、（64.5±12.9）%,PFS率分别为：（92.3±7.4）%、（64.5±14.7）%、（53.7±15.7）%;急变期患者6、12、19个月OS率分别为：（86.4±7.3）%、（45.4±11.4）%、（19.4±9.8）%,PFS率分别为：（70.1±12.6）%、（37.6±15.6）%、（18.8±15.4）%。慢性期达到CMoR、CCyR的患者与仅达CHR者 PFS及OS比较差异均有统计学意义（P ≤0.001）;多因素分析显示：耐药是影响慢性期患者PFS（P＝0.000,RR＝46.744）及OS（P＝0.007,RR＝20.270）的因素。伊马替尼口服非血液学毒性较轻,患者多可耐受;血液学毒性是减量或停药的主要原因。结论　伊马替尼治疗CML慢性期疗效显著优于加速期及急变期;慢性期患者达到CCyR甚至CMoR是获得长期生存的关键,伊马替尼耐药是伊马替尼治疗CML面临的主要问题。     

DNA damage by haloalkanes in human lymphocytes cultured in vitro

The DNA damaging activity of 7 haloalkanes was studied in a short-term in vitro system which utilized human lymphocytes. The parameters studied were the inhibition of scheduled (duplicative) and unscheduled (reparative) DNA syntheses seen as tritiated thymidine uptake. The results obtained suggested that chloromethyl methyl ether (CMME), 1,2-dibromoethane (DBE), trichloroethylene (TCE) and 1,2-dichloroethane (DCE) gave positive results such as DNA damaging agents, while carbon tetrachloride (CTC), chloroform (TCM) and dichloromethane (DCM) gave low or negative results.     

Hyperfractionated-accelerated or conventionally fractionated radiotherapy for early glottic cancer.

PURPOSE: To evaluate the effect of shortening overall treatment time by hyperfractionated-accelerated radiotherapy for T2N(0)M(0) glottic carcinomas. Results for local control and survival were calculated and compared to those for T1N(0)M(0) tumors treated with a once-a-day fractionated schedule. METHODS AND MATERIALS: Between 1990 and 1998, 92 patients with T1N(0)M(0) and 45 patients with T2N(0)M(0) glottic cancers were treated with radical radiotherapy. The T1N(0)M(0) tumors were treated with a once-a-day fractionated schedule lasting 6.5 weeks to a total dose of 62.4 Gy. The T2N(0)M(0) tumors received a split-course hyperfractionated-accelerated treatment over a total of 4.5 weeks to a total dose of 64.6 Gy.Results: The 5-year local control was 85% for T1N(0)M(0) and 88% for T2N(0)M(0), whereas the 5-year locoregional control was 85% for both groups. The 5-year overall survival was 70% and 53% for T1N(0)M(0) and T2N(0)M(0), respectively. No significant statistical difference was found between the two groups for the parameters analyzed. The number of serious late complications was few and comparable for the two groups. CONCLUSIONS: Hyperfractionated-accelerated radiotherapy proved beneficial for T2N(0)M(0) glottic cancer, giving local control rates comparable to those for T1N(0)M(0) tumors.     

Purification and biochemical characterization of a virus-specific reverse transcriptase from human osteosarcoma tissue.

A RNA-dependent DNA polymerase (RTase) was purified from human osteosarcoma tissue by successive column chromatography of the microsomal fraction on DEAE-cellulose (DE-23 and DE-52) and phosphocellulose. The purified enzyme has a molecular weight of about 68,000, a pH optimum of 8.1, a Mg2+ optimum of 0.8 mM, Mn2+ optimum of 1.0 mM and a KCl optimum of 60 mM. The enzyme transcribes (rA)n . (dT)12, (rC)n . (dG)12-18 and (2-O-methyl C)n . (dG)18, but is unable to transcribe (dA)n . (dT)10. The enzyme has no catalytic activity in the presence of oligodeoxynucleotide initiators alone, indicating the absence of terminal deoxynucleotidyl transferase. The purified enzyme is able to transcribe the heteropolymeric regions of a 70S RNA from R(Mu)LV. The presented data support the presence of a RNA-dependent DNA polymerase in human osteosarcoma tissue with biochemical properties, resembling those of C-type RNA tumor viruses.     

Differences in biodistribution between 99mTc-depreotide, 111In-DTPA-octreotide, and 177Lu-DOTA-Tyr3-octreotate in a small cell lung cancer animal model

AIM: (177)Lu-DOTA-Tyr(3)-octreotate is a candidate radiopharmaceutical for the therapy of somatostatin receptor (sstr)-positive small cell lung cancer (SCLC). Scintigraphy of lung tumors is made with 2 alternative somatostatin analogs, (111)In-DTPA-octreotide or (99m)Tc-depreotide. The aim of this study was to compare the biodistribution of these 3 radiopharmaceuticals in SCLC xenografted to nude mice. METHODS: Nude mice, bearing tumors from the human SCLC cell line NCI-H69, were intravenously injected with 10 MBq (2.4 microg) (99m)Tc-depreotide and 2 MBq (0.5 microg) (111)In-DTPA-octreotide simultaneously. The activity concentration (%IA/g) was measured in tumor and normal tissue at 2, 4, and 24 hours postinjection (hpi). The results were compared with earlier published biodistribution data of 3 MBq (0.7 microg) (177)Lu-DOTA-Tyr(3)-octreotate in the same animal model. RESULTS: The activity concentration of (111)In-DTPAoctreotide in tumor was higher than the activity concentration of (99m)Tc-depreotide at 2-24 hpi, p < 0.05. The highest tumor uptake at 24 hpi was, however, found for (177)Lu-DOTA-Tyr(3)-octreotate. The activity concentration of (99m)Tc-depreotide was significantly higher in the heart, lungs, liver, the salivary glands, spleen, and bone marrow than for (111)In-DTPA-octreotide at 2-24 hpi. Saturation of the somatostatin receptors may have influenced the uptake in tumor and sstr-positive normal tissues. CONCLUSION: The low tumor-to-lung and tumor-to-liver activity concentration ratios for (99m)Tc-depreotide could result in a lower detection rate of SCLC with this compound versus (111)In-DTPA-octreotide. (177)Lu-DOTA-Tyr(3)-octreotate gave the highest tumor-activity concentration, and has, thus, the best properties for therapy.     

超声内镜与多层螺旋CT诊断胰腺神经内分泌肿瘤的价值

目的:探讨超声内镜(EUS)与多层螺旋CT(MSCT)诊断胰腺神经内分泌肿瘤(pNENs)的价值.方法:回顾性分析2012年至2016年43例均行EUS和MSCT检查并经组织病理学确诊为pNENs患者的临床、影像和病理资料,比较EUS和MSCT对pNENs的检出率和敏感性,并分析EUS和MSCT在肿瘤最大径≥2 cm或<2 cm、功能性或无功能性pNENs诊断中是否存在差异.结果:43例经组织病理学确诊的pNENs中,男23例、女20例,年龄(57.2±13.6)岁(28~75岁),肿瘤最大径(2.6±2.1) cm(0.6~7.3 cm),其中19例≥2 cm、24例<2 cm,功能性pNENs 26例、非功能性pNENs 17例.总体而言,EUS和MSCT检出率分别为90.7%(39/43)和69.8%(30/43),差异具有统计学意义(P=0.015);EUS和MSCT敏感性分别为71.8%(28/39)和73.3%(22/30),差异无统计学意义(P=0.887).按肿瘤最大径不同比较:EUS和MSCT对肿瘤最大径≥2 cm pNENs的检出率分别为100%(19/19)和100%(19/19),差异无统计学意义(P=1.000);敏感性分别为73.7%(14/19)和78.9%(15/19),差异无统计学意义(P=0.703).EUS和MSCT对肿瘤最大径<2 cm pNENs的检出率分别为83.3%(20/24)和45.8%(11/24),差异具有统计学意义(P=0.007);敏感性分别为70.0%(14/20)和63.6%(7/11),差异无统计学意义(P=0.717).按肿瘤有无功能比较:EUS和MSCT对功能性pNENs的检出率分别为88.5%(23/26)和53.8%(14/26),差异有统计学意义(P=0.006);敏感性分别为73.9%(17/23)和64.3%(9/14),差异无统计学意义(P=0.534).EUS和MSCT对非功能性pNENs的检出率分别为94.1%(16/17)和94.1%(16/17),差异无统计学意义(P=1.000);敏感性分别为68.8%(11/16)和81.3%(13/16),差异无统计学意义(P=0.414).结论:MSCT对直径≥2 cm 的pNENs检出率和敏感性较好,但对直径<2 cm的pNENs检出率和敏感性较低,有必要联合EUS检查.     

STI571与三氧化二砷对多药耐药bcr-abl阳性白血病细胞的协同抑制作用

目的　研究酪氨酸激酶抑制剂STI5 71与三氧化二砷 (As2 O3 )联合应用对多药耐药bcr abl阳性白血病细胞的协同效应。方法　采用MTT法比较STI5 71单独或与不同浓度的As2 O3 联合应用对bcr abl和mdr1共同阳性的白血病细胞系K5 6 2 n/VCR的抑制作用。结果　 1μmol/L的STI5 71对K5 6 2 n/VCR细胞无明显细胞毒作用 ,与 10 -5,10 -6,10 -7,10 -8mol/L的As2 O3 联合应用 ,细胞毒作用明显增强。As2 O3 单独对K5 6 2 n/VCR细胞的IC50 为 1.879μmol/L ,加STI5 71后 ,IC50 为 0 .15 5 μmol/L ,协同抑制作用为 12 .12倍。结论　STI5 71与As2 O3 联合应用对于bcr abl与mdr1共同阳性的白血病细胞有更强的抑制作用     

PEI-RGD/125I(αV)ASODN 的制备及其对肝癌HepG2细胞侵袭力的抑制

目的：探讨以PEIRGD(polyethyleneimineArgGlyAsp)为转染载体的125I(αV)ASODN投递在体外对HepG2肝癌细胞侵袭力的影响。方法:125I标记整合素αV亚基的ASODN,以聚乙烯亚胺衍生物PEIRGD为载体制备PEIRGD/125I(αV)ASODN复合物,通过受体介导方式转染进入HepG2细胞,利用Boyden小室侵袭模型检测复合物对HepG2细胞侵袭力的影响。结果:(1)125I(αV)ASODN的标记率为（73.78±4.09）%,放化纯度为（96.68±1.38）%,37 ℃放置48 h后的放化纯度仍>90%,表明其稳定性良好;(2) HepG2细胞对PEIRGD/ 125I(αV)ASODN的摄取于4 μl/2 μg时达到峰值\[（12.77±085）%\],之后明显降低,故选择2 μl/1 μg作为PEIRGD/ 125I(αV)ASODN对HepG2细胞的作用剂量;(3)相对于其他实验组和对照组,PEIRGD/ 125I(αV)ASODN组显著降低了HepG2细胞的侵袭能力（P<0.01）。结论:以PEIRGD为载体投递 125I(αV)ASODN能有效抑制HepG2细胞的侵袭力。     

Recurrence of endometrial cancer and its pathological factors

The number of patients with uterine endometrial cancer has increased in recent years in Japan. The studies on the prognostic factors of endometrial cancer, however, have not been made in detail as compared with those on the prognostic factors of cervical cancers. We have therefore investigated retrospectively the prognoses of 94 cases with endometrial cancer treated in our clinic from 1973 to 1984. Out of 31 cases (32.9%) with recurrence, 13 cases were at the Stage I and II, and the recurrence ratios were 11.4% for Stage Ia, 18.2% for Stage Ib and 31.3% for Stage II. The prognosis of endometrial carcinoma appears to depend on the endocervical involvement of the cancer. Five prognostic factors for Stage I and II endometrial cancers analyzed here are as follows; (1) histologic differentiation (grade), (2) size (diameter) of the primary tumor, (3) myometrial invasion, (4) vascular invasion, (5) lymphnode metastasis. (1) The recurrence ratio was 15.0% in the well differentiated (Grade 1) group, 25.0% in the moderately differentiated (Grade 2) group, 27.3% in the poorly differentiated (Grade 3) group, and 12.5% in adenoacanthoma. (2) The ratio of recurrence was 2.9% with less than 3 cm diameter, 24% with 3-6 cm diameter, and 30% with greater than 6 cm diameter in tumor size. (3) The ratio of recurrence was 2.9% with less than 1/3, 24% with 1/3-2/3, and 30% with greater than 2/3 myometrial invasion. (4) The ratio of recurrence was 43.8% with vascular invasion, and 5.6% without it. (5) The ratio of recurrence was 75% with lymphnode metastasis, and 8.8% without it.(ABSTRACT TRUNCATED AT 250 WORDS)     

单价抗CD20抗体诱导人B细胞淋巴瘤Raji细胞的凋亡

背景与目的:抗CD20抗体和片段已应用于非霍奇金淋巴瘤的临床治疗,但仍需要开发新的抗CD20抗体和片段(未修饰的或放射性标记的),以治疗对美罗华(利妥昔单抗)无反应的患者。鼠源性抗CD20抗体HI47的嵌合抗体片段Fab和F(ab)'2已被构建。本研究目的是观察HI47(鼠抗-CD20抗体)和其嵌合抗CD20抗体片段抑制肿瘤细胞生长和诱导肿瘤细胞凋亡的作用。方法:用免疫荧光法测定抗CD20抗体与CD20+人B细胞淋巴瘤Raji细胞的结合能力;MTT法测定抗CD20抗体片段对Raji细胞生长的影响;用膜联蛋白Ⅴ染色和DNA琼脂糖凝胶电泳检测和验证抗CD20抗体片段诱导Raji细胞凋亡。结果:HI47和其嵌合的抗CD20抗体片段均可与CD20+Raji细胞结合,结合率可达90%以上;HI47不能与美罗华竞争结合Raji细胞;HI47和其嵌合的抗CD20抗体片段浓度为100μg/ml对Raji细胞的抑制率分别为:(57.0±1.5)%、(65.2±2.5)%、(77.2±3.2)%;单价的抗CD20抗体片段Fab(20μg/ml)能够诱导Raji细胞的凋亡,早期凋亡率为17%。结论:HI47的嵌合抗体片段对Raji细胞有抑制作用,能诱导Raji细胞的凋亡。     

Ⅲ+Ⅳ期非小细胞肺癌三维适形放疗正常肺V_5、V_(10)预测放射性肺损伤前瞻性临床研究

目的 探讨非小细胞肺癌三维适形放疗正常肺低剂量体积对放射性肺损伤的预测作用.方法 采用三维适形后程加速超分割放疗经病理或细胞学证实的非小细胞肺癌患者100例.Ⅲ期14例,Ⅲb期36例,Ⅳ期50例.鳞癌49例,腺癌48例,腺鳞癌3例.初治79例、术后复发8例,术后残留12例,术后辅助1例.单纯放疗9例,放化疗91例.放疗剂量60～80 Gy,60～69 Gy 24例,≥70 Gy76例.化疗方案采用紫杉类+铂类一线方案.用剂量体积直方图计算正常肺V_5、V_(10)、V_(20)、V_(30)和平均肺剂量(MLD).肺损伤评估根据CTC 3.0标准.结果 全组V_5为37%～98%,中位值65%;V_(10)为27%～78%,中位值47.5%;V_(20)为17%～54%,中位值31%;V_(30)为9%～31%,中位值24%.100例患者中发生放射性肺炎(RP)1级34例,2级27例,3级8例,4级1例,5级1例.75例患者中发生放射性肺纤维化1级46例,2级14例,3级2例.V_5、V_(10)、V_(20)、MLD与≥1级RP相关,V_(5)、V_(20)、V_(30)、MLD与≥2级RP相关,V_5与≥3级RP相关.V_(5)、V_(20)、V_(30)、分别>65%、31%、24%时发生≥2级RP概率增加,V_(5)、V_(20)分别>65%、31%时发生≥3级RP概率增加,V_(20)>31%时发生≥1级RP概率增加.大体肿瘤体积、计划靶体积与≥1级RP、≥2级放射性肺纤维化相关.性别、年龄、临床分期、处方剂量、照射野数目与各级放射性肺损伤无关.结论 剂量体积参数V_(5)、V_(10)与RP发生相关,可能成为放射肺损伤有效的预测因子.