大肝癌患者行 TACE 序贯射频消融的疗效及复发因素

目的：探讨经导管肝动脉化疗栓塞（TACE）联合序贯射频消融术（RFA）治疗大肝癌患者的疗效及复发因素。方法：选取我院2013年1月－2015年1月肿瘤外科中晚期原发性大肝癌患者110例并分为肝动脉化疗栓塞组（TACE 组）与肝动脉化疗栓塞联合序贯经皮射频消融术组（TACE ＋RFA 组）各55例,TACE 组患者行一次或多次单一肝动脉化疗治疗;TACE ＋RFA 组在肝动脉化疗治疗结束后1～2周再行序贯经皮射频消融术治疗。结果：TACE 组与 TACE ＋RFA 组总有效率分别为63．64％（35／55）、94．54％（52／55）。TACE ＋RFA 组1年生存率为72．7％（40／55）,2年生存率为20．0％（11／55）,而 TACE 组分别为56．36％（31／55）、7．27％（4／55）。Log －rank 检验结果显示肿瘤数量、分期、血清甲胎蛋白水平等为大肝癌患者预后的因素,与患者预后有一定关系。结论：经导管肝动脉化疗栓塞（TACE）联合经皮射频消融术（RFA）治疗原发性中晚期大肝癌可以有效提高患者生存率,延长患者的生存期。肿瘤数量、直径、分期等是影响患者复发的危险因素。     

射频消融术加肝动脉化疗栓塞术治疗原发性肝癌

目的探讨超声导向射频消融术(RFA)联合肝动脉化疗栓塞(TACE)治疗原发性肝癌的治疗效果。方法应用超声引导下对80例原发性肝癌患者进行RFA联合TACE(治疗组)和对70例肝癌患者进行射频消融术,比较观察该法治疗组与单纯射频消融治疗组治疗前、后肿瘤大小、血供变化及临床疗效。结果该法治疗组与单纯射频消融治疗组术后肿瘤血供消失和减少率分别为95%、70%;3个月复查彩超肿瘤缩小25%以上者分别为90%、85.7%。结论射频消融联合肝动脉化疗栓塞术是一种有效治疗肝癌的新方法。同时,彩超为实时观察肝癌血供状态,声像图变化提供重要依据,在指导治疗和判定疗效方面有重要意义。     

冷循环射频消融术联合经导管动脉栓塞化疗治疗中晚期肝癌的临床疗效

目的 探讨冷循环射频消融术联合经导管动脉栓塞化疗(TACE)治疗中晚期肝癌的临床疗效.方法 根据手术方式的不同将126例中晚期肝癌患者分为TACE组(n=63)和联合组(n=63).TACE组患者接受单纯TACE治疗,联合组患者接受冷循环射频消融术联合TACE治疗.比较治疗前后两组患者的肝功能指标[丙氨酸转氨酶(ALT...     

射频消融联合肝动脉化疗栓塞治疗原发性肝癌的临床观察

目的探讨射频消融术(RFA)联合肝动脉化疗栓塞术(TACE)治疗原发性肝癌的临床疗效。方法采用随机数表法将64例原发性肝癌(肿瘤直径为3~5cm)患者分为两组,每组32例,对照组患者行单纯RFA治疗,观察组患者给予RFA联合TACE治疗,比较两组患者治疗后甲胎蛋白(AFP)水平和卡氏评分,并比较两组患者无瘤生存率。结果两组患者治疗后AFP均明显降低,卡氏评分明显提高,且观察组优于对照组,差异均有统计学意义(均P<0.05)。观察组患者随访期间,2年及3年无瘤生存率均明显高于对照组,差异有统计学意义(P<0.05)。结论 RFA联合TACE治疗原发性肝癌(肿瘤直径3~5 cm)与单纯RFA比较,可进一步提高临床疗效并改善患者的预后。     

肝动脉化疗栓塞联合经皮射频治疗中晚期肝癌的疗效观察

目的探讨肝动脉化疗栓塞联合经皮射频治疗中晚期肝癌的临床疗效。方法将60例中晚期肝癌患者随机分为单纯接受动脉化疗栓塞治疗的对照组和接受肝动脉化疗栓塞联合经皮射频治疗的观察组,比较2组患者治疗后的肿瘤体积、新生血管情况、5年复发率、5年生存率及平均生存时间等差异。结果 1观察组肿瘤体积缩小>50%的患者(66.67%)显著多于对照组(P<0.05);2观察组患者VEGFA、VEGFB、VEGFC表达水平分别为(82.21±11.17、77.42±9.32、52.76±7.32)ng/m L,明显低于对照组患者(P<0.05);3观察组患者5年复发率(60.00%)明显低于对照组患者,5年生存率(78.67%)及平均生存时间(4.82±0.74)年均明显高于对照组患者(P<0.05)。结论肝动脉化疗栓塞联合经皮射频治疗有助于缩小中晚期肝癌患者的肿瘤体积,抑制肿瘤血管新生、降低复发率、延长患者生存时间,具有积极的临床意义。     

经导管动脉栓塞化疗联合射频消融术治疗原发性肝细胞肝癌的效果观察

目的 探讨选择性经导管动脉栓塞化疗(TACE)联合射频消融术(RFA)治疗原发性肝细胞肝癌的疗效及对患者生存的影响.方法 将78例原发性肝细胞肝癌患者按治疗方式不同分为对照组(TACE治疗,n=37)和研究组(TACE联合RFA治疗,n=41).对比两组患者的临床疗效、并发症发生情况及生存情况.结果 研究组患者总有效率...     

原发性肝癌综合介入治疗的疗效分析

目的探讨原发性肝癌综合介入治疗的疗效。方法回顾性分析1126例原发性肝癌患者手术前后行经导管肝动脉化疗栓塞术(TACE)、TACE后射频消融(RFA)治疗、TACE或经导管肝动脉化疗灌注治疗(TAI)后辅以中药和生物治疗的临床资料,分析患者肝功能、肿瘤标志物、癌灶影像资料和生存率等,比较各种综合介入治疗的价值。结果全组患者1、3、5年生存率分别为67.8%、28.7%和18.8%。其中术前TACE组1、3、5年生存率分别为74.7%、41.4%和36.9%,术后TACE组1、3、5年生存率分别为78.9%、40.4%和37.5%;TACE RFA组的近期有效率为93.4%,1、3年生存率分别为74.5%和36.8%;TACE组的近期有效率为83.2%,1、3、5年生存率分别为69.3%、21.7%和8.4%;TAI治疗的近期有效率为27.5%,1、3年生存率分别为11.6%和0。TACE RFA组和TACE组间肝功能Child降级、瘤内与瘤周血流信号消失和甲胎蛋白转阴率差异均无统计学意义,TACE RFA组、TACE组与TAI组肝功能Child降级差异无统计学意义。结论原发性肝癌手术切除前后TACE效果最佳,手术前与手术后行TACE疗效相近;TACE RFA疗效优于TACE;TAI疗效较差。     

经皮肝瘤内注入无水乙醇结合TACE治疗中晚期原发性肝癌的疗效观察

目的　评估B超引导下经皮肝穿刺注射无水乙醇结合肝动脉化疗栓塞术治疗中晚期原发性肝癌的时机选择与疗效。方法　对 52例中晚期原发性肝癌采用B超引导下经皮肝穿刺瘤内注射无水乙醇 (PEI) +肝动脉插管化疗栓塞术 (TACE)治疗并与同期 58例单纯肝动脉化疗栓塞术 (对照组 )比较。结果　治疗组的肿瘤缩小率、AFP下降、Karnofsky评分、0 .5年、1年累计生存率明显优于对照组。结论　PEI+TACE为中晚期原发性肝癌较好的一种综合治疗方法     

TACE联合RFA对原发性肝癌患者的近期及远期疗效观察

目的 探讨经肝动脉插管栓塞化疗术(TACE)联合射频消融术(RFA)治疗原发性肝癌的近期临床效果及远期预后.方法 选取85例原发性肝癌患者的临床资料进行回顾性分析,根据治疗方法的不同将患者分为TACE组40例、联合组(TACE+RFA)45例,对比两组患者的临床疗效及预后.结果 治疗后,联合组患者的近期疗效总有效率为71.11％,高于TACE组的50.00％(P﹤0.05);治疗后,联合组患者的血清AFP水平明显低于TACE组(P﹤0.01),两组的KPS评分比较,差异无统计学意义(P﹥0.05);随访3年,联合组失访2例,TACE组失访3例,联合组患者的3年生存率为28.89％(13/45),TACE组患者的3年生存率为15.00％(6/40),两组比较,差异无统计学意义(P﹥0.05),联合组的中位生存时间为25个月,长于TACE组的19个月(P﹤0.05);两组患者并发症发生率比较,差异无统计学意义(P﹥0.05).结论 TACE联合RFA治疗原发性肝癌的临床效果优于单用TACE治疗.     

射频消融术与肝动脉化疗栓塞术治疗肝转移癌

目的探讨射频消融术(RFA)与肝动脉化疗栓塞术(TACE)治疗肝转移癌的疗效和临床应用价值.方法对不宜或不能手术的转移性肝癌患者40例行RFA(A组),38例行TACE(B组).观察缓解率、半年、1年、2年生存率.结果A组缓解率、半年、1年、2年生存率为65%、87.5%、70%、22.5%.B组缓解率、半年、1年、2年生存率分别为78.9%、94.7%、78.9%、39.5%.结论对肝转移癌患者TACE术疗效优于RFA.     

Bacteria and cancer--antagonisms and benefits

There is considerable historical and recent evidence concerning the antagonisms between acute bacterial infections or their toxins and cancer and allied diseases. These data provide renewed incentives to undertake clinical programmes with mixed bacterial vaccines in many countries at the present time.     

Religiosity and physical and emotional functioning among African American and White colorectal and lung cancer patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

Renal irradiation and the pharmacology and toxicity of methotrexate and cisplatinum

We used a rat model to study the effects of renal irradiation on the pharmacology of methotrexate (MTX) and cisplatinum (cis-Pt). Unanesthetized rats were given bilateral kidney irradiation (20 Gy in 9 fractions). At 9 months after irradiation, 3% of the animals had died and survivors showed moderately impaired renal function. At 15 months, 30% of the animals had died and survivors showed severely impaired renal function. Some animals were given i.v. MTX 1 week to 15 months after irradiation. In irradiated rats, the area under the MTX plasma clearance curve equaled that of controls through 6 months, and was significantly above controls from 9 months on. Other animals were given i.p. cis-Pt 1 week to 9 months after irradiation. The acute toxicity of cis-Pt was the same in control and irradiated rats when cis-Pt was given immediately before or after irradiation. Beginning 3 months after irradiation there was a progressive increase in cis-Pt toxicity and a simultaneous decrease in urinary platinum excretion. Irradiated animals that survived cis-Pt treatment showed increased radiation nephritis; the greatest effect occurred when cis-Pt was given 3 months or more after irradiation. MTX and cis-Pt clearance decreased when renal dysfunction was first observed and changes in renal function preceded changes in drug clearance and toxicity.     

VEGF及KDR在大肠腺瘤和腺癌中的表达及意义

目的：探讨VEGF和KDR在大肠腺瘤和大肠腺癌中的表达及临床病理特征的关系。方法：大肠腺瘤和大肠腺癌组织标本各100例,采用免疫组织化学染色法检测VEGF和KDR在标本中的表达情况。结果：VEGF和KDR在大肠腺癌组中的阳性表达明显高于大肠腺瘤组（P〈0.05）;在正常大肠黏膜均未见VEGF和KDR表达的阳性染色;VEGF阳性表达组中KDR的阳性表达率为70%,显著高于VEGF阴性表达组中KDR的阳性表达率16%,两组比较有统计学意义（P〈0.01）。结论：大肠腺癌组织中KDR的表达与肿瘤大小、转移情况、浸润深度密切相关;VEGF和KDR在大肠腺瘤中的表达与患者的年龄、性别及分型均无相关性,而与增生程度相关（P〈0.05）。在大肠腺癌患者中VEGF及KDR表达更高,二者具有协同效应。     

Morphine and tumor growth and metastasis

Morphine is an analgesic widely used to alleviate cancer pain. In addition, the perioperative management of pain in cancer surgery patients most often includes opioids. However, there are reports that these drugs may alter cancer recurrence or metastasis. Several mechanisms have been proposed, such as the modulation of the immune response or cellular pathways that control the survival and migratory behavior of cancer cells. The published literature, however, presents some discrepancies, with reports suggesting that opioids may either promote or prevent the spread of cancer. It is of great importance to determine whether opioids, in particular the most widely used, morphine, may increase the risk of metastasis when used in cancer surgery. This review examines the available data on the effects of morphine which influence cancer metastasis or recurrence, including immunomodulation, tumor cell aggressiveness, and angiogenesis, with special emphasis on recently published clinical and laboratory based studies. We further discuss the parameters that may explain the difference between reports on the effects of morphine on cancer.     

肾上腺素能β受体与肿瘤生长及转移

大量研究表明肿瘤细胞可表达β受体，而一些神经递质、药物和社会心理因素可能通过β受体影响肿瘤的生长和转移，β受体激动剂、β受体阻滞剂以及抑郁等社会心理因素可加强或削弱这种作用。这为表达β受体肿瘤的治疗开辟了新的道路，提供了新的治疗靶点。