肺癌患者血管紧张素转换酶变化的观察

目的　研究肺癌患者血清血管紧张素转换酶(SACE)的活性及其化疗后的变化。方法　用紫外线分光光度计测定肺癌患者、肺炎患者及正常人的SACE。结果　肺癌患者的SACE活性明显低于肺炎组及正常组(P<0.01)。肺癌患者经化疗后SACE活性明显增高(P<0.01)。结论　测定SACE活性有助于肺部良、恶性病变的鉴别诊断及监测肺癌预后     

刮吸解剖法和传统电刀法在乳腺癌、肺癌、食管癌手术中的比较研究

目的比较刮吸解剖法和传统电刀法在乳腺癌、肺癌、食管癌手术中的应用情况。方法收集2014年10月至2016年6月南通市肿瘤医院收治的98例乳腺癌、肺癌、食管癌手术患者的临床资料。48例行刮吸解剖法手术,为刮吸解剖组,其中乳腺癌14例、肺癌16例、食管癌18例;50例行传统电刀法手术,为传统电刀组,其中乳腺癌16例、肺癌17例、食管癌17例。对两组的术中出血量、手术时间及淋巴结清扫数目进行比较。结果刮吸解剖组:乳腺癌术中出血量为(33.21±9.32)ml,手术时间为(65.71±6.75)min,淋巴结清扫数目为(12.14±2.32)个;肺癌术中出血量为(296.25±67.71)ml,手术时间为(104.38±13.02)min,淋巴结清扫数目为(19.63±3.30)个;食管癌术中出血量为(271.67±48.40)ml,手术时间为(166.39±15.40)min,淋巴结清扫数目为(19.78±2.02)个。传统电刀组:乳腺癌术中出血量为(51.25±10.72)ml,手术时间为(73.44±9.61)min,淋巴结清扫数目为(9.25±2.24)个;肺癌术中出血量为(397.65±72.40)ml,手术时间为(115.59±14.12)min,淋巴结清扫数目为(17.06±2.86)个;食管癌术中出血量为(336.47±71.40)ml,手术时间为(191.76±15.10)min,淋巴结清扫数目为(18.06±2.01)个。两组均无围手术期死亡病例,刮吸解剖组优于传统电刀组,在术中出血量、手术时间、淋巴结清扫数目方面两组比较,差异有统计学意义(均P0.05)。结论刮吸解剖法用于乳腺癌、肺癌、食管癌手术安全,可减少术中出血,加快手术速度,提高手术质量。     

肿瘤患者血清中鸟氨酸脱羧酶的研究

用高效液相色谱法测定了正常人及乳腺癌、宫颈癌、食管癌、肺癌患者血清中鸟氨酸脱羧酶活性。结果表明,肿瘤患者血清中鸟氨酸脱羧酶的活性升高,P＜0.05。其乳腺癌、宫颈癌、食管癌及肺癌的阳性率分别为:75.0%、63.6%、50.0%和42.9%。说明测定血清中鸟氨酸脱羧酶的活性对肿瘤的诊断有一定临床意义。     

高能射线照射对人血清血管紧张素Ⅰ-转换酶的影响

本文报告直线加速器,高能X线,感应加适器高能β-线和180KV深部X线放射治疗的肺癌,食管癌、乳腺癌、宫颈癌、颅内肿瘤、鼻咽癌和喉癌等126例病人的血清血管紧张素I—转换酶(SACE)的观察结果。肺癌病人放疗前SACE为33.4±8.6u,略低于正常值35.7±7.6u(P>0.05),高能射线放射治疗后,其SACE似有轻度增高的趋向(P>0.05)。肺癌病人治疗前的SACE水平与疗效无明显相关性。皮肤癌和腮腺粘液表皮癌SACE明显高于正常。其他肿瘤病人的SACE水平放疗前、后与正常值无明业差别。     

肺癌与食管癌术后乳糜胸的临床特点分析

目的探讨肺癌和食管癌切除及淋巴结清扫术后乳糜胸病例的临床特点。方法回顾性分析1203例肺癌术后9例乳糜胸患者和2361例食管癌术后34例乳糜胸患者的临床资料。结果肺癌组术后乳糜胸的发生率(0.8%)低于食管癌组(1.4%),并且临床症状及体征明显较食管癌组轻,保守治疗成功率高。所有患者痊愈出院。结论肺癌术后乳糜胸的发生率、病因、临床表现、诊断及治疗与食管癌术后乳糜胸有明显不同。     

肺癌D-二聚体定量与抗凝血酶Ⅲ活性测定的意义

目的对119例肺癌患者D二聚体（D-dimer）和抗凝血酶Ⅲ（antithrombinⅢ,AT-Ⅲ）活性进行检测,以探讨上述指标与肺癌的关系及意义。方法肺癌患者119例,对照组30例。D二聚体定量（D-dimer）和抗凝血酶Ⅲ活性测定用STAGOSTA-Compact全自动凝血仪检测。结果肺癌患者D-dimer[（2.26±1.24）μg/ml]明显高于对照组[（0.31±0.25）μg/ml]（P＆lt;0.01）。肺癌患者抗凝血酶Ⅲ活性[（73.03±24.66）%]低于对照组[（98.11±16.31）%];肺癌转移组（45例）D-dimer明显高于肺癌局限组（74例）[（2.96±1.51）μg/ml对（1.32±1.03）μg/ml,P〈0.01]。结论肺癌患者均有不同程度继发纤溶亢进及抗凝活性减低。凝血及纤溶的异常在肺部肿瘤的发生和发展中起重要的作用。D-dimer测定对肺癌的转移及预后有重要的价值。     

非小细胞肺癌血清Cyfra21—1检测临床应用探讨

Cyfra21－1是血清中可溶性角蛋白19的碎片，文献报道对非小细胞肺癌（NSCLC）是较有意义的肿瘤标记物，作者检测110例NSCLC血清值，并与正常人及其它恶性肿瘤对比，以探讨其在NSCLC的诊断、治疗评价和预后监测中的临床意义，现报告如下。1材料与方法分为NSCLC组，其它恶性肿瘤组，以及正常人组。NSCLC组110例，全部为本院肿瘤科住院患者，男92例、女18例；年龄28～71岁，平均57岁。其中鳞癌52例，腺癌对例，未定型12例，术后15例。其它恶性肿瘤组64例，男45例、女19例，全部为本院住院患者；病种有鼻咽癌、恶性淋巴瘤、肝癌、胃…     

联合检测外周血T淋巴细胞AgNOR活性及T淋巴细胞亚群评估食管癌围手术期细胞免疫变化规律

背景与目的食管癌患者存在着细胞免疫功能抑制,测定T淋巴细胞核仁区的AgNOR活性及T淋巴细胞亚群,可以了解T淋巴细胞的免疫活性状态,对研究肿瘤的生物学行为具有重要意义。本研究旨在通过动态观察食管癌患者围手术期外周血T淋巴细胞AgNOR的活性及T淋巴细胞亚群的变化规律,研究细胞免疫机能状态及手术对食管癌患者细胞免疫功能的影响。方法分别抽取75例健康人外周血和70例食管癌患者术前、术后第3天、术后第9天的外周血,利用KL型肿瘤免疫图像分析系统检测AgNOR活性,流式细胞术分析T淋巴细胞亚群。结果食管癌患者术前AgNOR活性[(5.5±0.8)%]明显低于健康人[(7.1±0.8)%](P<0.00),CD3 、CD3 CD4 无明显变化(P>0.05),CD4 CD25 、CD4 /CD8 明显上升(P<0.05),CD3 CD8 、CD8 CD25 亚群明显下降(P<0.00)。术后第3天外周血T淋巴细胞AgNOR、CD3 、CD3 CD4 与CD4 /CD8 最低,术后第9天最高;CD3 CD8 亚群、CD4 CD25 亚群、CD8 CD25 亚群则从第3天开始逐渐恢复,术后第9天最高。食管癌患者术后第9天CD3 、CD3 CD4 与健康人相比无显著性差异(P>0.05);外周血T淋巴细胞AgNOR、CD3 CD8 与CD8 CD25 仍未恢复到健康人水平(P<0.05);CD4 CD25 仍明显高于健康人(P<0.00)。结论手术创伤引起食管癌患者暂时性细胞免疫抑制,但从第3天开始可观察到细胞免疫功能恢复,术后第9天继续恢复,但仍未恢复到正常水平。     

恶性肿瘤患者血清脂结合唾液酸含量的改变

本文用改良硫代巴比妥酸显色法测定了100例正常受试者和85例恶性肿瘤忘者血清脂结合唾液酸的含量,其结果是正常人为167.6±62.4mg/L,27例肺癌患者为795.4±185.8mg/L,阳性率为92％;14例白血病患者为541.2±127.6mg/L,阳性率为93％;11例食管癌患者为650.8±287.5mg/L,阳性率为91％;9例胃癌患者为601.8±228.4mg/L,阳性率为100％;5例卵巢癌患者为740.4±331mg/L,阳性率为80％。故本法可作为诊断肺癌等恶性肿瘤的一种诊断指标。     

中晚期食管癌胸腔镜根治术的疗效观察

目的探讨中晚期食管癌行胸腔镜食管癌根治术治疗的临床疗效。方法选取2012年1月至2014年12月间南京医科大学附属淮安一院收治的178例中晚期食管癌患者,按其手术方式分为胸腔镜食管癌根治组(100例),三切口食管癌根治开放组(78例)。记录患者术中情况、术后拔管时间、住院费用、并发症发生情况及复发率和死亡率。结果两组患者均顺利完成手术,胸腔镜组无中转开胸病例,围术期两组均无死亡病例。胸腔镜组平均术中出血量(158.5±26.5)ml、引流时间(4.5±1.5)d、引流量(470.0±250.0)ml、平均住院时间(12.5±2.5)d和并发症发生率为20.0%,均优于开放组的(176.5±28.5)ml、(7.5±2.5)d、(900.0±360.0)ml、(16.5±3.5)d和29.5%,两组比较差异均有统计学意义(均P<0.05)。胸腔镜组淋巴结清扫数量(22.8±6.8)枚、阳性淋巴结率(9.5±1.5)%、手术时间(158.5±26.5)min和住院费用(5.5±0.3)万元,与开放组的(23.7±7.0)枚、(9.6±1.5)%、(176.5±28.5)min和(5.3±0.2)万元比较,差异均无统计学意义(均P>0.05)。胸腔镜组患者复发或转移9例(9.0%),开放组为10例(12.8%),组间比较差异无统计学意义(P>0.05)。胸腔镜组患者死亡3例(3.0%),开放组患者死亡4例(5.1%),组间比较差异无统计学意义(P>0.05)。胸腔镜组总生存率为97.0%,开放组为94.9%,组间比较差异无统计学意义(P>0.05)。结论胸腔镜下治疗中晚期食管癌临床疗效理想,术后恢复快,术后并发症发生率低,适于临床上使用。     

A blueprint for cancer screening and early detection: Advancing screening’s contribution to cancer control

From the mid-20th century, accumulating evidence has supported the introduction of screening for cancers of the cervix, breast, colon and rectum, prostate (via shared decisions), and lung. The opportunity to detect and treat precursor lesions and invasive disease at a more favorable stage has contributed substantially to reduced incidence, morbidity, and mortality. However, as new discoveries portend advancements in technology and risk-based screening, we fail to fulfill the greatest potential of the existing technology, in terms of both full access among the target population and the delivery of state-of-the art care at each crucial step in the cascade of events that characterize successful cancer screening. There also is insufficient commitment to invest in the development of new technologies, incentivize the development of new ideas, and rapidly evaluate promising new technology. In this report, the authors summarize the status of cancer screening and propose a blueprint for the nation to further advance the contribution of screening to cancer control.     

Twinning and the Incidence of Breast and Gynecological Cancers (United States)

Increasing epidemiological and experimental evidence indicates that the carcinogenic pathway in the breast and female reproductive organs is driven, at least in part, by factors associated with reproduction. We conducted a retrospective cohort study, comparing the risk of ovarian, breast, endometrial, and cervical cancers among women who had records of at least one twin pregnancy, compared with women who had given birth to only single children. Subjects were selected from the Utah Population Database, which consists of multiple linked datasets including genealogy, births and deaths and cancer registries. We used Poisson regression to calculate relative risks, adjusted for the number of pregnancies and the age of the mother at the birth of first and last children, with singleton mothers as the reference group in each case. The risks of breast and ovarian cancers did not differ between mothers of twins and mothers of single children. The risk of endometrial cancer was slightly lower in mothers of twins than in mothers of singleton children (RR = 0.90, 95% CI 0.67-1.21). Conversely the risk of cervical cancer was higher among twin mothers (RR = 1.78, 95% CI 0.88-3.52). This latter finding supports previous data suggesting that reproductive hormones act as cofactors in the etiology of cervical cancer.     

Risk factors for colorectal cancer following breast cancer

Objective. To investigate risk factors for colorectal cancer following breast cancer. Methods. In this nested case-control study, all women (n=14,900) with a first primary breast cancer (1978–1992) were identified from the western Washington population-based Surveillance, Epidemiology, and End Results Cancer Registry. Cases (n=160) developed a second primary colorectal cancer before 1995, at least 6 months after the first cancer diagnosis. Controls (n=310, matched to the cases on calendar year, age and breast cancer stage) were randomly selected from those who did not develop a second primary cancer and who survived to the case's colorectal cancer diagnosis date. Characteristics of the cases and controls at initial diagnosis were compared using conditional logistic regression. Results. The incidence of colorectal cancer was associated with a family history of breast cancer (v.s. no family history, matched odds ratio (mOR)=2.1, 95% confidence interval (CI): 1.1–4.1), high body mass index (30 kg/m² v.s. <30 kg/m², mOR=2.2, CI: 1.2–3.9), and lobular breast cancer histology (v.s. ductal, mOR=2.0, CI: 0.9–4.4). Risk was unrelated to menopausal status, prior hormone replacement therapy and estrogen/progesterone receptor status of the breast tumors. Conclusions. The risk of developing a second primary colorectal cancer may be elevated among certain subsets of breast cancer patients.     

Neoplasms in skin and subcutis over the breast, simulating breast neoplasms: case reports and literature review

Twenty cases of neoplasms in skin and subcutaneous tissue over the breast were reviewed. There were 17 women, from 15 to 70 years of age, and three men, from 25 to 66 years of age. Among the benign skin neoplasms, superficial leiomyoma, granular cell tumor, and eccrine acrospiroma were misdiagnosed clinically as primary breast carcinoma. Among the malignant neoplasms in subcutaneous tissue, there were three metastatic malignant melanomas, one metastatic epidermoid bronchogenic carcinoma, and two malignant lymphomas. It is interesting that four of these six patients had no prior history of malignant lesion, the subcutaneous nodule presenting as the first manifestation of an occult primary. It is concluded that histological diagnosis of such tumors may lead to avoidance of unnecessary radical surgery.     

结直肠神经内分泌肿瘤的研究进展

结直肠神经内分泌肿瘤来源于结直肠神经内分泌细胞,发病率较低,但近年有上升趋势.WHO病理学将结直肠神经内分泌肿瘤分为神经内分泌瘤、神经内分泌癌、混合型腺-神经内分泌癌和增生性及肿瘤前病变.结直肠神经内分泌肿瘤细胞具有激素合成及分泌功能,但不一定都出现相应的临床症状.不同分类、分期的结直肠神经内分泌肿瘤的诊断及治疗方法也...     

Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening

Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates from the National Health Interview Survey, and select issues related to cancer screening. In this 2018 update, we also summarize the new American Cancer Society colorectal cancer screening guideline and include a clarification in the language of the 2013 lung cancer screening guideline. CA Cancer J Clin 2018;68:297–316 . © 2018 American Cancer Society .     

从高发现场视角看食管癌和贲门癌的临床研究趋势

我院流行病室开展食管癌和贲门癌高发现场研究已历30余年,所取得的最显著成绩主要有以下4个方面：（1）对食管癌癌前病变（即鳞状上皮不典型增生）及其逐级发展和演变规律的确认,以及对各级不典型增生诊断及处理的经验;（2）对食管癌早诊早治方法的探索,以及实践所得的优异效果;（3）食管鳞状细胞癌易发部位的发现及其对食管癌早期诊断的贡献;（4）胃贲门癌高发位点的发现及其对贲门癌早诊早治的贡献。在此基础上,结合我们长期在高发现场的实际工作经验,展望今后食管癌和贲门癌临床研究的趋势。     

Metastatic Breast Cancer Presenting as a Subconjunctival Mass

Breast cancer is the most common primary source of orbital metastasis. Metastasis occurs through hematogenous spread and predominantly involves the choroid. We present a case of a metastatic subconjunctival mass associated with primary breast cancer. To our knowledge, this is the first reported case of its kind. A 41-year-old woman presented with complaints of conjunctival injection and a foreign body sensation in the left eye. She had a history of breast cancer and had been treated 2 years previously with modified radical mastectomy followed by adjuvant radiotherapy and chemotherapy. Slit-lamp examination showed a cystic mass under the temporal bulbar conjunctiva, associated with dilated overlying conjunctival vessels. An excisional biopsy revealed a poorly differentiated adenocarcinoma. Positron emission tomography examination for systemic malignancy revealed multiple systemic metastasis. Metastatic disease should be considered in the differential diagnosis of subconjunctival lesions, and ophthalmic manifestations can play an important role in the detection of metastatic spread of a known primary breast cancer.