热休克蛋白与泌尿系统肿瘤关系的研究进展

热休克蛋白(HSP)与肿瘤的发生、发展密切相关,在肿瘤进展的不同阶段,HSP的表达情况也相应改变。HSP与泌尿系肿瘤的关系密切,HSP27可作为判断前列腺癌预后的一个独立指标;其表达与膀胱癌分期、分级、复发、转移和患者生存率等无显著相关性;HSP27的磷酸化密度和模式有望成为肾癌诊断新的标志物,对研制开发新的抗肿瘤药物有重大意义。     

同时相肝贲门或胃重复癌4例报告

本文报告了同时相肝、贲门或胃重复癌４例，根据病床经验及病理资料，作者认为在诊断为贲门或胃癌时又发现肝恶性肿瘤，不应轻易地以晚期癌而放弃联合脏器的根治性切除机会，本病的预后不比单发癌差。     

结,直肠癌肝转移的外科治疗

对６８例结、直肠癌肝转移患者中的１３例行手术治疗。作者认为：把握手术时机和适应证，提高手术切除成功率是提高存活率的关键。     

MCMs在男性泌尿生殖系肿瘤诊断、预后中的应用

MCMs是一种近期研究发现的DNA复制启动因子 ,它在肿瘤细胞中高表达 ,并与肿瘤细胞分化程度密切相关 ,对男性泌尿生殖系肿瘤诊断及预后有较高的特异性和敏感性。     

肝癌孤立肾上腺转移的诊治进展

肾上腺是肝细胞性肝癌(Hepatocellular carcinoma,HCC)最常见的转移部位之一,且转移发生后病人预后不佳,故早期发现、合理选择治疗方案对改善HCC肾上腺转移患者的预后具有重要意义.本文综述肝细胞性肝癌孤立肾上腺转移的诊断和治疗.     

肾盂输尿管癌术后膀胱灌注化疗对复发膀胱癌的影响

目的 探讨肾盂输尿管癌术后膀胱灌注化疗对膀胱复发癌的影响.方法 对96 例获随访的原发性肾盂输尿管癌患者的临床资料进行回顾性研究总结.结果 行肾盂输尿管膀胱部分切除术术后未进行膀胱灌注化疗的患者膀胱癌复发率为34.4%(11/32),术后行膀胱灌注化疗者膀胱癌复发率为18.8%(12/64),差异有显著性意义(pO.05).术中先行输尿管末端结扎者术后膀胱癌复发率较未采取结扎措施者低,但两者相比未见统计学意义(P>O.05).结论 肾盂输尿管癌行肾输尿管膀胱酃分切除术后预防性膀胱灌注化疗可有效降低复发件膀胱癌的发生率.术中游离肾输尿管前行输尿管末端结扎并同时行预防性膀胱灌注化疗对预防肾盂输尿管癌术后再发膀胱癌可能有效.     

实体恶性肿瘤循环肿瘤细胞检测的研究进展

恶性实体肿瘤远处转移是导致肿瘤患者死亡的主要原因。目前,恶性肿瘤的诊断主要依赖影像学检查、病理学检查及肿瘤标志物等。随着精准医疗时代的到来,循环肿瘤细胞(CTC)检测技术应运而生,已成为肿瘤学界的研究热点,使人类对恶性肿瘤的检测达到单细胞水平,从而被视为恶性肿瘤的"液体活检"样本,并具有无创、多次、实时获取及整体性等优点,在实体恶性肿瘤的诊断、治疗及病情监测等方面具有独特优势。本文通过综述相关文献,分析了常见CTC检测技术的特点及其临床应用现状,旨在为进一步完善CTC检测技术,指导其在科研及临床中的应用提供参考。     

原发性小肠肿瘤

原发性小肠肿瘤是少见疾病，发病率低，误诊率高，早期缺乏典型的症状和体征，迄今尚无特异性诊断方法，应引起临床重视。     

RhoC及其与肿瘤作用的研究进展

近年来,RhoC与肿瘤之间关系的研究是一个热点,研究表明,RhoC参与了恶性肿瘤的发生、发展等过程,并且,RhoC的过量表达与肿瘤的侵袭转移密切相关,笔者在回顾国内外对于RhoC研究的基础上,就RhoC及其与肿瘤作用的研究进展作一综述.     

CXCR4特异性拮抗剂AMD3100对肿瘤细胞生长转移关系的研究进展

趋化因子CXCL12即基质细胞衍生因子1(stromal cell derived factor-1,SDF-1),与其趋化因子受体CXCR4在介导恶性肿瘤的浸润转移中发挥重要作用,可能与恶性肿瘤的发生、发展密切相关,AMD3100作为一种新型的CXCR4特异性拮抗剂,可通过与CXCR4结合而特异性阻断CXCR4与CXCL12结合,而达到对肿瘤转移的抑制作用.     

Systematic review of anorectal leiomyosarcoma: Current challenges and recent advances

BACKGROUND The anorectal leiomyosarcoma(LMS) is an aggressive malignant neoplasm.Owing to the rarity of LMSs, an optimal treatment modality has yet to be determined.AIM To collect all published data on anorectal LMS characteristics, explore current treatment options, and review recent cases of postradiation LMS.METHODS A literature search of the Pub Med electronic database was conducted using the Me SH terms "rectal neoplasms", "anus neoplasms" and "gastrointestinal neoplasms" combined with "leiomyosarcoma". The search was limited to English language and human studies. All available case reports and case series of anal or rectal LMSs that were published from the beginning of January 1996 to May 2017 were included if the diagnosis of LMS had been confirmed by histopathologic examination. Data were analyzed using simple statistics(mean, median, and standard deviation). Independent sample t-test was used to compare means for continuous variables.RESULTS A total of 27 articles reporting on 51 cases of anorectal LMS were identified.Among these cases, 11.7% had undergone previous pelvic radiotherapy(developing LMS at 13-35 years afterwards). Anorectal LMS affected the rectum in 92.2% of the cases, and no sex-based predominance was observed. Surgical resection with negative margins remains the mainstay of treatment, which can be accomplished with wide local excision or radical resection. The local recurrence rate was higher among cases who received wide local excision(30%), as compared to radical resection(20%); however, the overall rate of metastasis was 51.61% regardless of the treatment approach. The use of neoadjuvant radiation lowers the risk of local recurrence compared to adjuvant radiotherapy, and facilitates R0 resection of the tumor. Cases treated with adjuvant chemotherapy showed better rates of distant recurrence and overall survival. Nonetheless,multidisciplinary team discussion is necessary to determine the optimal management plan whilst considering patient-and disease-related factors.CONCLUSION A multidisciplinary team approach, considering the underlying patient-and disease-related factors, is necessary for optimal management of these complex tumors.     

肾细胞癌并发尿路移行细胞癌的诊断与治疗

目的 探讨肾细胞癌并发尿路移行细胞癌的临床特点和诊治方法。方法 回顾性分析5例肾细胞癌并发尿路移行细胞癌患者的临床资料。男4例，女1例。年龄42～75岁，平均62岁。间歇无痛全程肉眼血尿4例，间歇全程肉眼血尿伴右侧腰痛1例。B超、IVU及CT提示肾肿瘤并发尿路肿瘤4例，肾癌不除外合并同侧肾盂占位1例。结果 5例均行根治性手术，4例同时行不同部位肿瘤根治术，1例行分次手术。病理为肾癌并发膀胱癌3例，肾癌并发同侧输尿管癌1例，肾癌并发同侧肾盂癌1例。随访6～18个月，平均11个月。1例术后10个月膀胱肿瘤局部复发，再行经尿道膀胱肿瘤切除术；4例无瘤生存。结论 肾细胞癌并发尿路移行细胞癌临床少见，对肾癌患者行泌尿系超声、IVU和术中肾脏剖开检查有助于正确诊断。根治性手术宜同时切除肾癌侧输尿管，以避免残余输尿管发生肿瘤。     

原发性肝癌合并胰腺癌一例

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腹腔镜下根治性手术切除直肠神经内分泌肿瘤（附7例报告）

目的总结直肠神经内分泌肿瘤的临床诊断和治疗策略。方法2007年1月～2011年12月对7例直肠神经内分泌肿瘤行腹腔镜下根治性切除。游离肠管周围间隙后,肿瘤下缘2em以远断直肠,距肿瘤近侧端10cm处断结肠,端端吻合器腹腔内吻合乙状结肠及直肠断端。结果腹腔镜下切除6例,中转开腹1例。2例内镜下切除者行腹腔镜下根治术后病理标本内均未见癌灶残留;余5例中,4例病理诊断为类癌,1例病理诊断为神经内分泌肿瘤Ⅱ级。3例直肠周围淋巴结转移,其中2例伴有肝转移。7例随访12～58个月,平均25．3月,1例术后半年出现直肠腺癌肝转移,再次行腹腔镜下肝转移灶切除术;1例射频消融肝转移灶后11个月复查发现直肠神经内分泌肿瘤肝转移,再次行射频消融术;余5例无复发、转移。结论直肠神经内分泌肿瘤具有恶性潜能,对于存在高危因素的肿瘤应行根治性手术治疗或密切随诊。     

胰外来源肿瘤的复杂胰十二指肠切除术

部分局部晚期肿瘤常累及腹部多个器官,伴有消化道梗阻,而无远处转移.部分此类患者可通过实施Ro切除,理论上有获得长期生存的可能.部分患者可通过R1切除,配合术后综合治疗,可达到解除消化道梗阻、减轻疼痛、延长生存时间的目的.将联合器官切除的复杂胰十二指肠切除术应用于胰外来源肿瘤（如局部晚期胃远端癌、结肠肝曲癌、胆囊癌及胆管癌）的手术治疗,能使部分患者获得Ro切除和术后的长期生存,部分患者术后生命质量明显改善,生存时间显著延长.     

膀胱移行细胞癌伴前列腺癌的诊断与治疗

目的　提高膀胱移行细胞癌伴前列腺癌的诊治水平。　方法　对 8例膀胱移行细胞癌伴前列腺癌患者的临床资料进行分析。　结果　 8例术前均经膀胱镜检查及活检病理证实为膀胱移行细胞癌。 7例经直肠前列腺穿刺活检确诊前列腺癌 ,1例为前列腺增生症 ,行膀胱前列腺全切术后病理证实为前列腺癌。 4例行经尿道膀胱肿瘤电切及双侧睾丸切除术 ,术后使用丝裂霉素或BCG等膀胱灌注及氟他胺内分泌治疗。 1例行膀胱前列腺全切加回肠膀胱术。 8例中 2例失访 ,3例因多发性转移 ,术后存活 <1年 ,3例行根治性膀胱前列腺全切术 ,术后随访 1.5～ 4.0年 ,经胸片、CT、同位素和PSA等检查未见肿瘤复发或转移。　结论　血清PSA测定、前列腺直肠指诊、经直肠前列腺B超检查、活检及膀胱镜检查是诊断膀胱移行细胞癌伴前列腺腺癌的主要方法 ,根治性膀胱前列腺切除是影响预后的重要因素     

Urological tumours in Germany. Basic data on 56,013 cases from hospital cancer registries

Summary Since 1985 a special work group involved in the coordination of hospital cancer registries in Germany (AKKK) has been collecting, storing and analysing data on tumour patients, received from cancer centres, oncological departments and specialised practices. The documentation of tumour patients is based, among other things, on information concerning localisation, histological findings and tumour spread. The data are stored in a central database administered by the work group. At present it contains data on approximately 500,000 oncological patients. In the period from 1987 to 1992, 56,013 initial entries were made concerning patients with urological tumours. Of these cases, tumours of the kidney (n = 11,424) constituted 20.4 %. In 94.6 % of the cases, histological investigation revealed a renal cell carcinoma – pT1: 5.8 %; pT2: 53.6 %, pT3: 37.2 % and pT4: 3.4 %. Tumours of the urinary bladder (n = 16,246) constituted 29.0 % of all urological tumours. In 93.8 % of the cases a transitional cell carcinoma was detected – pTis: 1.0 %; pTa: 36.9 %; pT1: 29.6 %; pT2: 16.9 %; pT3: 11.4 %; pT4: 4.4 %. Transitional cell carcinomas of the ureter or of the collecting system (n = 1,846) constituted 3.3 % of the cases. The proportion of testicular tumours (n = 6,594) amounted to 11.8 %; 53.6 % of these germ-cell tumours (n = 6,281) were seminomas and 46.6 % were non-seminomas. In all, 66.3 % of the cases were lymph-node negative. Tumours of the prostate (n = 19,903) constituted 35.5 % of the cases. In the period from 1987 to 1992, the proportion of lymph-node-positive prostate carcinomas decreased from 39.8 % to 16.2 %. The detailed analysis of these data shows how the hospital cancer registries can support the discussion regarding diagnosis and therapy of urological tumours.