卵巢透明细胞癌10例临床病理分析

卵巢透明细胞癌是一种并不罕见的卵巢上皮性肿瘤.病理形态以透明细胞和(或)鞋钉样细胞衬覆的小囊和小管构成为特征.现就对我院10例卵巢透明细胞癌患者的手术病理标本进行临床病理分析如下:     

卵巢透明细胞癌18例临床分析

目的:分析18例卵巢透明细胞癌的临床特点、预后及与子宫内膜异位症的关系.方法:对18例原发性卵巢透明细胞癌患者回顾性分析其治疗方法、对化疗的敏感性和生存率,以及合并子宫内膜异位症患者对化疗的敏感性和生存率.结果:卵巢透明细胞癌患者常发生月经紊乱或绝经后出血,Ⅰ期患者比例较高,多发生于单侧卵巢,常伴发卵巢子宫内膜异位症,是否合并子宫内膜异位症对化疗的敏感性和生存率无统计学差异.结论:卵巢透明细胞癌临床特点不同于其他的卵巢上皮性恶性肿瘤,其临床分期早,对化疗不敏感,易复发,预后差.伴有子宫内膜异位症与否与预后无相关性.本病预后与临床分期直接相关,与肿瘤体积、有/无腹水、肿瘤扩散程度、肿瘤侵犯单侧或双侧卵巢等因素密切相关.     

卵巢透明细胞癌18例临床分析

目的：分析18例卵巢透明细胞癌的临床特点、预后及与子宫内膜异位症的关系。方法：对18例原发性卵巢透明细胞癌患者回顾性分析其治疗方法、对化疗的敏感性和生存率,以及合并子宫内膜异位症患者对化疗的敏感性和生存率。结果：卵巢透明细胞癌患者常发生月经紊乱或绝经后出血,I期患者比例较高,多发生于单侧卵巢,常伴发卵巢子宫内膜异位症,是否合并子宫内膜异位症对化疗的敏感性和生存率无统计学差异。结论：卵巢透明细胞癌临床特点不同于其他的卵巢上皮性恶性肿瘤,其临床分期早,对化疗不敏感,易复发,预后差。伴有子宫内膜异位症与否与预后无相关性。本病预后与临床分期直接相关,与肿瘤体积、有/无腹水、肿瘤扩散程度、肿瘤侵犯单侧或双侧卵巢等因素密切相关。     

超声诊断卵巢透明细胞癌

目的 探讨术前超声诊断卵巢透明细胞癌(ovarian clear cell carcinoma,OCCC)的临床价值.方法 回顾性分析14例经手术病理检查证实的OCCC患者资料,观察OCCC的临床特征及术前超声表现.结果 3例病灶位于双侧卵巢,11例病灶位于单侧卵巢.超声表现为类圆形或类椭圆形肿块,边界清,有包膜;实性...     

原发性卵巢透明细胞癌53例

目的:探讨卵巢透明细胞癌(OCCC)的临床特点及预后.方法:回顾性分析我院1995年1月～2005年12月53例原发性卵巢透明细胞癌患者临床资料,对其临床特点与治疗情况进行总结并分析其预后.结果:53例透明细胞癌占同期本院卵巢上皮癌的4.3%,根据FIGO分期,Ⅰ～Ⅱ期38例占71.70%,5年生存率36.84%,复发率30.23%;Ⅲ期患者15例,5年生存率28.67%,复发率46.67%.两者相比较有统计学差异(P=0.01).Ⅰ+Ⅱ期/Ⅲ期患者理想的肿瘤细胞减灭术5年生存率分别为40.00%/20.00%;不理想的肿瘤细胞减灭术5年生存率均为0,有统计学意义,P<0.05.紫杉醇联合铂类/传统铂类为主的化疗治疗有效率分别为33.33%/26.32%,两者相比较无统计学差异,P=0.10.术后联合放疗的患者5年生存率50.00%,与术后单纯化疗的患者相比差异有统计学意义,P=0.02.OCCC术后联合免疫治疗组与非联合组5年生存率比较无统计学意义(P=0.43),但2年及5年无疾病进展生存率(PFS)分别为80.00%/40.00%;25.00%/18.70%,两者相比较有统计学差异(P<0.02;P<0.05).是否合并子宫内膜异位症对生存率无统计学差异.结论:卵巢透明细胞癌以早期患者多见,易合并子宫内膜异位症,易复发,对化疗不敏感,预后差;紫杉醇联合铂类化疗有效率与传统铂类化疗相比较无明显差异;所有OCCC患者应行理想细胞减灭术,尤其对于早期患者尤为重要,术后联合放疗、免疫治疗,可望改善预后.     

121例卵巢透明细胞癌临床病理及预后因素分析

目的探讨卵巢透明细胞癌（OCCA）的临床特点及预后影响因素。方法回顾性分析1999年2月至2009年9月间我院收治的121例OCCA患者的临床资料。结果本组发病年龄24～73岁,中位发病年龄48岁。FIGO分期：Ⅰ期57.0%（69/121）,Ⅱ期9.9%（12/121）,Ⅲ期30.6%（37/121）,Ⅳ期2.6%（3/121）。总的5年生存率（49.8%）：Ⅰ期68.7%,Ⅱ期76.4%,Ⅲ期13.9%,Ⅳ期0。18.2%（22/121）合并子宫内膜异位症;复发率41.7%（40/96）;残存肿瘤对紫杉醇联合卡铂化疗的反应率44.4%（8/18）。单因素分析结果显示：FIGO分期、淋巴结清扫、残存肿瘤大小、腹水/腹腔冲洗液细胞学结果、足够的化疗疗程、无进展时间（PFI）与OCCA的预后有关。治疗前和化疗3程后CA125水平也与OCCA的预后有关。本研究中,发病年龄、合并子宫内膜异位症、合并其他类型上皮癌、盆腔肿物大小和不同的化疗方案与OCCA的预后无关。Cox回归多因素分析结果显示,PFI是OCCA预后的独立影响因素（RR=0.289,P=0.002）。结论 OCCA以早期患者多见,易合并子宫内膜异位症,易复发,化疗反应率低,预后差。OCCA患者行理想肿瘤细胞减灭术,术后足够疗程的化疗可望改善预后。PFI是OCCA预后的独立影响因素。     

57例Ⅰ期卵巢透明细胞癌临床分析

目的分析I期卵巢透明细胞癌患者的临床特点及预后影响因素。方法回顾性分析2010年1月至2018年8月期间在郑州大学第一附属医院首诊并接受手术治疗的57例Ⅰ期卵巢透明细胞癌患者的病例资料,随访时间截止至2019年10月。采用Cox回归模型进行生存分析。结果57例Ⅰ期卵巢透明细胞癌患者发病年龄为(50.51±7.40)岁,61.4%的患者以自觉腹部包块为主诉就诊,96.5%的患者为单侧发病,57.9%的患者的肿瘤直径在10 cm及以上(57.9%)。所有患者均接受手术治疗,仅1例未行全面分期手术,3例术后未行化疗,所有接受化疗的患者中,有3例发生耐药,7例复发,1例死亡。中位生存时间为30个月,中位疾病无进展生存时间为29个月。患者的疾病无进展生存时间与肿瘤直径(P=0.008)及化疗周期数(P=0.033)有关。结论Ⅰ期卵巢透明细胞癌患者经过全面分期手术及化疗后,预后相对较好,铂类耐药较少发生,肿瘤直径和化疗周期数是患者预后独立影响因素。     

57例I期卵巢透明细胞癌临床分析

目的 分析I期卵巢透明细胞癌患者的临床特点及预后影响因素.方法 回顾性分析2010年1月至2018年8月期间在郑州大学第一附属医院首诊并接受手术治疗的57例Ⅰ期卵巢透明细胞癌患者的病例资料,随访时间截止至2019年10月.采用Cox回归模型进行生存分析.结果 57例Ⅰ期卵巢透明细胞癌患者发病年龄为(50.51±7.40...     

子宫内膜异位症相关性卵巢透明细胞癌和卵巢子宫内膜样癌的临床病理特征研究

目的 研究子宫内膜异位症(EM)相关性卵巢透明细胞癌(CCC)和卵巢子宫内膜样癌(EC)的临床病理特征.方法 选取CCC和EC患者共167例,根据是否为EM恶变将患者分为EM组(n=84)和非EM组(n=83).比较两组患者的年龄、生育史、EM病史、临床表现、凝血功能、血清CA125水平、超声检查结果、术中情况及术后病理特点.结果 EM组患者的发病年龄、初潮年龄均明显小于非EM组(P﹤0.01),未绝经患者所占比例明显低于非EM组(P﹤0.01);EM组患者的孕次、产次明显低于非EM组(P﹤0.001),不孕症患者所占比例明显高于非EM组(P﹤0.001);EM组中既往有EM病史的患者所占比例高于非EM组(P﹤0.05);临床表现方面,EM组患者的痛经、月经紊乱发生率均明显高于非EM组(P﹤0.01);EM组患者的PT、APTT明显短于非EM组(P﹤0.001);术后,EM组患者的血清CA125水平低于非EM组(P﹤0.05);两组患者超声检查结果比较,差异无统计学意义(P﹥0.05);EM组患者的肿瘤直径明显大于非EM组(P﹤0.001);两组患者的FIGO分期比较,差异有统计学意义(P﹤0.05),其中EM组患者中Ⅰ~Ⅱ期患者所占比例高于非EM组.结论 EM相关性CCC和EC与单纯CCC和EC存在明显不同的临床病理特征,具有确诊年龄及初潮年龄小、绝经比例更高、孕产次更低、既往有EM病史患者所占比例更高、痛经和月经紊乱表现更多、PT和APTT更短、血清CA125水平较低和临床病理分期较早等特点.     

卵巢透明细胞癌15例临床病理分析

卵巢透明细胞癌少见,国内至今仅见几十例报道,本文收集15例,报告如下:1 临床资料 年龄26～59岁,平均47岁,低于文献报道的50～56岁.均有下腹部包块,阴道不规则出血3例,消瘦3例,腹痛6例,腹水5例.肿瘤位于左侧卵巢6例,右侧卵巢7例,双侧2例.与周围组织粘连5例,破裂3例,转移至子宫2例、大网膜及膀胱1例、腹膜扩散2例、浸润至阔韧带2例.按1985年FiGo分期法分期,Ia期8例,Ib期1例,Ic期3例,Ⅱa、Ⅱb和Ⅲ期各1例.肿瘤大小7×5×5cm～25×18×17cm不等.2 病理 肿瘤最大直径7～25cm,平均15.1cm,半囊半实性10例,实性5例,囊内为粘     

HMVP与MVP方案治疗晚期非小细胞肺癌的临床研究

目的 :旨在观察羟基喜树碱 (hydroxycamptothecin ,HCPT)联合丝裂霉素 (mitomycin ,MMC)、长春花碱酰胺 (vindesine ,VDS)和顺铂 (cisplatin ,DDP)组成的HMVP和MVP方案治疗晚期NSCLC的近期、远期疗效和毒副反应。方法 :将 90例晚期NSCLC患者随机分为HMVP组 (4 6例 )与MVP组 (4 4例 ) ,观察两组的近期及远期疗效、毒副反应和生存情况。结果 :HMVP和MVP有效率分别为 39.5 4 %和 35 .5 7% ,两组之间无显著性差异 (P >0 .0 5 ) ;两组的中位缓解期、中位生存期、一年及二年生存率亦无明显差异。两组的Ⅲ～Ⅳ度白细胞抑制率、Ⅲ～Ⅳ度血小板抑制率、Ⅲ～Ⅳ度恶心 /呕吐发生率、Ⅲ～Ⅳ度便秘发生率之间均无显著性差异 (P >0 .0 5 )。结论 :MVP方案治疗晚期NSCLC的疗效略低于HMVP方案 ,但后者未显示出明显的疗效优势 ,却可能增加白细胞抑制、恶心 /呕吐和便秘的发生率 ,也增加了患者的经济负担 ;故在NSCLC化疗中宜选择MVP方案     

后加速放射治疗食管癌的疗效分析

目的分析后加速放射治疗食管癌的疗效。方法自1997年8月至1998年4月对73例经病理证实的食管鳞癌病人,随机分为两组常规组(36例)、后加速组(37例)。常规组照射180CGY/次/日,5次/周,总剂量为66.6GY/7.4周。后加速组照射前程为180CGY/次/日,5次/周,剂量达43.2GY/4.6周,后改为150CGY/次,2次/日,间隔6小时以上,10次/周,总剂量为67.2GY/6.4周。结果两组照射结束时,局控率无明显的差异,后加速组1年生存率和局控率分别为86.5%(32/37)和78.4%(29/37),常规组分别为52.8%(19/36)和50%(18/36),后加速组疗效明显高于常规组(P<0.05),后加速组放疗副反应和并发症无明显增加,后加速组死于复发的比例比常规组低,分别为10.8%(4/37)和36.11%(13/36)(P<0.05),两组的主要死因是局部复发,其次是远处转移,常转至肝和肺。结论后加速组放疗技术对于食管癌患者的放射治疗,是一种比较合理有效的照射方法,不增加放疗副反应和并发症,能否提高食管癌的长期生长率,有待长期大量的病例研究。     

Adjuvant treatment for the elderly patient with resected gallbladder cancer: a SEER-Medicare analysis

BackgroundIn patients with resected gallbladder cancer (GBC), the role of adjuvant chemotherapy (aCT) remains ill-defined, especially in elderly patients. This study evaluates the value of aCT in elderly patients with GBC and assesses response according to tumor stage.MethodsPatients of ≥65 years of age with resected GBC diagnosed from 2004–2015 were identified using a Surveillance, Epidemiology and End Results (SEER)/Medicare linked database. After propensity score matching, survival of patients treated with aCT was compared to survival of patients who did not receive aCT using Kaplan-Meier and Cox proportional hazards analysis.ResultsOf 2,179 patients with resected GBC, 876 (25%) received aCT. In the full cohort of 810 propensity-score matched patients, survival did not differ between patients treated with aCT (17.6 months ) and without aCT (19.5 months, P=0.7720). Subgroup analysis showed that survival was significantly better after aCT in T3/T4 disease (12.3 vs. 7.2 months, P=0.013). Interaction analysis showed that benefit of aCT was primarily seen in combined T3/T4, node-positive disease (HR 0.612 , P=0.006).ConclusionsIn this large cohort of elderly patients with resected GBC, aCT was not associated with increased survival. However, aCT may provide a survival benefit in T3/4, node-positive disease.     

Investigation of the Effect of Neoadjuvant Chemotherapy on Stage Ⅱ Breast Cancer

OBJECTIVE To investigate the effect of neoadjuvant chemotherapy in treatment of Stage Ⅱ breast cancer. METHODS The data from 113 patients with breast cancer of the same pathologic type in Stage Ⅱ,during the period of 1995 to 2001,were analyzed retrospectively.Among the patients,47 were treated with neoadjuvant chemotherapy,and 66 received no adjuvant therapy before surgery（control group）.After the patients of the neoadjuvant chemotherapy group had received 2 courses of chemotherapy with the CMF regimen,the surgical procedure was conducted. RESULTS Complete remission（CR）was attained in 9 of the 47 cases receiving neoadjuvant chemotherapy and partial remission（PR）was reached for 22 cases.The rate of breast-conserving surgery was enhanced from 22.73%to 46.81%（P〈0.05）in the neoadjuvant treatment group. There was no difference in the 5-year overall survival（OS）and disease-free survival（DFS）rate between the two groups（P〉0.05）,but the 5-year OS and DFS of the cases with clinical tumor remission was higher compared to the control group（P〈0.05）. CONCLUSION Neoadjuvant chemotherapy can enhance the rate of breast conservation for Stage Ⅱ breast cancer and may improve the prognosis of the cases with clinical remission.     

The role of hyperthermia as a treatment for non-muscle invasive bladder cancer

Non-muscle invasive bladder cancer (NMIBC) has a high tendency for recurrence and progression. Currently, all known intravesical agents are associated with adverse effects (AEs) and limited efficacy. The combination of hyperthermia (HT) with intravesical Mitomycin C (MMC) chemotherapy has been shown to improve outcomes. The added efficacy of HT to MMC was first shown in preclinical studies. The reports on patients with NMIBC have indicated that the treatment is safe and well tolerated. Several clinical studies reported the efficacy of radiofrequency-induced chemotherapy effect (RITE) in the treatment of patients with NMIBC. This modality was shown to be superior to MMC alone. RITE was effective also in patients with high-risk NMIBC, including those who failed Bacillus Calmette-Guérin (BCG). This study provides an updated review of literature regarding the use of RITE in patients with NMIBC.     

两种不同方案治疗晚期非小细胞肺癌的疗效比较(英文)

Objective: The aim of this study was to analyze and compare the recent efficacy and toxicity of a three-drug platinum-based regimen (A regimen): [cisplatin (DDP) + gemcitabine (GEM) + vinorelbine (NVB)] and a two-drug combination without a platinum drug (B regimen): GEM + NVB, which were used to treat 55 advanced non-small cell lung cancer (NSCLC) patients, in a bid to provide a guidance for clinical treatment. Methods: Twenty-four cases of advanced NSCLC (stage III-IV) patients were treated with A regimen ...     

LP和TP方案治疗晚期非小细胞肺癌的临床研究(英文)

Objective:The aim of the study was to evaluate the responses and toxicities of liposome encapsulated paclitaxel (LEP) plus cisplatin (DDP) (LP regimen) and paclitaxel (TAX) plus DDP (TP regimen) in the treatment of advanced non-small cell lung cancer (NSCLC). Methods: A total of 89 cases with advanced NSCLC was randomized into two groups: the LP group (57 patients) and the TP group (32 patients). The responses, toxicities and survivals of the two groups were compared. Results: The response rates were 40.00%...     

Preclinical rationale for combination of crizotinib with mitomycin C for the treatment of advanced colorectal cancer

Colorectal cancer (CRC) is a leading cause of cancer-related deaths in the United States. We analyzed 26 MSI-High and 558 non-MSI-High CRC tumors. BRCA2 mutations were highly enriched (50%) in MSI-High CRC. Immunohistochemistry showed that BRCA2-mutated MSI-High CRC had high c-MET (64%) expression compared with BRCA-WT (17%). We hypothesized a mechanistic link between BRCA2-deficiency and c-MET overexpression and synergistic interaction between drugs that treat BRCA-deficient tumors (mitomycin C (MMC) or PARP inhibitors) and c-MET inhibitors (crizotinib). We tested CRC cell lines for sensitivity to MMC plus crizotinib or other drug combinations including PARP-inhibitors. Combined treatment of tumor cells with crizotinib and MMC led to increased apoptosis as compared with each drug alone. Additionally, combination treatment with increasing concentrations of both drugs demonstrated a synergistic anti-cancer effect (CI = 0.006–0.74). However, we found no evidence for c-MET upregulation upon effective BRCA2 knockdown in tumor cells ?/+DNA damage. Although we found no mechanistic link between BRCA2 deficiency and c-MET overexpression, c-MET is frequently overexpressed in CRC and BRCA2 is mutated especially in MSI-H CRC. The combination of crizotinib with MMC appeared synergistic regardless of MSI or BRCA2 status. Using an in-vivo CRC xenograft model we found reduced tumor growth with combined crizotinib and MMC therapy (p = 0.0088). Our preclinical results support clinical testing of the combination of MMC and crizotinib in advanced CRC. Targeting cell survival mediated by c-MET in combination with targeting DNA repair may be a reasonable strategy for therapy development in CRC or other cancers.     

小细胞肺癌的外科治疗

目的　探讨以手术为主的综合疗法对小细胞肺癌的临床治疗效果。方法　回顾性分析 84 5例小细胞肺癌临床资料 :其中 5 73例广泛期病变均采用化疗或放疗 ;局限期病变 2 72例 :化疗或 /和放疗 5 0例 ;手术 术后化疗 4 8例 ;术前化疗 手术 术后化疗或 /和放疗 174例 ;比较分析、评价不同方法的疗效。结果　广泛期病变 1、2、3年存活率分别为 13%、6 .8%、0 % ;局限期病变 :化疗组和术后化疗组 1、3、5年存活率分别为 74 .2 %、31.2 %、4 .3%和 87.5 %、4 6 .6 %、31.9% ,二组间 1年存活率无显著差异 (P >0 .0 5 ) ,3、5年的存活率差异显著 (P <0 .0 5 ) ;而术前先化疗、后手术 ,术式包括肺叶切除、全肺切除、支气管 /肺动脉袖式切除重建 ,术后再化疗 /放疗的 174例 ,其 1、3、5、10年存活率分别为 88.4 % ,5 8.9% ,4 9.5 % ,11.5 %。颅内、肝脏和骨髓广泛转移为影响长期存活的主要原因。结论　小细胞肺癌对化疗和放疗均敏感 ,广泛期病变已无手术适应症 ,应采用以化疗 /放疗为主的保守治疗。而局限期小细胞肺癌则应选择以手术为主、辅以术前、术后化疗 /放疗的综合方法 ,可获得较为满意、甚至长期存活的临床效果     

Carcinosarcoma of the ovary: 19 years of prospective data from a single center

BACKGROUND: A review of clinicopathologic features and outcome in women with carcinosarcoma of the ovary (also known as malignant mixed mesodermal tumor [MMMT]) compared with a group of women with serous adenocarcinoma (SAC) of the ovary was conducted. METHODS: Between 1984 and 2002, 1568 patients with epithelial ovarian carcinoma and 70 patients with ovarian carcinosarcoma underwent treatment at the Edinburgh Cancer Centre. Analysis was performed on 65 patients with MMMT, and 746 patients with SAC were selected as a group for comparison. Baseline variables were recorded prospectively and response to chemotherapy and progression-free and cause-specific survival between the groups were compared. RESULTS: Patients with carcinosarcoma had a mean age of 66.6 years, which is significantly older than those with SAC (62.0 years) (P < 0.001). The objective response rate to platinum-based chemotherapy was found to be significantly lower in patients with carcinosarcoma (25% vs. 60%; P = 0.02). Cause-specific survival in the carcinosarcoma group was poor and significantly shorter than that observed in the SAC group (median survival of 8.2 months vs. 20.7 months; P < 0.0001). Progression-free survival in patients with carcinosarcoma also was found to be significantly shorter compared with patients with SAC (median progression-free survival of 6.4 months vs. 12.1 months; P < 0.001). Achieving optimal debulking at the time of initial surgery was found to be a highly significant factor in patients with carcinosarcoma with regard to determining outcome (median survival of 14.8 months for patients with optimally debulked International Federation of Gynecology and Obstetrics Stage III disease vs. 3.1 months for patients with suboptimally/nondebulked Stage III disease; P < 0.001). CONCLUSIONS: Ovarian carcinosarcoma is a distinct entity with a poor prognosis. Patients with carcinosarcoma differ from those with SAC with regard to having an older mean age of onset, an inferior response to platinum-based chemotherapy, and worse progression-free and cause-specific survival. The extent of benefit from chemotherapy is unclear.