血清CA153、CA125和CEA联合检测在乳腺癌诊断中的应用

Objective To study the clinical singificance of serum tumor markers (CA153, CA125 and CEA) in doagnosis of breast cancer. Methods Electrochemiluminescence immunoassay (ECLIA) was used to analyze serum levels of CA153,CA125 and CEA in 55 patients with breast canc-er (breast cancer group),20 patients with benign breast lesions (benign breast lesion group) and 20 healthy controls (healthy control group). Results The levels of CA153, CA125 and CEA in breast cancer group were significantly higher than those in healthy control group (P<0.05); the levels of CEA and CA153 in breast cancer group were significantly higher than those in benign breast lesion group (P<0.05);the level of CA153 in postoperative patients was statistically lower than that in pre-operative patients (P<0.05);the levels of CEA and CA153 in breast cancer patients with stage Ⅲ and Ⅳ were significantly higher than those in healthy controls (P<0.05); the level of CA153 with stage Ⅲ and Ⅳ was higher than that in ones with stage Ⅰ and Ⅱ. The combined dection of CA153, CA125 and CEA in breast cancer patients increased the experimental sensitivity to 53.8% and specific-ity to 83.3%. Conclusion Detections of CA153,CA125 and CEA contribute to diagnosis of breast cancer. CA153 and CEA are of clinical practical value in differential diagnosis of benign and malignant breast tumor,monitoring of course of breast cancer.     

提高乳腺钙化灶超声显示率的临床研究

Objective To evaluate the value of MicroPure software system in the display of calcification and diagnostic accuracy of breast carcinoma.Methods Sixty-three patients with 68 breast lesions were checked by conventional ultrasound,X-ray and MicroPure software technique.The calcification was described and the lesions were classified with BI-RADS.All cases were pathologically confirmed by biopsy or operation.Results ①Compared to the detection rate for calcification of X-ray,the display rate of conventional ultrasound was 80.6% ,and the display rate of MicroPure software technique was 100%.②The area under the curve of diagnosing benign and malignant of breast lesions was 0.916,0.857 and 0.970 respectively with ultrasound,X-ray and MicroPure software technique.③Three lesions was classified Ⅲ in BI-RADS with conventional ultrasound,and Ⅳ in BI-RADS with MicroPure software.The pathologic results were malignant.Conclusions MicroPure software system obviously raised the ultrasonic display rate of calcification,meanwhile,it raised the diagnostic accurate rate of breast cancer.It especially raised the tendency rate for the patients who were classified between Ⅲ and Ⅳ in BI-RADS.     

GP和PathVysion HER2试剂盒检测乳腺癌患者HER2基因状态的比较

目的 通过与进口PathVysion HER2试剂盒比较,评价国产金菩嘉GP HER2试剂盒检测乳腺癌患者HER2基因状态的临床应用价值.方法 收集108例乳腺浸润性导管癌(简称"乳腺癌")肿瘤组织标本,分别采用FISH技术与GP HER2试剂盒和PathVysion HER2试剂盒检测乳腺癌患者HER2基因表达水平,比较2种试剂盒检测乳腺癌患者HER2基因表达差异,并评价GP HER2试剂盒检测乳腺癌患者组织标本中HER2基因扩增的敏感度、特异度和准确性.结果 GP HER2试剂盒和PathVysion HER2试剂盒检测乳腺癌患者组织标本中HER2基因扩增率分别为25.0%(27/108)和26.9%(29/108).与PathVysion HER2试剂盒相比,GP HER2试剂盒检测乳腺癌患者组织标本中HER2基因扩增的敏感度、特异度和准确性分别为89.7%(26/29)、98.7%(78/79)和96.3%(104/108),PPV和NPV均为96.3%(26/27,78/81).GP HER2试剂盒检出第17号染色体多倍体的敏感度、特异度和准确性分别为93.3%(14/15)、100%(93/93)和99.1%(107/108).结论 GPHER2试剂盒在检测乳腺癌患者组织标本中HER2基因状态的敏感度和特异度及准确性高,在临床评价乳腺癌HER2基因状态中具有广泛应用价值.

Abstract：

Objective To evaluate clinical application of Jin Pujia GP HER2 probe kit in testing HER2 gene status of breast cancer through comparing it with PathVysion HER2 probe kit. Methods HER2 gene status were detected from 108 cases with invasive ductal breast cancer using GP and PathVysion HER2 probe kits by FISH. HER2 gene expression levels were measured by GP and PathVysion HER2 probe kits, and the sensitivity, the specificity and the accuracy of GP HER2 probe kit were evaluated. Results HER2 gene amplification positive rates detected by GP HER2 probe kit and PathVysion HER2 probe kit were 25.0%(27/108) and 26.9% (29/108), respectively. As compared with PathVysion HER2 probe kit, the sensitivity, the specificity and the accuracy of the GP HER2 kit were 89. 7% (26/29), 98.7% (78/79)and 96. 3% ( 104/108), respectively, whereas the PPV and NPV were 96. 3% (26/27) and 96. 3% (78/81), respectively. The GP HER2 probe kit had a sensitivity of 93.3% ( 14/15), a specificity of 100%(93/93) and an accuracy of 99. 1% (107/108) for detecting polysomy 17. Conclusion GP HER2 probe kit has high sensitivity and specificity for detecting HER2 gene status in breast cancer patients, and it has clinical application value.     

胸腺瘤48例临床病理的预后相关性研究

Objective To study the relation of Clinicopathological characteristics and prognostic of thy-mic epithelial tumors. Methods To review and analyze the clinical data about 48 cases with thymic epithelial tumours were treated in surgery of our hospital,, according to the normal sort of WHO (2004 years) thymus tumor classification criteria to classify, according to the results of the clinical and follow-up and Masaoka clinical stage and prognosis, and other factors The relevance of the study. Results 48 cases of histological type of thymoma: A type for 4 cases(8.3%) ,AB type for 3(6.3%) ,B1 type for 9(18.8%) ,B2 type for 8(16.7%) ,B3 type for 11 cases(22.9% ) ,C type for 13 cases(27.1% ). Clinical staging: Ⅰ period of 12 cases(25.0% ), Ⅱ period of4 cases( 8.3% ), Ⅲ period of 13 cases(27.1% ), Ⅳ period of 19 cases(39. 6 percent). The results of follow-up data show that, Ⅰ,Ⅱ,Ⅲ,Ⅳ Thymectomy period after 3-year survival rates were 100% and 100% ,68.3%, 35.8% ;5-year survival rates were 66.5% and 66.5% ,39.7%, 18.6% and the survival rate of patients with Masaoka closely related to the clinical stage, patients with thymoma is the most important independent prognostic indicators. Conclusion Masaoka's clinical stage of survival in patients with thymoma is the most important prognostic parameters,type of tumor is complete excision is the impact on the survival of patients with thymoma an important factor.     

胸腺瘤48例临床病理的预后相关性研究

Objective To study the relation of Clinicopathological characteristics and prognostic of thy-mic epithelial tumors. Methods To review and analyze the clinical data about 48 cases with thymic epithelial tumours were treated in surgery of our hospital,, according to the normal sort of WHO (2004 years) thymus tumor classification criteria to classify, according to the results of the clinical and follow-up and Masaoka clinical stage and prognosis, and other factors The relevance of the study. Results 48 cases of histological type of thymoma: A type for 4 cases(8.3%) ,AB type for 3(6.3%) ,B1 type for 9(18.8%) ,B2 type for 8(16.7%) ,B3 type for 11 cases(22.9% ) ,C type for 13 cases(27.1% ). Clinical staging: Ⅰ period of 12 cases(25.0% ), Ⅱ period of4 cases( 8.3% ), Ⅲ period of 13 cases(27.1% ), Ⅳ period of 19 cases(39. 6 percent). The results of follow-up data show that, Ⅰ,Ⅱ,Ⅲ,Ⅳ Thymectomy period after 3-year survival rates were 100% and 100% ,68.3%, 35.8% ;5-year survival rates were 66.5% and 66.5% ,39.7%, 18.6% and the survival rate of patients with Masaoka closely related to the clinical stage, patients with thymoma is the most important independent prognostic indicators. Conclusion Masaoka's clinical stage of survival in patients with thymoma is the most important prognostic parameters,type of tumor is complete excision is the impact on the survival of patients with thymoma an important factor.     

胸腺瘤48例临床病理的预后相关性研究

Objective To study the relation of Clinicopathological characteristics and prognostic of thy-mic epithelial tumors. Methods To review and analyze the clinical data about 48 cases with thymic epithelial tumours were treated in surgery of our hospital,, according to the normal sort of WHO (2004 years) thymus tumor classification criteria to classify, according to the results of the clinical and follow-up and Masaoka clinical stage and prognosis, and other factors The relevance of the study. Results 48 cases of histological type of thymoma: A type for 4 cases(8.3%) ,AB type for 3(6.3%) ,B1 type for 9(18.8%) ,B2 type for 8(16.7%) ,B3 type for 11 cases(22.9% ) ,C type for 13 cases(27.1% ). Clinical staging: Ⅰ period of 12 cases(25.0% ), Ⅱ period of4 cases( 8.3% ), Ⅲ period of 13 cases(27.1% ), Ⅳ period of 19 cases(39. 6 percent). The results of follow-up data show that, Ⅰ,Ⅱ,Ⅲ,Ⅳ Thymectomy period after 3-year survival rates were 100% and 100% ,68.3%, 35.8% ;5-year survival rates were 66.5% and 66.5% ,39.7%, 18.6% and the survival rate of patients with Masaoka closely related to the clinical stage, patients with thymoma is the most important independent prognostic indicators. Conclusion Masaoka's clinical stage of survival in patients with thymoma is the most important prognostic parameters,type of tumor is complete excision is the impact on the survival of patients with thymoma an important factor.     

在数字钼靶环境下研究早期乳腺癌的影像特点

Objective To improve the pairs of molybdenum and rhodium target X ray of early breast cancer diagnostic accuracy. Methods 41 cases confirmed by surgery and pathology of early breast cancer X ray findings were analyzed retrospectively. Results signs of early breast cancer: 23 cases of nodular masses;calcification in 17 cases, X ray no clear lumps or nodules and calcification of the only 2 cases of malignant signs; non-symmetry of high density 12; limitations associated with skin thickening nipple retraction in 2 cases.Conclusion ①mass is an important basis for the diagnosis of early breast cancer;②micro-calcification is still an important basis for the diagnosis of early breast cancer, even more than the direct signs of (mass) more specific; ③non-symmetry of the limitations of dense breast structure of local distortions disorders, inflammation and surgical history of the exclusion, it should be possible to consider breast cancer ;④In addition to malignant calcification, the more than two kinds of indirect signs of co-exist, we should attach great importance to be further examination or short-term review.     

GSTA1基因多态性对环磷酰胺辅助化疗的乳腺癌患者预后的影响

Objective To investigate the association between the genetic polymorphisms in GSTA1 and the clinical outcome of breast cancer patients treated with cyclophosphamide-based adjuvant chemotherapy. Methods A total of 137 breast cancer patients receiving cyclophosphamide-based adjuvant chemotherapy were recruited ( 124 cases with infiltrative ductal carcinoma, 5 cases with infiltrative lobular carcinoma and 8 cases with other histological types). PCR-LDR method was used to detect the genotypes of GSTA1. Survival curves were generated by the Kaplan-Meier method, and verified by the log-rank test. Cox proportional hazards regression analysis was used to estimate the prognostic factors in multivariate analysis. Results Of the 137 breast cancer patients, the genotypic frequencies of the GSTA1 * A/* A,* A/* B and * B/* B were 67.2% ( 92/137 ), 31.4% ( 43/137 ) and 1.5% ( 2/137 ), respectively. No significant differences were found between the genotypic frequencies and groups categorization according to age, stage, lymph node metastasis, ER or PR status (x2 = 0. 722,1. 967, 3. 303, 0. 226 and 0. 709, all P ＞0. 05 ) ;through Fisher exact test, also no significant differences were found between the genotypic frequencies and group categorization according to tumor size, histological types and grading ( all P ＞ 0. 05 ) . The recurrence rates in patients with GSTA1 * A/* A and * A/* B or * B/* B genotypes were 47. 8% (44/92) and 31.1% ( 14/45 ), respectively, and the mortality rates were 22. 8% ( 21/92 ) and 17. 8% ( 8/45 ),respectively. Patients with GSTA1 * A/* B and * B/* B genotypes were significantly associated with reduced hazard of relapse (x2 =18.723, P＜0. 01)and mortality (x2 =7.352, P＜0.01), compared to cases with the common * A/* A genotypes, according to Kaplan-Meier survival analysis and log-rank test. Moreover,Cox multivariate analysis showed that GSTA1 polymorphisms appeared to be an independent risk factor for recurrence-free survival ( OR =0. 222, 95% CI:0. 108-0. 458, P ＜0. 01 ) and overall survival ( OR =0. 362,95% CI:0. 145-0. 902, P ＜ 0. 05 ). Conclusion These data indicate that GSTA1 polymorphism may be a potential prognostic factor for recurrence-free survival and overall survival in breast cancer patients treated with cyclophosphamide-based adjuvant chemotherapy.     

GSTA1基因多态性对环磷酰胺辅助化疗的乳腺癌患者预后的影响

Objective To investigate the association between the genetic polymorphisms in GSTA1 and the clinical outcome of breast cancer patients treated with cyclophosphamide-based adjuvant chemotherapy. Methods A total of 137 breast cancer patients receiving cyclophosphamide-based adjuvant chemotherapy were recruited ( 124 cases with infiltrative ductal carcinoma, 5 cases with infiltrative lobular carcinoma and 8 cases with other histological types). PCR-LDR method was used to detect the genotypes of GSTA1. Survival curves were generated by the Kaplan-Meier method, and verified by the log-rank test. Cox proportional hazards regression analysis was used to estimate the prognostic factors in multivariate analysis. Results Of the 137 breast cancer patients, the genotypic frequencies of the GSTA1 * A/* A,* A/* B and * B/* B were 67.2% ( 92/137 ), 31.4% ( 43/137 ) and 1.5% ( 2/137 ), respectively. No significant differences were found between the genotypic frequencies and groups categorization according to age, stage, lymph node metastasis, ER or PR status (x2 = 0. 722,1. 967, 3. 303, 0. 226 and 0. 709, all P ＞0. 05 ) ;through Fisher exact test, also no significant differences were found between the genotypic frequencies and group categorization according to tumor size, histological types and grading ( all P ＞ 0. 05 ) . The recurrence rates in patients with GSTA1 * A/* A and * A/* B or * B/* B genotypes were 47. 8% (44/92) and 31.1% ( 14/45 ), respectively, and the mortality rates were 22. 8% ( 21/92 ) and 17. 8% ( 8/45 ),respectively. Patients with GSTA1 * A/* B and * B/* B genotypes were significantly associated with reduced hazard of relapse (x2 =18.723, P＜0. 01)and mortality (x2 =7.352, P＜0.01), compared to cases with the common * A/* A genotypes, according to Kaplan-Meier survival analysis and log-rank test. Moreover,Cox multivariate analysis showed that GSTA1 polymorphisms appeared to be an independent risk factor for recurrence-free survival ( OR =0. 222, 95% CI:0. 108-0. 458, P ＜0. 01 ) and overall survival ( OR =0. 362,95% CI:0. 145-0. 902, P ＜ 0. 05 ). Conclusion These data indicate that GSTA1 polymorphism may be a potential prognostic factor for recurrence-free survival and overall survival in breast cancer patients treated with cyclophosphamide-based adjuvant chemotherapy.     

间期荧光原位杂交技术检测多发性骨髓瘤基因组异常的临床意义

目的 探讨I-FISH技术检测MM基因组异常的临床意义.方法 应用CC技术(常规R显带)和I-FISH技术[包括GLP13q14(RB1基因)、GLP17p13.1(P53基因)、GLP13q14.3(D13S319)、GLP1q21及GLP14q32(IgH基因)DNA序列探针]分别对20例初治的MM患者(按Bataille分期,Ⅰ期7例、Ⅱ期5例、Ⅲ期8例)进行基因组检测;比较两种方法对MM染色体和基因组异常的检出率;并分析基因组异常与Bataille分期的关系.结果 CC技术从20例MM患者中检出1例[5%(1/20)]染色体异常,且为复杂核型--46,XX,-2,del(3)(p21),add(6)(q26),der(10)(q26),der(14)(32),+mar,inc[6].I-FISH检出12例[60%(12/20)]基因组异常,其中基因组异常发生频率在RB1、D13S319和P53均为30%(6/20),IgH和1q21均为20%(4/20);经配对χ2检验,I-FISH的检出率高于CC技术(χ2=9.09,P=0.001).在20例MM患者中,RB1基因异常的6例,Ⅰ期占1/20,Ⅱ期占1/20,Ⅲ期占4/20;D13S319异常的6例,Ⅰ期占2/20,Ⅱ期占1/20,Ⅲ期占3/20;P53基因异常的6例,Ⅰ期占2/20,Ⅲ期占4/20;1q21异常的4例,Ⅰ期和Ⅲ期占2/20;IgH基因异常的4例,Ⅰ期占1/20,Ⅲ期占3/20.结论 I-FISH对MM患者基因组异常检出率较高,其可检出不同Bataille分期的MM患者.

Abstract：

Objective To investigate the clinical significance of I-FISH for detection of genomic abnormalities in MM. Methods Twenty newly diagnosed MM patients(seven cases at stage Ⅰ , five cases at stage Ⅱ and eight cases at stage Ⅲ according to Bataille staging) were analyzed by combining the technique of CC (R-binding stain) and I-FISH [ including GLP13q14 (RBI gene), GLP17p13. 1 (P53 gene),GLP13q14. 3(D13S319) ,GLP1q21 ,GLP14q32(IgH gene) DNA sequence probes]. These two methods were compared for the detection rates of chromosomal and genomic abnormalities in MM and the association between genomic abnormalities and Bataille stages was also analyzed. Results CC examination showed only 1 case [5% (1/20) ] was found complex chromosomal abnormalities--46,XX,-2,del(3) (p21) ,add(6)(q26) ,der(10)(q26),der(14)(q32), + mar, inc[6]. While I-FISH assay showed that 12 cases [60%(12/20) ] were found genomic abnormalities. The frequencies of RB1, D13S319 and P53 were all 30%(6/20), and the frequencies of IgH gene and 1q21 were both 20% (4/20). The detection rate of the I-FISH was much higher than CC (χ2 = 9. 09, P = 0. 001) according to paired χ2 test. Of 20 patients,6 cases had RB1 gene abnormality, 1 case at stage Ⅰ , 2 cases at stage Ⅱ and 4 cases at stage Ⅲ. Of 20 patients, 6 cases had D13S319 gene abnormality, 2 cases at stage Ⅰ , 1 case at stage Ⅱ and 3 cases at stage Ⅲ. Of 20 patients, 6 cases in 20 had P53 gene abnormality, 2 cases at stage Ⅰ and 4 cases at stage Ⅲ. Of 20 patients, 4 cases had 1q21 gene abnormality, 2 cases at stage Ⅰ and 2 cases at stage Ⅲ. Of 20 patients, 4 cases had IGH gene abnormality, 1 case at stage Ⅰ and 3 cases at stage Ⅲ. Conclusion Ⅰ-FISH has higher detection rate for the genomic abnormalities in MM and can be used in detection of MM patients in different Bataille stages.     

236例老年胃癌患者的外科诊治与分析

目的探讨老年人胃癌的临床病理特征及外科手术治疗。方法 236例患者均接受手术治疗,其中行胃部分或全部切除术215例,未能切除21例。术前并存慢性疾病89例(37.7%)。结果术后出现并发症80例,死亡4例。术后pTNM分期:Ⅰa期39例(16.5%),Ⅰb期27例(11.4%),Ⅱ期41例(17.4%),Ⅲa期47例(19.9%),Ⅲb期31例(13.1%),Ⅳ51例(21.6%)。5年生存率Ⅰa期、Ⅰb期、Ⅱ期、Ⅲa期、Ⅲb期、Ⅳ期分别为90.5%、89.3%、62.3%、30.6%、19.4%和1.9%。结论老年胃癌患者病理分期多为Ⅲa期、Ⅳ期,术前多伴有慢性疾病,手术是首选治疗方法,但要注意围术期处理。     

EpCAM和CD44在胃癌中的表达及临床意义

通过检测上皮细胞粘附分子（epithelial cell adhesion molecule,Ep CAM）、CD44在不同胃组织中的表达差异,探讨其与胃癌发生、浸润和转移的关系。方法采用免疫组化法检测经病理证实的胃腺癌组织标本42例、不典型增生组织标本25例和正常胃组织标本25例中Ep CAM和CD44的表达,分析其表达与临床病理参数间的关系,及Ep CAM和CD44表达的相关性。结果 Ep CAM在胃腺癌组织、不典型增生组织和正常胃组织中的阳性表达率两两比较差异均有统计学意义（88.1%,64.0%,8.0%,P均〈0.01）,在胃腺癌组织中表达与淋巴结转移、浆膜侵润和TNM分期（Ⅰ~Ⅱ/Ⅲ~Ⅳ）有关（P均〈0.05）;CD44在胃腺癌组织中、不典型增生组织和正常胃组织的阳性表达率两两比较亦均有统计学差异（69.4%,40.0%,12.0%,P均〈0.01）,其在胃腺癌组织中表达与胃癌TNM分期、分化程度（中高分化/低分化）和淋巴结转移有关（P〈0.05,P〈0.01）。Ep CAM和CD44在胃腺癌组织中的表达呈正相关（r=0.363,P〈0.01）。结论 Ep CAM和CD44在胃癌的发生、发展中起重要作用,与胃癌的浸润、转移有关,联合检测可作为胃癌早期诊断、判断预后的的指标。     

CD3~+、CD4~+、CD8~+T细胞水平在胃癌患者外周血中的变化

目的探讨T淋巴细胞亚群CD3+、CD4+、CD8+和CD4+/CD8+比值水平在胃癌患者外周血中的表达及意义。方法采用血液分析仪技术,检测40例胃癌手术前患者(按临床分期为Ⅰ～Ⅱ级组18例,Ⅲ～Ⅳ级组22例)及25名正常对照组外周血CD3+、CD4+、CD8+细胞和CD4+/CD8+比值T细胞水平。结果胃癌患者外周血CD3+、CD4+细胞、CD4+/CD8+比值分别为0.78%±0.35%、0.37%±0.21%、0.61%±0.42%,明显低于正常对照组(P<0.05);胃癌Ⅲ～Ⅳ级组CD3+、CD4+细胞CD4+/CD8+比值分别为0.42%±0.27%、0.21%±0.17%、0.29%±0.25%,明显低于Ⅰ～Ⅱ级组(0.95%±0.35%、0.45%±0.19%、0.76%±0.30%,P<0.05)。结论检测胃癌患者手术前外周血CD3+、CD4+、CD8+细胞和CD4+/CD8+比值T细胞水平,可以初步评估胃癌患者机体免疫状态,也为肿瘤的免疫增强治疗提供了理论依据。     

胃癌患者多层螺旋 CT 灌注参数与血清血管内皮生长因子关系的研究

目的：探讨不同分期胃癌患者多层螺旋 CT 灌注参数与血清血管内皮生长因子之间的关系。方法依据TNM 分期和病理分期,选择我院2011年10月至2012年10月收治的胃癌患者67例,分为胃癌Ⅰ-Ⅱ期患者和Ⅲ-Ⅳ期患者两组,采用 Toshiba Actvion16螺旋 CT 仪和 Stellant 高压注射器进行螺旋 CT 灌注扫描,并使用胰腺灌注软件处理数据。比较两组患者的灌注参数（血容量 BF、血流量 BS、平均通过时间 MTT 和渗透性表面容积 PS）、Ⅰ-Ⅱ期患者和Ⅲ-Ⅳ期患者血清血管内皮生长因子（VEGF）水平,采用 person 相关分析研究灌注参数与血清 VEGF 的相关性。结果胃癌Ⅲ-Ⅳ期患者灌注参数 BF 和 PS 高于胃癌Ⅰ-Ⅱ期患者,存在统计学差异（P ＜0．05）,但两组灌注参数 BV、MTT 之间无统计学差异（P ＞0．05）;胃癌Ⅰ-Ⅱ期患者与Ⅲ-Ⅳ期患者血清 VEGF 水平存在显著性差异（P ＜0．01）。胃癌Ⅰ-Ⅱ期患者与Ⅲ-Ⅳ期患者血清 VEGF 值与灌注参数 BF、PS 之间相关性显著,尤其是 PS,相关性系数分别为0.635和0．715,P 值均为0．001。结论多层螺旋 CT 灌注参数 PF、PS 对胃癌分期具有很大的应用价值,能为临床诊治提供参考。     

宫颈癌血流动力学指标与其临床病理特征的相关性研究

目的探讨宫颈癌组织内彩色多普勒超声血流动力学指标与肿瘤临床病理特征之间的相关性。方法36例宫颈癌患者治疗前行经阴道彩色多普勒超声检查,记录肿瘤组织内超声血流指标——收缩期峰值血流速度（PSV）、阻力指数（RI）,同时记录肿瘤的组织学分类、临床分期及鳞状细胞癌患者的血清鳞状细胞癌抗原（SCC—Ag）值;分析超声血流指标与肿瘤的组织学类型、临床分期及SCC—Ag值之间的关系。结果36例宫颈癌中Ⅰ期8例、Ⅱ期18例、Ⅲ期9例、Ⅳ期1例;其中鳞状细胞癌30例,腺癌及腺鳞癌共6例。不同组织学类型的宫颈癌癌组织内PSV、RI之间差异无统计学意义;而不同临床分期的宫颈癌癌组织内的PSV、RI之间的差异具有统计学意义,表现为临床分期Ⅲ／Ⅳ期者PSV较Ⅰ／Ⅱ期者高,而RI较Ⅰ／Ⅱ期者低;SCC—Ag与PSV间存在线性正相关关系（r=0．524,P〈0．05）,与RI间不存在线性相关关系。结论宫颈癌组织内超声血流指标与肿瘤临床病理特征间存在相关性,具有一定的临床监测意义。     

外周血CEA mRNA、Survivin mRNA、MMP-2 mRNA和TIMP-2 mRNA水平与乳腺癌的关系

目的研究外周血癌胚抗原（CEA）、生存素（Survivin）、基质金属蛋白酶-2（MMP-2）及金属蛋白酶抑制剂-2（TIMP-2）mRNA表达与乳腺癌的关系。方法采用逆转录实时定量聚合酶链反应（real-time PCR）检测54例乳腺癌患者和23名正常对照组外周血MMP-2 mRNA、TIMP-2 mRNA、CEAmRNA和Survivin mRNA的表达水平。以正常对照组结果为正常参考范围,分析乳腺癌患者外周血CEA mRNA和Survivin mRNA表达的阳性率。结果乳腺癌患者外周血可检测到不同水平的CEA mRNA、Survivin mRNA、MMP-2 mRNA和TIMP-2 mRNA的表达。Ⅰ/Ⅱ期及Ⅲ/Ⅳ期乳腺癌组外周血MMP-2 mRNA表达量高于正常对照组（P〈0.01）;TIMP-2/MMP-2比值则低于正常对照组（P〈0.05、P〈0.01）;Ⅲ/Ⅳ期乳腺癌患者外周血CEAmRNA和Survivin mRNA表达量高于正常对照组（P〈0.01）。Ⅲ/Ⅳ期乳腺癌患者外周血MMP-2 mRNA、CEA mRNA、Survivin mRNA表达量及TIMP-2/MMP-2比值与Ⅰ/Ⅱ期乳腺癌患者比较差异有统计学意义（P〈0.01）。Ⅲ/Ⅳ期乳腺癌患者外周血CEAmRNA和Survivin mRNA表达的阳性率明显高于Ⅰ/Ⅱ期乳腺癌患者（P〈0.01、P〈0.05）。结论采用逆转录real-time PCR检测外周血CEA、Survivin、MMP-2 mRNA的表达以及TIMP-2/MMP-2比值可以成为一种无创性乳腺癌辅助诊断、分期、转移的方法。     

胃癌外周血CD4^＋-CD25^high-Foxp^3＋-调节性T细胞异常增高与TGF-β1、PGE2的相关性分析

目的：探讨胃癌患者外周血中CD4^＋-CD25^high-Foxp^3＋-调节性T细胞（Treg）的比例与血清中转化生长因子131（TGF-β1）、前列腺素E2（PGE2）表达水平的相关性。方法：采用流式细胞术检测26名健康体检者（对照组）和39例胃癌患者（胃癌组）外周血中CD4^＋-CD25^high-Foxp^3＋-细胞比例，同时运用ELISA法检测其血清中TGF-β1、PGE2的表达水平。结果：胃癌患者的CD4^＋-CD25^high-Foxp^3＋-细胞比例与其TNM分期相关，该比例随TNM分期上升而上升，其中TNMⅢ、Ⅳ期患者与健康对照者间的细胞比例差异有统计学意义（P〈0．01）。胃癌组和健康对照的组血清TGF-β1[（14．85±6．16）μg／L比（10．33±3．25）μg／L]和PGE2表达[（100．46±47．52）ng／L比（74．12±44．96）ng／L]间差异亦有统计学意义（P〈0．01），其中TNM Ⅲ、Ⅳ期患者TGF-β1水平与Treg相关（r=0．750，P〈0．01），而PGE2在TNM Ⅰ、Ⅱ期和TNMⅢ、Ⅳ期均与Treg相关（r=0．704，P〈0．01；r=0．748，P〈0．01）。结论：胃癌患者外周血中CD4^＋-CD25^high-Foxp^3＋-细胞比例随肿瘤的进展而增高，而其血清TGF-β1、PGE2表达水平与CD4^＋-CD25^high-Foxp^3＋-细胞116例相关。     

恶性肿瘤颈部转移淋巴结超声分区分析

目的分析不同恶性肿瘤颈部转移淋巴结的超声分区特征。方法颈部淋巴结转移恶性肿瘤患者248例,其中甲状腺癌79例,食管癌31例,喉癌23例,鼻咽癌27例,舌癌14例,上颌窦癌7例,肺癌29例,乳腺癌38例,超声分析各恶性肿瘤患者转移淋巴结分区情况。结果甲状软骨以上头颈部原发肿瘤（喉癌、鼻咽癌、舌癌、上颌窦癌）71例,其Ⅱ区淋巴结转移率（92%）高于Ⅰ、Ⅲ、Ⅳ区（49%、37%、11%）（P〈0.05）;甲状软骨以下颈部原发肿瘤（甲状腺癌、食管癌）110例,Ⅲ、Ⅳ、Ⅵ区淋巴结转移率（82%、97%、80%）高于Ⅱ、Ⅴ区（16%、35%）（P〈0.05）;头颈部外的原发肿瘤（肺癌、乳腺癌）67例,Ⅳ、Ⅴ区淋巴结转移率（96%、85%）高于Ⅲ区（16%）（P〈0.05）。结论恶性肿瘤颈部淋巴结转移超声分区特征可为临床诊断提供参考。     

结直肠癌患者测定血脂和单克隆抗体肿瘤标志物水平进行诊断的临床研究

目的 探讨结直肠癌患者测定血浆血脂和单克隆抗体肿瘤标志物水平进行诊断的临床意义.方法 96例结直肠癌患者(包括Ⅰ～Ⅱ期62例和Ⅲ～Ⅳ期34例)和30例良性结直肠瘤患者血脂和单克隆抗体肿瘤标志物CA199、CA724、CA153 水平分别由生化法和电化学发光免疫分析法进行测定,并进行了对比性研究.结果 Ⅰ～Ⅱ期结直肠癌患者血清TC、HDL-C 和HDL-C/TC比值水平较之良性结直肠瘤患者无明显差异(P均＞0.05);而Ⅲ～Ⅳ期结直肠癌患者较之良性结直肠瘤患者血清TC水平明显增高(P＜0.01),血清HDL-C和HDL-C/TC比值水平明显降低(P均＜0.01).Ⅰ～Ⅱ期和Ⅲ～Ⅳ期结直肠癌患者血清CA199、CA724和CA153水平较之良性结直肠癌患者均明显增高(P＜0.01).单克隆抗体肿瘤标记物的阳性率显示:良性结直肠瘤患者的阳性率为3.33%～13.33%,结直肠癌患者血清CA199、CA724和CA153的阳性率为39.58%、37.50%、35.40%,CA199+CA724的阳性率为58.33%.CA724+CA153的阳性率为62.50%,CA199+CA724+CA153的阳性率为84.44%.结论 结直肠癌患者血清TC水平增高和HDL-C、HDL-C/TC比值水平的降低是诊断中、晚期癌症的良好指标,单克隆抗体肿瘤标志物CA199、CA724和CA153水平的联合测定是提高结直肠癌患者阳性率的重要措施.     

彩色多普勒超声在乳腺单纯性黏液腺癌与纤维腺瘤鉴别诊断中的价值

目的 探讨彩色多普勒超声在乳腺单纯性黏液腺癌与纤维腺瘤鉴别诊断中的价值.方法 对25例乳腺单纯性黏液腺癌与30例纤维腺瘤患者进行彩色多普勒超声检查,分析病灶的声像图表现、内部和周边的血流分布及多普勒频谱,将诊断结果与病理结果进行对照.结果 彩色多普勒超声对乳腺单纯性黏液腺癌与纤维腺瘤诊断的符合率分别为76.0%、93.3%,90%纤维腺瘤可见清晰包膜,内部回声均匀,单纯性黏液腺癌则无包膜,内部回声大多杂乱不均;纤维腺瘤Ⅰ～Ⅱ级血流检出率仅为40%,而单纯性黏液腺癌Ⅰ～Ⅲ级血流检出率高达76%,二者的血流分级和阻力指数(RI)差异均有显著统计学意义.结论 彩色多普勒超声在乳腺单纯性黏液腺癌与纤维腺瘤的鉴别诊断中具有重要的临床价值.