原发性肝癌患者可溶性白细胞介素-2受体的变化及其临床意义

对３４例原发性肝癌（ＰＬＣ）患者外周血可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）、ＮＫ活性、Ｔ淋巴细胞亚群进行测定。结果：ＰＬＣ患者ｓＩＬ－２Ｒ水平明显高于健康对照组（Ｐ＜０．０１），ＮＫ活性、Ｔ淋巴细胞亚群ＣＤ３、ＣＤ４、ＣＤ４／ＣＤ比值均低于正常人（Ｐ＜０．０１），而ＣＤ８高于正常对照组（Ｐ＜０．０５）。Ⅱ、Ⅲ期ＰＬＣ患者ｓＩＬ－２Ｒ水平显著高于Ⅰ期患者（Ｐ＜０．０１）。ｓＩＬ－２Ｒ水平≥１０００ｕ／ｍｌ、５００～１０００ｕ／ｍｌ、＜５００ｕ／ｍｌ者６个月内的死亡率分别为８０．０％、２９．４％、０％。肝癌切除术后２周ｓＩＬ－２Ｒ水平较术前低（Ｐ＜０．０５），免疫治疗后４周ｓＩＬ－２Ｒ水平亦较治疗前低（Ｐ＜０．０５）。细胞免疫水平都有所改善。提示测定外周血ｓＩＬ－２Ｒ水平可作为ＰＬＣ的免疫状态、病情严重程度、疗效观察及预后估计的生物学指标。     

肝细胞癌病人血清白细胞介素12水平变化及其临床意义

目的 探讨ＨＣＣ病人血清ＩＬ－１２水平变化及其临床意义，研究ＩＬ－１２在ＣＣ发生发展过程中的作用。方法 应用ＥＬＩＳ ＨＣ同人及３０例良性对照组血清ＩＬ－１２水平。结果 ＨＣＣ组血清ＩＬ－１２水平明显低于对照组，Ⅳ期ＨＣＣ病人血清ＩＬ－１２水平明显低于Ⅱ、Ⅲ期病人，肝功能，肿瘤直径，是否存在门静脉癌栓显著影响ＨＣＣ病人血清ＩＬ－１２水平，ＩＬ－１２水平与ＡＦＰ水平不相关。术后ＩＬ－１２水平先降低、     

乳腺癌患者手术前后血清可溶性白细胞介素-2受体水平的变化

为探讨血清可溶性白细胞介素２ 受体（ｓ Ｉ Ｌ２ Ｒ）水平与乳腺癌的分期和预后的关系，采用 Ｅ Ｌ Ｉ Ｓ Ａ 法对 ３７ 例乳腺癌患者手术前后血清 ｓ Ｉ Ｌ２ Ｒ 进行检测，同期检测了 １３ 例乳腺良性疾病患者及 ４０ 例正常人血清 ｓ Ｉ Ｌ２ Ｒ水平。结果： 乳腺癌患者血清ｓ Ｉ Ｌ２ Ｒ明显高于乳腺良性疾病组和正常对照组，其术后 ２０ 天血清 ｓ Ｉ Ｌ２ Ｒ水平明显低于术前； 乳腺癌患者血清 ｓ Ｉ Ｌ２ Ｒ水平与临床分期密切相关，Ⅲ期患者明显高于Ⅰ、Ⅱ期，且术后 ２０ 天仍保持在较高水平上。由此提示，血清 ｓ Ｉ Ｌ２ Ｒ 的表达水平与乳腺癌患者的临床分期和预后密切相关，可作为鉴别乳腺良恶性疾病的一项参考指标。     

肝细胞癌病人血清可溶性白细胞介素2受体水平变化及其临床意义

目的：研究肝细胞肝癌（HCC）病人血清可溶性白细胞介素2受体（SIL-2R）水平的变化情况及其临床意义。方法：用酶联免疫吸附试验方法（ELISA）检测60例HCC病人、30例良性肝胆疾病病人以及20例健康对照者血清SIL-2R水平,结合临床资料分析其临床意义。结果：HCC组血清SIL-2R水平显著性高于其他两组（P＜0.01),良性肝胆疾病组与健康对照组血清SIL-2R水平无显著性差异（P＞0.05)。HCC组中血清SIL-2R水平与疾病分期有较好的相关性,随HCC分期升高,SIL-2R水平增高。血清SIL-2R水平与AFP水平无相关性（r=0.197,P＞0.05)。血清SIL-2R水平可作为HCC早期诊断的良好指标,以100pmol/L为切割值,其灵敏度为81.7%,特异度为100%,诊断符合率90%。血清SIL-2R水平变化受手术因素影响。术后SIL-2R水平先升高后降低,降低程度与肿瘤切除与否有关。术后肿瘤复发病人血清SIL-2R水平升高。结论：血清SIL-2R水平可作为HCC病人早期诊断、病情判断、复发监测的重要指标。     

谷氨酰胺对梗阻性黄疸大鼠可溶性白细胞介素2受体的影响

梗阻性黄疸（简称梗黄）是普外科常见疾病，围手术期易发生感染、脓毒症等并发症，严重影响患者预后，免疫功能低下是其主要原因之一。本研究通过建立大鼠梗黄模型，给予力太（Dipeptiven，丙氨酰谷氨酰胺注射液，含L谷氨酰胺13．46g／100m1），探讨谷氨酰胺（Gln）对梗黄大鼠可溶性白细胞介素2受体（sIL-2R）的影响。     

射频治疗原发性肝癌前后可溶性白细胞介素-2受体和肿瘤坏死因子的变化

目的　研究原发性肝癌患者集束电极射频治疗前后血清可溶性白细胞介素 - 2受体 (SIL - 2 R)和肿瘤坏死因子(TNF)水平的变化及其临床意义。方法　采用 EL ISA双抗体夹心法 ,检测 4 2例原发性肝癌 (HCC)患者集束电极射频治疗前后血清 SIL - 2 R和 TNF的表达水平的改变 ,并与健康对照组比较 ;分析 SIL - 2 R和 TNF与 AFP的相关性。结果　治疗前 HCC患者血清 SIL - 2 R和 TNF水平明显高于对照组 (P<0 .0 1) ;集束电极射频治疗后 1周 ,血清 SIL - 2 R和 TNF水平无明显变化(P>0 .0 5 ) ;治疗后 2周 ,血清 SIL - 2 R和 TNF水平降低 ,与治疗前比较差异有显著性 (P<0 .0 1) ,但仍高于对照组 (P<0 .0 1) ;血清 SIL - 2 R/ TNF水平与 AFP水平不相关。结论　原发性肝癌患者集束电极射频治疗后血清中 SIL - 2 R和 TNF水平下降 ,机体免疫功能增强 ;并可作为早期诊断、病情判断、复发检测的重要指标     

胃癌患者手术前后可溶性白细胞介素2受体水平表达的动态研究

应用ＥＬＩＳＡ法动态检测了６０例胃癌患者手术前后血清可溶性白细胞介素２受体（ｓＩＬ２Ｒ）水平的变化,并与３０例健康人及４０例腹部非肿瘤择期手术患者对照比较。结果：胃癌患者术前１天及术后１０天的ｓＩＬ２Ｒ水平明显高于两个对照组;术后２０天与两个对照组比较则无明显差异,ｓＩＬ２Ｒ水平呈逐渐下降趋势。结论：胃癌患者血中出现免疫抑制物ｓＩＬ２Ｒ水平明显增高,而于根治手术切除肿瘤及转移淋巴结后,ｓＩＬ２Ｒ水平逐渐降低,提示患者免疫功能可得到改善。     

原发性肝癌患者血清sIL—2R水平的检测及临床意义

本实验采用ＥＬＩＳＡ夹心法对４９例原发性肝癌患者血清中可溶性白细胞介素Ⅱ受体进行了检测，８例为治愈患者；１２例伴有转移；２９例无转移，以２１例健康献血人员为对照。结果显示原发性肝癌患者血清ｓＩＬ－２Ｒ水平显著升高，伴有转移组明显高于其它组，治愈组同正常对照组仍相差明显，结果表明，ｓＩＬ－２Ｒ异常升高在原发性肝癌患者机体免疫抑制机制及免疫监视能力下降方面起着极重要的作用，且和肿瘤转移及病情变化密切相     

急性髂股静脉血栓形成血清可溶性白细胞介素Ⅱ受体测定的临床意义

对４０例急性髂股静脉血栓形成病人进行血清可溶性白细胞介素Ⅱ受体（ＳＩＬ－２Ｒ）和白细胞介素Ⅱ（ＩＬ－２）测定，结果表明４０例患者均存在高水平的ＳＩＬ－２Ｒ和低水平的ＩＬ－２，同时表明二者水平的高低与病情轻重密切相关。提示血清ＳＩＬ－２Ｒ和ＩＬ－２测定有助于急性髂股静脉血栓形成病人病情监测及预后判断。     

乙型肝炎患者外周血中IL-6和sIL-2R含量变化及其意义

目的探讨细胞因子IL-6和sIL-2R在乙型肝炎病毒感染后的免疫应答中所起作用和临床意义。方法使用ELISA定量检测75例乙型肝炎患者和15例健康对照的血浆IL-6和sIL-2R含量。结果急性乙型肝炎患者组血浆IL-6和sIL-2R含量明显高于健康对照组;在慢性乙型肝炎中,随着病情加重,血浆IL-6和sIL-2R含量随之升高,特别是轻度组及中度组与重度组间存在显著性差异(P<0.05);在ALT正常组与ALT异常组之间比较发现,ALT异常组的血浆IL-6和sIL-2R含量明显高于ALT正常组(P<0.05,P<0.01)。结论乙肝患者机体存在免疫应答异常导致免疫损伤,IL-6和sIL-2R含量变化能部分反映机体肝细胞损伤情况和损伤机制。     

Tumor angiogenesis predicts recurrence with normal serum carcinoembryonic antigen in advanced rectal carcinoma patients

P = 0.001, 0.043, respectively). These results suggest that a high degree of tumor angiogenesis in sections of T3/T4 rectal cancer may therefore be an important predictor for CEA-negative recurrence. (Received for publication on June 8, 1998; accepted on Mar. 11, 1999)     

肝细胞肝癌病人血清IL-12、IL-2、sIL-2R水平的相关性

目的探讨肝细胞肝癌 (hepatocellularcarcinoma ,HCC)病人血清IL 12、IL 2、sIL 2R水平的相关关系。方法 6 0例HCC病人 ,随机分为 2组。试验组 (30例 )接受IL 2 (IL 2 10 0万U/d× 7d ,静脉点滴注射 )治疗 ;对照组 (30例 )没有接受生物治疗。两组基础治疗基本相似。采用酶联免疫吸附 (ELISA)法检测所有病人治疗前后血清IL 12、IL 2、sIL 2R水平变化。结果血清IL 12水平与血清IL 2水平正相关 ,IL 12与sIL 2R无关 ,IL 2与sIL 2R负相关。IL 2治疗后平均血清IL 12、IL 2、sIL 2R水平显著性升高。IL 2治疗后血清IL 12水平下降的HCC病人预后差。结论IL 12与IL 2之间可能存在一个反馈环路 ,sIL 2R是这个环路的负调节因素。IL 2治疗可刺激内源性IL 12释放。HCC病人的预后可能与IL 2诱生的IL 12变化有关     

Developments in treatment of primary irresectable rectal cancer

Abstract The treatment options for primary irresectable rectal cancers are discussed. Assessment of tumour stage is the first step for an appropriate choice of treatment. Following a diagnosis of rectal cancer, a vast array of diagnostic procedures is available to determine its stage, and thereby its best treatment options. From the many (new) diagnostic options the merits and drawbacks are discussed. If a diagnosis of irresectability is made, further treatment options should include radiotherapy in most cases, some aspects of timing and application, i.e. intra-operative treatment are discussed. Chemotherapy options are manifold, the results are discussed and some new options are explored.     

高压氧治疗对严重烧伤患者血中sIL-2R和Fn含量变化的影响

目的通过观察高压氧治疗(Hyperbaric Oxygen Therapy,HBOT)对烧伤患者血中可溶性白介素2受体(Soluble interleukin-2 receptor,sIL-2R)及纤维连接蛋白(Fibronectin,Fn)含量的影响,探讨 HBOT 防治烧伤感染的价值。方法选择42例严重烧伤患者(烧伤面积>30%或Ⅲ度面积>10%),随机分为 HBOT 组(25例)和非 HBOT 组(17例),另选40名健康献血员作正常对照组。于伤后8h 及1,2,3,5,7,10,14,17,21,28,35天采集静脉血,ELISA 法测定血清 sIL-2R,火箭免疫电泳法测定其血浆 Fn,同时观察两组患者脓毒症发生率。结果非 HBOT 组:与正常对照组相比,伤后各时相点血清 sIL-2R 水平显著升高,而血浆 Fn 含量明显降低(P<0.05或 P<0.01);HBOT 组:与正常对照组相比,除伤后21天外,其余各时相点血清 sIL-2R 升高不明显;除伤后8h外,其余各时点血浆 Fn 降低不明显(P>0.05)。但与非 HBOT 组相比,伤后各时相点血清 sIL-2R均显著降低,而血浆 Fn 则明显增高(P<0.05或 P<0.01);与此同时,脓毒症发生率亦明显降低(P<0.05)。结论 HBOT 可显著降低严重烧伤患者血清 sIL-2R,而明显增高血浆 Fn,故对防治烧伤感染可能有益。     

Use of adjuvant,preoperative chemo-radiotherapy in patients with locally advanced rectal cancer

Background: The objective of this study was to perform a non‐randomised prospective examination of the efficacy of adjuvant, preoperative chemo‐radiotherapy in patients with locally advanced rectal cancer. Methods: Between 1996 and 2001, patients presenting with biopsy‐proven, locally advanced, rectal cancers within 12 cm of the anal verge were referred for a long course of adjuvant chemo‐radiotherapy prior to their surgery. Locally advanced lesions were defined by either: (i) endoanal ultrasound showing at least full thickness penetration of the rectal wall (i.e. T3, T4); (ii) abdominal computed tomography scan showing infiltration of adjacent structures, or; (iii) clinical examination demonstrating a fixed lesion. All patients were followed through the hospital colorectal unit. A Kaplan?Meier survival analysis was used to determine survival and local recurrence rates. Results: There were 60 patients with a mean age of 61.5 years (range 33?77 years) with a sex distribution of males to females of 1.7?1.0. Curative resections were performed in 81% of these patients. The remainder (n = 12) were found to have either metastatic disease at operation (n = 5), inoperable disease (n = 2), or had positive resection margins on histology (n = 7). The mean follow up was 2.1 years (maximum 5.1 years). The overall 2‐year survival rate was 86.1% (95% CI ±5.4%). In patients undergoing curative resections, the overall 2‐year survival rate was 91.4% (95% CI ±4.8%), and the 2‐year disease free survival rate was 85.1% (95% CI ±6.2%). The 2‐year local recurrence rate was 7.5%. Conclusions: The use of adjuvant, preoperative, chemo‐radiotherapy in patients with locally advanced rectal cancer is associated with high short‐term survival and a low recurrence rate.     

Preoperative tumour staging with multidisciplinary team assessment improves the outcome in locally advanced primary rectal cancer

Aim Multidisciplinary team meetings have been introduced as a result of developments in preoperative radiological tumour staging and neoadjuvant treatment. Multidisciplinary team recommendations will influence treatment decisions but their effect on patient outcome is unknown. The aim of this study was to assess outcome in relation to preoperative local and distant staging, with or without multidisciplinary team assessment. Methods A population‐based registry of all patients with rectal cancer, treated in the Stockholm region from 1995 to 2004, identified 303 patients with locally advanced primary rectal cancer. The patients were classified into three groups: group 1, preoperative local and distant radiological tumour staging with discussion at a multidisciplinary team meeting; group 2, preoperative staging but no multidisciplinary team assessment; and group 3, no proper preoperative radiological staging. Results Neoadjuvant treatment was more prevalent in groups 1 and 2 than in group 3. The incidence of R0 resection differed significantly between the groups (52% in group 1, 43% in group 2 and 21% in group 3; P < 0.001). Local tumour control was achieved in 57%, 36%, and 19% of patients in groups 1, 2 and 3, respectively (P < 0.001). The estimated overall 5‐year survival of patients was 30%, 28% and 12% in groups 1, 2 and 3, respectively. Conclusion Preoperative radiological tumour staging in patients with locally advanced primary rectal cancer and discussion at a multidisciplinary team meeting increases the proportion of patients receiving neoadjuvant treatment and cancer‐specific end‐points.