肺癌神经内分泌分化与术后生存关系探讨

目的 探讨非小细胞肺癌神经内分泌(NSCLC—NE)分化与患者手术后生存关系。方法 收集1997年4月至1999年4月98例肺癌手术切除病理标本，采用免疫组化标记特异性烯醇化酶(NSE)及突触素(SY)，并按强弱区分为“ 、 、 ”。对同一手术病例标本采用电镜观察特异性NE颗粒。术后病例随访36月，最长60月。采用Cox多因素风险模型分析NSCLC-NE分化与患者术后生存的关系。结果 91例为非小细胞肺癌。非小细胞肺癌NF阳性表达率为63．7％(58/91)，其中NSE阳性表达54例(59．3％)，SY阳性表达22例(24．1％)，电镜观察NE持异性颗粒30例(33．0%)。结合免疫组化和电镜观察，NSCLC-NE分化44例(48．4％)。Cox模型多因素分析结果表明NSCLC-NE分化者术后生存时间明显缩短(P=0.048)。术后生存与肺癌细胞分化程度(P=0．006)、病理分期(P=0．001)、NE表达强弱(P=0．054)有密切关系。结论 NSCLC-NE分化与肿瘤细胞分化和患者术后生存有关。采用NE标志物标记肿瘤，并观察其强弱改变．对术后评估具有较重要的参考意义，可作为为临床判断患者预后指标之一。     

肺癌神经内分泌分化与术后生存关系探讨

目的探讨非小细胞肺癌神经内分泌(NSCLC-NE)分化与患者手术后生存关系。方法收集1997年4月-1999年4月98例肺癌手术切除病理标本,采用免疫组化标记特异性烯醇化酶(NSE)及突触素(SY),并按强弱区分为“ 、 、 ”。对同一手术病例标本采用电镜观察特异性NE颗粒。术后病例随访36例,最长60月。采用Cox多因素风险模型分析NSCLC-NE分化与患者术后生存的关系。结果91例为非小细胞肺癌。非小细胞肺癌NE阳性表达率为63.7%(58/91),其中NSE阳性表达54例(59.3%),SY阳性表达22例(24.1%),电镜观察NE特异性颗粒30例(33.0%)。结合免疫组化和电镜观察NSCLC-NE分化44例(48.4%)。Cox模型多因素分析结果表明NSCLC-NE分化者术后生存时间明显缩短(P=0.048)。术后生存与肺癌细胞分化程度(P=0.006)、病理分期(P=0.001)、NE表达强弱(P=0.054)有密切关系。结论NSCLC-NE分化与肿瘤细胞分化和患者术后生存有关。采用NE标志特标记肿瘤,并观察其强弱改变,对术后评估具有较重要的参考意义,可作为临床判断患者预后指标之一。     

肺癌神经内分泌分化与术后生存关系探讨(英文)

目的探讨非小细胞肺癌神经内分泌(NSCLC-NE)分化与患者手术后生存关系。方法收集1997年4月～1999年4月98例肺癌手术切除病理标本,采用免疫组化标记特异性烯醇化酶(NSE)及突触素(SY),并按强弱区分为“+、++、+++”。对同一手术病例标本采用电镜观察特异性 NE 颗粒。术后病例随访36例,最长60月。采用Cox 多因素风险模型分析 NSCLC-NE 分化与患者术后生存的关系。结果 91例为非小细胞肺癌。非小细胞肺癌 NE 阳性表达率为63.7%(58/91),其中 NSE 阳性表达54例(59.3%),SY 阳性表达22例(24.1%),电镜观察 NE 特异性颗粒30例(33.0%)。结合免疫组化和电镜观察 NSCLC-NE 分化44例(48.4%)。Cox 模型多因素分析结果表明 NSCLC-NE 分化者术后生存时间明显缩短(P=0.048)。术后生存与肺癌细胞分化程度(P=0.006)、病理分期(P=0.001)、NE 表达强弱(P=0.054)有密切关系。结论 NSCLC-NE 分化与肿瘤细胞分化和患者术后生存有关。采用 NE 标志特标记肿瘤,并观察其强弱改变,对术后评估具有较重要的参考意义,可作为临床判断患者预后指标之一。     

胃癌中神经内分泌细胞的临床病理学意义

 本文应用铬粒素A（CgA）、胃泌素（GAS）、生长抑素（SS）及5-羟色胺（5-HT）对120例普通型胃癌用免疫组化SP法标记其神经内分泌细胞。结果表明：四种激素抗体检测，以CgA最敏感、阳性率最高为31.7%;高分化腺癌CgA阳性率显着高于低分化和未分化癌（P<0.05）,但高分化腺癌CgA阳性病例以（+）为主，未分化癌以（++）为主；而SS.5HT的阳性率，高、低分化腺癌均高于未分化癌（P>0.05）.CgA及5-HT阳性病例淋巴结转移率高于阴性病例（P<0.05）,CgA（++）病例术后生存期明显短于CgA（+）及CgA（-）者（P<0.05）,GAS、5-HT及SS阳性与阴性病例术后生存期无显着差异。     

术后辅助化疗在消化道神经内分泌癌中的临床研究

  目的  消化道神经内分泌癌（neuroendocrine carcinomas,NECs）是一种罕见的侵袭性肿瘤。对于无远处转移的患者,可选择根治性手术,但术后易出现复发转移,预后差。术后辅助化疗在NECs中的疗效尚不明确,缺乏相关临床研究数据,无标准治疗方案。本研究观察接受根治性手术的消化道NECs患者接受术后辅助化疗对比单纯手术与生存的相关性。  方法  回顾性分析2018年6月至2020年9月于郑州大学附属肿瘤医院接受根治手术的消化道NECs患者的临床病理资料。根据是否接受术后辅助化疗分为辅助化疗组和单纯手术组。辅助化疗组于术后4~6周开始接受至少2个周期以铂类为基础的化疗。主要研究终点为2年无病生存率（disease-free survival,DFS）,次要研究终点为不同辅助化疗方案DFS。  结果  共筛选62例患者,其中男性52例（83.9%）,女性10例（16.1%）,中位年龄为65（38~84）岁。食管NECs为12例（19.3%）,胃NECs为45例（72.6%）,小肠和结直肠NECs为5例（8.1%）。38例（61.3%）患者接受了术后辅助化疗,其中21例采用依托泊苷联合铂类（EP）方案化疗,17例采用伊立替康联合铂类（IP）方案化疗。21例患者术后辅助治疗超过4个周期。24例（38.7%）患者接受了单纯手术治疗。术后辅助化疗组和单纯手术组2年DFS分别为58.7%和14.7%（P < 0.001）。多因素分析提示,对于淋巴结阳性的患者接受术后辅助化疗可明显提高生存获益（HR:6.403,95%CI:1.329~27.465,P=0.020）。  结论  在可切除的消化道NECs中,术后辅助化疗可降低术后复发转移风险,提高患者的无病生存获益,但辅助化疗方案的选择仍需进行深入的研究。      

胃癌伴神经内分泌分化的临床病理及预后分析

背景与目的:胃是人体重要的具有神经内分泌功能的器官之一,部分胃癌在发生、发展过程中伴随着神经内分泌细胞分化(neuroendocrine cell differentiation,NED)现象,NED对胃癌患者预后的影响还存在争议。本研究旨在探讨胃癌伴NED的临床病理特点、治疗及预后。方法:回顾性分析复旦大学附属肿瘤医院胃及软组织外科2001年3月—2009年7月收治的17例胃癌伴NED患者和具有相同分期的34例不伴NED胃癌患者的临床资料,比较两组患者的临床病理特征和预后差异。结果:肿瘤的发生部位和分化程度与胃癌是否伴有NED具有明显相关性。伴NED的胃癌患者的1年和3年生存率明显低于不伴NED的胃癌患者的1年和3年生存率(71%vs79%,38%vs 47%,χ2=4.212,P=0.040)。多因素分析结果显示,患者年龄、浸润深度及远处转移是独立的预后因素。结论:免疫组织化学染色对伴NED胃癌的确诊具有重要价值,伴有NED可能是胃癌预后不良的重要因素之一。     

胃癌中神经内分泌激素与癌转移关系的探讨

胃癌中神经内分泌激素与癌转移关系的探讨王鲁平１虞积耀２郑集义２田玉旺１吴霞１邓永江胃癌中存在有神经内分泌（Ｎｅｕｒｏｅｎｄｏｃｒｅｎｅ简称ＮＥ）细胞，一些作者认为胃癌中ＮＥ细胞分泌的激素与胃癌的生物学行为有关，本文报道应用组织学，免疫组织化学方法对胃...     

胃癌腹膜转移患者行胃癌切除术及术后化疗的生存分析

目的:探讨胃癌腹膜转移患者行手术及术后化疗的意义。方法:回顾性分析胃癌腹膜转移病例89例,收集有效随访病例的相关术前临床和病理学资料、术中探查所见转移方式、手术方式、术后处理措施等数据。结果:通过对患者临床病理学特征进行单因素分析显示,手术方式（P=0.004）、化疗（P=0.003）、腹膜转移方式 (P<0.05)、Borrmann分型 (P<0.05)对胃癌腹膜转移的预后生存具有显著性影响。结论:对于胃癌腹膜转移患者,无论患者转移程度如何,如果没有绝对手术禁忌证,建议行胃癌切除D1淋巴结清扫,术后配合化疗。     

Studies onthe Relationship between Neuroendocrine Cellular Differentiation in Gastric Cancers and Post-operative Survival Time

OBJECTIVE To examine the ultrastructure of gastric cancer cel s by the electron microscope,in order to assess the relationship between neuroendocrine differentiation and post-operative survival time. METHODS NSE,Syn and CgA immunohistochemical labeling was conducted in 168 cases with a common-type of gastric cancer.Electron microscopy was performed in 80 cases with positive immunohistochemical labeling. These cases were fol owed-up for over 5 years and the post-operative survival data analyzed. RESULTS Neuroendocrine granules were found by electron microscopy in 39 cases.The rate of neuroendocrine differentiation found was 23% (39/168),using routine diagnostic criteria and electron microscopy(REM). The post-operative survival time of gastric cancer patients with neuroendocrine differentiation was significantly shorter(P=0.0032)compared to those without neuroendocrine differentiation. CONCLUSION It is of significant clinical importance to determine if the neuroendocrine cells are differentiated in gastric cancers.The gastric cancer patients with neuroendocrine differentiation have a shorter post-operative survival time and a poorer prognosis.Electron microscopy is a reliable method of providing a diagnosis.     

Factors Predicting Survival of Patients with Gastric Cancer

Background: Gastric cancer is one of the most common causes of cancer death in Taiwan. The literaturehas previously shown that age, tumor site, T categories, and number of metastatic nodes significantly affectprognosis. The aim of this study was to determine the long-term survival of patients with gastric cancer, aswell as the effect of particular prognostic factors on survival. Materials and Methods: This was a survivalanalysis study with retrospective design. We reviewed the records of 64 patients with adenocarcinoma of thestomach who had undergone gastrectomy with curative intent between 2009 and 2012 at a teaching hospitalin southern Taiwan. Data extracted from patient documents included age, gender distribution, tumor location,and pathological grading. Results: The median follow-up time was 4 years, and there were 31 deaths attributedto gastric cancer. Kaplan-Meier analysis revealed that retrieval of less than 15 lymph nodes from a patient wasa significant predictor of survival. A significant predictor of poorer survival was higher pathological grading.Conclusions: Our results indicate that the number of lymph nodes retrieved and pathological grading     

Relationship of Amplification and Expression of the C-MYC Gene with Survival among Gastric Cancer Patients

Background: During the past decades, the incidence and mortality rate of stomach cancer has demonstrateda great decrease in the world, but it is still one of the most common and fatal cancers especially among menworldwide, including Iran. The MYC proto-oncogene, which is located at 8q24.1, regulates 15% of genes and isactivated in 20% of all human tumors. MYC amplification and overexpression of its protein product has beenreported in 15-30% of gastric neoplasias. The aim of this investigation was to find the relative efficacy of CISH(chromogenic in situ hybridization) or IHC (immunohistochemistry) in diagnosis and prognosis of gastric cancer,as well as the relationship of amplification and expression of C-MYC gene with patient survival. Materials andMethods: In this cross-sectional study, 102 samples of gastric cancer were collected from patients who hadundergone primary surgical resection at the Cancer Institute Hospital, Tehran University of Medical Sciences,from July 2009 to March 2014. All samples were randomly selected from those who were diagnosed with gastricadenocarcinomas. CISH and IHC methods were performed on all of them. Results: Patients were classifiedinto two groups. The first consisted of stage I and II cases, and the second of stage III and IV. Survival tests forboth groups was carried out with referrnce to CISH test reults. Group II (stage III & IV) with CISH+ featuredlower survival than those with CISH- (p=0.233), but group I (stage I & II) patients demonstrated no significantvariation with CISH+ or CISH- (p=0.630). Kaplan-Meier for both groups was carried out with IHC test findingsand showed similar results. This data revealed that both diffuse and intestinal types of gastric cancer occurredsignificantly more in men than women. Our data also showed that CISH+ patients (43%) were more frequentin comparison with IHC+ patients (14.7%). Conclusions: For planning treatment of gastric cancer patients, byfocusing on expanding tumors, which is the greatest concern of the surgeons and patients, CISH is a better andmore feasible test than IHC, in regard to sensitivity and specificity. Therefore, CISH can be used as a feasible testfor tumor growth and prognosis in stage III and IV lesions. This study also indicated that C-MYC amplificationin gastric cancer is correlated with survival in advanced stages.     

Goseki Grade and Tumour Location Influence Survival of Patients with Gastric Cancer

Background: Owing to the variability of histopathological features and biological behaviour in gastriccarcinoma, a great number of categorisation methods such as classical histopathologic grading, Laurenclassification, the TNM staging system and the newly presented Goseki grading method are used by pathologistsand other scientists. In our study, we aimed to investigate whether Goseki grade and tumour location havean effects on survival of gastric cancer cases. Materials and Methods: Eighty-four patients with gastricadenocarcinoma were covered in the investigation. The importance of Goseki grading system and tumour locationwere analysed in addition to the TNM staging and other conventional prognostic parameters. Results: Themedian survival time in our patients was 35 months (minimum: 5, maximum: 116). According to our findings,there was no relation between survival and tumour size (p=0.192) or classical histological type (p=0.270). Incontrast, the Goseki grade and tumour location significantly correlated with survival (p=0.007 and p<0.001,respectively). Additionally, tumours of the intestinal type had a longer median survival time (60.0 months) thandiffuse tumours (24.0 months). Conclusions: In addition to the TNM staging system, tumour location and theGoseki grading system may be used as significant prognostic parameters in patients with gastric cancer.     

腹腔镜下近端胃癌术后近远期并发症及患者生存质量分析

目的：通过比较腹腔镜辅助下行近端胃癌术式与传统开腹近端胃癌术式的疗效,探讨临床治疗胃癌的最佳手术方式。方法将58例胃癌患者根据患者自身情况和临床医生建议,分为观察组（腹腔镜下近端胃癌根治术）和对照组（传统开腹近端胃癌根治术）,每组各29例。记录并分析患者术后恢复情况和术后并发症比例,并进行统计学比较。结果所有患者手术均顺利完成,无死亡病例。观察组所需手术时间较长,但术中出血量较少,住院天数少,首次排气和进食时间较短,与对照组比较,差异均具有统计学意义（P均＜0．05）。2组清扫淋巴结数目无统计学差异（P＞0．05）。对照组和观察组患者术后CD4＋T细胞比例、CD4＋／CD8＋T细胞比例均有不同程度下降,差异均具有统计学意义（ P均＜0．05）,但CD8＋T细胞比例并未有统计学差异（P＞0．05）。对照组术后并发症发生率高于观察组,但差异无统计学意义（P均＞0．05）。结论腹腔镜术式可降低术中出血量,且可以完全清扫淋巴结,对免疫系统影响较小,有利于患者术后早日恢复,应在临床使用中大范围推广。     

胃癌D2根治术后辅助化疗起始时间与预后的关系

[目的]探讨胃癌D2根治术后化疗起始时间与患者预后的关系.[方法]对我院2007～2011年间298例胃癌D2根治术后接受辅助化疗的患者进行了随访及系统分析.根据手术距辅助化疗开始的时间(≤45d和＞45d)分析化疗起始时间与预后间的关系.[结果]298例患者中化疗开始时间≤45d,233例(78％),开始时间＞45d65例(22％).全组患者3年生存率为55.3％,5年生存率为9.6％.多因素分析显示化疗起始时间是胃癌患者的独立预后因素.[结论]胃癌D2根治术后最佳化疗开始时间应在45d内,延迟辅助化疗开始时间(＞45d)可能与患者生存率降低有关.     

Association between ABCB1 Immunohistochemical Expression and Overall Survival in Gastric Cancer Patients

Gastric cancer (GC) is one of the most common malignancies worldwide. The ABCB1 protein, a member of the ATP-binding cassette (ABC) transporter family, encoded by the ABCB1 gene, considerably influences the distribution of drugs across cell membranes as well as multidrug resistance (MDR) of antineoplastic drugs. In contrast to the extensive knowledge on the pharmacological action of ABCB1 protein, the correlation between the clinical-pathological data and ABCB1 protein expression in patients with GC remains unclear. The aim was to investigate association between ABCB1 expression and overall survival in GC patients. Human tumor fragments from 57 GC patients were examined by immunohistochemistry assay. We observed lower survival rate of patients with GC who were positive for ABCB1 expression (p=0.030). Based on these observations, we conclude that GC patients with positive ABCB1 protein immunohistochemical expression in their tumors suffer shorter overall survival.