吃主食护大肠

英国剑桥大学最近在一项研究中,分析了10多个国家的人的饮食习惯和癌症之间的关系,结果发现,食用淀粉类食物越多,小肠、结肠和直肠癌的发病率越低.比如,以肉类食物为主食的澳大利亚人,结肠癌发病率是以淀粉类食物为主食的中国人的4倍.     

凉菜拌出夏日风情

不知不觉又进入了夏季,南方的潮湿,北方的燥热,常常使人食欲不振,精神委靡,尤其是对于康复期的病友来说,怎一个"热"字了得.夏季的饮食调养,应选择清凉爽口、少油腻、易消化的食物.这时从配角一跃成为主角的凉菜就闪亮登场了,不论生拌、热炝,每道菜都做足了开胃功夫,它们少油,少盐,对我们的健康大有裨益;省时省力,让我们减轻在厨房的劳动强度.只要掌握烹饪技巧,制作起来还是很简单的.     

过敏体质,怎么吃?

什么是过敏呢?过敏反应又称作变态反应,是患者身体对一种或多种物质的过强反应.其主要机制是由于过敏性素质患者的体内产生了过多的过敏抗体——免疫球蛋白E,它和环境中的过敏原相互作用,刺激机体产生和释放某些过敏介质,导致不同组织的损伤,继而产生各种症状.     

文艺汇演群星璀璨

2006年1月8日,中国抗癌协会癌症康复会在"北京展览馆剧场"圆满成功地举办了"阿斯利康首届全国癌症康复者文艺汇演--生命恋歌".这次文艺汇演有26个省、市上报节目50多个,经筹备组认真筛选,选出正式参加演出的节目16个,特邀节目3个,出演的癌症患者近300人.     

钻石之光--山药

"每个人都能在自家的后院找到钻石",有人借用此言,把山药比做养生的钻石. 山药是一种薯科植物,它的根茎垂直而颀长,往往盈尺,生长在坚硬的山冈的土质中,旋转攀缘.阳光下,山药的叶子很美,颜色从浓到浅,绿得缤纷,但被我们称之为钻石的是它营养丰富的块状根茎.山药的外观看上去粗糙,细小密布的根须如刺如须,但削了皮,却洁白得如水生荸荠,分泌一些透明的黏液,柔滑得抓它不住,仿佛泥鳅从手中挣脱.     

Benefit of adjuvant chemoradiotherapy in patients with pathologically lymph node-positive and locally advanced gastric cancer

Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy(CRT)and adjuvant chemotherapy(ChT)for T3–4/N+gastric cancer(GC)following D2/R0 dissection,and identify the specific subgroups that could benefit from adjuvant CRT.Methods All eligible patients were divided into the CRT group and ChT group.We assessed the survival outcomes and patterns of recurrence for each group,and determined the prognostic factors for survival by performing Cox proportional risk regression analyses.Results A total of 192 gastric cancer patients were included in the study.The estimated 3-year and 5-year disease-free survival(DFS)probabilities in the CRT and ChT groups were 52.9%vs.36.7%(P=0.024)and 41.2%vs.31.1%(P=0.148),respectively,and the estimated 3-year and 5-year overall survival(OS)probabilities were 82.4%vs.70.0%(P=0.044)and 52.0%vs.35.6%(P=0.022).Patients in the CRT group had a lower risk of locoregional recurrence than those in the ChT group(20.6%vs.34.4%;P=0.031).The subset analyses revealed that patients with stage N1–2 disease were more likely to benefit from adjuvant CRT than from adjuvant ChT(DFS:53.1%vs.36.4%;P=0.039;OS:53.1%vs.38.6%;P=0.036).Conclusion For locally advanced gastric cancer patients with LN+,adjuvant CRT showed superior survival benefits compared with adjuvant ChT alone.Patients with N1–2 achieved better survival from adjuvant CRT.     

苦参碱对HepG2细胞杀伤作用及机制研究

Objective:To investigate the death mode of human hepatoma cells exposed to matrine and the role of glutathione (GSH) and cytochrome c.Methods:The MTT test and Cell Death Detection ELISA were used to identify cell death mode and viability of cells exposed to matrine.The volume of intracellular GSH was detected by GSH reductase.Finally Western blotting was chosen to analyze the expression of cytochrome c and Caspase-9 in HepG2 cells treated by matrine.Results:The apoptotic cell death induced by matrine in Hep G2 cells dramatically increased in the time-,dose-dependent manner.Matrine can exhaust intracellular GSH effectively to change the redox state in cells.Furthermore it affect the cytotoxicity of matrine.Results of Western blotting showed that matrine induced the release of cytochrome c from mitochondria to cytoplasm,and then stimulate the cleavage of Cespese-9 in a time-dependent manner.Conclusion:Matrine induced apoptosis in Hep G2 cells through the mitochondrial pathway,and oxidative stress via depletion of GSH is directly involved in the apoptotic process.     

肺癌放疗新技术

肺癌是危害人类生命的最主要的癌肿,是名副其实的"癌王",特别是在发达国家更是如此.简单地说美国男性死于恶性肿瘤患者中约每3人中有1例是肺癌,女性中每4人中有1人是肺癌.中国随着城市化进度的加快和吸烟人群的增多,肺癌患者会越来越多.笔者在美国最著名的癌症医院--德州安德森肿瘤中心做客座教授期间接触了来自世界各地的放疗科医生,他们都在努力研究如何延长肺癌患者的生存期,提高生存质量.下面介绍一下这方面的最新技术.     

熏烤煎炸不安全

据说人类发现用火是由于森林起火烧焦了动物而引起的,从那时起,便尝到了烧烤味道的鲜美.时至今日,熏烤煎炸食品气味香,味道美,仍不免会令人垂涎三尺,颇受嘴馋的人或一些儿童、少女青睐,从而造就许多中国人有喜食这类食品的习惯.这类食品如在聚餐酒桌上品尝助兴,少量吃点在所难免,如果大量贪食则可能会对健康不利.化学家在研究癌症病因时,发现一种很强的致癌物质苯并芘,它属于多环芳烃类化合物,与熏烤煎炸食物有关,并引起人们的关注.     

18F-FDG PET/CT融合显像对乳腺癌新辅助化疗疗效的预测价值

背景与目的:既往研究表明,18F-FDG PET显像结果与肿瘤新辅助治疗后的临床或病理反应密切相关.本研究拟探讨乳腺癌新辅助化疗前后18F-FDGPET/CT融合显像与细胞凋亡间的关系,以求进一步明确PET/CT对乳腺癌新辅助化疗疗效的预测价值.方法:45例原发性乳腺癌患者细针穿刺确诊后给予新辅助化疗三个周期,新辅助化疗前后行PET/CT融合显像检查并计算肿瘤区与非肿瘤区放射性比值(tumor to non-tumor activity ratio,T/N),dTUP末端标记技术检测穿刺及手术标本的癌细胞凋亡指数(apoptotic index,AI).结果:新辅助化疗后临床疗效评价完全缓解4例(8.9%),部分缓解29例(64.4%),疾病稳定10例(22.2%),疾病进展2例(4.4%).化疗前后肿瘤平均T/N值分别为3.23±0.63、2.31±0.49(P=0.006),下降6.4%～50.8%.化疗前后AI分别为(2.81±0.76)%、(17.31±6.85)%(P＜0.001),增高1.9%～41.3%.T/N值下降率与AI变化值间存在直线相关关系(r(.)=0.850,P＜0.001).以化疗后T/N值下降≥20%为阈值,PET/CT预测肿瘤临床缓解的灵敏度、特异度分别为90.9%、83.3%,阳性、阴性预测值分别为93.8%、76.9%,准确率为92.1%.结论:18F-FDG PET/CT融合显像与乳腺癌新辅助化疗后的细胞凋亡状态密切相关,对预测化疗疗效具有一定的应用价值.     

乳腺癌新辅助化疗角度测量定位法肿块体表投影临床应用价值的探讨

目的:探讨应用角度测量定位法确定乳腺癌新辅助化疗后肿块体表投影的应用价值。方法:对16例新辅助化疗的乳腺癌患者,应用角度测量定位法记录肿块4个位点与穿刺点的距离和角度,标记化疗前肿块的位置。化疗后根据记录的角度和距离复原标记点的位置,比较和分析化疗前后测量点的完全符合率,确定该测量方法的可行性和实用性。结果:14例共56个测量点(87.5%),化疗前体表肿块测量点与化疗后按角度和距离复原化疗前肿块的4个位点完全符合;误差<0.1cm 1例(6.25%)。误差0.1～0.5cm 1例(6.25%)。结论:肿块角度测量定位法具有较好的可行性和准确性;对明显突出皮肤的肿块和下垂型乳房的肿块需辅助其他测量方法。     

Sentinel lymph node biopsy is accurate after neoadjuvant chemotherapy for breast cancer.

PURPOSE: Sentinel lymph node (SLN) biopsy has proved to be an accurate method for detecting nodal micrometastases in previously untreated patients with early-stage breast cancer. We investigated the accuracy of this technique for patients with more advanced breast cancer after neoadjuvant chemotherapy. PATIENTS AND METHODS: Patients with stage II or III breast cancer who had undergone doxorubicin-based neoadjuvant chemotherapy before breast surgery were eligible. Intraoperative lymphatic mapping was performed with peritumoral injections of blue dye alone or in combination with technetium-labeled sulfur colloid. All patients were offered axillary lymph node dissection. Negative sentinel and axillary nodes were subjected to additional processing with serial step sectioning and immunohistochemical staining with an anticytokeratin antibody to detect micrometastases. RESULTS: Fifty-one patients underwent SLN biopsy after neoadjuvant chemotherapy from 1994 to 1999. The SLN identification rate improved from 64.7% to 94.1%. Twenty-two (51.2%) of the 43 successfully mapped patients had positive SLNs, and in 10 of those 22 patients (45.5%), the SLN was the only positive node. Three patients had false-negative SLN biopsy; that is, the sentinel node was negative, but at least one nonsentinel node contained metastases. Additional processing revealed occult micrometastases in four patients (three in sentinel nodes and one in a nonsentinel node). CONCLUSION: SLN biopsy is accurate after neoadjuvant chemotherapy. The SLN identification improved with experience. False-negative findings occurred at a low rate throughout the series. This technique is a potential way to guide the axillary treatment of patients who are clinically node negative after neoadjuvant chemotherapy.     

Her-2/neu expression in locally advanced breast carcinomas: pre- and post-neoadjuvant chemotherapy

Clinical studies have shown a correlation of HER-2/neu amplification/over-expression and favorable response to neoadjuvant chemotherapy and anti-HER-2/neu antibody treatment. However, contradictory findings also have been reported. Some tumors may develop resistance to neoadjuvant chemotherapy after an initial period of sensitivity. Our study attempts to evaluate the effects of neoadjuvant chemotherapy on HER-2/neu status in locally advanced breast cancer. Thirty-nine patients with locally advanced breast cancers established by core needle biopsy received neoadjuvant chemotherapy and were compared with 60 patients with breast cancers who did not receive neoadjuvant chemotherapy. IHC for HER-2/neu was performed on paraffin sections of the core biopsy before treatment and the excised specimen following chemotherapy and scored as Negative (0-1+), 2+ and 3+. The results of the study and the controls were compared and analyzed using Fisher's exact test. HER-2/neu IHC scores decreased in 28.5% (15/39) of patients receiving neo-adjuvant chemotherapy compared to 11.7% (7/60) of patients in the control (p < 0.013). HER-2/neu IHC status changed from strongly positive to negative (3+ to 0) in five of 39 (12.5%) in the study group and in 2 of 60 (3.3%) in control group (p = 0.104). For patients receiving neoadjuvant chemotherapy in whom the tumor becomes refractory to chemotherapy or recurs, repeat testing for HER-2/neu status may be necessary. Elimination of HER-2/neu positive tumor cells may account for the changes in the IHC scores and the development of resistance to neoadjuvant chemotherapy.     

BCRP和Ki-67与乳腺癌新辅助化疗疗效的关系

目的:探讨乳腺癌组织中乳腺癌耐药蛋白(breast cancer resistance protein,BCRP)和Ki-67的表达与新辅助化疗疗效之间的关系.方法:回顾性分析我科2012 年10月至2014年8 月收治的Ⅱ-Ⅲ期乳腺癌新辅助化疗患者65例,采用免疫组化方法检测BCRP和Ki-67的表达,分析BCRP、Ki-67的表达水平与新辅助化疗疗效的关系.结果:原发性乳腺癌组织中BCRP的阳性表达率为67.7%.BCRP的表达水平与新辅助化疗后病理组织学反应有关,组织学显著反应组(病理反应4~5级)BCRP的表达水平明显低于非显著反应组(病理反应1~3级),差异有统计学意义(x2=12.77,P=0.001).化疗前Ki-67高表达组临床缓解率明显高于低表达组(x2=17.72,P<0.00). 结论: 联合检测乳腺癌组织中BCRP和Ki-67 的表达水平对新辅助化疗疗效有一定的预测价值.     

影响乳腺癌新辅助化疗后病理完全缓解的临床因素分析

目的:探讨影响乳腺癌新辅助化疗后病理完全缓解（pathological complete response,pCR）的临床因素。方法:回顾分析新辅助化疗并行根治性手术的120例女性乳腺癌患者的临床资料;所有患者均接受6~8周期EC-T方案化疗,化疗结束后2~4周行根治性手术。采用χ2检验及 Logistic 回归分析影响pCR和非pCR的临床因素。结果:疗效结果单因素分析显示:T分期、N分期、乳腺癌分子分型、治疗前Ki-67表达水平、治疗前血小板水平与乳腺癌新辅助化疗后肿瘤pCR率显著相关。Logistic二元回归分析发现乳腺癌非Luminal分子亚型和新辅助化疗前高血小板水平是影响乳腺癌新辅助化疗后pCR的独立预测因素。结论:乳腺癌非Luminal分子亚型和新辅助化疗前高血小板水平是影响乳腺癌新辅助化疗后pCR的决定性因素。     

CDK8与CD133在乳腺癌新辅助化疗疗效评价中的作用

目的  探讨CDK8与CD133在乳腺癌新辅助化疗疗效评价中的作用。 方法 选择2016年1月至2017年12月,徐州市中心医院临床Ⅱ、Ⅲ期原发性乳腺癌患者40例,行空芯针穿刺活检,病理证实为乳腺癌后予新辅助化疗至少3个周期,用免疫组化和蛋白质印迹法检测化疗前后标本CDK8与CD133的变化。 结果 新辅助化疗前后,TNM分期、肿瘤直径大小、淋巴结转移个数相比,差异有统计学意义（P＜005）。CDK8与CD133在乳腺癌中高表达,新辅助化疗后乳腺癌组织CDK8与CD133表达减少;癌旁正常乳腺组织及纤维腺瘤组织CDK8和CD133表达量均低于新辅助化疗前乳腺癌组织（均P＜005）。新辅助化疗前后,CDK8和CD133变化一致,且与疗效变化一致。 结论 CDK8与CD133可作为新辅助化疗疗效预测因子。     

乳腺癌新辅助化疗前后Ki-67、HER-2、ER和PR的变化与临床缓解率的关系

目的 比较新辅助化疗前后的乳腺癌患者肿瘤组织中Ki-67、HER-2、ER和PR的改变,探索其变化与临床缓解情况之间的关系。方法 回顾性收集接受新辅助化疗的乳腺癌患者103例,本次观察前均未行任何放疗、化疗和内分泌治疗。化疗前接受14 G空心针刺活检诊断为局部浸润性导管癌或小叶癌。患者经4个周期化疗后94例患者接受手术切除。化疗前后的肿瘤组织采用福尔马林固定,石蜡包埋病理切片法,免疫组化染色法检测化疗前后肿瘤组织中Ki-67、HER-2、ER和PR的变化情况。采用WHO标准评价化疗后的临床缓解率。结果 103例病例经新辅助化疗后有9例发生转移,94例经化疗后进行了手术治疗。术前穿刺和术后肿瘤组织切片染色比较,Ki-67、ER和PR表达发生了明显的改变,而HER-2的前后变化差异不显著。但是,仅Ki-67的表达变化与肿瘤缓解率的关系显著。结论 在乳腺癌的新辅助治疗中,Ki-67的变化可能作为预测新辅助化疗肿瘤缓解率的一个指标,对临床用药和化疗结局有一定的指示作用。     

Do Decreased Breast Microcalcifications After Neoadjuvant Chemotherapy Predict Pathologic Complete Response?

BackgroundClinical response evaluation by image examination after neoadjuvant chemotherapy for breast cancer is important for determining drug response and progression. Mammography is less correlated with pathologic response assessment than magnetic resonance imaging or ultrasonography. The present study clarified characteristics of breast cancer patients with decreased microcalcifications after neoadjuvant chemotherapy to increase the accuracy of mammographic assessment.Patients and MethodsConsecutive patients who received neoadjuvant chemotherapy for breast cancer at our hospital from January 2013 to June 2017 were retrospectively reviewed. Characteristics of cases of microcalcifications before neoadjuvant chemotherapy and those showing a reduction after were examined. Stromal tumor-infiltrating lymphocytes were evaluated in the biopsy. Pathologic complete response was also explored in patients exhibiting a decrease in microcalcifications by neoadjuvant chemotherapy.ResultsSeventy breast cancer cases were included; 37 had no malignant microcalcifications before neoadjuvant chemotherapy and 33 did. Breast cancer with microcalcifications was significantly more positive for human epidermal growth factor receptor 2 than those without microcalcifications (48% vs. 22%, P = .018). Only 6 of 33 patients with microcalcifications before neoadjuvant chemotherapy showed a decrease after treatment. These patients tended to have high stromal tumor-infiltrating lymphocytes (50% vs. 17%), segmental microcalcifications (66% vs. 33%), and pleomorphic/linear microcalcifications (83% vs. 37%).ConclusionThese results suggest that neoadjuvant chemotherapy is able to decrease malignant calcifications, particularly segmental and pleomorphic/linear microcalcifications. By clarifying the mechanisms of formation and disappearance of microcalcifications, a consensus can be reached on whether microcalcifications apparent by mammography are useful for evaluating response to neoadjuvant chemotherapy.     

乳腺癌新辅助化疗中MCM7和C—erbB-2的表达及其临床意义

目的：探讨乳腺癌新辅助化疗前后MCM7和C—erbB-2蛋白的表达状况,分析其与化疗疗效的关系。方法：采用免疫组化法检测55例乳腺癌新辅助化疗前后标本中MCM7和C—erbB-2的表达。结果：新辅助化疗有效率为76．4％。化疗前MCM7蛋白阳性表达显著高于化疗后（P〈0．01）,而化疗前后C—erbB-2蛋白阳性表达差异无显著性（P〉0．05）。化疗有效组（42例）MCM7蛋白阳性表达显著高于无效组（13例）（P〈0．01）,而化疗有效组C—erbB-2蛋白阳性表达显著低于无效组（P〈0．01）。结论：ET方案新辅助化疗有较好的疗效,可能通过抑制MCM7蛋白表达来阻止乳腺癌细胞的增殖。MCM7高表达,C—erbB-2阴性者化疗更为敏感,二者可作为临床指导乳腺癌化疗并预测化疗敏感性的分子生物学指标。