Improved survival of patients with metastatic breast cancer receiving combination chemotherapy

Groups of patients with newly diagnosed metastatic breast cancer who were consecutively registered into a breast cancer clinic beginning January 1956 (210 patients), January 1966 (210 patients), and January 1975 (251 patients), were analyzed to determine the impact on survival of the various treatment modalities utilized in each decade. Comparisons of survival were made among subgroups of patients with similar prognostic features. Except for patients with very poor performance status, all subgroups showed a significantly improved survival in the 1970s compared with the earlier decades. Combination chemotherapy was considered to be the major factor in the survival improvement.     

Direct laryngoscopic observations in progressive hoarseness of voice

Hoarseness is a common disorder of voice which indicates abnormality at the level of glottis. We present our study of forty cases of progressive hoarseness of voice who underwent direct laryngoscopy during a period of January 2003 to January 2004 in our hospital. The observations were recorded und the data was evaluated.     

食管黏膜延长胃浆肌层包套吻合术在颈部消化道重建中的应用

目的探讨食管黏膜延长胃浆肌层包套吻合术在颈部消化道重建中预防吻合口三大并发症的作用。方法自2007年1月至2009年1月共行左颈部食管黏膜延长胃浆肌层包套吻合术治疗食管胸中、上、颈段癌286例。结果无一例吻合口瘘、狭窄及手术死亡,返流性食管炎2例。结论食管黏膜延长胃浆肌层包套吻合术用于食管癌切除颈部消化道重建,操作简单,安全有效。     

成人髓母细胞瘤11例临床分析

背景与目的:髓母细胞瘤是好发于儿童的恶性的胚胎性神经上皮肿瘤,成人则较为少见。本文总结报道成人髓母细胞瘤的诊治方法及治疗效果。方法:回顾性分析本院2003年1月至2010年1月的11例成人髓母细胞瘤的临床表现、影像学特点、治疗措施并进行随访。结果:11例表现为颅内压增高和小脑功能受损症状。均行MR检查,位于小脑蚓部4例,小脑半球4例,小脑蚓部+小脑半球2例,桥小脑角1例。表现为T1低或稍低信号,T2和水抑制多为高或稍高信号,增强肿瘤不均匀中度强化。行手术全切除6例,次全切除5例。术后病灶局部加全中枢神经系统放疗+化疗6例,行头颅病灶局部放射治疗1例。7例患者获术后定期MR检查、随访1～8年,3例失访,1例术后放弃治疗出院。术后MR复查证实中枢神经系统原位复发并脊髓转移2例。术后2年生存率100%,5年生存率50%。结论:成人髓母细胞瘤发病率低,临床表现及放射学特点与儿童髓母细胞瘤有许多不同点,诊断相对困难,综合治疗是主要治疗手段,治疗效果不理想。     

Angiosarcoma of the breast: the experience of the European Institute of Oncology and a review of the literature

Angiosarcoma of the breast (AB) is a rare entity: its overall incidence is estimated at between 0.002% and 0.005% per year. Some potential risk factors have been described, mainly previous irradiation of the breast. We report the experience of the European Institute of Oncology with this unusual disease from January 1996 to January 2006: sixteen patients with angiosarcoma, 9 (56%) of whom had primary AB and 7 (44%), secondary AB, are discussed.     

Omitting axillary dissection: could we offer a more tailored management to elderly patients with breast cancer?

Breast Cancer Research and Treatment - We retrospectively reviewed the data from patients ≥ 70 years old treated between January 2012 and January 2017. Axillary staging was scarcely used in...     

~（18）F-FDG PET-CT延迟显像对肺部炎性假瘤诊断价值的研究

目的探讨18F-FDG PET-CT延迟显像对肺部炎性假瘤诊断价值。方法回顾我科自2006年1月至2011年1月,经手术病理证实为炎性假瘤42例患者,在手术前经PET-CT全身常规和注射后3 h肺部延迟显像检查,测定两次显像病灶的标准摄取值（SUVmax）,并计算18F-FDG的储留指数（RI）。18F-FDG PET-CT诊断炎性假瘤预测性标准：（1）1.4〉SUVmax〉0.5;（2）1.25 mm薄层CT图像形态学征象。18F-FDG PET/CT诊断炎性假瘤回顾性标准：（1）1.4〉常规SUVmax〉0.5,18F-FDGRI〈5%;（2）2.5≥常规SUVmax≥1.4,18F-FDG RI〈8;（3）4≥常规SUVmax≥2.5,18 F-FDG RI〈10;（4）常规SUVmax〉4,18F-FDG RI〈15;（5）1.25 mm薄层CT图像形态学征象。把应用以上两种诊断标准做出的诊断结果相比较。结果应用预测性诊断标准,22例PET/CT影像诊断结果与病理相符合,8例被误诊断为结核球,12例被误诊断为肺癌。诊断正确率为52.3%。应用回顾性诊断标准,34例PET/CT影像诊断结果与病理相符合,1例被误诊为结核球,7例被误诊为肺癌。诊断正确率为80.9%。结论 18F-FDG PET-CT延迟显像有助于对炎性假瘤的检出,结合应用SUVmax及RI两项指标可提高诊断正确率。     

绿茶与消化系统恶性肿瘤流行病学研究的Meta分析

[目的]探讨绿茶与消化系统恶性肿瘤发生的关系。[方法]利用MEDLINE、EM-BASE、中国生物医学文献数据库、万方数据库,检索1979年1月～2010年1月国内外公开发表的关于绿茶与消化系统恶性肿瘤关系的病例对照研究和队列研究文献,利用R软件及其Meta程序包对检索结果进行综合分析。[结果]纳入本次Meta分析的文献共83篇。经Meta分析综合后,与不饮绿茶或饮绿茶较少者相比,饮绿茶较多者的相对危险度值及其95%可信区间为0.88(95%CI:0.81～0.95)。其中绿茶可以降低胃癌的发病风险,合并RR为0.73(95%CI:0.57～0.93),有统计学意义;绿茶对食管癌、结肠癌、胰腺癌的保护作用没有统计学意义,其合并RR分别为0.89(95%CI:0.71～1.13),0.96(95%CI:0.84～1.10),0.73(95%CI:0.45～1.19);而肝癌的结果0.77(95%CI:0.57～1.03)处于临界统计学意义的水平。此外,亚组分析提示绿茶对女性食管癌有保护作用,合并RR为0.32(95%CI:0.17～0.59)。绿茶与直肠癌合并的RR为1.10(95%CI:0.97～1.24),结果没有统计学意义。[结论]绿茶与消化系统恶性肿瘤之间有比较密切的关系,可能是胃癌、肝癌、食管癌(女性)等消化系统恶性肿瘤的保护因素之一。     

乳腺癌组织瘦素与凋亡调节因子表达相关性的研究

目的:探讨在乳腺癌病理组织中瘦素表达与凋亡调节因子Survivin、Bcl-2和BAX表达的相关性。方法:选取首都医科大学附属北京友谊医院普外科2003-01-2005-01,接受手术切除的102例乳腺癌患者的组织标本蜡块,免疫组织化学方法测定组织中Leptin和Sur-vivin、Bcl-2、BAX的表达。统计分析leptin与Survivin、Bcl-2、BAX在乳腺癌组织中表达的相关性,以及它们与乳腺癌临床病理特征的相关性。结果:瘦素在乳腺癌中表达与肿瘤大小(r=0.246,P=0.013)、淋巴结转移(r=0.209,P=0.035)和远处转移(r=0.215,P=0.030)呈正相关;Survivin在乳腺癌组织中表达与肿瘤大小(r=0.313,P=0.001)、远处转移(r=0.204,P=0.040)呈正相关;Bcl-2在乳腺癌组织中表达与肿瘤大小(r=0.246,P=0.013)、淋巴结转移(r=0.287,P=0.003)呈正相关。瘦素与Survivin(r=0.247,P=0.012)、Bcl-2(r=0.230,P=0.020)在乳腺癌组织中表达呈正相关。结论:在乳腺癌组织中,瘦素的表达...     

Radiation therapy of carcinoma of the nasal vestibule

Between January 1968 and January 1978, 46 patients were treated radiotherapeutically for carcinoma of the nasal vestibule in the Rotterdamsch Radio-Therapeutisch Instituut. In 32 patients who received electron-beam therapy the treatment results appear to be dependent on tumour dose, tumour size, tumour localisation and degree of differentiation. Both the use of tissue equivalent filling in the nasal cavity and an interval during radiation treatment have no influence on the treatment results.     

From evidence to practice: Audit of adjuvant chemotherapy after complete resection of non-small cell lung cancer in an Australian lung cancer center

Objective: To investigate patterns in the rate of referral and uptake of platinum‐based adjuvant chemotherapy following resection of non‐small cell lung cancer (NSCLC) after recent landmark evidence‐based publications. Design and setting: An audit of all patients who underwent complete resection of NSCLC by a specialist thoracic surgeon between 1 January 2002 and 31 December 2004. Results of several randomised trials of adjuvant therapy (including the largest ever multicentre trial) were reported during this period and confirmed an overall and disease‐free survival benefit. Patients: One hundred and twenty‐six adult patients who underwent complete resection of histologically confirmed NSCLC between 1 January 2002 and 31 December 2004. Main outcome measure: Percentage of patients referred, commencing and completing platinum‐based adjuvant chemotherapy between January and June 2002, July and December 2002, January and June 2003, July and December 2003, January and June 2004, and July and December 2004. Results: Of patients who underwent complete resection of NSCLC in each of the 6‐month intervals, 0.0%, 3.4%, 30.8%, 52.2%, 58.8% and 68.3% were referred for adjuvant chemotherapy, respectively. Treatment delivery rates were 0.0%, 3.4%, 7.7%, 30.4%, 29.4% and 36.8%, respectively. The most common reason for failing to receive adjuvant chemotherapy after referral was excessive risks compared with benefits of treatment as perceived by the medical oncologist and/or patient. Conclusion: Both rate of referral and utilization of platinum‐based adjuvant chemotherapy have increased with successive publications of evidence of survival benefit. Further improvements may be possible by routine referral policy, earlier timing and choice of regimen.     

５２例原发性口腔黏膜恶性黑色素瘤的临床分析

目的　探讨影响原发性口腔黏膜恶性黑色素瘤临床预后的相关因素。方法　收集２００４年１月至２０１０年１月５２例原发性口腔黏膜恶性黑色素瘤患者的临床病理资料,采用Ｋａｐｌａｎ-Ｍｅｉｅｒ法分析临床病理因素与预后的关系。结果　５２例患者中,４２例Ｔ３患者的平均生存时间为４８.４个月,１０例Ｔ４ａ患者为１１.３个月,差异有统计学意义（Ｐ＜０.００１）;３２例Ｎ０患者的平均生存时间为５０.０个月,２０例Ｎ１患者为２９.８个月,差异有统计学意义（Ｐ＝０.００４）;１７例Ⅲ期患者的平均生存时间为５５.９个月,３５例Ⅳ期患者为３４.８个月,差异有统计学意义（Ｐ＝０.００７）;４０例接受化疗的患者平均生存时间为４７.８个月,而未接受化疗者为１９.０个月,差异有统计学意义（Ｐ＝０.０１）。口腔黏膜恶性黑色素瘤的临床分期、化疗与否及综合治疗方案均与预后相关,而原发灶的处理方式、颈淋巴结清扫术与预后无关。结论　口腔黏膜恶性黑色素瘤治疗提倡综合序列治疗,化疗为主要的辅助治疗手段,可以延长患者的生存时间。     

垂体瘤卒中的诊断和治疗(附32例报告)

1990年1月至1996年1月我科共收治32例垂体腺瘤卒中病人，占同期垂体腺瘤病人的6.4％。临床主要表现头痛、恶心呕吐、视功能障碍、眼肌麻痹和意识障碍。内分泌学检查部分病人有垂体功能低下，影像学检查显示垂体腺癌和颅内出血。本文就垂体腺瘤卒中病人的病因、诊断及治疗原则进行了讨论。     

Hepatoid adenocarcinoma of the stomach

Received: January 9, 2001 / Accepted: March 13, 2001     

乳腺癌患者术后满意度影响因素的有序logistic分析

目的研究社会人口学及临床因素与乳腺癌患者术后满意度的关系。方法随机选取2004年1月至2006年1月天津肿瘤医院收治的500例Ⅰ-Ⅱ期乳腺癌患者进行横断面问卷调查。患者在本院完成保乳手术或改良根治术，年龄24～75岁，平均48．5岁。采用乳腺癌患者一般情况调查表进行问卷凋查，用有序logistic回归分析与患者术后恢复满意度有关的社会人口学（包括年龄、收入、文化程度等）及临床相关因素。结果量表的回收率是97．6％，有效的量表468份。手术方式是患者术后形体满意度的影响因素（P〈0．05）；在上肢恢复情况方面，收入（P〈0．05）和手术方式（P〈0．05）是重要的影响因素：结论保乳手术后患者的形体和上肢恢复满意度均高于根治术患者，另外收入水平通过影响患者对治疗方式的选择而间接影响患者的上肢恢复情况；应针对这些因素采取进一步的措施以提高患者术后的满意度。     

食管神经内分泌癌90例临床预后分析

[目的]探讨食管神经内分泌癌的临床特点、治疗方法及预后。[方法]回顾性分析1995年1月至2011年1月间收治的90例食管神经内分泌癌的临床和随访资料。[结果]全组患者中位生存时间为10.0个月;1、3、5年生存率分别为44.6%、21.6%和14.4%。局限期患者中位生存时间为11.5个月,广泛期患者中位生存时间为6.0个月,差异有统计学意义（P〈0.05）。局限期患者接受单一治疗、综合治疗的中位生存时间分别为9.8个月和16.7个月,差异有统计学意义（P〈0.05）。[结论]食管神经内分泌癌恶性程度高、预后差,综合治疗较单一治疗方案可提高患者生存率。     

Management of laryngo-tracheal stenosis by shiann - yann lee technique

Laryngotracheal stenosis is a partial or complete cicatricial narrowing of endolarynx or trachea. It has became mare common for two reasons; first, increasing prolonged endotracheal intubations for mechanical ventilation, secondly, increase in trauma to anterior part of neck due to vehicular accidents. We present our study of 30 cases of laryngotracheal stenosis operated by ‘Shiann Yann Lee’s technique with T tube stealing from January 1997 to January 2003. In our experience this is relatively simple technique with higher success rate of decannulation.     

多西紫杉醇联合替吉奥胶囊治疗晚期食管胃交界腺癌的临床观察

目的:探讨多西紫杉醇联合替吉奥胶囊治疗晚期食管胃交界腺癌的临床疗效和不良反应。方法:2009年1月—2011年1月经病理学确诊的58例晚期食管胃交界腺癌患者接受多西紫杉醇联合替吉奥胶囊治疗:多西紫杉醇35mg/m2静脉注射d1和d8,替吉奥胶囊胶囊每天70mg/m2d1～14,每3周为1个化疗周期。每2个化疗周期评价近期疗效。每个化疗周期后评价不良反应。对所有患者进行随访,评估生存情况。结果:58例患者均可评价疗效,其中完全缓解5例(8.6%)、部分缓解21例(36.2%),疾病稳定18例(31.0%),疾病进展14例(24.1%),有效率为44.8%(26/58)。中位TTP为8.0个月,MST为10.5个月。主要不良反应包括骨髓抑制、口腔炎、手足综合征和胃肠不良反应等。Ⅲ～Ⅳ级中性粒细胞减少发生率为25.9%(15/58)。结论:多西紫杉醇联合替吉奥胶囊治疗晚期食管胃交界腺癌的近期疗效较好,不良反应可以耐受。     

乳腺癌术后患者心理状态评估及干预策略改进(英文)

Objective: The aim of the study was to investigate the level of self-image of patients after breast cancer surgery, and explore factors influencing self-image among patients who have experienced different types of surgeries, and set out a foundation for the improvement of care strategies. Methods: The 538 patients with primary breast cancer who underwent surgery in the Department of Breast Surgery, First Hospital of China Medical University, Shenyang, China, from January 2004 to January 2009 were included i...     

Predictive Role of GSTs on the Prognosis of Breast Cancer Patients with Neoadjuvant Chemotherapy

Objective: To evaluate the predictive value of GST gene polymorphisms with regard to prognosis of breastcancer patients receiving neoadjuvant chemotherapy. Methods: A total of 159 patients were included in our studybetween January 2005 and January 2007. All the patients were followed up until January 2012. Genotypingwas based upon the duplex polymerase-chain-reaction with the PCR-CTPP method. Results: Patients withnull GSTM1 and GSTP1 Val/Val genotypes had significantly had better response rates to chemotherapy whencompared with non-null GSTM1 and GSTP1 Ile/ Ile genotypes (OR=1.96 and OR=2.14, respectively). Patientswith the GSTM1 null genotype had a longer average survival time and significantly lower risk of death thandid those with non-null genotypes (HR=0.66). Similarly, those carrying the GSTP1 Val/Val genotype had 0.54-fold the risk of death of those with GSTP1 Ile/ Ile (HR=0.54). Conclusion: A significant association was foundbetween GSTM1 and GSTP1 gene polymorphisms and clinical outcomes in breast cancer cases.