结直肠癌树突状细胞浸润及癌周淋巴细胞反应与预后的关系

目的研究结直肠癌树突状细胞（ＤＣ）浸润和癌周淋巴细胞反应的关系及对预后的影响．方法１９８０年～１９８７年结直肠癌手术７１例，均有随访记录，癌及癌周组织采用Ｓ－１００蛋白抗体ＡＢＣ免疫组化染色，行ＤＣ计数．结果术后生存期≥５年者癌组织ＤＣ数量（５７６７／ｍｍ３±１３３８／ｍｍ３）明显高于＜５年者（３０５９／ｍｍ３±９３１／ｍｍ３）（Ｐ＜００１）．癌周淋巴细胞反应强度和癌组织ＤＣ浸润密度及５年生存率密切相关．结论结直肠癌癌组织ＤＣ浸润密度和癌周淋巴细胞反应强度反映了机体抗肿瘤免疫力，是估计预后的良好指标．     

耐多药相关蛋白在人非小细胞肺癌组织中的表达

目的　检测人非小细胞肺癌组织中耐多药相关蛋白（ＭＲＰ） 的表达,探讨其与瘤组织学类型、分化程度、临床分期及预后的关系。方法　采用免疫组化方法及逆转录聚合酶链反应（ＲＴＰＣＲ）技术,分别检测了９２ 份人非小细胞肺癌石蜡组织中ＭＲＰ的表达及１６ 份人非小细胞肺癌新鲜组织中ＭＲＰ基因的表达。结果　９２ 份人非小细胞肺癌组织中（ 鳞癌４３ 例,腺癌４９ 例）ＭＲＰ表达阳性检出率为５４％（５０／９２） ,１６ 份人非小细胞肺癌组织中ＭＲＰ基因表达阳性检出率为３１％ （５／１６）。ＭＲＰ在腺癌中的表达阳性率明显高于鳞癌（ Ｐ＜ ０－０５） ,ＭＲＰ表达与瘤分化程度、肿瘤大小及淋巴结转移无显著相关。ＭＲＰ阳性患者术后５ 年生存率为１６％ （８／５０）,ＭＲＰ 阴性患者术后５ 年生存率为５２％ （２２／４２） ,二者经统计学处理,差异有显著性（ Ｐ＜ ０－０５）。ＭＲＰ阳性患者术后５ 年生存率有随其瘤组织中该蛋白表达阳性程度的增加而降低之趋势。结论　非小细胞肺癌患者瘤组织中ＭＲＰ的表达与瘤组织学类型及预后明显相关。     

非小细胞肺癌组织蛋白酶D的表达及与预后的关系

目的探讨组织蛋白酶Ｄ（ＣＤ）表达与肺癌患者预后的关系。方法采用链霉抗生物素蛋白－过氧化物酶（Ｓ－Ｐ）快速免疫组织化学法检测非小细胞肺癌（ＮＳＣＬＣ）患者肺癌组织和配对淋巴结标本中ＣＤ表达。结果６６％（４２／６４）的肺癌组织ＣＤ表达阳性，其中鳞癌为５７％（１７／３０），腺癌为７４％（２５／３４）。在３５例转移淋巴结标本中，２０例５７％ＣＤ阳性。Ⅲ～Ⅳ期肺癌病例中，肺癌组织ＣＤ表达高于Ⅰ～Ⅱ期病例（Ｐ＜０．０５）。腺癌伴有淋巴结转移组，ＣＤ表达显著高于淋巴结阴性组（Ｐ＜０．０１）。结论肺癌组织ＣＤ高表达与肿瘤临床分期和腺癌的淋巴结转移关系密切，ＣＤ有可能作为ＮＳＣＬＣ患者的预后指标。     

人肝癌中p16和CDK4基因的遗传变异及其与HBV感染之间的关系

目的探讨抑癌基因ｐ１６和癌基因ＣＤＫ４的遗传变异在人肝癌发生发展中的作用及其相互关系以及与ＨＢＶ感染之间的关系。方法取手术切除的肝癌标本,用Ｓｏｕｔｈｅｒｎ杂交法对ｐ１６和ＣＤＫ４基因以及ＨＢＶ的状态进行检测,同时切片行病理检查。结果３６例肝癌中４例有ｐ１６纯合性缺失,３例半合子丢失,总丢失率为１９．４％,其中约１／３的ｐ１６丢失发生在肿瘤小于５ｃｍ的肝癌;在有ＨＢＶ－ＤＮＡ整合和无整合的病例中,ｐ１６的丢失率差异无显著性。３７例肝癌中５例（１３．２％）发生ＣＤＫ４扩增,与ｐ１６的丢失无重叠;ＣＤＫ４的扩增全部发生在有ＨＢＶ整合的肝癌中。结论ｐ１６的丢失在部分肝癌的发生发展中起着一定的作用,但与ＨＢＶ－ＤＮＡ的整合无关;ＣＤＫ４的扩增可能与ＨＢＶ－ＤＮＡ的整合以及肝癌的进展有关。     

Ⅲa期非小细胞肺癌综合治疗的远期效果

对胸外科１９７９至１９９１年底手术切除的７８８例Ⅲａ期非小细胞肺癌（ＮＳＣＬＣ）的治疗结果进行分析。同时，将全组中３１６例综合治疗与４７２例单纯手术病例作对经丛组５年生存率１５．３％，综合治疗组５年生存率２３．０％，单纯手术组５年生存率１０．０％。综合治疗组５年生存率：鳞癌２６．６％，腺癌２２．８％。单纯术手术组５年自下而上率：鳞癌１４．１％，腺癌９．９％。本文分析表明：Ⅲａ期ＮＳＣＬＣ综合治疗住     

影响慢性阻塞性肺疾病患者预后因素的探讨

目的探讨影响慢性阻塞性肺疾病（ＣＯＰＤ）患者预后的因素。方法对１９７７年７月～１９９２年６月住院的８８例ＣＯＰＤ患者进行５～２０年随访。８８例患者中吸烟者占７７％，从事厨房劳动女性１３％。首诊均经右心漂浮导管检测，肺动脉平均压（ｍＰＡＰ）＜２０ｍｍＨｇ（１ｍｍＨｇ＝０．１３３ｋＰａ）。在随访期进行肺通气功能、血压、心电、血流动力学、夜间动脉血氧饱和度（ＳａＯ２）等监测，每５年重复一次。结果２０年随访共死亡３８例，病死率５年为６％、１０年为２５％、２０年为４３％。肺通气功能及动脉血氧分压逐年下降，二氧化碳分压逐年上升，首诊时ｍＰＡＰ为１６～２０ｍｍＨｇ的４１例中，１０年随访复查２０例ｍＰＡＰ＞２０ｍｍＨｇ，１５例死亡。夜间ＳａＯ２下降者（１６／３０）中，ｍＰＡＰ＞２０ｍｍＨｇ者８例，死亡６例。８８例患者痰中培养出致病菌５７株，死亡者占４３株。结论吸烟、厨房油烟污染、反复呼吸道感染、夜间ＳａＯ２下降，ｍＰＡＰ＞１６ｍｍＨｇ为影响ＣＯＰＤ预后的危险因子。     

急性呼吸窘迫综合征患者的血液及肺组织中血管内皮细胞标 …

目的 观察急性呼吸窘迫综合征（ＡＲＤＳ）患者的血管内皮细胞标记物改变。方法 ＡＲＤＳ临床患者１３例,检测血中循环内皮细胞（ＣＥＣ）、血浆颗粒膜蛋白－１４０（ＧＭＰ－１４０）,内皮素（ＥＴ－１）和血管性假血友病因子（ｖＷＦ）含量并与１０例正常对照血标本测定值比较;另取ＡＲＤＳ患者尸检肺组织及正常对照肺组织各５例,以免疫组化方法检测肺组织ｖＷＦ含量。结果 ＡＲＤＳ患者ＣＥＣ计数、血浆ＧＭＰ－１４０、Ｅ     

165例III期小细胞肺癌的外科治疗评价

对胸外科１９７９年－１９９１年底经手术切除的１６５例ＩＩＩ期小细胞肺癌（ＳＣＬＣ）的治疗效果进行分析，并将其中的８７例综合治疗病例与７８例单纯手术病例进行对比讨论。同时，就综合治疗组中术前化学治疗和放射治疗对预后的影响做了观察。全组５年生存率占１６．６％。ＴＮＭ分期５年生存离ＩＩＩａ期达２０．４％，ＩＩＩｂ期为０。综合治疗５年生存率占２２．８％，单纯手术５年生存率占７．９％。结果提示：ＩＩＩａ期Ｓ     

老年人急性髓细胞白血病P-糖蛋白表达的临床意义

目的探讨Ｐ－糖蛋白（Ｐ－ｇｌｙｃｏｐｒｏｔｅｉｎ，Ｐ－ｇｐ）在初治老年人急性髓细胞白血病（ＡＭＬ）中的表达特点及其预后意义。方法采用流式细胞术（ｆｌｏｗｃｙｔｏｍｅｔｒｙ，ＦＣＭ）及抗Ｐ－ｇｐ细胞膜外区域单克隆抗体ＵＩＣ２检测了３７例初治老年人ＡＭＬ白血病细胞Ｐ－ｇｐ表达。结果１６例（４３％）患者Ｐ－ｇｐ阳性（Ｐ－ｇｐ＋），Ｐ－ｇｐ与干细胞或祖细胞抗原ＣＤ３４表达显著相关，与其它免疫表型无关。在可评估疗效的３２例中，Ｐ－ｇｐ＋１５例中的４例（２７％）获得完全缓解（ＣＲ），缓解率显著低于Ｐ－ｇｐ阴性（Ｐ－ｇｐ－）１７例中的１１例（６５％）（Ｐ＜０．０５）。ＣＤ３４阳性（ＣＤ３４＋）１４例中ＣＲ３例（２１％），也显著低于ＣＤ３４阴性（ＣＤ３４－）者１８例中１２例（６７％）（Ｐ＜０．０５）。Ｐ－ｇｐ－及ＣＤ３４－１３例中１１例（８５％）获得ＣＲ。结论Ｐ－ｇｐ阳性及ＣＤ３４阳性是老年人ＡＭＬ预后差的重要指标     

CF并DDP增效5-FU治疗晚期大肠癌21例

１９９６年２月～２０００年２月,我们应用甲酷四氢叶酸钙（ＣＦ）并顺铂（ＤＤＰ）增效５－氯脉嘧啶（５－ＦＵ）联合化疗治疗晚期大肠癌２１例,疗效较为满意。报告如下。 临床资料;本组男１５例,女６例;年龄３５～７０岁,平均５２岁;初治者６例,复治者１５例;均经病理或细胞学证实为晚期大肠癌。病理类型：管状腺癌１２例,粘液腺癌６例,乳头状腺癌３例。Ｄｕｋｅ’ｓ分期均为Ｄ期。 方法：ＣＦ２００ｍｇ／（ｍ２·ｄ）、ＤＤＰ２０ｍｇ／ｄ、５－ＦＵ３７５ｍｇ／（ｍ２．ｄ）静滴第１～５天。常规应用思丹西酮止吐,每周查血…     

手术切除肺腺癌患者免疫细胞浸润分析及预后关系

目的探究肺腺癌手术患者免疫细胞浸润模式及预后关系。方法基于GSE68465数据集,利用CIBERSORT软件包,对442例样本中22种免疫细胞进行定量分析,利用Survival包,Kaplan-Meier法分析22种免疫细胞含量与总生存率关系,利用Cox多变量回归分析构建肺腺癌手术患者免疫细胞预后风险模型,根据风险评分中位数,分为高风险组和低风险组,绘制Kaplan-Meier生存曲线和ROC曲线,评估模型的预测效果。结果肺腺癌组织浸润的免疫细胞主要有浆细胞、M2巨噬细胞和M0巨噬细胞,肺腺癌组织与正常组织免疫浸润存在显著差异。静息NK细胞与预后关系显著(P<0.05)。基于5种免疫细胞构建预后风险模型(Risk Score=8.156×静息NK细胞+9.059×活化CD4+记忆T细胞+3.899×活化肥大细胞+2.452×M0巨噬细胞+5.575×活化树突状细胞),高风险组较低风险组预后显著较差(P<0.0001),ROC曲线提示该风险模型具有较好的预后预测效果。结论免疫细胞浸润风险评分模型可以有效预测肺腺癌手术患者预后。     

Prognostic significances of tumor-infiltrating S-100 positive dendritic cells and lymphocytes in patients with hepatocellular carcinoma

BACKGROUND/AIMS: To investigate the prognostic significances of dendritic cells and lymphocytes infiltration in hepatocellular carcinoma. METHODOLOGY: The clinicopathological and follow-up data of 44 patients with hepatocellular carcinoma, who underwent curative resection of tumor in our hospital from January 1995 to July 1996, were collected. Immunohistochemical staining was employed to detect the S-100 positive dendritic cells in the tumor tissue, and lymphocytes infiltration was evaluated simultaneously. The relationship of the tumor-infiltrating dendritic cells and lymphocytes to the postoperative recurrence-free time and survival rate was analyzed. RESULTS: Either the tumor-infiltrating dendritic cells or the tumor-infiltrating lymphocytes alone had no significant relationship to the postoperative recurrence-free time and survival rate. By taking into consideration both tumor-infiltrating dendritic cells and lymphocytes simultaneously, the patients were classified into two groups. Group A included patients having dendritic cell counts > or = 20 cells/10 high power fields together with positive lymphocytes infiltration (n = 17), and group B consisted of patients having dendritic cell count > or = 20 cells/10 high power fields but with negative lymphocytes infiltration or dendritic cell count < 20 cells/10 high power fields with either positive or negative lymphocytes infiltration (n = 27). There were no significant differences in clinicopathological features between two groups. The recurrence-free time was markedly longer in group A as compared with group B, with a median time of 21.6 months for group A and 4.1 months for group B (P < 0.05). The 1-, 3-, 4-year survival rates were significantly greater in group A than those in group B, being 83.5% vs. 42.2%, 61.8% vs. 28.4% and 48.7% vs. 23.0%, respectively (P < 0.01). CONCLUSIONS: Marked infiltration of dendritic cells together with lymphocytes in tumor tissue was closely related to the improved clinical prognosis in patients with hepatocellular carcinoma, and represented as an independent prognostic factor.     

LKB1和VEGFR2评价肺腺癌预后的意义

目的探讨LKB1、VEGFR2在肺腺癌中的表达情况,分析其预后意义。方法应用免疫组化方法检测46例肺腺癌中LKB1、VEGFR2的表达情况。结果 LKB1在癌旁正常肺组织、淋巴结转移阴性组肺腺癌、Ⅰ～Ⅱ期肺腺癌中的表达阳性率明显高于肺腺癌组织、淋巴结转移阳性组肺腺癌和ⅢA期肺腺癌(82.61%vs 63.04%、75.00%vs 44.44%、75.00%vs35.71%),差异有统计学意义(P<0.05)。VEGFR2在癌旁正常肺组织、淋巴结转移阴性组肺腺癌、Ⅰ～Ⅱ期肺腺癌中的表达阳性率则明显低于肺腺癌组织、淋巴结转移阳性组肺腺癌和ⅢA期肺腺癌(34.78%vs 58.70%、46.43%vs 77.78%、46.88%vs85.71%),差异有统计学意义(P<0.05)。结论 LKB1、VEGFR2在肺腺癌中的表达情况可能与肺腺癌患者的预后有关,LKB1低表达、VEGFR2高表达可能提示预后不良。     

肺腺癌EGFR基因19、21外显子突变与临床病理特征及预后的关系

目的分析肺腺癌表皮生长因子受体(EGFR)基因19、21外显子突变与临床病理特征及预后的关系。 方法回顾性分析2017年1月至2018年6月100例经病理证实为肺腺癌的患者临床资料与标本,采用PCR-ARMS技术检测标本EGFR基因19、21外显子突变情况,分析EGFR基因突变与临床病理特征及预后的关系。 结果100例肺腺癌标本共检测出47例EGFR突变,突变率为47.00%,其中第19号外显子突变20例(42.55%),包括6种形式的突变,以核苷酸框架缺失为主,最常见的类型为核苷酸从2234-2248位缺失15bp的delE746-A750突变,共11例,占55.00%;第21号外显子突变27例(57.45%),包括5种形式的突变,均是碱基置换突变,最常见的类型为2573位点的T被G取代的L858R,共17例,占62.96%;女性、无吸烟史、临床分期Ⅰ期患者EGFR19与EGFR21突变率高于其他患者(P<0.05);Logisitic回归分析显示性别、吸烟史、肿瘤直径、临床病理分期是影响EGFR19、EGFR21突变的因素。100例肺腺癌患者全部获得有效随访,EGFR19突变患者2年无进展生存率、总生存率分别为80.00%、85.00%,未突变患者分别为65.00%、73.75%;EGFR21突变患者2年无进展生存率、总生存率分别为81.48%、92.59%,未突变患者分别为63.01%、69.86%;女性、临床分期较早、无淋巴结转移、发生EGFR21突变患者2年生存率低于其他患者(P<0.05);Logisitic回归分析显示男性、临床分期较晚、有淋巴结转移、EGFR21未突变是肺腺癌患者不良预后的独立危险因素。 结论肺腺癌EGFR基因19、21外显子突变与性别、吸烟史、肿瘤直径、临床分期有关,同时也是预测预后的有效方法。     

CEACAM5在肺腺癌中的表达及临床意义

目的 通过检测癌胚抗原相关细胞黏附分子5(CEACAM5)在肺腺癌中的表达,探究其临床意义及预后.方法 回顾性分析2016年8月-2017年8月在本院确诊为肺腺癌的患者51例,取肺腺癌患者病变肺部组织作为实验组;从中选取42例取癌旁组织作为对照组.采用免疫组化SP法检测肺部肺腺癌组织和癌旁组织CEACAM5的表达,并利...     

Prognosis of malignant intraductal papillary mucinous tumours of the pancreas after surgical resection. Comparison with pancreatic ductal adenocarcinoma

BACKGROUND: Although the prognosis in malignant resectable intraductal papillary mucinous tumours of the pancreas (IPMT) is often considered more favourable than for ordinary pancreatic ductal adenocarcinoma, the long term outcome remains ill defined. AIMS: To assess prognostic factors in patients with malignant IPMT after surgical resection, and to compare long term survival rates with those of patients surgically treated for ductal adenocarcinoma. METHODS: Seventy three patients underwent surgery for malignant IPMT in four French centres. Clinical, biochemical, and pathological features and follow up after resection were recorded. Patients with invasive malignant IPMT were matched with patients with pancreatic ductal adenocarcinoma, according to age and TNM stages; survival rates after resection were compared. RESULTS: Surgical treatment for IPMT were pancreaticoduodenectomy (n=46), distal (n=14), total (n=11), or segmentary (n=2) pancreatectomy. The operative mortality rate was 4%. IPMT corresponded to in situ (n=22) or invasive carcinoma (n=51). In the latter group, 17 had lymph node metastases. Overall median survival was 47 months. Five year survival rates in patients with in situ and invasive carcinoma were 88% and 36%, respectively. On univariate analysis, abdominal pain, preoperative high serum carbohydrate antigen 19.9 concentrations, caudal localisation, invasive carcinoma, lymph node metastases, peripancreatic extension, and malignant relapse were associated with a fatal outcome. Using multivariate analysis, lymph node metastases were the only prognostic factor (OR 7.5; 95% CI: 3.4 to 16.4). Overall five year survival rate was higher in patients with malignant invasive IPMT compared with those with pancreatic ductal carcinoma (36 v 21%, p=0.03), but was similar in the subset of stage II/III tumours. CONCLUSIONS: The prognosis of patients with resected in situ/invasive stage I malignant IPMT is excellent. In contrast, prognosis of locally advanced forms is as poor as in patients with pancreatic ductal adenocarcinoma.     

Outcome of surgical treatment of adenocarcinoma in Barrett''s oesophagus.

A retrospective study was performed of an 11 year period (1978-88) to analyse the survival of 112 patients (85 men and 27 women, mean age 63 years) with adenocarcinoma in a columnar lined (Barrett's) oesophagus in respect of surgical treatment, tumour staging, and histological grading. Presenting symptoms were dysphagia (60%) and pain (25%). Only six patients were previously known to have a columnar lined oesophagus. Eighty five patients (76%) underwent partial resection of the oesophagus and cardia. Postoperative mortality was 6%. After resection (n = 85), the 5 year survival was 24%. Survival was significantly better for patients without regional lymph node metastases (stage 0, I, IIA (n = 61): 5 year survival 30%) and even better if the tumour was restricted to the submucosa (stage 0, I (n = 12): 5 year survival 63%). Survival was not influenced by the histological grade of the tumour. Staging based on infiltration of the oesophageal wall and lymph node spread is valuable in determining the prognosis for patients with adenocarcinoma in Barrett's oesophagus.     

Long-term survival after multimodality treatment for resectable pancreatic cancer.

BACKGROUND: The prognosis of pancreatic adenocarcinoma after radical pancreatectomy is poor, especially in advanced-stage disease. STUDY AIM: To determine the survival rates and evaluate the effectiveness of multimodality treatment for advanced pancreatic cancer. METHODS: From November 1983 to January 1993, 30 patients with pancreatic adenocarcinoma including 9 with carcinoma of the body and tail were treated by a multimodal approach consisting of extended pancreatectomy, intraoperative radiotherapy (IORT), and hepatic artery or portal vein infusion of mitomycin C (MMC) followed by systemic bolus injection. All surviving patients were followed for more than 8 yr and survival rates were calculated by the Kaplan-Meier method. RESULTS: There were no operative or hospital deaths. Eight patients survived for more than 5 yr, 3 of whom survived more than 10 yr. The 5-yr survival rate for 27 patients excluding 3 with metastasis to the liver, peritoneum, or lung was 31%, with a median survival of 31.1 mo. Among them, the 1-, 3-, and 5-yr survival rates for 19 patients with regional nodal metastasis were 95, 50, and 28%, respectively, with a median survival of 36.0 mo. CONCLUSION: The multimodality treatment combined with IORT and MMC chemotherapy appeared to have a benefit for prognosis of advanced pancreatic adenocarcinoma.     

Surgical strategy for non-small cell lung cancer in octogenarians

BACKGROUND AND OBJECTIVES: This study was conducted to determine the optimal surgical strategy for octogenarians with non-small cell lung cancer. METHODS: An observational study of 73 patients aged 80 years and over who underwent surgery for non-small cell lung cancer. Postoperative survival, mortality and morbidity were analysed. RESULTS: The age of the patients ranged from 80 to 89 with a mean of 83. Cancer types included adenocarcinoma (n = 46), squamous cell carcinoma (n = 22) and large cell carcinoma (n = 5). Lobectomy was performed in 47 patients and limited surgery in 26. The 5-year survival rate was 57.4% in pathological stage I, 88.9% in stage II and 18.2% in stage III, respectively. The 5-year survival rate of patients with stage I disease treated by limited resection (58.8%) was similar to that of patients treated by lobectomy (54.9%). Limited resection for stage IA showed slightly better survival than lobectomy (69.4% vs 48.2%, P = 0.10), however, lobectomy was superior to limited resection for stage IB (63.2% vs 16.7%, P = 0.07). Postoperative complications occurred in 27 patients (37%) and nine patients (12%) had multiple complications. There were three postoperative deaths (4.1%). CONCLUSION: The early detection of the disease, hopefully in stage IA enables surgical treatment by limited resection of patients aged 80 years and over. A favourable prognosis as well as low morbidity can be anticipated in such cases.