^125I粒子植入联合支气管动脉化疗栓塞治疗非小细胞肺癌

目的 探讨^125I粒子植入联合支气管动脉化疗栓塞治疗非小细胞肺癌（NSCLC）的临床应用价值.方法 34例NSCLC患者,进行支气管动脉化疗栓塞治疗16例（A组）,^125I粒子植入联合支气管动脉化疗栓塞治疗18例（B组）,治疗后进行疗效评价及生存分析.结果 A、B两组治疗有效率分别75%和83.3%;中位生存时间分别为为7.4个月和12.6个月;6、12、24个月生存率分别为62.5%、37.5%、0%和83.3%、55.5%、22.2%,两组中位生存时间及6、12、24个月的生存率差异有统计学意义（P ＜ 0.05）.结论 125I粒子植入联合支气管动脉化疗栓塞是NSCLC的一种有效治疗方法,可以延长患者的生存时间.     

替尼泊苷联合奥沙利铂及氟尿嘧啶对胃癌患者术后辅助化疗疗效观察

目的:观察VOF方案(替尼泊苷+奥沙利铂+5-氟尿嘧啶)用于胃癌患者术后辅助化疗的治疗效果及不良反应.方法:胃癌根治术后应用VOF方案化疗者45例为VOF组,仅行根治术的41例胃癌患者为单纯手术组,比较2组生存率、中位总生存时间和无病生存时间以及药物不良反应.结果:VOF组和单纯手术组的1,3,5 a总生存率分别为88.9%,62.2%,37.8%和70.7%,46.3%,22.0%,中位总生存时间分别为52.8个月和24.9个月(P＜0.05);1,3,5 a无病生存率分别为77.8%,57.8%,31.1%和58.5%,34.1%,17.1%,中位无病生存时间分别为44.8个月和21.6个月(P＜0.05);VOF组患者白细胞计数减少、厌食及恶心、呕吐发生率分别为84.4%,68.9%,62.2%.结论:对胃癌患者术后应用VOF方案辅助化疗可明显提高术后生存率及无病生存时间,不良反应可耐受.     

腹腔热灌注化疗治疗晚期胃癌并恶性腹腔积液疗效观察

目的探讨体外循环恒温持续腹腔热灌注化疗治疗晚期胃癌并恶性腹腔积液的临床疗效。方法22例晚期胃癌并恶性腹腔积液患者,行体外循环恒温持续腹腔热灌注化疗,水温控制在42～43℃,灌注液为生理盐水3000mL,灌注药物为氟尿嘧啶＋顺铂,灌注时间90min,隔日1次,共治疗3次。结果22例患者均顺利完成腹腔热灌注化疗,其中完全缓解19例（86．36％）,部分缓解3例（13．64％）,有效率100％,临床获益率100％;主要不良反应为消化道不良反应和骨髓抑制。结论采用体外循环恒温腹腔热灌注化疗治疗晚期胃癌并恶性腹腔积液疗效确切,不良反应可耐受。     

绿脓杆菌制剂对人肝癌MHCC97L细胞增殖和侵袭能力的影响

Objective To investigate the effects of Pseudomonas aeruginosa vaccine (PA) on proliferation and invasiveness of the hepatocellular carcinoma cell line MHCC97L with metastatic potential. Methods Proliferation, growth curve, plate efficiency, flow cytometry, transwell invasion assay, cell motility assay, scarification test, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP2) protein activity were evaluated after cells were treated with PA at various concentrations. Results PA can inhibit the proliferation and plate efficiency of MHCC97L cell markedly in a dose-dependent manner. The IC50 of cells treated with PA for 48 h and 72 h was 3.1 ×108/ml and 1.9 × 108/ml, respectively. The doubling time increased and plate efficiency decreased gradually when cells treated with 0.5 × 108/ml, 1 × 108/ml and 2 × 108/ml PA (P＜0.01). PA could induce cell cycle arrest at the G1 phase in a dose-dependent manner by flow cytometric analysis. The average amount of invading cell per field in cell invasion assay and motility assay were 4. 8 ± 1.3 and 8. 8±2.2 when cells treated with 1× 108/ml PA, which was significantly lower than that of control group (8. 6±2. 1 and 15. 6±1.2 ) (P＜0.01) Scarification test showed that the metastatic ability of cells treated with 1 × 108/ml PA significantly lower than that in the control group. Comparison between cells treated with 1 × 108/ml PA and control group, no remarkable difference was found regarding expression of VEGF and MMP2 in supernatant of cell culture. Conclusion PA can inhibit proliferation and plate efficiency of HCC cell line MHCC97L, which is in part mediated by the cell cycle arrest at the G1 phase. PA could inhibit invasiveness of HCC cell line MHCC97L, which is unrelated to the VEGF and MMP2 protein activity.     

消炎痛抑制肝细胞肝癌生长转移的研究

目的 观察消炎痛(Indomethacin)对有转移潜能的人肝癌MHCC97L细胞增殖侵袭的影响和对裸鼠肝癌生长和转移的抑制作用.方法 (1)体外实验:采用0.2 mmol/L的消炎痛分别作用于MHCC97L细胞,观察细胞增殖、侵袭实验、运动实验和血管内皮生长因子(VEGF)和基质金属蛋白酶2(MMP-2)蛋白表达[酶联免疫吸附试验(ELISA)].(2)体内实验:建立转移性人肝癌裸鼠原位模型后,将裸鼠随机分为对照组和消炎痛组.6周后处死动物,测量肿瘤体积,计算抑瘤率、肺转移灶数目及肺转移率.免疫组织化学方法检测VEGF、MMP-2、环氧合酶-2(COX-2)蛋白的表达.结果 (1)体外实验:0.2mmol/L消炎痛明显抑制MHCC97L细胞增殖(P值均＜0.01),消炎痛组穿过人工基底膜(侵袭实验)和上室底膜(运动实验)的细胞数分别为2.2±1.3和4.4±1.1,明显低于对照组(11.4±1.9和12.8±1.8,P值均＜0.01);ELISA法检测发现,消炎痛组VEGF蛋白和MMP-2蛋白含量和对照组比较明显降低(P值均＜0.01).(2)体内实验:对照组、消炎痛组肿瘤体积分别为(1700 ±422)mm3 和(1170±585)mm3(P＜0.05),肺转移率分别为75%和50%(P＞0.05),平均肺转移灶数目分别为2.92±2.07和1.33±1.56(P＜0.05);与对照组比较,消炎痛组的抑瘤率为31.2%.免疫组织化学染色显示,消炎痛组VEGF、MMP-2、COX-2蛋白的表达和对照组比较均有降低(P值均＜0.01).结论 在一定条件下,消炎痛可抑制肝细胞肝癌的生长转移,其作用和抑制VEGF蛋白和MMP-2蛋白的表达有关.

Abstract：

Objective To study the effects of indomethacin on proliferation and invasion of hepatocellular carcinoma (HCC) cell line MHCC97L with metastatic potential and the effect of indomethacin on the growth and metastasis of HCC. Methods (1) In vitro; Proliferation, Transwell invasion assay, cell motility assay, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) protein activity were evaluated after cells were treated with 0. 2 mmol/L indomethacin. (2)In vivo: Mice bearing xenografts in the liver were randomly divided into control and indomethacin groups. At the end of sixth week, the mice were killed and tumor volume, inhibitory rate, immunohistochemistry assay (IHA) and metastasis were evaluated. Results (1)In vitro; 0. 2 mmol/L indomethacin could inhibit the proliferation of MHCC97L cells markedly (P ＜0. 01). The average amount of invading cells per field in cell invasion assay and motility assay was 2. 2 ± 1. 3 and 4.4 ± 1. 1 respectively in indomethacin group, significantly less than in control group ( 11. 4 ± 1. 9 and 12. 8 ± 1. 8 respectively, P ＜0. 01). The expression of VEGF and MMP-2 in cells treated with indomethacin was significantly lower than in control group (P ＜0. 01). (2)In vivo; Tumor volume, incidence and number of lung metastases in control and indomethacin groups were (1700 ±422) mm3 and (1170 ± 585) mm3 (P ＜ 0. 05), 75% and 50% ( P ＞ 0.05), 2. 92 ± 2. 07 and 1.33 ±1.56 (P＜0. 05) , respectively. Inhibition rate in indomethacin group was 31.2%. IHA showed that the expression of VEGF, MMP-2, and cyclooxygenase-2 ( COX-2) was down-regulated in indomethacin group (P ＜0.01). Conclusion Indomethacin could inhibit the growth and metastasis of HCC, which was in part mediated by down-regulation of VEGF and MMP-2.     

贲门癌根治术中切脾与否对患者免疫功能的影响

目的 探讨切脾与不切脾对进展期贲门癌患者根治术后免疫功能的影响。方法 将进展期贲门癌患者45例随机分为两组：贲门癌根治术联合脾切除（24例）和单纯行贲门癌根治术组（21例）。测定两组患者手术前后的免疫球蛋白（Ig）A、IgM、IgG和C3、C4变化，并进行比较分析。结果 手术前后两组患者体液IgA、IgM、IgG、C3、C4变化差异无统计学意义（P〉0．05）。结论 切除脾脏对贲门癌患者术后免疫功能无明显影响。     

喉返神经显露在甲状腺手术中的应用

目的:寻找甲状腺手术中识别喉返神经的有效解剖标志.方法:将355例行甲状腺切除术的患者为分3组,术中以甲状软骨下角为解剖标志显露喉返神经(甲状软骨下角组)119例,共解剖喉返神经158条;以甲状腺下动脉为解剖标志显露喉返神经(甲状腺下动脉组)118例,共解剖喉返神经155条;以气管食管沟为解剖标志显露喉返神经(气管食管沟组)118例,共解剖喉返神经167条.结果:甲状软骨组喉返神经损伤12条,损伤率为7.59%;动脉组喉返神经损伤8条,损伤率为5.16%;气管食管沟组喉返神经损伤2例,损伤率为1.20%.三者之间差异有统计学意义(P＜0.05).结论:以气管食管沟为解剖标志识别喉返神经可以有效地降低喉返神经的损伤率.     

胃癌术后切缘野生型p53、Cerb-B-2基因表达与吻合口复发的相关性

[目的]评价胃癌切缘标本中野生型p53、Cerb-B-2基因表达在胃癌术后吻合口复发中的作用。[方法]采用免疫组化方法检测25例胃癌术后吻合口复发患者及32例术后无吻合口复发患者的切缘标本中野生型p53、Cerb-B-2基因的表达分布。[结果]吻合口复发组野生型p53、Cerb-B-2基因的阳性表达率分别为40.00%、28.00%,而无吻合口复发组分别为12.50%、6.25%（均P〈0.05）。[结论]p53、Cerb-B-2基因表达与胃癌术后吻合口复发有相关性,可作为评估术后吻合口复发的风险因子。     

热灌注TACE、RFA联合125I粒子植入治疗原发性肝癌

目的 探讨热灌注(hyperthermic perfusion)经肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)、射频消融(radiofrequency ablation,RFA)联合125I粒子植入治疗原发性肝癌(primary hepatical carcinoma,PHC)的临床应用价值.方法 PHC患者15例,共25个肿瘤灶,病灶大小1～8cm,所有患者均先进行热灌注TACE,然后在CT引导下RFA及125I粒子植入治疗.本组内放疗处方剂量规定为60Gy,随访观察疗效及相关并发症.结果 随访时间6～40个月(平均26.8个月),全组肿瘤完全坏死率为96%,除1例粒子游走外,未出现其他严重并发症.结论 热灌注TACE、RFA联合125I粒子植入治疗PHC,近期疗效明显,可望成为PHC更有效的治疗新模式.     

索拉非尼治疗晚期原发性肝癌18例疗效及不良反应分析

目的评价索拉非尼治疗晚期肝细胞性肝癌的疗效及安全性。方法总结2009年10月~2011年6月本科应用索拉非尼治疗的18例晚期原发性肝癌患者的临床资料。观察其临床疗效、平均病情进展时间、6个月及1年生存率、生存质量和不良反应。结果服药8周后,18例患者均为稳定(100.00%);服药后16周后,1例患者腹水消失,为部分缓解(5.56%),13例为稳定(72.22%),4例为进展(22.22%)。平均服用索拉非尼时间11.9月,平均病情进展时间5.8个月。6个月生存率94.44%(17/18),1年生存率50.00%(9/18)。生存质量改善6例(33.33%),稳定8例(44.44%),下降4例(22.22%)。大多数患者为1~2级毒副反应。结论索拉非尼可提高晚期肝细胞性肝癌患者的6个月及1年生存率,且耐受性良好。