3D打印非共面模版引导125I粒子植入治疗头颈部肿瘤个体化设计与应用

目的 对比3D打印非共面模板引导¹²⁵I粒子植入治疗头颈部肿瘤的术前、术后计划的物理剂量学参数,探索头颈部肿瘤放射性粒子植入治疗用个体化模板设计方法的安全性、可行性、精确性。方法 2016年1月-2016年12月于北京大学第三医院接受3D打印模板辅助CT引导放射性¹²⁵I粒子植入的头颈部复发/转移恶性肿瘤的患者42例。处方剂量110~160Gy,设计制作3D打印非共面模板42块,对比术前、术后物理剂量学参数,包括D90、最小周边剂量(mPD)、V100、V150、V200、适形指数(CI)、靶区外体积指数(EI)、均匀性指数(HI)。结果 为42例患者设计、制作的42块导板术中就位良好,与术前计划相比,术后D90、V100、CI、EI、HI均相近(P=0.490、0.407、0.893、0.143、0.079),mPD、V150、V200不同(P=0.036、0.007、0.000)。结论 术后验证的主要剂量学指标较好地达到了术前计划要求,有良好的治疗精确性,可以满足临床需求。     

转移性肝癌外放射肝动脉化疗栓塞综合治疗

（目的）探讨转移性肝癌的外放射、肝动脉化疗栓塞的综合治疗价值。（方法）回顾性分析转移性肝癌的肝动脉化疗栓塞、外放射综合治疗（28例）及单纯外放射治疗（25例）的治疗效果。〔结果〕综合治疗组的有效率为53．6％，1年、2年、3年生存率分别为60．7％、32．2％、14．3％，单纯放疗组的有效率为32％，1年、2年、3年生存率分别为44．0％、28．0％、12．0％。综合治疗组、单纯放疗组的平均生存期分别为14．6个月、11．8个月。其中III期患者的平均生存期综合治疗组（13．4个月）明显优于单纯放疗组（7．1个月，P＜0．05）。（结论）综合治疗未能提高I、II期转移性肝癌的治疗效果，但能明显延长III期患者的生存期。     

Detection and significance of lymph node micro-metastases in patients with node-negative gastric carcinoma

Lymph node ndcrometastases refer to minute cancermetastases in lymph nodes whose diameter is less than 2nun,l'] and they are difficult to be observed with routinehistologic exndnation. In early years serial sectioningwas frequently used in detectingl lymph node ulnicrometastases. Since the 80's inununohistochemicaltechnique has been commonly employed, and recentlyreverse iran s criptas es -polymeras e chain reaction is al s oaPPlied in order to detect ndcrometastases.12--SJ Althoughall techn…     

Spectrum and immunophenotyping of 653 patients with B‐cell chronic lymphoproliferative disorders in China: A single‐centre analysis

The incidence of B‐cell chronic lymphoproliferative disorders (B‐CLPDs) is significantly lower in China than that in western countries. There have been studies involving small cohorts with conflicting results regarding the spectrum of B‐CLPDs in China, and the types and immunophenotyping of B‐CLPDs in China remain largely unexplored. We conducted a retrospective analysis of 653 cases of B‐CLPDs seen in our centre from 2011 to 2015. Four‐colour flow cytometry was used to determine the expression of each immunological marker, and the diagnostic values of the immunological markers were also investigated. Chronic lymphocytic leukaemia (CLL) was the most common type of B‐CLPD, which was consistent with that in west countries. However, the proportions of CLL (55.9%), follicular lymphoma (2.6%), and hairy cell leukaemia (0.2%) were lower, while the proportion of lymphoplasmacytic lymphoma/WaldenstrÖm macroglobulinaemia (5.4%) was higher in China, as compared with western countries. With respect to immunophenotypic characteristics, CD23 (31.7%) was more frequently expressed in mantle cell lymphoma (MCL) in our cohort than that in western countries. Immunophenotyping was useful in differentiating MCL from CLL or B‐cell prolymphocytic leukaemia and lymphoplasmacytic lymphoma/WaldenstrÖm macroglobulinaemia from splenic marginal zone lymphoma. CD200 was of better diagnostic performance (accuracy: 94.6%) in differentiating CLL from MCL compared with CD23 (accuracy: 93.3%). Some cases of B‐CPLDs, however, had no definite diagnoses, which were diagnosed as CD5⁺B‐CPLDs unclassified (7.7%) and CD5^?B‐CPLDs unclassified (15.8%). This is the largest study that systematically explores the spectrum and immunophenotyping of B‐CLPDs in Asia, confirming that spectrum of B‐CLPDs in China was different from that in western countries. The immunophenotypic features of B‐CLPDs were similar between China and western countries, although a few disparities exist. Cases with no definite diagnoses warrant further studies in the future.     

树突状细胞对LPAK抗人肝癌细胞的促进作用

目的观察人血树突状细胞（DC）联合LPAK细胞（L）体外抗人肝癌BEL-7402细胞（B）的杀伤效应,并对死亡细胞进行形态学分析.材料和方法LD组为DC＋L＋B,L组为L＋B,二组均采用L：B为5：1和10：1两种放靶比,应用TUNEL法及杀伤细胞检测技术,比较LD和L组的抗肿瘤效应。结果人血DC联合LPAK细胞与单用LPAK细胞的抗肿瘤活性比较,LD组＞L组（P＜0.01）,但二者均能诱导BEL-7402细胞调亡;调亡的肿瘤细胞是TUNEL阳性,在LD组较L组明显增多。结论DC能明显增强LPAK细胞对人肝癌细胞的杀伤活性,但不改变LPAK细胞诱导肿瘤细胞调亡的死亡模式。     

Gli1在鼻咽癌组织中的表达及临床意义

目的:探讨神经胶质瘤相关癌基因1(Gli1)在鼻咽癌组织中的表达及其临床意义.方法:免疫组化方法检测89例鼻咽癌组织及21例正常鼻咽组织中Gli1的表达情况,分析Gli1的表达与与鼻咽癌患者临床病理参数及预后之间的关系.结果:Gli1在鼻咽癌组织的表达水平显著高于正常鼻咽组织(P＜0.01),且Gli1的表达水平与鼻咽癌的T分期、淋巴结转移程度及临床分期显著相关(P＜0.05).此外,Gli1蛋白表达越高,患者的生存时间也明显缩短.结论:Gli1在鼻咽癌组织中呈过表达,可能在鼻咽癌的发生、发展中起重要作用,Gli1有可能成为鼻咽癌治疗的新靶点之一.     

Solid cancer incidence among Chinese medical diagnostic x‐ray workers, 1950–1995: Estimation of radiation‐related risks

The objective of this study was to estimate solid cancer risk attributable to long‐term, fractionated occupational exposure to low doses of ionizing radiation. Based on cancer incidence for the period 1950–1995 in a cohort of 27,011 Chinese medical diagnostic X‐ray workers and a comparison cohort of 25,782 Chinese physicians who did not use X‐ray equipment in their work, we used Poisson regression to fit excess relative risk (ERR) and excess absolute risk (EAR) dose–response models for incidence of all solid cancers combined. Radiation dose reconstruction was based on a previously published method that relied on simulating measurements for multiple X‐ray machines, workplaces and working conditions, information about protective measures, including use of lead aprons, and work histories. The resulting model was used to estimate calendar year‐specific badge dose calibrated as personal dose equivalent (Sv). To obtain calendar year‐specific colon doses (Gy), we applied a standard organ conversion factor. A total of 1,643 cases of solid cancer were identified in 1.45 million person‐years of follow‐up. In both ERR and EAR models, a statistically significant radiation dose–response relationship was observed for solid cancers as a group. Averaged over both sexes, and using colon dose as the dose metric, the estimated ERR/Gy was 0.87 (95% CI: 0.48, 1.45), and the EAR was 22 per 10⁴PY‐Gy (95% CI: 14, 32) at age 50. We obtained estimates of the ERR and EAR of solid cancers per unit dose that are compatible with those derived from other populations chronically exposed to low dose‐rate occupational or environmental radiation.     

人乳头瘤病毒致癌关键因素的研究进展

人乳头瘤病毒（human papillomavirus,HPV）感染与多种疾病相关,特别是高危型人乳头瘤病毒更是与头颈部鳞癌、生殖器官癌等多种癌症关系密切,其中与宫颈癌的相关性尤为显著。人乳头瘤病毒基因组共分为早期基因编码区（E）、晚期基因编码区（L）和长控制区（LCR）,这些基因各自发挥功能,并与宿主细胞相互作用使正常宫颈组织发生癌变。因此大量的研究工作围绕此展开,本文将对目前关于HPV基因组各功能区基因作用及致癌机制的研究成果加以综述。