Unusual gastric tumors: radiologic-pathologic correlation.

The overlap of radiologic findings in many gastric tumors makes differentiation difficult. However, some unusual gastric tumors have characteristic radiologic features that may suggest a specific diagnosis. At barium study, lipomas typically manifest as a smooth submucosal mass or an ulcerated lesion with a "bull's-eye" appearance that is indistinguishable from other mesenchymal tumors. At computed tomography (CT), lipomas usually manifest as well-circumscribed submucosal masses with fat attenuation. At radiology, glomus tumors appear as smooth submucosal masses with or without ulceration and may contain tiny flecks of calcification. These tumors frequently demonstrate strong enhancement on early-phase contrast material-enhanced images. At barium study, lymphangiomas may appear as smooth intramural masses that are indistinguishable from other mesenchymal tumors. At CT, they manifest as non-enhancing extramucosal masses with homogeneous low attenuation. Diffuse lesions in Brunner gland hamartoma manifest as multiple small nodules, producing a characteristic "cobblestone" appearance. Lymphomas may have typical imaging features (eg, more pronounced and homogeneous mural thickening) that can help differentiate them from adenocarcinoma. In addition, adenocarcinomas may demonstrate unusual findings such as transpyloric spread, unusually large polyps, or intratumoral calcifications. Familiarity with these radiologic features of gastric tumors can help ensure correct diagnosis and proper management.     

Gastric mucosa-associated lymphoid tissue lymphoma: spectrum of findings at double-contrast gastrointestinal examination with pathologic correlation.

Mucosa-associated lymphoid tissue (MALT) is found in the surface epithelium of the stomach. MALT lymphoma is extranodal lymphoma originating from MALT. In the stomach, a strong association with Helicobacter pylori infection has been demonstrated. Low-grade gastric MALT lymphoma has been reported to have variable features at upper gastrointestinal (UGI) examination. Twenty-two patients with low-grade MALT lymphoma had ulcers (n = 11), fold thickening (n = 7), mucosal nodularity (n = 7), masses (n = 6), or prominent areae gastricae (n = 4) at UGI examination. Six patients with high-grade MALT lymphoma had masses (n = 4), fold thickening (n = 3), ulcers (n = 1), or mucosal nodularity (n = 1) at UGI examination. These findings were similar to those in gastric carcinoma or gastritis. Differentiation of low-grade MALT lymphoma from gastritis or gastric carcinoma was more difficult than differentiation of high-grade MALT lymphoma. Lesions of MALT lymphoma associated with H pylori gastritis were diffuse or multiple in 65% of cases; however, lesions of MALT lymphoma without proved H pylori gastritis were focal or solitary in 80% of cases. Therefore, multiplicity of lesions in MALT lymphoma was closely associated with H pylori infection.     

Tau蛋白表达与复发转移性乳腺癌紫杉醇化疗敏感性关系

【摘要】〓目的〓探讨复发转移性乳腺癌组织中Tau蛋白的表达情况及其与紫杉醇药物姑息性化疗敏感性的相关性。方法〓采用免疫组化Envision二步法检测136例复发转移性乳腺癌患者转移病灶的组织样本中Tau蛋白的表达水平,χ2检验或Fisher 精确概率法分析其与复发转移性乳腺癌临床病理特征及与紫杉醇类药物姑息性化疗敏感性的关系。结果〓复发转移性乳腺癌患者Tau蛋白的阳性表达率为28.68%(39/136),Tau蛋白的阳性表达与患者的年龄、身体密度、ECOG分值、病理分型、组织学分级、孕激素受体、表皮生长因子受体-2、增殖指数Ki-67及P53阳性表达均无相关性,但与乳腺癌组织的雌激素受体表达相关(P<0.05)。而且,Tau蛋白的表达与紫杉醇药物性化疗疗效相关(P<0.01)。结论〓Tau蛋白表达水平与复发转移性乳腺癌紫杉醇类药物姑息性化疗敏感性呈负相关,临床检测Tau蛋白表达可能可作为复发转移性乳腺癌行紫杉醇类药物性姑息性化疗方案的选择依据。     

第6版日本《胃癌治疗指南》更新要点解读

日本《胃癌治疗指南》是日本乃至全球胃癌治疗领域的重要指导性文件,其临床意义重大。2021年3月"第93届日本胃癌学会年会"于线上召开,对2018年以来胃癌治疗的新方法、新思路、新探索进行了总结,并以此为基础对第5版《胃癌治疗指南》进行更新,于2021年7月出版。新版指南在胃癌内镜治疗、手术治疗、化疗的适应证、推荐方案等方面均有不同程度的更新。     

人参二醇组皂苷增强顺铂对人前列腺癌DU145细胞凋亡的效应

目的 探讨人参二醇组皂苷(panoxadiol saponin PDS)与顺铂(cisplatin,DDP)联合应用对DU145前列腺癌细胞增殖及凋亡的影响.方法 采用MTT比色法检测PDS与DDP联合应用对DUl45细胞增殖活力的影响;吖啶橙染色观察诱导细胞凋亡情况;流式细胞仪分析细胞周期及凋亡,并计算细胞平均凋亡率;免疫化学和Western blot技术观察细胞内激活的caspase3的表达.结果 100mg/L,PDS与0.2 u mol/L DDP联合给药:(1)48h后可使单独应用0.2 1.tmol/L DDP组其肿瘤细胞生长抑制率由16.35%提高到47.13%;(2)吖啶橙荧光染色可见细胞呈现明显凋亡形态,其凋亡率与2μmol/L DDP组相当:(3)流式细胞术结果显示,可使单独应用0.2μmol/L DDP组其诱导DU145细胞凋亡率从5.53%提高到19.39%,相当于其10倍剂量即2.0 μmol/L DDP的诱导凋亡效应(21.05%),明显高于PDS单独应用的凋亡率:(4)免疫化学和Western blot结果显示,可使单独应用O.2 μmol/L DDP组细胞内激活的caspase3阳性细胞率与2 μmol/L DDP组相当.结论 PDS能增强DDP对DU145前列腺癌细胞的致凋亡效应.     

Automated Computational Detection of Interstitial Fibrosis,Tubular Atrophy,and Glomerulosclerosis

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经皮肝动脉化疗栓塞(TACE)对不同分型门静脉癌栓的疗效观察

目的观察经皮肝动脉化疗栓塞(TACE)对不同分型门静脉癌栓肝癌病人的疗效。方法2000年1月至2003年1月，48例肝癌合并门静脉癌栓按是否接受TACE治疗分为两组：TACE组(n=38)和保守治疗组(n=10)，比较两组病人的生存期和不同分型门静脉癌栓的治疗效果。结果TACE治疗组和保守组的中位生存期分别为5．0(4．4，5．6)个月和2．0(1．8，2．2)个月，差异有显著性(P=0．0000)。Ⅰ(n=6)、Ⅱ(n=11)、Ⅲ(n=20)、Ⅳ型(n=1)癌栓病人经TACE治疗后中位生存期分别为12．0、5．0、4．0、3．0个月(P=0．0013)。结论TACE对累及二级及二级以上门静脉分支癌栓(即Ⅰ型癌栓)疗效显著。     

Survivin启动子介导的胞嘧啶脱氨酶(CD)自杀基因的抗肿瘤研究

目的 探讨Survivin启动子介导的CD/5-FC自杀系统的抗肿瘤效果.方法 利用Survivin启动子替换pEGFP-N1载体上的巨细胞病毒(CMV)启动子,构建重组表达载体pSurP-EGFP,通过报告基因绿色荧光蛋白(GFP)的表达确定Survivin启动子的特异性;将酿酒酵母的胞嘧啶脱氨酶(CD)基因克隆在pSurP-EGFP中,构建成重组载体pSurP-CD,转染肿瘤细胞后利用毛细管电泳仪检测前药5-氟胞嘧啶(5-FC)的转化效率,同时分析肿瘤细胞的凋亡.结果 GFP的表达表明Survivin启动子具有较好的肿瘤靶向性;毛细管电泳检测表明CD能够有效地将5-FC转化为5-FU,显微镜观察和流式分析表明了Survivin启动子介导的CD的抗肿瘤效果.结论 Survivin启动子能有效地介导CD自杀基因的表达,具有较好的靶向性抗肿瘤效果.     

急诊护理干预在严重创伤性休克患者的应用效果分析

目的：探究急诊护理对严重创伤性休克患者应用的效果。方法整群选取2013年3月—2014年8月该院接收的114例严重创伤性休克患者作为研究对象,利用随机数法分为两组,对对照组实施一般护理,对观察组实施包括个人护理、呼吸道护理、心理护理、药物治疗在内的急诊护理,对两组家属认可程度、急救情况、并发症发生情况及患者预后情况进行比较分析。结果观察组满意53例,一般3例,不满意1例,家属认可情况明显优于对照组,P＜0.05,差异有统计学意义;急救良好者41例,治愈患者数37例,无并发症患者数46例,综合各指标均优于对照组,P＜0.05,差异有统计学意义;恢复良好者46例,中残者6例,重残者4例,死亡者1例,患者预后情况优于对照组,P＜0.05,差异有统计学意义。结论急诊护理干预对严重创伤性休克患者的治疗及预后效果优于一般护理。