PEG-rhG-CSF 对同期放化疗所致Ⅲ度粒细胞缺乏患者挽救性治疗的临床研究

目的：探讨聚乙二醇化重组人粒细胞刺激因子（ PEG-rhG-CSF）对同期放化疗所致Ⅲ度粒细胞缺乏患者挽救性治疗的疗效及不良反应,为其在临床中合理应用提供依据。方法对105例同期放化疗所致Ⅲ度粒细胞缺乏的恶性肿瘤患者进行分析,试验组包括：PEG-50组38例、PEG-100组26例、 PEG-R组21例,给药方式依次为PEG-rhG-CSF 50μg／kg 单次皮下注射,100μg／kg 单次皮下注射, PEG-rhG-CSF 50μg／kg 单次皮下注射＋rhG-CSF 5μg· kg -1· d -1皮下注射,外周血中性粒细胞绝对计数（ ANC）≥2珑．0×109／L后停用rhG-CSF;对照组为R组20例,即rhG-CSF 5μg· kg-1· d-1皮下注射,ANC≥2．0×109／L后停用。对上述4组患者的时间-中性粒细胞增殖率、时间-ANC值、粒细胞缺乏所致不良症状的缓解时间、药物不良反应发生率进行统计学分析。结果试验组中性粒细胞增殖率和中性粒细胞绝对值均较对照组显著增高（ P ＜0．05）,各试验亚组的临床效应发挥均始于用药12～24 h,于24 h左右达到改善粒细胞缺乏的治疗目的, P-50组与P＋R组的时间中-性粒细胞增殖率和时间-ANC值无明显差异（ P ＞0．05）;试验组与对照组缓解因粒细胞缺乏所致临床症状所需的时间无明显差异（ P ＞0．05）。结论 PEG-rhG-CSF对于同期放化疗所致Ⅲ度粒细胞缺乏患者的挽救性治疗推荐剂量为单次50μg／kg皮下注射,其效应发挥时间始于12～24 h之后,如果在此期间ANC值无明显提高,无需加用rhG-CSF。     

顺铂联合足叶乙甙对卵巢癌治疗的机制研究

目的 研究顺铂联合足叶乙甙(EP)方案对卵巢癌细胞增殖和细胞周期的影响以及可能的作用机制,为EP方案用于卵巢癌的治疗提供理论依据.方法 体外培养的SKOV3细胞经不同浓度的顺铂和足叶乙甙作用24h,应用MTT法检测药物的细胞毒作用,测定其A值;流式细胞仪测定细胞周期分布的变化,免疫细胞化学法检测细胞周期因子CyclinB1、P34cdc2和Survivin蛋白的表达,探讨可能的机制.结果 足叶乙甙和不同浓度的顺铂联合应用,可明显抑制SKOV3细胞的增殖,引起细胞周期的S期和G2/M期细胞比例的增加,G0/G1期比例明显下降,且下调CyclinB1、P34cdc2和Survivin蛋白的表达.结论 顺铂联合足叶乙甙对SKOV3细胞具有显著的协同效应,加强了对细胞周期的阻滞,其机制可能与细胞周期因子CyclinB1、P34cdc2和Survivin的表达下调有关.     

放疗联合射频热疗治疗术后局部复发性直肠癌临床观察

术后盆腔局部复发性直肠癌患者53例，其中行单纯放射治疗（放疗）21例（单放组），行放疗联合射频热疗（放热组）32例。骶部及会阴部疼痛、里急后重、血便、尿频及血尿缓解率放热疗组分别为100％、92．86％、95．83％、100％，单放组分别为71．42％、60％、61．53％、100％，前三者两组相比，P均〈0．05；治疗结束后3～5周盆腔CT检查显示瘤体缩小者放热疗组为96．87％，单放组为85．71％，两组相比，P〉0．05；膀胱放射反应、Ⅰ～Ⅱ级骨髓抑制，放热组分别为3、3例，单放组分别为2、3例，两组相比，P均〉0．05；两组患者的生存时间均未超过32周。认为放疗联合射频热疗治疗术后局部复发性直肠癌在缓解临床症状方面的效果明显优于单纯放射治疗，急性不良反应并无增加。     

E-钙黏蛋白在鼻咽癌组织中的表达水平及其与颈部淋巴结转移的关系

Objective To investigate the expression of E-cadherin in nasopharyngeal carcinoma ( NPC) and its relationship with cervical lymph node metastasis. Methods The expression of E-cadherin in 80 patients with NPC was detected by immunohistochemistry. Results Lower expression of E-cadherin was associated with advanced N-stage of the tumor ( P = 0. 018 ). There was no significant correlation between the expression of E-cadherin and lymph node size ( P = 0.435 ). The expression of E-cadherin was higher in patients with cervical lymph node metastasis limited to a single area than that distributing in some scattered areas (P = 0. 000). There was a trend that the expression of E-cadherin in the cases with the tumor and lymph nodes in the same side was higher (56. 5% ) than that in the patients with bilateral lymph node metastases (32. 6% ) , however, the difference was not significant (P =0. 059). The expression rates of E-cadherin in patients with lymph node metastasis in levels Ⅱ , Ⅲ and Ⅴa were higher than that in levels Ⅰ , Ⅳ, Vb and Ⅵ, but with a non-significant difference (P = 0.059). Conclusion The expression of E-cadherin has influence on the lymph node metastasis in nasopharyngeal carcinoma. E-cadherin expression is negatively correlated with the numbers of the lymph node metastases and the metastasis distance, i. e. a lower expression of E-cadherin leads to an advanced N-stage. The lymph node metastasis of nasopharyngeal cancer from above to below is more considerably influenced by E-cadherin expression than the metastasis towards contralateral lymph nodes.     

E-钙黏蛋白在鼻咽癌组织中的表达水平及其与颈部淋巴结转移的关系

Objective To investigate the expression of E-cadherin in nasopharyngeal carcinoma ( NPC) and its relationship with cervical lymph node metastasis. Methods The expression of E-cadherin in 80 patients with NPC was detected by immunohistochemistry. Results Lower expression of E-cadherin was associated with advanced N-stage of the tumor ( P = 0. 018 ). There was no significant correlation between the expression of E-cadherin and lymph node size ( P = 0.435 ). The expression of E-cadherin was higher in patients with cervical lymph node metastasis limited to a single area than that distributing in some scattered areas (P = 0. 000). There was a trend that the expression of E-cadherin in the cases with the tumor and lymph nodes in the same side was higher (56. 5% ) than that in the patients with bilateral lymph node metastases (32. 6% ) , however, the difference was not significant (P =0. 059). The expression rates of E-cadherin in patients with lymph node metastasis in levels Ⅱ , Ⅲ and Ⅴa were higher than that in levels Ⅰ , Ⅳ, Vb and Ⅵ, but with a non-significant difference (P = 0.059). Conclusion The expression of E-cadherin has influence on the lymph node metastasis in nasopharyngeal carcinoma. E-cadherin expression is negatively correlated with the numbers of the lymph node metastases and the metastasis distance, i. e. a lower expression of E-cadherin leads to an advanced N-stage. The lymph node metastasis of nasopharyngeal cancer from above to below is more considerably influenced by E-cadherin expression than the metastasis towards contralateral lymph nodes.