原发性肝癌CD44v mRNA表达与抑癌基因DCC mRNA表达、癌细胞DNA含量的关系

目的：探讨原发性肝癌中ＣＤ４４ｖ表达与抑癌基因ＤＣＣ表达、癌细胞ＤＮＡ含量之间的关系。方法：应用ＲＴ－ＰＣＲ法检测３０例原发性肝癌中ＣＤ４４ｖｍＲＮＡ和ＤＣＣｍＲＮＡ的表达情况，并根据ＣＤ４４ｖｍＲＮＡ的表达情况取２０例标本（阴性及微弱表达者１０例为Ⅰ组；高度表达者１０例为Ⅱ组）检测其癌细胞ＤＮＡ干系水平。结果：３０例受检标本中，ＣＤ４４ｖｍＲＮＡ中度以上表达２３例（７６．６７％），ＤＣＣｍＲＮＡ表达缺失者１８例（６０％），且两者基本重合。在ＤＮＡ干系水平方面，Ⅰ组病例二倍体明显高于Ⅱ组病例，异倍体则明显低于Ⅱ组的病例（Ｐ＜０．０１）；转移相关的临床病理指标Ⅱ组亦较Ⅰ组为重。结论：在原发性肝癌的侵袭转移过程中，ＣＤ４４ｖｍＲＮＡ的高表达与ＤＣＣｍＲＮＡ的表达缺失关系密切，两者间可能有协同关系。此外，ＣＤ４４ｖｍＲＮＡ表达与肝癌细胞ＤＮＡ干系水平的变化一致，再次证实了ＣＤ４４ｖｍＲＮＡ表达在肝癌侵袭转移中的重要性。     

先天性肝内胆管扩张症的术式选择

先天性肝内胆管扩张症的术式选择第二军医大学长海医院肝胆外科研究所（上海，２００４３３）钱光相先天性肝内胆管扩张症又称Ｃａｒｏｌｉ病，临床并非罕见。它可累及单侧肝内胆管或双侧肝内多处肝胆管，常同时伴有肝外胆管扩张，由于胆汁潴贸易于并发化脓性肝胆管炎、肝...     

成人肝胆管囊肿的外科治疗——附10例报告

肝内胆管囊肿又称Caroli氏病,临床并非罕见,其诊断较单纯肝外胆管囊肿困难,治疗效果亦不够满意。我院1961年～1985年手术治疗成人胆管囊肿41例中肝内胆管囊肿14例。肝外囊肿的治疗近年累有报告;肝内囊肿报告甚少,本文拟对随访1年以上的10例对其诊治的特殊性进行探讨。     

间断性和持续性肝缺血再灌注对线粒体功能的影响

间断性和持续性肝缺血再灌注对线粒体功能的影响孙经建张柏和吴孟超陈汉钱光相作者采用大鼠肝缺血再灌注损伤模型，观察肝线粒体功能，以及肝组织内钙离子、脂质过氧化物（ＬＰＯ）和超氧化物歧化酶（ＳＯＤ）含量的变化，旨在比较间断性与持续性肝血流阻断对上述指标的影...     

Expression of splice variants of CD44 in tumor－adjacent tissue of human primary liver cancer

ＥｘｐｒｅｓｓｉｏｎｏｆｓｐｌｉｃｅｖａｒｉａｎｔｓｏｆＣＤ４４ｉｎｔｕｍｏｒ－ａｄｊａｃｅｎｔｔｉｓｓｕｅｏｆｈｕｍａｎｐｒｉｍａｒｙｌｉｖｅｒｃａｎｃｅｒ￥（刘鹏飞）（吴孟超）（陈汉）（钱光相）（傅继梁）ＬｉｕＰｅｎｇｆｅｉ；ＷｕＭｅｎｇｃｈａｏ...     

Surgical Treatment of Bile Duct Cancer at Hepatic Hilum:A Clinical Analysis of 60 Cases

The incidence of bile duct cancer at hepatic hilum has a tendency toincrease in recent years.This paper is to report 60 cases during a10-year-period from 1975 to 1985.The cancer at the hepatic hilum(60 cases)made up 73％ of all extrahepatic bile duct cancers(82 cases),and accounted for1.65％ of 3626 biliary operations done at the same period.The clintcalmanifestations of the patients could be categorized into three types,the presentingsymptoms were obstructive jaundice in 29 cases,of which 25 had beenmisdiagnosed as infectious hepatitis;the symptoms of acute cholangitis were foundin 12 cases;and in 14 cases,various symptoms and signs of biliary diseases hadbeen found for a long time before the diagnosis was established as cancer.In theremaining 5 cases,miscellaneous manifestaions were revealed.The patients wereexamined with B- US(19 cases),ERCP(10 cases)and PTC(39 cases).The finaldiagnosis was established according to the findings of PTC and/or ERCP,surgical exploration,or histopathological examination.Surgery was performed on56 cases.Only 6 out of the 56 received radical resection of the cancer withhemi-hepatectomy;palliative internal drainage of the bile duct was done on 15cases,external drainage on 23 cases,and other palliative measures on 12 cases.The average survival time after operation was 24.5 months in 6 cases with radicalresection,8.7 months in 48 cases with palliative measures,and only 5 months in 4cases without surgical intervention.Early diagnosis is imperative if successfultherapy is expected.It is suggested that a patient over 40 years of age,sufferingfrom“infectious hepatitis”or obstructive jaundice,be watched out for thepossibility of hilum cancer,and appropriate examinations such as B-US,CT,ERCP or PTC be carried out.It is emphasized that PTC plays an important rolein the diagnosis of hilum cancer.In severe cases,the intrahepatic bile ducts couldbe examined with PTC of the two sides at one time.Exploratory laparotomyshould be performed on suspected cases.     

Changes of gastric acid secretion and somatostatin after Roux-en-Y cholangiojejunostomy.

The authors studied the changes of gastric acid secretion and determined the levels of somatostatin(SS) and gastrin (Gn)in blood, gastric jujce and     

逆行胰胆管造影对胆道恶性梗阻的诊断价值

我院自1983年1月至1989年3月采用内镜逆行胰胆管造影(ERCP)1200例次,查到胆道恶性梗阻67例(5.6%)。此项检查对胆道疾病诊断能提供清晰X线影像,是唯一能在内镜直视下诊断十二指肠粘膜及乳头部病变的重要手段,并可立即取得病变组织样本,对诊断提供有特殊价值的佐证。现将诊断后经手术及病理证实的59例进行分析。     

严重胰腺十二指肠复合伤的治疗

胰腺损伤合并腹膜后十二指肠破裂为严重的腹部外伤,诊断处理困难,胰腺外伤死亡率约20%,合并十二指肠破裂者死亡率更高,近一年我们连续收治严胰重十二指肠复合伤3例,将其报告于后并对有关治疗问题进行讨论。例1 男,33岁。上腹及背部被巨石撞击挤压,伤后腹部剧痛4小时入院。血压90/70mmHg,脉搏100次/分,面色苍白,见右上腹壁肿胀并有瘀斑。全腹压痛及肌紧张,以上腹明显,转移浊音阳性,腹穿有血性液。血淀粉酶515苏氏单位。X片左第6肋骨折,胸9压缩骨折,相当于胰头处有软组织肿块影。剖腹术见:腹直肌断裂并有血肿,腹内有500ml血性液体,淀粉酶大于500苏氏单位,后腹膜自肠系膜根部结肠旁沟至肾区有巨大血肿并混有胆汁,十二指肠二、三段交界处有3×2cm前后壁对穿性穿孔,胰头前方巨大血肿     

胆道癌NDPK/nm23的表达及意义

目的　研究转移抑制基因ＮＤＰＫ／ｎｍ２３ 在胆道良恶性病变中的表达及与转移性的关系。方法　４３ 例胆囊腺癌,２０ 例胆管癌,８ 例胆囊腺瘤和５ 例胆囊炎的石蜡包埋组织切片,经免疫胶体金方法（ＩＧＳＳ）染色,并在显微镜下计数阳性细胞。结果　胆囊腺癌中ＮＤＰＫ 在转移性及非转移性肿瘤中的表达率分别为２３．５％ （４／１７） ,和３４．６％（９／２６） ,两者间无显著性差异（ Ｐ＞ ０．０５）,而胆管癌中分别为１４．３％（１／７）和４６．１％ （６／１３）,两者间有显著性差异（ Ｐ＜ ０．０５）。ＮＤＰＫ在良恶性病变中的表达无显著性差异,并与肿瘤的病理分级无关。结论　ｎｍ２３ 基因可能在胆囊腺癌和胆管癌的转移过程中起不同的调节作用,其表达程度与胆管癌的转移呈负相关而与胆囊腺癌的转移无关。