副乳腺癌的诊断和治疗(附1例报道及文献复习)

副乳腺癌(accessory breast carcinoma)的发病率低,临床上少见,查阅文献报告不多。我科最近收治一例,结合文献报告讨论如下。 临床资料 女性患者,36岁,病案号980764。以“右腋前包块1年,左乳包块2月”之主诉入院。1年前发现右腋前包块,无胀痛等不适。3月前肿块增大至鸡蛋大小,固定,在当地医院曾手术切开肿瘤(未能切除并送病理检查)即诊断为“良性肿瘤”。未行近一步治疗。2月前,发现左乳房有一花生米大小包块,活动,质硬,不痛。1周前行右腋前包块穿刺,诊断为癌,即来我院。查体:双乳房对称,无乳头内陷及皮肤桔皮样改变,右乳无压痛,未及肿块。右腋前胸肌外缘可见一肿物隆起,与乳房无连续,     

制备小鼠去细胞拟胚体对Lewis肺癌细胞的促分化作用

BACKGROUND: Co-culture with embryonic stem cells or embryonic tissues can induce differentiation of carcinoma cells into normal epithelial cells or decrease malignancy of carcinoma cells. Acellular embryoid bodies retain the structure and important cytokines of embryonic tissues. OBJECTIVE:To prepare acellular embryoid bodies from mouse embryonic stem cells and to investigate their effects on differentiation of mouse Lewis lung carcinoma cells at three-dimensional culture in vitro. METHODS: Mouse embryonic stem cells (D3) were dynamically cultured for 7 days to produce embryoid bodies followed by decellularization with 0.1% sodium dodecyl sulfate. Mouse Lewis lung carcinoma cells were co-cultured with acellular embryoid bodies as test group or cultured in three-dimensional matrigel medium for 7 days as control group, respectively. Cell proliferation and expression of E-cadherin were detected by immunohistochemical staining and western blot assay, respectively. In addition, mRNA expressions of Slug and E-cadherin were observed using RT-PCR technology. RESULTS AND CONCLUSION: Uniform mouse embryoid bodies were successfully prepared, and were completely decellularized with sodium dodecyl sulfate. After 7-day three-dimensional matrigel culture, in the control group, multicellular tumor spheroids were formed, accompanied by a higher Ki67 positive rate; Lewis lung carcinoma cells in the test group were repopulated in the acellular embryoid bodies showing significantly lower Ki67 positive rate. Compared with the control group, the absorbance of Paxillin in the test group was significantly smaller, and the absorbance of E-cadherin was significantly higher (P < 0.05). Besides, mRNA expressions of Slug and E-cadherin were significantly decreased and increased in the test group compared with the control group, respectively (P < 0.05). These findings indicate that the acellular embryoid bodies can promote differentiation of mouse Lewis lung carcinoma cells in three-dimensional culture in vitro. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松; ORCID: 组织工程0000-0003-2685-4218(吕卫东)     

套入式食管粘膜胃粘膜吻合术146例报告

食管癌及贲门癌手术，在消化道重建中，使食管粘膜和胃粘膜都较其肌层长约1．5cm，行胃壁包套式粘膜对粘膜吻合术，粘膜吻合突入胃腔内，临床应用146例，显示该手术具有预防和减少吻合瘘，吻合口狭窄及抗返流的作用。     

亚甲蓝在乳腺癌前哨淋巴结活检中的应用

目的探讨亚甲蓝作为蓝染料在乳腺癌前哨淋巴结活检中的应用价值。方法对已确诊的72例乳腺癌病人亚甲蓝皮下注射后行腋窝前哨淋巴结切除,送冰冻病理检查,再行乳腺癌改良根治术,并常规腋窝淋巴结清扫,术后病理石腊切片检查前哨淋巴结及手术切除标本。结果本组病例中68例共检出前哨淋巴结132枚,失败4例。前哨淋巴结的检出率94.4%,准确率91.8%,敏感度92%,假阴性率8%,假阳性率为0。结论采用亚甲蓝作为蓝染料应用于乳腺癌前哨淋巴结活检术,其前哨淋巴结活检的各项指标与其他蓝染料(专利蓝)相当,且材料广泛、费用低廉,具有临床应用前景。     

I~(125)粒子组织内照射控制乳腺癌术后局部复发的临床研究

目的:研究I125粒子组织内照射控制乳腺癌术后局部复发的有效性,总结I125粒子植入的技术规律及操作经验。方法:对78例乳腺癌患者在术中永久性植入I125放射性粒子进行组织内照射治疗,术后1周均使用CAF方案化疗4～6周期,且口服三苯氧胺综合治疗;比较本组病例与既往行外放射治疗乳腺癌病例常见并发症的发生率;术后1周拍胸部正侧片观测植入粒子的数目和实际分布情况,并与手术前治疗计划(TPS)复合验证。结果:全组78例获得6～26个月的随访,中位13个月。其中死亡及骨转移各2例,各占2.56%;局部复发、淋巴结转移各3例,各占3.84%;肺部转移4例,占5.12%;失访1例,占1.28%;而66例局部无复发及转移,局部复发控制有效率达84.6%。本组病例中无外放射治疗的常见并发症。通过经术后X线片验证,粒子数目符合率达100%,粒子空间分布符合率仅为43%。结论:I125放射性粒子组织内照射控制乳腺癌术后局部复发疗效显著,并发症少,有一定的临床应用前景。     

肝癌纵隔及锁骨上淋巴结转移1例报告并文献复习

原发性肝癌(primary carcinoma of liver, PLC)是肝细胞和(或)肝内胆管上皮细胞发生的恶性肿瘤,是我国常见、高发的恶性肿瘤之一,在西方发达国家也在升高[1].因受肝脏解剖和生理因素影响,其发生肝内肝外转移较早,侵犯部位较多,转移机制复杂,一经发现约80%的患者便失去手术机会,且临床治疗效果及预后差,受到世界广泛关注.大多数肝癌以血行转移为主(如肺、骨、肾上腺等),伴有淋巴结转移的肝癌并不多见,且多是首先出现在腹腔淋巴结(肝门、腹主动脉旁淋巴结),而出现纵隔、锁骨上淋巴结转移临床少见.笔者经治1例肝癌纵隔、锁骨上淋巴结转移患者,结合文献资料报道如下.     

Stathmin 基因在非小细胞肺癌中的表达

目的：检测 Stathmin 基因在非小细胞肺癌组织中的表达,探讨其与临床病理因素的关系。方法：用免疫组织化学 SP 法检测135例非小细胞肺癌及20例癌旁肺组织中 Stathmin 蛋白的表达,分析其与患者年龄、性别、肿瘤分化程度等临床病理特征之间的相关性。结果：小细胞肺癌组织中 Stathmin 基因蛋白的表达水平明显高于癌旁肺组织（P ＜0．05）,Stathmin 的表达与淋巴结转移有关（P ＜0．05）。结论：Stathmin 基因在非小细胞肺癌组织中的表达显著上调;Stathmin 基因的表达与淋巴结转移有关,而与年龄、性别、肿瘤大小、TNM分期、组织类型无关。     

热消融治疗肺部亚实性结节专家共识(2021年版)

局部热消融技术在肺部结节治疗领域正处在起步与发展阶段,为了肺结节热消融治疗的临床实践和规范发展,由"中国医师协会肿瘤消融治疗技术专家组""中国医师协会介入医师分会肿瘤消融专业委员会""中国抗癌协会肿瘤消融治疗专业委员会""中国临床肿瘤学会消融专家委员会"组织多学科国内有关专家,讨论制定了"热消融治疗肺部亚实性结节专家共...     

国产吻合器附加食管斜形切除新方法临床应用(附143例食管癌弓上吻合报告)

目的　探讨国产GF—Ⅰ型吻合器附加食管斜形切除新方法预防吻合口并发症的临床效果。方法　 1992年 4月至 2 0 0 3年 3月连续对食管中段癌采用弓上机械吻合 ,在切除肿瘤上端食管时 ,与食管长轴呈 3 5°～ 45°斜形角度 ,常规胃底组织包埋加固吻合口。结果　术后 3周钡剂造影 ,吻合口均通畅 ,呈规则或不规则椭圆形。无吻合口瘘 ,仅 1例术后 4个月发生狭窄 ,经扩张置管后治愈。胃液返流情况 :明显返流占 16 2 % ;轻度返流占 45 9% ;无返流占 3 7 8%。结论　此方法能明显改进机械吻合效果 ,显著降低吻合口瘘、狭窄及胃液返流等并发症 ,具有临床实用价值。     

新辅助化疗对非小细胞肺癌患者淋巴细胞免疫功能的影响及治疗

OBJECTIVETo observe the effects of neoadjuwant chemotherapy and neoadjuwant chemotherapy plus KLT on cell immunofunction in patients of NSCLC and therapy.METHOD26 patients of NSCLC were rolled in A team,treated with neoadjuwant chemotherapy only;and 28