多原发大肠癌37例临床分析

目的 探讨多原发大肠癌的临床特点、诊断治疗及预后。方法 对1974-1998年37例多原发大肠癌进行回顾性分析。结果 37例占同期收治原发大肠癌的2．74％(37／1348)，其中同时多原发大肠癌15例，异时多原发大肠癌22例，癌灶部位以右半结肠和直肠为多，异时多原发大肠癌55％(12／22)在3年内发生，41％(9／22)在8年后发生，全部癌灶除1例外均得到根治性切除，同时多原发大肠癌5年生存率为5／9，异时多原发大肠癌5年生存率为15／21，二次癌术后5年生存率为7／18。结论 提高对多原发大肠癌的警惕性，术前全面检查，术中仔细探查，术后定期复查，争取早期发现，积极手术治疗，以提高生存率。     

小肠间质瘤的外科治疗

胃肠道间质瘤(Gastrointestinal Stromal Tumors,GIST)是一种发生于消化道的少见的肿瘤,所占比例不足1%,发病率约2/10万.但它是胃肠道最常见的间质细胞肿瘤,其中小肠间质瘤占胃肠道间质瘤的第2位.     

不可忽视的胃疼

2007年春天,年逾花甲的杨老先生偶感胸口憋闷,试着吃了些小药调理之后身体果真舒服许多,老人对此便没有太在意。可过了不久,不但胸口憋闷,胃又有些发紧的感觉,到医院看了看,吃了些治心脏病的药,胸闷胃紧的症状非但未减轻,反而出现了胃疼的感觉,想着自己不舒服的情况持续近一年了,老人有些着急了,这好好的一个人,年轻的时候工作生活那么辛苦都没有患上胃病,怎么上了年纪,生活规律了,反倒添上了胃疼的毛病呢？     

Clinicopathological analysis of 50 rectal cancer cases diagnosed as adenoma in biopsy

Objective: To evaluate the clinicopathological characteristics of rectal cancer diagnosed as adenoma in biopsy.Methods: 50 rectal cancer cases diagnosed as adenoma in biopsy were analyzed retrospectively in this study by comparing the biopsy and postoperative pathology. Results: Among these 50 patients, biopsy pathology showed 26% (13/50) adenoma with mild dysplasia, 30% (15/50) adenoma with moderate dysplasia, and 44% (22/50) adenoma with severe dysplasia. In 8 cases, the adenomas were smaller than 2cm. On postoperatively surgical pathology, only 10 cases were carcinoma-in-situ, while 40 cases were invasive cancer. Conclusion: Special emphasis should be taken to biopsy-negative rectal adenomas and those smaller than 2cm.     

PROMOTER HYPERMETHYLATION OF p16 GENE IN PRE- AND POST-OPERATIVE PLASMA OF PATIENTS WITH GASTRIC ADENOCARCINOMA

Objective: To detect promoter hypermethylation of p16 gene in matched pre- and post-operative plasma of patients with gastric adenocarcinoma for evaluating the effectiveness of therapeutic intervention. Methods: Tissue samples, pre- and post-operative plasma of 84 patients were collected. Plasma of 15 healthy people was collected as control. After sodium-bisulfite treatment, extracted DNA was amplified for p16 promoter by methylation-specific polymerase chain reaction (MSP). The PCR products were detected by both gel-ethidium bromide electrophoresis and high performance liquid chromatogram (HPLC). Results: Among 84 patients, p16 hypermethylation was detected in 26 (31.0%) cancer tissues and 2 (0.02%) tumor-adjacent tissues and 12 (14.3%) pre-operative plasma, while negative in plasma of healthy people. For positive plasma cases, the paired tumor tissues were confirmed to be methylated.Within available 30 pairs of matched pre- and post-operative plasma, 6 pre-operative plasma was positive, and only 1 of 6 plasma remained hypermethylated after surgery. The results detected by HPLC exactly matched those by gel-electrophoresis. Conclusion: The alteration of status of p16 hypermethylation in post-operative plasma is considered the consequences of surgical intervention. Although p16 hypermethylation has no role in pre-operative staging of gastric cancer, detecting hypermethylated p16 in plasma could be utilized in monitoring patients after surgery.     

CARCINOSARCOMA OF GALLBLADDER： A CASE REPORT

Carcinosarcoma is a rare entity of neoplasma, and even rarte in gallbladder. The tumor is composed of both malignant epithelial and mesenchymal components that may grow intermingled or separated. The prognosis is generally poor with a median survival of 7.8 months, mimicking that of gallbladder carcinoma. Here we report one case that achieved long-term survival after surgical resection and adjuvant therapy with oxaliplatin- containing regimen. Case Report A 75 year-old man presented with a ma…     

胃癌外科的现状与发展趋势

胃癌是我国常见的消化道恶性肿瘤,外科手术仍然是胃癌治疗的主要手段.从Billroth医生第一例胃大部切除至今已有120余年,胃癌外科治疗从一般的胃大部切除术进入以清除淋巴结为目的的根治术;从解剖学为基础的手术走向以解剖学、肿瘤生物学及免疫学为基础的手术;从只重视手术的安全性到根治性、安全性及机能性统一;从只重视切除肿瘤到以切除原发肿瘤及受侵器官,彻底清除区域淋巴结及杀灭腹腔脱落癌细胞的外科治疗;从单一的手术进入以围手术期治疗加规范化手术的新的治疗模式.     

Major hepatic resection under total vascular exclusion

The major complications associated with liver resection are bleeding, hepatic decompensation and iatrogenic injury to the bile ducts and structures in the porta hepatis during its dissection. Operative blood loss and the amount of intraoperative blood transfusion has been shown repeatedly to be the single most important factor affecting the immediate prognosis of patients undergoing hepatic resection. Massive blood loss associated with the standard techniques of liver resection is frequently c…     

细胞周期抑制蛋白p16、p27异常表达与胃癌生物学行为的关系

目的：探索细胞周期抑制蛋白p16、p27异常表达与胃癌生物学行为的关系。方法：免疫组织化学方法（S－P法）检测胃癌组织中p16,p27的表达,结合临床病理资料和随访资料进行回顾性研究,并作出评价。结果：p16表达降低与胃癌分期增加、淋巴结转移及不良预后显著相关。p27表达降低与淋巴结转移、浆膜浸润、晚期胃癌、弥漫型胃癌及不良预后显著相关。结论;p16,p27异常表达与胃癌不良的生物学行为及预后有关,可作为预后指标,有利于个体化治疗及提高胃癌的疗效。