清扫淋巴结数和N1淋巴结阳性数与Ⅱ期非小细胞肺癌预后的关系

Objective The aim of this study was to evaluate if factors associated with dissected lymph nodes affect the outcome of completely resected stage II (T1-2N1) non-small cell lung cancer (NSCLC). Methods Clinical data of 121 patients with complete resection of stage II NSCLC in Sun Yat-sen University Cancer center from January 1998 to December 2004 were reviewed retrospectively and the effect of factors of dissected lymph nodes on overall survival (OS) and disease-free survival ( DFS) of NSCLC was analyzed.Results The univariate analysis demonstrated that the total number of removed lymph nodes, the number of involved N1 lymph nodes, the ratio of involved N1 lymph nodes and the total number of removed N2 lymph nodes were significant prognostic factors for OS. In the multivariate analysis, the total number of removed lymph nodes and the number of involved N1 lymph nodes were independent prognostic factors for OS. In both of univariate and multivariate analyses, tumor size, the total number of removed lymph nodes and the number of involved N1 lymph nodes were independent prognostic factors for DFS.Conclusion For patients with completely resectable stage II NSCLC, 10 or more lymph nodes should be removed at the surgical resection. Total number of removed lymph nodes ≥ 10 is a favorable prognostic factor and involved N1 ≥ 3 is an adverse one.     

清扫淋巴结数和N1淋巴结阳性数与Ⅱ期非小细胞肺癌预后的关系

目的 探讨淋巴结清扫相关指标与完全切除的Ⅱ期(T1～2N1)非小细胞肺癌(NSCIC)患者预后的关系.方法 回顾性分析121例完全切除的Ⅱ期NSCLC患者,分析清扫的淋巴结数、N1阳性数、N2淋巴结的总数、N1淋巴结的转移度等淋巴结的临床指标对总生存率(OS)和无病生存率(DFS)的影响.结果 单因素分析显示,清扫的淋巴结数、N1淋巴结阳性数、N1淋巴结转移度和清扫N2淋巴结的总数与OS相关;多因素分析显示,清扫的淋巴结数、N1淋巴结阳性数为影响OS的独立因素.单因素分析和多因素分析均显示,肿瘤直径、清扫淋巴结总数、N1淋巴结阳性数为DFS的独立因素.结论 对于可完全切除的Ⅱ期NSCLC患者,术中至少应清扫10枚以上淋巴结.清扫淋巴结的总数≥10枚是预后的良好因素,而N1阳性淋巴结数≥3枚是预后的不良因素.     

乳腺癌患者骨髓中MUC1 mRNA的检测及其临床意义

目的:探讨乳腺癌患者骨髓中MUC1mRNA的表达及其临床意义。方法:应用RT-PCR技术检测75例乳腺癌患者、15例乳腺良性病变患者和8位健康人骨髓中的MUC1mRNA表达,并分析MUC1mRNA表达与临床病理因素和相关分子指标(Ki67、p53和VEGF)的关系。结果:75例乳腺癌患者中,32例检测出MUC1mRNA阳性表达,阳性表达率为42·7%(32/75)。乳腺良性病变患者和健康人骨髓中未检测到MUC1mRNA表达。MUC1mRNA阳性表达与乳腺癌临床分期、腋窝淋巴结转移和ER状况有关,P<0.05;与年龄、肿瘤大小和PR表达状况差异无统计学意义,P>0.05;与乳腺癌组织中Ki67、p53和VEGF表达均无相关。结论:MUC1mRNA可作为检测乳腺癌患者骨髓微转移的分子指标之一。骨髓微转移的检测可为乳腺癌患者的治疗和预后判断提供帮助。     

续断舒筋膏质量控制方法研究

目的:建立续断舒筋膏质量控制方法.方法:采用薄层色谱法(TLC)对方中的当归、川芎、防风、羌活、独活、冰片、薄荷脑等中药进行定性鉴别,同时对乌头碱进行限量鉴别.结果:薄层色谱能明显检出当归、川芎、防风、羌活、独活、冰片、薄荷脑,专属性强,无阴性干扰,乌头碱限量符合中国药典规定.结论:TLC定性鉴别方法简便易行,重现性好,灵敏度高,可用于续断舒筋膏的质量控制.     

非小细胞肺癌组织学异质性研究

[目的]采用肺癌组织大切片和免疫组化的检测方法，进一步了解非小细胞肺癌组织异质性的情况。[方法]收集98例经外科切除的非小细胞肺癌肺叶标本，按肿瘤的最大径面取材，制成大切片，HE染色后，按WHO（2004）肺癌组织学分类进行观察和诊断；用免疫组化检测肿瘤的Syn和CgA表达情况。[结果]54例（55．1％）表现为单一组织类型，其中鳞癌20例，腺癌34例。12例（12．2％）癌表现两种或三种亚型；32例（32．7％）表现出两种或以上组织类型，其中腺鳞癌24例（占24．5％）；44例（占44．9％）伴有神经内分泌分化；根据光镜下形态和免疫组化结果，63例（64．3％）表现出肿瘤的异质性。[结论]异质性常见于非小细胞肺癌中。病理组织大切片能更全面了解肺癌异质性的表现。