血清恶性肿瘤特异性生长因子检测对乳腺癌新辅助化疗疗效的预测价值

目的:探讨局部进展期乳腺癌新辅助化疗前后血清恶性肿瘤特异性生长因子(TSGF)水平变化及其对疗效的预测价值.方法:对2002/2006收治住院的96例Ⅱb～Ⅲ期乳腺癌患者应用CEF方案进行新辅助化疗.CEF 方案:环磷酰胺(CTX) 500 mg/m2,d1,8;表阿霉素( EPI) 50 mg/m2,d1,8;5-氟尿嘧啶(5-Fu) 500 mg/m2,d1,8.28 d为1 个周期,所有患者完成2 个周期新辅助化疗后评价疗效.于治疗前1 d及治疗2周期后各采外周静脉血2 mL,用光电比色法检测血清TSGF水平.结果:新辅助化疗总有效率为48%(46/96),其中38例(40%)降低了临床分期,完全缓解7例,部分缓解39例,无疾病进展者.96例乳腺癌患者化疗前TSGF阳性率为73%(70/96).TSGF阳性组和阴性组总有效率分别为49%(34/70),46%(12/26),无显著性差异(χ2＝0.044,P=0.833,＞0.05).化疗前血清TSGF水平为(71.1±6.5)×103 U/L;化疗后为(58.6±7.2)×103 u/L,较化疗前显著下降(P＜0.05).其中临床完全缓解和部分缓解患者血清TSGF水平化疗后较化疗前均有一定程度下降(P＜0.05);而病情稳定患者血清TSGF水平较化疗前无显著下降(P＞0.05).结论:血清TSGF水平不足以预测新辅助化疗的疗效,但新辅助化疗前后TSGF水平变化对疗效预测有一定的临床意义.     

The Effect-enhancing and Toxicity-reducing Action of the Extract of Herba Scutellariae Barbatae for Chemotherapy in Hepatoma H22 Tumor-bearing Mice

Objective： To investigate the effect-enchancing and toxicity-reducing action of the extract of Ban Zhi Lian （半枝莲 Herba Scutellariae Barbatae, EHSB） for chemotherapy in hepatoma H22 tumor-bearing mice. Methods： The tumor-bearing mice were divided into 6 groups randomly： a model group, a high dose EHSB group, a low dose EHSB group, a 5-fluorouracil （5-FU） group, a 5-FU＋high dose EHSB group and a 5-FU＋low dose EHSB group, and with a normal group set as the controls. All the groups were treated for 10 days. The life prolongation rate, toxic reactions of chemotherapy, WBC count, the body weight, tumor weight, thymus index and spleen index, and phagocytic function of intra-abdominal macrophages were investigated in the H22 tumor-bearing mice. Results： The increase of the body weight in both the 5-FU＋EHSB groups was significantly higher than that in the 5-FU group, with the toxic reactions such as anorexia, abdominal distension and emaciation significantly alleviated. Growth of the tumor was significantly inhibited in the high dose EHSB group, the 5-FU group, the 5-FU＋high dose EHSB group, and the 5-FU＋low dose EHSB group. The survival time in the 5-FU＋high dose EHSB group and the 5-FU＋low dose EHSB group was significantly prolonged as compared with that of the 5-FU group. The life prolongation rate was 98.72% in the 5-FU＋high dose EHSB group and 52.11% in the 5-FU＋low dose EHSB group. Growth of the transplanted tumor was significantly inhibited in the high dose EHSB group, the 5-FU group, the 5-FU＋high dose EHSB group, the 5-FU＋low dose EHSB group. The tumor inhibition rate in the high dose EHSB group, the 5-FU group, the 5-FU＋high dose EHSB group and the 5-FU＋low dose EHSB group was 36.98%, 42.26%, 65.28% and 52.45%, respectively. 5-FU combined with a high-dose EHSB could significantly enhance the tumor inhibition rate （P〈0.05）. The thymus index and the spleen index significantly increased in the high dose EHSB group, and atrophy of the immunological organs induced     

乳头血性溢液的诊断与治疗

目的:总结乳头血性溢液的诊断和治疗方法,为临床合理诊断治疗提供依据.方法:回顾性分析1998年至2006年本院收治的220例乳头血性溢液病例.结果:乳腺癌的细胞学诊断准确率50.85%,钼靶X线片诊断准确率76.27%,联合诊断准确率86.44%,冰冻活检准确率100%,联合诊断准确率优于乳头溢液涂片法和X线钼靶摄片法,差异具有统计学意义(P＜0.05).其中导管内乳头状瘤60.91%(134/220),乳腺癌26.82%(59/220),囊性增生、炎症、导管扩张症12.27%(27/220).结论:联合诊断可提高准确率,手术治疗及术中冰冻活检是合理治疗方式.     

^153钐-乙二胺四甲基膦酸联合伊班磷酸钠缓解骨转移性癌疼痛

目的 ^153钐-乙二胺四甲基膦酸(^153Sm-EDTMP)联合伊班磷酸钠控制多发性骨转移癌疼痛，探讨其疼痛缓解率。方法 106例多发性骨转移癌患用^153Sm-EDTMP联合伊班磷酸钠治疗，观察骨痛缓解及生活质量提高情况。结果 严重( )：CR23例，PR16例，MR3例，NR3例。中度( )CR18例，PR15例，MR3例，NR2例。轻度( )：CR14例，PR7例，NR2例。止痛有效率87．7％，生活质量明显提高，无严重毒副反应。结论 ^153Sm-EDTMP联合伊班磷酸钠治疗多发性骨转移安全有效。     

PPARγ对人胰腺癌细胞中抑癌基因PTEN表达的影响

AIM: To explore the relationship between the expression of PTEN gene and the expression of PPARgamma, and the human pancreatic cancer cells PANC-1 were cultured in vitro. METHODS: The effects of rosiglitazone and GW9662 on the expression of PTEN gene and PTEN protein in the human pancreatic cancer cells PANC-1 were detected by RT-PCR and immunohistochemistry respectively. In addition, the percentage of the expression of PTEN protein was analyzed by flow cytometry. RESULTS: The expression of PTEN gene and PTEN protein in human pancreatic cancer cells PANC-1 were all increased significantly after treated with rosiglitazone. While those were markedly reduced in GW9662 treated groups, and it has a dose-effect relationship between them. CONCLUSION: The expression of PTEN gene were paralleled with the expression of PPARgammain human pancreatic cancer cells PANC-1, which may be related to its inhibitory effects on pancreatic tumor cells.     

Clinical Effects of Shenqi Fuzheng Injection in the Neoadjuvant Chemotherapy for Local Advanced Breast Cancer and the Effects on T-lymphocyte Subsets

Objective： To evaluate clinical effects of Shenqi Fuzheng Injection （参芪抉正注射液） in the neoadjuvant chemotherapy for local advanced breast cancer and the effects on T-lymphocyte subsets. Methods： During the period from 2000 to 2005, 126 patients with local advanced breast cancer were treated with the neoadjuvant chemotherapy. They were randomly divided into the following two groups： a control group of 61 cases treated by chemotherapy alone and a study group of 65 cases treated by chemotherapy plus Shenqi Fuzheng Injection, All the cases of both groups were given the CEF （CTX 500 mg/m^2, d1, 8; EP140 mg/m^2, d1, 8; and 5-Fu 500 mg/m^2, d1,8） regimen. The clinical effects, the effects on T-lymphocyte subgroup and NK cells, and the toxic side effects were observed. Results： All the patients completed two cycles of the chemotherapy, and the efficacy and the toxic side effects were evaluated. For the primary tumor in the breast, the total effective rate was 69.2% （45/65） in the study group and 49.2% （30/61） in the control group with a statistically significant difference in the intergroup comparison （x^2=5.251, P=0.022, 〈 0.05）. There was no progression of the disease in both the groups, and there were no grade IV toxic side effects in the two groups. The major toxic responses were myelosuppression and gastrointestinal reaction, which were milder in the study group than the control group, and with a shorter recovery course in the former than the latter. Besides, an obvious rise of the T-lymphocyte subgroup and NK cells was found in the study group after the neoadjuvant chemotherapy, with a very significant difference from the controls （P〈0.01）. Conclusions： Shenqi Fuzheng Injection can improve and regulate immune function of the patients with local advanced breast cancer given the neoadjuvant chemotherapy, and therefore it can enhance the curative effect and reduce the side effect as well.     

肝癌并高热、癌性周围神经病1例并文献回顾

肝癌是危害人体健康的重要肿瘤之一,黄疸、肝区疼痛、纳差、腹胀、乏力、消瘦等症状是其常见的临床表现.癌性发热一般为中度发热37℃-38℃,少见高热,多为伴随症状.本病例发热为首发症状,体温高达39℃,行介入栓塞治疗后,高热消退.癌性周围神经病的发病率较低,多见于肺癌,肝癌更为少见,故加以报告,并对癌性神经病的诊断治疗进展加以文献回顾.     

皮肤转移癌5例报告并文献复习

目的：了解皮肤转移癌的特点，提高皮肤转移癌的诊治水平。方法：报道5例来源于不同恶性肿瘤的皮肤转移癌病例，并复习相关文献。结果：5例肿瘤的恶性程度较高，皮肤转移发生在术后6月到18月，其中4例合并重要脏器转移，临床症状与皮肤病症状类似，通过以化疗为主的综合治疗获得较好疗效。结论：皮肤转移癌的临床发生率较低，常合并其他重要脏器转移，预示肿瘤已进入晚期，其诊断依靠病史和结节活检。及时诊断、积极治疗对于减轻患者痛苦，延长生存期有重要意义。     

原发性胃恶性淋巴瘤的诊断和外科治疗

目的：探讨原发性胃恶性淋巴瘤的诊治方法。方法：1988年1月～1997年2月收治27例胃恶性淋巴瘤，全部经剖腹探查及病理检查证实。病变完全切除者20例，部分切除者7例，全部患者术后辅以CHOP(环磷酰胺、表阿霉素、长春新碱、强的松)化疗。结果：随访率92．6％(25／27)，全组总的5年生存率为72％(18／25)。结论：胃镜下活检最具确诊价值，治疗以根治性手术作为首选，辅以放化疗。     

153Sm-EDTMP与伊班磷酸钠联合治疗乳腺癌多发性骨转移

目的探讨1 53 Sm EDTMP和伊班磷酸钠联合控制乳腺癌骨转移疼痛和病灶的临床价值。方法 76例乳腺癌骨转移患者分别用1 53 Sm EDTMP及联合伊班磷酸钠治疗 ,观察骨痛缓解及骨转移灶控制情况。结果1 53 Sm EDTMP组止痛有效率 80 .0 0 % ,骨转移灶控制率 1 5 .0 0 % ;联合治疗组止痛有效率 94 .4 4 % ,骨转移灶控制率 4 4 .4 4 % ,具有显著性差异 (均P <0 .0 5 )。结论 1 53 Sm EDTMP治疗乳腺癌多发性骨转移安全有效 ,联合伊班磷酸钠治疗可提高疗效