天地欣(国产香菇多糖)配合化疗治疗中晚期胃肠道腺癌72例临床观察

用国产香菇多糖（天地欣）配合化疗治疗中晚期胃肠道腺癌40例与32例未加用香菇多糖的同种治疗病例比较发现，香菇多糖对增强患者的免疫功能很有效（P＜0．01），短期内对提高化疗的总缓解率帮助不大（P＞0．05），对降低化疗的毒副反应及改善生活质量有一定影响。香菇多糖（天地欣）的毒副反应小，疗效确切。     

The therapeutic effect of intratumoral injection of GM-CSF gene-modified allogenic macrophages on tumor-bearing mice

Both the antigen presenting ability and the cytotoxicity of macrophages can be enhanced by GM-CSF gene transfer. In the present study, the therapeutic effect of intratumoral injection with GM-CSF gene-modified allogenic macrophages on tumor-bearing mice observed. The peritoneal macrophages of C57BL/6 mice were transfected with GM-CSF gene mediated by recombinant adenovirus and the subcutaneous CT26 colon adeno-carcinoma-bearing BALB/c mice were treated by intratumoral injection of the above macrophages. The survival time of the tumor-bearing mice were prolonged significantly and some tumor mass disappeared completely. The necroses of the tumor cells and massive infiltration of inflammatory cells were observed 6 days after treatment 30 days after treatment, only the leftover of tumor cells and the inflammatory cells remained. The data indicated that introtumoral injection of GM-CSF gene-modified allogenic macrophages displayed more potent therapeutic effect on the preestablished tumor-bearing mice. Supported by National High Biotechnology Foundation (Z20-01-03). This is one of papers of the special issue on gene therapy research (Chin J Cancer Res Vol. 9 No. 4 December, 1997).     

Cutaneous metastases from adenocarcinoma of unknown primary

Cutaneous manifestations of malignancy are not uncommon, especially in advanced disease. They may also occur early in malignant disease or they may even signify recurrence particularly if they are paraneoplastic in nature. Clinical diagnosis can be difficult because of the wide spectrum of appearance of these lesions, and, in many cases, because of the lack of an identifiable underlying primary. Presented here is the case of a 65-year-old woman with multiple inflammatory cutaneous metastases, which were sclerodermoid in nature. These appeared 14 months after initial diagnosis of adenocarcinoma of unknown primary (ACUP) and signified the beginning of a rapid deterioration in her condition. The coexistence of limited systemic sclerosis (scleroderma) and ACUP initially raised several interesting diagnostic possibilities. Adenocarcinoma of unknown primary and the sclerodermoid reaction in malignancy are discussed.     

Stage IV ovarian clear cell adenocarcinoma treated effectively by chemotherapy with etoposide and cisplatin (EP)

We report a case of stage IV ovarian clear cell adenocarcinoma (OCCA) in a 72-year-old woman who was treated postoperatively with etoposide combined with cisplatin (EP). The patient exhibited bulky intrapelvic and para-aortic lymph nodes with metastases to the cervical lymph nodes. The primary lesion was resected and, postoperatively, she received one course of combination chemotherapy consisting of cyclophosphamide, 500 mg/m²; doxorubicin, 50 mg/m²; and cisplatin, 70mg/m² (CAP), followed by six courses of combination chemotherapy consisting of etoposide, 80mg/m² days 1 through 5 and cisplatin, 70 mg/m² on day 5 every 4 weeks. After five courses of EP, the lymph node metastases had virtually disappeared. The patient is now disease-free 21 months after the initial surgery. These findings suggest that EP may be useful in treating OCCA.     

Association of Helicobacter pylori Infection with Gastric Adenocarcinoma

Gastric adenocarcinoma is the most prevalent cancer in South Korea, and Helicobacter pylori (H. pylori) infection is also common. This study was performed to examine the association between H. pylori infection and gastric cancer, taking into account various other factors. To investigate the association between gastric adenocarcinoma and H. pylori infection, determined by urease-positive reaction in the CLO test, a total of 175 paired specimens (175 tumor and 175 tissues adjacent to tumor) of stomach cancer patients and a total of 113 control specimens were obtained. The positive H. pylori infection rates were 78.9% (138/175) among the patients in specimens of tumor or tissues adjacent to the tumor and 41.6% (47/113) among controls in the CLO test. A positive correlation between H. pylori infection and gastric cancer was observed (age-adjusted odds ratio, 7.0; MH χ²=34.5 with P <0.0005). These data suggest that stomach cancer patients in Korea have high infection rates of H. pylori regardless of site specificity, and this infection might be causally associated with stomach cancer.     

MNNG诱发大鼠腺胃癌模型的建立及p53,ras基因表达的研究

目的建立N一甲基一N’一硝基一N一亚硝基胍（N－methy1－N’－nitro－N－nitrosoguanidine，MNNG）诱发大鼠腺胃癌模型并观察p53，ras基因的表达。方法给Wistar大鼠饮用MNNG水溶液（终浓度为80μg／ml），用ABC法检测P53和P21蛋白的表达。结果MNNG成功地诱发出了胃癌、胃腺瘤、胃息肉、胃粘膜不典型增生和历上皮化生等病变。胃癌肝转移2例，淋巴结转移1例。P53蛋白在肠化及不典型增生皆阴性，胃癌阳性率为50％；P21蛋白在肠化及不典型增生中阳性率为44％，在癌组织中为23％。结论MNNG能诱发大鼠脾胃癌等病变，P53基因突变在胃癌发生发展过程中起一定作用，而ras基因激活是一个早期现象。     

重组人催乳素(rhPRL)在huPBL/SCID嵌合模型中对人直肠癌的治疗效应及免疫机理初探

通过体内实验进一步证实rhPRL对机体免疫功能的调节作用,以及用于过继细胞免疫治疗的可能性。我们选用CB17 SCID纯系小鼠,腹腔注入人结肠腺癌细胞(HT29),2小时后腹腔注入尼龙毛纯化的人淋巴细胞(T/NK细胞),同时开始进行rhPRL治疗,并设HBSS对照和rhIL-2治疗对照组。结果表明,rhPRL在体内外均无直接抗癌效应,反而可促进肿瘤生长。当SCID荷瘤鼠同时移植入人的T/NK细胞时出rhPRL可明显提高T/NK细胞的抗癌效果,生存期明显延长(P<0.05)。平均生存期由70.4天延至112.1天,在对照组全部死亡时(d105),rhPRL治疗组有60％存活,且在实验终止时(>160天)仍有40％存活。分析其抗癌机理发现,rhPRL体外可直接促进人T/NK细胞增殖,其分泌上清可抑制肿瘤生长,同时发现人T/NK细胞与HT29共育4小时中rhPRL亦可直接促进杀伤活性。     

T细胞及相关免疫分子在淋巴细胞趋化因子增强肿瘤自杀基因疗法中的作用

本室以往的研究表明,用腺病毒作为载体将大肠杆菌胞嘧啶脱氨酶(CD)基因与小鼠淋巴细胞趋化因子(Itn)基因联合体内转染,具有显著的抗肿瘤效应.本文对其免疫机理进行了进一步研究,发现CT26结肠腺癌细胞体外经过CD/Ltn基因转染并给予前体药物5-FC后,CT26结肠腺癌细胞表达CD80和CD54分子明显增加,提示经CD自杀基因和Ltn基因联转移后,肿瘤细胞免疫原性增加.荷瘤小鼠体内经联合治疗后,小鼠脾细胞分泌IL-2和IFN-γ明显增加.体内用抗CD4、CD8抗体阻断实验研究结果的表明,联合应用自杀基因和Ltn基因治疗主要通过诱导CD8~ T细胞发挥抗肿瘤作用.     

胃腺癌组织中KAI1/CD82蛋白的表达及其意义

目的 探讨KAI1／CD82蛋白在胃腺癌组织中表达及其与胃癌生物学行为的关系。方法应用免疫组织化学技术S-P法检测68例胃腺癌组织中KAI1／CD82蛋白的表达，以20例非肿瘤性胃黏膜组织作对照。对随访14个月～13年的35例做生存分析。结果 68例胃腺癌组织KAI1／CD82蛋白阳性表达率为26、5％（18／68），对照组胃黏膜组织阳性表达率95．0％（19／20）；高／中分化胃腺癌KAI1／CD82蛋白阳性表达率较低分化者为高，分别为41．4％（12／29）、15．4％（6／39），P〈0．05；无淋巴结转移胃腺癌的KAI1／CD82蛋白阳性表达率较有淋巴结转移者为高，分别为45.5％（10／22）、5.3％（8／46），P〈0.05；侵及黏膜及黏膜下层、肌层和浆膜层胃腺癌KAI1／CD82蛋白阳性表达率分别为66、7％（4／6）、34.8％（8／23）、15.4％（6／39），P〈0.05。KAI1／CD82蛋白在Ⅰ～Ⅱ期胃腺癌阳性表达率为37.0％（17／46），在Ⅲ～Ⅳ期胃腺癌中阳性表达率为13.6％（1／22），P〈0.05。KAI1／CD82蛋白阳性患者术后1、3、5、7、10年生存率分别为100.0％（7／7）、85.7％（6／7）、57.1％（4／7）、42.9％（3／7）和28．6％（2／7），而KAI1／CD82阴性患者术后生存率分别为89、3％（25／28）、42、9％（12／28）、14．3％（14／28）、7．1％（2／28）和3、6％（1／28）。KAI1／CD82蛋白阳性患者术后1、3、5、7和10年生存率比KAI1／CD82阴性患者术后1、3、5、7和10年生存率显著提高，P〈0．05。结论 KAI1／CD82蛋白在胃腺癌的表达与肿瘤浸润深度、分化程度、临床分期及淋巴结转移有关，与患者性别、年龄无关。检测KAI1／CD82蛋白有助于临床评估病情，判断预后。     

胃粘液腺癌149例临床病理学特点

目的:比较胃粘液腺癌(Mucinous gastric carcinoma,MGC)不同分期的临床病理学差异,探讨影响MGC预后的临床病理学特征.方法:分析1982年1月～1997年12月收治的MGC患者149例的临床病理及其预后.结果:MGC更易发生浆膜浸润(Ⅲ、Ⅳ期S2 S3:67.5%);浸润性更强(Ⅰ Ⅱ期T3:6.2%;Ⅲ Ⅳ期T3:44.4%);中晚期更易腹膜种植(P2 P3:30.7%);中晚期更易发生淋巴结转移(N1 N2:80.3%);根治性切除率早期明显高于中晚期(P＜0.005);Ⅰ Ⅱ期5年生存率早期明显提高(53.1%),中晚期仅为13.7%,两者之间比较有明显差别(P＜0.005).结论:不同时期MGC临床生物学行为不尽相同,其预后不良的原因与确诊时病期晚,发生浆膜浸润率、淋巴结转移率、腹膜播散率高和根治性切除率低有关.