肿瘤切除联合同期心脏手术18例临床分析

目的总结肿瘤切除联合同期心脏手术的经验。方法从2000年至2007年,我科共实施肿瘤切除联合同期心脏手术18例,其中根治性肾切除7例,肺癌根治4例,肺楔形切除3例,食管贲门癌根治2例,子宫及卵巢切除2例。同期心脏瓣膜置换1例,冠脉旁路移植(CABG)16例。体外循环3例,非体外循环15例。结果全组患者无院内死亡,1例术后发生膈下脓肿经引流痊愈。随访6～80个月,术后远期4例死亡,1例死于心肌梗死,3例死于癌扩散。本组术后1,5年生存率分别为86.6%和70.9%。结论肿瘤切除联合同期心脏手术安全可行,远期效果可能与肿瘤自身生物学行为相关。     

Potential mechanism for Calvados-related oesophageal cancer

The old Normandian habit of consumption of hot Calvados is associated with an increased risk of oesophageal cancer compared to other alcoholic beverages. The role of alcohol consumption in the risk of oesophageal cancer is well established. The first metabolite of alcohol, acetaldehyde is a potential local carcinogen in humans. Accordingly, different acetaldehyde concentrations in different beverages could account for some of the variations in cancer risk with regard to the type of alcoholic beverage. Eighteen samples of farm-made Calvados were collected in Normandy. Samples of commercially available beverages were purchased, including factory-made Calvados, other spirits, wines, beer and cider. The samples were analysed gas-chromatically for acetaldehyde and ethanol concentrations. All results are expressed as mean ± SD. The mean acetaldehyde concentration of all Calvados samples (1781 ± 861 μM, n = 25) differed highly significantly (p < 0.001) from that of all wine samples (275 ± 236 μM), from all other spirits samples (1251 ± 1155 μM, p < 0.05), and from all beer and cider samples (233 ± 281 μM, p < 0.001). Farm-made Calvados and farm-made cognac had the highest mean acetaldehyde concentration of the measured beverages. The high concentration of acetaldehyde combined with possible effects of the high temperature at which Calvados is consumed could account for the increased risk of Calvados-related oesophageal cancer.     

护理干预对放射治疗的鼻咽癌患者生活质量影响

目的 探讨护理干预对鼻咽癌患者放射治疗生活质量的影响.方法 将56例放射治疗鼻咽癌患者随机分为对照组和干预组,对照组给予常规护理,干预组在常规护理的基础上实施准确评估、心理指导、防治并发症特殊护理,对两组患者进行生活质量核心量表(QOL-C30)测评.结果 干预组干预后躯体功能、心理功能、社会功能及物质生活维度评分高,与对照组比较差异有统计学意义(P＜0.05).结论 护理干预能提高生活质量完成放疗治疗,顺利完成治疗.     

同时性多原发大肠癌36例临床分析

目的 探讨同时性多原发大肠癌的诊断和外科治疗方法.方法 回顾性分析36例同时性多原发大肠癌患者的临床资料.结果 全部病例均行同期手术切除,其中姑息性切除1例,根治性切除35例.其5年、10年生存率分别为58.3%及41.7%,与同期大肠单癌病例相比差异无统计学意义.结论 大肠癌患者术前或术中应常规行全程结肠镜检查,术中应常规解剖标本;治疗原则是根治性切除.     

细胞色素P450 CYP1A1基因多态与鼻咽癌易感性的关联分析

Objective To investigate the association between CYP1A1 gene polymorphisms and susceptibility of nasopharyngeal carcinoma in Cantonese nuclear families through family-based association study. Methods A total of 457 Cantonese nuclear families, consisting of 2134 members, were recruited as subjects. Each family included two parents and at least one offspring with nasopharyngeal carcinoma. Two single nucleotide polymorphisms (SNP) in CYP1A1 named m1 (rs4646903) and m2 (rs1048943) , were genotyped by PCR-RFLP assay and verified by directly sequencing. The genotype data were analyzed with family-based association test (FBAT) software to check the linkage and association between the two genetic markers and susceptibility of nasopharyngeal carcinoma. Results FBAT analysis showed that the minor allele frequencies (MAF) of the two SN P were 0. 442 (C) and 0. 339 (G) respectively. For m1 polymorphism in CYP1A1 gene was not significantly associated with nasopharyngeal carcinoma in our study population whether stratified with VCA-IgA or not (without stratification : X2=2. 399, P=0. 301 ; with stratification : Iow-titer group (VCA-IgA<1 : 80), MAF=0. 457 (C), X2=1.221, P=0.543 ; high-titer group (VCA-IgA ≥1 : 80), MAF=0. 427 (C), X2=2. 832, P=0. 243). For m2 polymorphism, when VCA-IgA<1 : 80, the G allele showed decreased transmission under additive and dominant model (MAF=0. 347 (G) ; Zadditive=-2. 120,Padditive=0. 034;Zdominant=-2. 303,Pdominant=0.021)and a boundary P value was got with global statistic (X2=5. 394, P=0. 067). Haplotype TG (0. 057), constructed by ml and m2, might decrease nasophargneal carcinoma risk (Z=-2. 002,P=0. 045). A boundary P value was also got with global statistic (X2=7. 067 ,P=0. 070). Conclusion There was no statistical significance between ml polymorphism and susceptibility of nasopharyngeal carcinoma in Cantonese nuclear families. And this study showed that m2 polymorphism might associated with the decrease of nasopharyngeal carcinoma in Cantonese nuclear families.     

Gender- and race-specific comparison of tobacco-associated cancer incidence trends in Florida with SEER regional cancer incidence data

OBJECTIVE: Analysis of state and national tobacco-associated cancer trends is critical for the identification of high-risk regions of the country that require the attention of the public health community. This study compares Florida race- and gender-specific cancer trends with pooled data obtained from nine Surveillance, Epidemiology, and End Results (SEER-9) registries. METHODS: Age-adjusted, race- and gender-specific cancer incidence trends were evaluated using joinpoint regression analysis. Pooled, age-adjusted incidence rates and standardized incidence rate ratios were computed for each cancer for the years 1999-2003 to compare Florida to SEER-9. RESULTS: Relative to SEER-9 whites and irrespective of gender, lung cancer rates in white Floridians were elevated through the 1990s. However, lung cancer rates have recently declined at a steeper rate among white Floridians than among SEER-9 whites. For years 1999-2003, black Floridians had significantly lower rates of lung, bladder, pancreas, and kidney cancer relative to SEER-9 blacks. The opposite pattern was evident for white Floridians with significantly higher rates of lung and laryngeal cancer relative to SEER-9 whites. CONCLUSION: Progress in the reduction of tobacco-associated cancers among white Floridians lags behind the progress noted in SEER-9 registries suggesting that additional state-directed smoking prevention and smoking cessation measures are needed.     

肿瘤分子靶向治疗的新观点

传统的细胞毒药物治疗肿瘤疗效已经达到了平台,单克隆抗体类靶向药物与化疗联合应用成为进一步提高疗效的关键.尽管靶向药物的特定性标靶人群尚未明确,但根据检测基因及蛋白状态、分子标准和临床标准选择合适的靶向药物已显示一定的应用前景.     

微小RNA与肿瘤

微小RNA(miRNA)是一类小分子的非编码调控的单链RNA,它参与有机体的生长、发育等多种生理过程.近年来研究表明肿瘤组织具有不同的miRNA表达,异常表达的miRNA影响了肿瘤细胞的发生、进展、分化、转移和复发.miRNA的不同表达不仅有助于肿瘤组织的诊断,而且可以指导预后.针对miRNA为靶点的动物学研究也发现,干扰某种miRNA表达可以减小肿瘤体积,抑制腹膜转移而发挥治疗作用.     

肿瘤新生血管生成抑制药物研究进展

新生血管生成抑制药物可以从不同途径阻断新生血管的生成,达到治疗肿瘤的目的.目前新牛血管生成抑制药物可分为阻断促血管生成因子作用通路的物、直接抑制内皮细胞药物、抑制基底膜降解的药物、抑制细胞整合素的药物、表皮生长因子受体抑制剂和其他种类,有较好的应用前景.     

1093例初治鼻咽癌的疗效和预后分析

目的 报道21世纪初中山大学肿瘤防治中心初治鼻咽癌的放疗现状及比较不同放疗技术对预后和生存质量的影响.方法 对根治性放疗的1093例初治鼻咽癌患者的资料进行回顾性分析.按2002年UICC分期标准,Ⅰ、Ⅱ、Ⅲ、Ⅳa+Ⅳb期分别为63、439、358、233例.812例采用X线透视模拟定位常规设野放疗(CR),155例采用CT模拟定位常规设野放疗(CT-sim CR),69例采用三维适形放疗(3DCRT),57例采用调强放疗(IMRT).放疗鼻咽部中位剂量为70 Gy.结果 全组5年局部控制率、区域控制率和无远处转移率分别为86.8%、95.3%和83.2%,5年无进展生存率和总生存率分别为66.9%和77.9%.CR、CT-sim CR、3DCRT、IMRT组5年总生存率和局部控制率分别为75.9%、83.5%、87.2%、86.6%(P=0.014)和84.5%、96.4%、91.0%、91.7%(P=0.006).3DCRT、IMRT组口干和张口困难发生率和程度较CR、CT-sim CR组明显减低(P=0.000和0.023).结论 采用CT模拟定位、3DCRT及IMRT技术能提高局部控制率和生存率,且3DCRT和IMRT技术能提高患者生活质量.