Groove pancreatitis associated with true pancreatic cyst

We report a case of groove pancreatitis (GP) associated with a true pancreatic cyst. An 81-year-old man who had suffered epigastric pain for 4 months was referred to Saisekai Kure Hospital. Computed tomography and endoscopic retrograde pancreatography showed a cystic lesion in the groove area of the pancreas. Serum amylase elevation and imaging findings suggested GP due to the cyst. Six weeks of medical treatment did not improve the clinical symptoms. Therefore, pancreatoduodenectomy was performed. Histologic examination revealed a true cyst with intraluminal necrosis, which produced a protein plug that obstructed the Santorini duct. The parenchyma surrounding the groove area showed marked fibrosis and inflammatory cell infiltration. GP due to true pancreatic cyst was diagnosed. Although GP is usually caused by overconsumption of alcohol, which leads to changes in the pancreatic juice and the ultimate blockage of pancreatic outflow, the histologic features in our patient suggest that true pancreatic cyst stands as a secondary cause of GP.     

一个RET原癌基因Met918Thr突变的多发性内分泌腺瘤病Ⅱb家系报道

目的 检测一个多发性内分泌腺瘤病(MEN)Ⅱb家系的RET原癌基因突变。方法 提取患者及其父母的外周血基因组DNA，对RET原癌基因第16外显子进行聚合酶链反应(PCR)，将PCR扩增产物进行直接基因测序和限制性内切酶分析。结果 检测到患者RET原癌基因第16外显子918密码子存在ATG(Met)／ACG(Thr)点突变，而在患者父母中未检测到该突变。结论 通过对MENⅡb患者及其父母的基因筛查发现，该患者点突变是杂合子错义突变。该疾病的诊断达到了基因水平。     

乳腺癌中P73、P21的表达及其意义

目的 :通过检测 P73蛋白、P2 1蛋白在乳腺癌中的表达及其与临床病理指标的关系 ,探讨乳腺癌的生物学特性 ,分析它们在乳腺癌的发生、转移中所起的作用。方法 :应用免疫组化 S-P法检测 68例乳腺癌石蜡包埋标本中 P73、P2 1的表达情况。结果 :a.在乳腺癌 - 级与 级之间 P73蛋白阳性率分别为 1 8.75 % ( 9/48)和 60 .0 0 % ( 1 2 /2 0 ) ,差异有显著性 ( P <0 .0 5 )。随着 P73阳性表达率增高 ,乳腺癌的恶性程度增高。b.淋巴结转移组 p2 1的阳性表达率 2 3 .3 3 % ( 7/3 0 )明显低于无淋巴结转移组的阳性率 5 2 .63 % ( 2 0 /3 8) ,差异有显著性( P <0 .0 5 )。c.P73、P2 1之间无相关。结论 :P73、P2 1与乳腺癌的发生、发展有关     

SA、F/TPSA及PSAD在前列腺癌诊断中的作用

目的 :探讨血清前列腺特异抗原 (PSA) ,血清总PSA及游离PSA比值 (F/TPSA)及前列腺特异性抗原密度(PSAD)在前列腺癌诊断中的作用。方法 :对 5 1例前列腺癌患者及 14 5例良性前列腺增生症患者PSA、F/TPSA及PSAD值的差异进行分析、比较。结果 :前列腺癌组血清PSA及PSAD高于良性前列腺增生组 ;而F/TPSA值低于良性前列腺增生组 ,差异均有显著性。结论 :PSA >4ng·ml-1作为筛选前列腺癌的临界值存在一定缺陷 ;当PSA <10ng·ml-1,F/T值有助于鉴别前列腺癌和良性前列腺增生 ;而PSAD对于筛选前列腺活检病例亦有一定价值。     

肝癌病人血浆和癌组织中血栓调节蛋白的检测

目的　检测肝癌病人血浆和肝癌组织中血栓调节蛋白 (TM )的表达 ,探讨TM与肝癌临床病理特征的关系。方法　用酶联免疫吸附夹心法检测 45例肝癌和 6例肝良性占位病人手术前后的血浆TM水平 ;用免疫组织化学法检测肝癌及肝良性占位组织中的TM蛋白表达水平。结果　术前肝癌组血浆TM水平 ( 10 .2± 5 .7)ng/mL明显高于肝良性占位组 ( 6.1± 2 .2 )ng/mL和正常人对照组 ( 5 .7± 1.0 )ng/mL ,P <0 .0 5 ;术前TM血浆水平肝癌伴门静脉癌栓组 ( 6.9± 4.5 )ng/mL和多发肝癌结节组 ( 8.1± 4.6)ng/mL明显低于无门静脉癌栓组( 11.4± 5 .6)ng/mL和单发肝癌结节组 ( 11.5± 5 .9)ng/mL ,P <0 .0 5 ;40例肝癌病人肝癌切除术前TM水平( 10 .8± 5 .3 )ng/mL与肝癌切除术后 ( 7.6± 4.2 )ng/mL相比差异显著 ,P <0 .0 5。肝良性占位组术前与术后相比差异无显著性 ,P >0 .0 5。肝癌组织中TM蛋白表达阳性的病人术前血浆TM水平明显高于TM表达阴性者 ,P <0 .0 5 ;而术后血浆TM水平两者则无显著性差异 ,P >0 .0 5。结论　肝癌病人血浆中TM水平升高 ,TM水平的高低与门静脉癌栓的形成有关     

经直肠超声对前列腺癌诊断的价值

目的：本文观察前列腺癌部位声像图特点并与病理对照，以便帮助对前列腺癌诊断及穿刺点的正确选择，提高前列腺穿刺活检阳性率。方法：总结64例经病理证实为前列腺癌的112个部位的经直肠超声声像图，观察有无异常回声肿块和异常血流区域。结果：112个前列腺癌部位其经直肠超声(TRUS)检查发现异常的有90个，占80．4％；TRUS检查未发现可疑之处的为22个，占19．6％。结论：TRUS可作为诊断前列腺癌和前列腺穿刺活检穿刺点选择的重要方法。     

Endorectal surface coil MR imaging of prostatic carcinoma with the inversion-recovery sequence

The value of inversion-recovery (IR) sequences in the diagnosis and staging of prostatic carcinoma with magnetic resonance (MR) imaging was studied. Twenty-six patients with carcinoma of the prostate were imaged at 1.5 T with an endorectal surface coil and with a variety of IR sequences and a set of spin-echo (SE) sequences for comparison. Ex vivo prostate specimens were imaged again at the same field strength. The two images were correlated with histologic sections. Cancer was identified with MR imaging in 96% of patients. Of the tumors more than 4 mm in diameter, 87% were identified on T2-weighted SE images, whereas only 26% were identified on IR images. However, IR images may be more useful in local staging of carcinoma. Gross capsular infiltration was present in only two patients; however, it was detectable (and excluded in five other patients) by means of IR images. It was not detectable on SE images. The high quality of images obtained with the endorectal coil was confirmed. The authors conclude that addition of the IR sequence to MR imaging with the endorectal coil may improve the usefulness of this examination.     

Comparison of characteristics of esophageal squamous cell carcinoma associated with head and neck cancer and those with gastric cancer

In ongoing reviews of 339 patients with surgically treated primary squamous cell carcinoma, there were 19 (5.6%) with concurrent gastric cancer and 11 (3.2%) with head and neck cancer. The incidences of intra-esophageal multiple occurrence of esophageal cancer are 27.3% and 26.3% in those with associated head and neck cancer and gastric cancer, respectively, and higher than 7.1% in those without such a concurrent cancer. There was no difference in the clinicopathological characteristics of those with concurrent head and neck and gastric cancers, except for the higher incidence of metachronous occurrence in the former. These findings suggest that, in cases of esophageal cancer associated with concurrent head and neck cancer and gastric cancer, intraesophageal multiplicity of the esophageal carcinoma is frequent and that preoperative serial evaluations is most important to design treatment and estimate the prognosis.