ERCC1､RRM1预测NSCLC患者GP方案化疗敏感性的对比研究

目的:对比切除修复交叉互补基因1(excision repair cross-complementing rodent repair deficiency,complementationgroup1,ERCC1)和核苷酸还原酶M1(ribonucleotide reductase M1,RRM1)低表达患者选择健择联合顺铂(gemcitabine andcisplatin,GP)方案和未经筛选经验性选用GP方案治疗晚期非小细胞肺癌(non-small-cell lung carcinoma,NSCLC)的临床疗效。方法:采用前瞻性的方法,根据组织标本是否适宜使用免疫组织化学方法检测分子标志物,在确诊为晚期NSCLC的患者中,ERCC1和RRM1低表达者归为A组,未经分子标志物检测的经验治疗者归为B组,经过4～6个周期的GP方案化疗,观察两组的疗效、无进展生存期(progressive-free survival,PFS)、总生存期(overall survival,OS)及化疗过程中的不良反应。结果:基于分子标志物结果选用GP方案较经验性选用GP方案有效率明显提高(χ2=5.377,P=0.02),PFS明显延长(P=0.03),差异有统计学意义;两组OS无显著性差异;不良反应无明显差异。结论:对ERCC1和RRM1低表达患者选择GP方案可以明显提高化疗有效率。     

Expression of cyclooxygenase-2 mRNA in drug-sensitive cell and drugresistant strains of ovarian cancer cell lines

Objective： To investigate the expression of cyclooxygenase-2 （COX-2） mRNA in drug-sensitive cell and drugresistant clones of ovarian cancer cell lines. Methods： RT-PCR and immunocytochemistry were used to investigate the expression of cyclooxygenase-2 in 3 clones drug-sensitive and 5 clones drug-resistant ovarian cancer cell. Results： Strong COX-2 mRNA expressions were detected in 3 clones of drug-sensitive cell and weak expressions were detected in 5 clones of drug-resistant cell. The protein expression of COX-2 in drug-sensitive cell was strongly positive reaction in immunocytochemistry stain and there was a weak positive reaction in 5 clones of drug-resistant cell. Conclusion： The expression of COX-2 mRNA in drug-sensitive cell strains is much higher than that in drugresistant strains of ovarian cancer cell lines, providing a basis of the chemoprevention for ovarian cancer.     

贝伐珠单抗联合紫杉醇治疗转移性乳腺癌的成本效果分析

【摘要】 目的 从现阶段医疗卫生角度出发,评价四川地区贝伐珠单抗联合紫杉醇治疗转移性乳腺癌的成本 效果优势。方法〓根据E2100临床试验数据,结合四川地区医疗费用水平,采用成本 效果分析法,以增量成本 效果比（ICER）为评价指标,评价贝伐珠单抗联合紫杉醇治疗转移性乳腺癌方案的优劣,并分析结果敏感度。结果〓紫杉醇与贝伐珠单抗联合组与紫杉醇单药组相比,ICER值远远高于3倍GDP;敏感度分析结果提示,当贝伐珠单抗药品费用下降50%时,联合组仍不具有成本 效果优势。贝伐珠单抗使用成本和医疗检查成本对总成本影响最大,其他参数影响较小。结论〓从我国现阶段医疗卫生角度出发,四川地区转移性乳腺癌使用贝伐珠单抗联合紫杉醇治疗,尚不具有成本效果优势。     

手术前动脉介入化疗对胃癌患者外周血淋巴细胞化学发光的影响

目的 :研究手术前动脉介入化疗对胃癌患者外周血淋巴细胞化学发光的影响。　方法 :选择 70例胃癌患者 ,分别在术前动脉介入化疗前和化疗后 1、3、5、7天抽取患者外周静脉血 ,分离淋巴细胞进行化学发光 (Ly CL)和细胞周期动力学检测 ,观察其化疗前、后的变化。　结果 :胃癌患者化疗后 2 4hLy CL迅速降低 (P <0 .0 1) ,最低值一般出现在化疗后 3～ 5天 ,然后逐渐上升 ,第 7天时基本恢复至化疗前的水平 (P >0 .0 5 )。同时淋巴细胞增生指数也有相同的变化 ,与Ly CL呈明显的正相关 (r =0 .6 1,P <0 .0 1)。　结论 :测定Ly CL强度变化可反映胃癌患者在术前动脉介入化疗过程中淋巴细胞免疫功能的变化 ,可作为患者免疫功能改变的动态观察指标 ,指导诊断和治疗。     

吉西他滨联合卡铂治疗老年晚期非小细胞肺癌临床疗效观察

目的观察分析吉西他滨联合卡铂治疗老年晚期非小细胞肺癌的临床疗效。方法选择我院2008年1月～2011年1月住院初治及复治的NSCLC患者21例,对初治、复治以及不同类型、不同分期的NSCLC患者的疗效及毒副作用情况进行分析。结果初治患者的疗效明显高于复治的疗效,两组比较差异具有统计学意义（P〈0．05）。不同类型NSCLC的疗效比较差异无统计学意义（P〉0．05）。不同分期NSCLC的疗效比较差异无统计学意义（P〉0．05）。主要不良反应为骨髓抑制、白细胞和血小板的减少。结论吉西他滨联合卡铂治疗老年晚期非小细胞肺癌临床疗效确切、毒副作用少,值得广泛推广和应用。     

CKl9 mRNA表达水平在乳腺癌微转移检测及治疗监测中的应用

目的探讨细胞角蛋白CKl9EnRNA表达水平在乳腺癌微转移检测及治疗监测中的应用。方法选择我院2004年2月-2011年8月健康体检者30例作为对照组,同时选择良性乳腺肿瘤30例,乳腺癌30例,对健康体检者、30例良性乳腺肿瘤和30例乳腺癌患者进行外周血中CKl9mRNA水平检查,统计比较组间的差异。结果CKl9mRNA在乳腺癌组表达明显高于良性乳腺疾病组．乳腺癌淋巴结转移组明显高于无淋巴结转移组,差异均有统计学意义（P〈0．05）。结论FQ—PCR检测CKl9mRNA对乳腺癌诊断特异性较高,具有确切的预测价值,可有效监测乳腺癌微转移和疗效,临床值得推广。     

辅助抗生素治疗宫颈癌前病变并发幽门螺杆菌感染的疗效观察

①目的探讨辅助抗生素治疗对宫颈癌前病变并发幽门螺杆菌（Hp）感染的治疗效果。②方法采用快速Hp尿素酶检测法筛选宫颈癌前病变的相关病例，用阴道镜和组织病理学进行诊断证实。对各类宫颈癌前病变创伤性治疗的同时，规范采用甲硝唑治疗。观察幽门螺旋杆菌阳性率的改变和临床表现的变化。③结果Hp感染与宫颈癌前病变发展为宫颈癌有相关性；除了手术治疗外，规范的甲硝唑治疗可以降低Hp感染的阳性发生率，同时，可以对宫颈癌起病因学治疗作用。④结论辅助抗生素治疗对宫颈癌前病变并发Hp感染的患者．可以起到消除潜在癌变的诱因和提高疗效的作用。     

彩色多普勒超声在诊断乳腺恶性肿瘤中的价值

目的探讨彩色多普勒超声在诊断乳腺恶性肿瘤中的作用。方法总结182例乳腺恶性肿瘤的二维及彩色多普勒超声检查血流显像（CDFI）信号的形态和数量、血流峰值及阻及阻力指数与病理学类型的关系。结果浸润性导管癌CDFI血流显像主要表现为内部血流、血流峰值和血流阻力均高于其他类型乳癌。其中导管原位癌主要表现为0级血流;髓样癌主要表现为Ⅰ级穿入血流（89.5%）;粘液癌主要表现为0～Ⅰ级穿入血流（93%）;炎症性乳癌表现为Ⅰ～Ⅱ级的周边血流（89%）和内部血流（93%）两种血流状态共存。浸润性导管癌肿块内CDFI血流峰值和阻力指数均高于导管原位癌、髓样癌和粘液癌,低于炎性乳癌,其差异具有统计学意义（P〈0.05）。结论乳腺癌超声显像具有特征性表现,通过恶性肿瘤的二维超声特点和彩色多普勒可初步明确乳癌的组织学类型,对乳腺恶性肿瘤的诊断具有重要价值。     

吗啡特殊用法治疗晚期癌痛

硬膜外腔、蛛网膜下腔、脑室内注射吗啡可以集中其脊髓吗啡受体及中枢吗啡受体作用而对顽固性癌痛有效,并且因用量减少而副作用减少,本文介绍其用法及量的滴定理论公式以及药物代谢动力学特点。     

Prostate cancer in Mexican-Americans: identification of risk factors

BACKGROUND: There is a paucity of information regarding prostate cancer (PCa) risk factors among Hispanics, the fastest-growing ethnic group in the United States. METHODS: This population-based case-control study included 176 Texas men of Mexican descent with PCa and 174 age- and ethnicity-matched controls. Demographic, lifetime occupational history, family history of cancer, lifestyle (e.g., smoking, alcohol, diet, and recreational physical activity) and anthropometric information were collected by personal interviews. Chemical exposure and physical activity were determined using job-exposure matrices for each reported job. RESULTS: Logistic regression models adjusted for relevant covariates were used to evaluate their independent effects. Compared to controls, cases were three times more likely to work in jobs with high agrichemical exposure (OR = 3.44, 95% CI 1.84-6.44), and 54% less likely to work in jobs with moderate/high occupational physical activity (OR = 0.46, 95% CI 0.28-0.77). In analyses stratified by stage, cases with organ-confined PCa were three times more likely to have high agrichemical exposure (OR = 3.39, 9%CI 1.68-6.84), and 56% less likely to have moderate/high levels of occupational physical activity (OR = 0.44, 95% CI 0.26-0.76). Increased risk of being diagnosed with advanced PCa was associated with obesity at time of diagnosis (OR = 2.50, 95% CI 1.20-5.20) and high levels of agrichemical exposure (OR = 4.65, 95% CI 1.97-10.97), but not with occupational physical activity. CONCLUSIONS: This case-control study, the first conducted in a homogeneous Hispanic population, identified modifiable PCa risk factors, such as physical activity and agrichemical exposure, which may be useful in developing interventions for this understudied population.