磁共振诊断胰腺癌的价值

目的：总结胰腺癌在磁共振（MRI）的表现,探讨MRI诊断胰腺癌的价值。方法：回顾性分析56例胰腺癌患者的MRI资料,与手术及病理结果对照,总结磁共振诊断胰腺癌的经验。结果：本组56例胰腺癌患者31例行手术治疗,术后病理确诊腺癌26例,腺鳞癌5例。25例因淋巴结转移或远处脏器转移而放弃手术治疗,经病理组织活检而确诊。MRI检出53例,诊断符合率为94．6％（53／56）。误诊3例。结论：MRI检查对胰腺癌具有较高的诊断价值,可以为临床诊断和选择治疗方案提供有价值的参考依据。     

The utility of DW-MRI in the diagnosis of pancreatic focal lesions

Background

Early diagnosis is crucial in management of pancreatic malignancy. DWMRI could be used in differentiating pancreatic lesions and judge about tumor aggressiveness.

Functional assessment of pancreatic parenchyma after secretin administration using serial T2-weighted echo-planar magnetic resonance imaging

Signal intensity (SI) changes of pancreatic parenchyma were evaluated after intravenous administration of secretin using T2-weighted single-shot spin-echo echo-planar imaging (EPI) to assess this method as a magnetic resonance (MR) test of pancreatic exocrine function. Nine volunteers were studied with serial single-shot EPI of the pancreas for 15 minutes after the injection of secretin or saline. The normal pattern of pancreatic SI change was demonstrated after intravenous injection of secretin, a single peak at 3-4 minutes in the head, body, and tail, followed by a gradual decrease in SI. Saline injection did not induce a significant SI change. There was no statistical difference in the peak contrast ratios (first mean, 1.21-1.25, vs. second mean, 1.18-1.22) and peak times (first mean, 3.2-3.7 minutes, vs. second mean, 3.1-3.6) in a repeat study. By evaluating the pattern of time-response curves obtained from serial T2-weighted EPI after secretin injection, pancreatic exocrine function may be directly assessed at the level of the head, body, and tail.     

胰腺实性假乳头状瘤临床病理特点及其诊治

目的探讨胰腺实性假乳头状瘤临床病理特点及其诊治。方法回顾性分析19例胰腺实性假乳头状瘤患者的临床病理资料。结果上腹疼痛14例,腹部肿块12例,影像学均能发现腹部肿块但不能明确诊断。肿块平均直经10．3cm,包膜完整10例,包膜不完整9例,质地呈实性8例,呈囊实性11例。快速冰冻病理10例,6例获得确诊。病理特征为肿瘤细胞围绕纤细血管轴心形成特征性的假乳头状结构,细胞形态一致,异型不明显。4例证实有胰腺和血管浸润。11例免疫组化结果是：波形蛋白（Vimentin）、神经元特异性烯醇化酶（NSE）、a1抗胰蛋白酶（a1-AT）、突触素（Syn）、孕激素（PR）为阳性,上皮膜抗原（EMA）、雌激素（ER）、嗜铬颗粒素A（CgA）、S-100蛋白为阴性。6例行胰十二指肠切除术,7例行肿瘤局部切除术,5例行胰体尾加脾切除术,1例胰体部肿瘤行胰腺阶段切除术。18例获随访,中位随访时间41（2-103）个月,肿瘤无复发,除1例出现营养不良外,余患者生存满意。结论胰腺实性假乳头状瘤为低度恶性肿瘤,确诊需依赖病理组织学检查。手术切除是治疗本病的良好方法。     

Catechol‐O‐methyltransferase,a new target for pancreatic cancer therapy

Catechol‐O‐methyltransferase (COMT) is an important molecule in different types of cancers. Its biological effect and therapeutic significance, however, rarely been investigated fully in pancreatic cancer. Immunohistologically, high COMT expression was significantly correlated with the longer overall survival of patients (P < 0.05), indicating its protective nature. The effects of COMT on cell growth, apoptosis, and invasion were evaluated using overexpression and silencing methods. In detail, we carried out experiments using one stably transduced and two transiently transfected pancreatic cancer cell lines in vitro, and one stably transduced cell line in vivo mice xenograft models. In vitro experiments showed that COMT inhibited cell proliferation, enhanced gemcitabine‐induced apoptosis, and inhibited cell invasion in stably transduced and transiently transfected cell lines by regulating the PI3K/Akt pathway, p53, and E‐cadherin. The COMT overexpressed and silenced cell lines showed significantly inhibited and enhanced growth capacities in in vivo xenograft models, respectively. In conclusion, COMT suppressed pancreatic cancer and its high expression predicted longer survival time. The interaction of COMT with the PI3K/Akt pathway makes it a potential target for therapy.     

糖尿病脑内胰岛移植临床初步研究(附三例报告)

本文报告胰岛细胞脑内移植治疗I型糖尿病共3例,分别经过3个月、4个月、6个月的临床观察,其临床症状明显改善或消失,空腹血糖由移植前平均12.38mmol/L下降至7.77mmol/L;3例患者普通胰岛素用量平均每日62.3~u,移植后第21～30天均完全停用胰岛素,其中1例已持续撤离胰岛素治疗达5个月。观察结果提示:胰岛移植物在患者的脑内成活,并具有良好的内分泌功能。     

Proportionate cancer mortality among workers in the Belarussian tanning industry

BACKGROUND: The tanning industry involves many occupational exposures. This study evaluates proportionate cancer mortality among workers employed in the Belarussian tanning plant in Minsk. METHODS: A total of 768 workers with seniority of not less than 6 months who were hired after January 1, 1953 and died before December 31, 2000 was investigated. Proportionate mortality ratios (PMRs) were calculated using the population of Minsk to generate expected numbers. RESULTS: Among women employed in the tannery, there was a significant excess of pancreatic cancer, based on eight deaths (expected = 2.56, PMR = 3.13, 95% CI = 1.35-6.17). Six of the eight pancreatic cancer deaths occurred among women occupied in dyeing-stuffing workshops (expected = 1.64, PMR = 3.67, 95% CI = 1.34-7.97), all among workers hired between 1962 and 1984 (expected = 1.06, PMR = 6.54, 95% CI = 2.6-13.4). CONCLUSIONS: Women in this tanning industry cohort experienced excess mortality of cancer of the pancreas, with suggested increases of corpus and cervix uteri, melanoma, and kidney cancers. For men, an insignificant increase in PMR of oral cavity-pharynx and pancreatic cancers was seen. Further prospective follow-up of living members of this cohort, will allow more in-depth analysis of rare cancer sites, latency, and duration of employment, and is warranted.     

胰腺浆液性微囊性囊腺瘤临床病理分析

目的 探讨胰腺浆液性微囊性囊腺瘤（serous microcystic adenomas of pancreaseas,SMAP）的临床病理学特征、免疫学表型和鉴别诊断要点。方法 对3例发生在胰腺的SMAP进行光学显微镜观察和免疫组织化学标记,并结合文献复习。结果 SMAP临床表现多为腹痛伴不明原因的消瘦。镜检：SMAP为微囊结构,囊内衬扁平或立方上皮,胞质透明,细胞核居中。免疫表型：腔面上皮细胞EMA和CK19阳性,CA19-9局灶阳性,Ki67阳性率小于2％,肌上皮细胞SMA阳性。ER、PR、CEA、CgA、Syn、S-100、Vimentin和Ⅷ因子相关抗原均为阴性。结论 SMAP是一种好发于女性的罕见良性肿瘤,病理形态学检查可明确诊断。但有时与其他胰腺肿瘤鉴别诊断时需要免疫组织化学的帮助,自身的良恶性诊断也需要长期随访。