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91.

Purpose

To assess correlations between whole tumour first-pass perfusion parameters obtained with 64-row multidetector computed tomography (MDCT), and microvessel density (MVD) in oesophageal squamous cell carcinoma.

Materials and Methods

Thirty-one consecutive patients with surgically confirmed oesophageal squamous cell carcinomas were enrolled into our study. All the patients underwent whole tumour first-pass perfusion scan with 64-row MDCT. Perfusion parameters, including perfusion (PF), peak enhanced density (PED), blood volume (BV), and time to peak (TTP) were measured using Philips perfusion software. Postoperative tumour specimens were assessed for MVD. Pearson correlation coefficient tests were performed to determine correlations between each perfusion parameter and MVD.

Results

Mean values for PF, PED, BV and TTP of the whole tumour were 28.85 ± 20.29 ml/min/ml, 23.16 ± 8.09 HU, 12.13 ± 5.21 ml/100 g, and 35.05 ± 13.85 s, respectively. Mean MVD in whole tumour at magnification (×200) was 15.75 ± 4.34 microvessel/tumour sample (vessels/0.723 mm2). PED and BV were correlated with MVD (r = 0.651 and r = 0.977, respectively, all p < 0.05). However, PF and TTP were not correlated with MVD (r = 0.070 and r = 0.100, respectively, all p > 0.05).

Conclusion

The BV value of first-pass perfusion CT could reflect MVD in oesophageal squamous cell carcinoma, and can be an indicator for evaluating the tumour angiogenesis.  相似文献   
92.
93.
《Cancer radiothérapie》2014,18(5-6):559-564
Lymph node invasion is an early event in the oesophageal carcinogenesis and represents the main prognostic factor in the curative setting. Even though the primacy of surgical resection has been challenged by the definitive radiochemotherapy for locally advanced squamous cell carcinomas of the oesophagus, surgery is now again a gold standard, in combination with (radio)chemotherapy, to improve locoregional disease control and long term survival. Surgery, especially lymphadenectomy, has consequently to be standardized through quality criteria. Lymph node stations invaded in œsophageal and junctional cancers, lymphadenectomy, and its impact on outcomes are discussed in this review based on the highest level of evidence published data.  相似文献   
94.
食管癌三维适形放疗与非常规分割放疗的比较研究   总被引:1,自引:0,他引:1  
我国是食管癌的高发国家,年新发病例占世界年新发病例的一半以上。根据我国肿瘤防治办公室测算,至2000年我国每年死于食管癌的人数超过19万人。放射治疗是中晚期食管癌的主要治疗手段。食管癌确诊时,只有20%的病例能根治切除,其余80%主要依靠放射治疗或放疗与其他治疗方法综合治疗。而根治切除的病例,40%发生局部复发,仍然要依靠放射治疗,常规分割放疗80%的病例,5a生存率大多不超过10%。为了提高食管放射治疗的生存率,近几年来的研究主要有以下几个方面:三维适形放疗;非常规分割放疗。1三维适形放疗(包括3DCRT,IMRT)食管癌放射治疗三维…  相似文献   
95.
The Paterson lamp is a convenient, low cost, portable, alternative light source to lasers for photodynamic therapy (PDT). A multiwavelength capability enables the clinician to vary the photosensitiser used. The Paterson lamp has been applied in the field of dermatology using a liquid light guide with distal optics for surface application. We now describe distal optics suitable for use with this light guide for intraluminal applications in the oesophagus and colorectum. The geometry of the site (oesophagus and colorectum) requires distal optics such as a cylindrical diffuser or a side-fire diffuser. We have designed new probes that diffuse light radially from the guide axis (cylindrical diffusion). The tips have a frosted glass surface that scatters and effectively couples light radially into the tissue. An acrylic spacer is placed over the diffuser to position the tissue at a constant diameter from the probe. This is held in position by a silicone sheath placed over the distal one metre. For use in the oesophagus, a channel, to facilitate intubation over a guide wire, is included. The diameter of the entire probe is 8.4 mm and the power output can be adjusted from 0–500 mW. Pilot PDT of tubulovillous adenomas of the rectum and Barrett's oesophagus using this light delivery system is currently underway and has shown good early response in the treated area. Paper received 6 October, 1997; accepted in final form 13 January 1998.  相似文献   
96.
97.

Background  

Treatment of oesophageal perforation remains controversial. This study shows that native oesophagus should be preserved. Early recognition improves survival.  相似文献   
98.
Introduction Oral mucositis is recognised as one of the most debilitating complications of high-dose cytostatic chemotherapy used to prepare for haematopoietic stem cell transplantation (HSCT), but very little is known about oesophageal mucositis, as endoscopy is not routinely performed. Materials and methods We incorporate the computed tomography (CT) scan in the diagnostic workup of fever during neutropenia to detect evidence of pulmonary complications. This allowed us to evaluate whether mucosal barrier injury to the oesophagus can be determined. We selected 46 patients without oesophageal cancer or immune suppression (controls), who had a normal oesophagus, and measured the mucosal thickness at the upper part (UP), middle part (MP) and lower part (LP) of the oesophagus. Next, we selected 30 patients having a CT scan done for diagnostic purposes within 14 days after HSCT and measured mucosal thickness at the same levels. We also scored oral mucositis and gut toxicity. Results The mucosal thickness of the UP, MP and LP, respectively, for the controls (mean ± SD) was 4.1 mm (±1.1), 4.2 mm (±1.2) and 4.8 mm (±1.3), and the corresponding values for the subjects were 5.9 mm (±2.2), 5.9 mm (±2.0) and 7.7 mm (±3.0). Analysis of variance showed statistically significant differences between subjects and controls at all oesophageal levels. All patients suffered from severe oral mucositis at the time. Conclusion Hence, mucosal barrier injury to the oesophagus can be objectively measured using CT scan.  相似文献   
99.
Objective: Dysphagia due to tuberculosis is rare in both the developing countries with high prevalence rates and the western population following the recent upsurge linked to the AIDS and immigration. Aim: To study tuberculosis as an aetiological factor in the causation of dysphagia and to evaluate the outcome of anti-tubercular treatment and surgical results in these patients. Methods: Retrospective review of experience with 14 cases of dysphagia due to tuberculosis encountered between 1996 and 2003. Results: The duration of symptoms ranged between 3 and 18 months. All of them underwent oesophagogastroscopy, barium swallow, fiberoptic bronchoscopy and CT scan of the chest. The aetiology was subcarinal node enlargement in seven, tracheo-oesophageal fistula in four, oesophageal ulcer in two and cervical node suppuration in one. Tuberculous involvement was confirmed by pathological examination in all patients. All of them received anti-tuberculous therapy. Seven patients required surgery, transthoracic repair of tracheo-oesophageal fistula in four patients, one patient required subcarinal node excision and two needed abscess drainage. There were no mortalities and there was complete relief of dysphagia in all of them. Conclusions: Tuberculosis as a causative factor for dysphagia should be considered in regions with high incidences of tuberculosis and in immunocompromised patients. Treatment with anti-tuberculous therapy is effective. Surgery is required only for complications of tuberculosis.  相似文献   
100.
Background: The aim of the present study was to assess luminal nitric oxide (NO) levels in the oesophagus during baseline and acidic conditions and to clarify the sources of such oesophageal NO formation. Methods: Healthy volunteers received an intra-oesophageal infusion of either HCl (100 mM) or NaCl (150 mM) on two separate study days. After a low nitrate diet, nitrate load or no dietary restrictions/pretreatment, direct intraluminal measurements of NO formation were performed using a tonometric technique. Endoscopy was performed and mucosal biopsies were taken and analysed by means of immunohistochemistry, Western blot and RT-PCR. Results: No intra-oesophageal NO was detected during baseline conditions with pH neutrality. During the infusion of HCl the NO levels rose dramatically to around 12000 ppb. This high rate of NO formation fell by 95% following deviation of saliva. NO formation after an acute nitrate load was almost doubled during acid perfusion compared to control. Immunohistochemistry demonstrated distinct staining for iNOS in the oesophageal squamous epithelial cells, and Western blot and RT-PCR confirmed the presence of iNOS. Conclusion: Two sources exist for intra-oesophageal NO formation, both dependent on the luminal acidity: 1) chemical reduction of salivary nitrite, a mechanism related to dietary intake of nitrate, and 2) NO formation within the oesophageal mucosal epithelium by enzymatic degradation of L-arginine. In the latter case, the NO synthase has antigenic characteristics, indicating the inducible isoform, although a functional behaviour suggests an unconventional subtype.  相似文献   
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