卡介苗体外对急性淋巴细胞性白血病患儿细胞毒性T淋巴细胞杀伤HL-60细胞效应的影响

目的：探讨卡介苗（BCG）体外对急性淋巴细胞性白血病(ALL)患儿外周血细胞毒性T淋巴细胞（CTL）杀伤HL-60细胞效应的影响。方法：应用Ficoll-Hypaque法分离ALL患儿（白血病组）和健康儿童（对照组）的外周血单个核细胞,在白介素-2（IL-2）、植物血凝素（PHA）和BCG作用下诱导成CTL细胞;应用流式细胞仪测定CD3、CD3+CD4+、CD3+CD8+比例变化;应用MTT法检测CTL对HL-60细胞的杀伤力。结果：培养前2 d,对照组和白血病组CTL细胞数量及体积均无明显变化,第3天开始两组细胞均开始增殖,体积变大,6～10 d达高峰;培养至第10天时,加入BCG的白血病组和对照组细胞数量分别较无BCG的白血病组和对照组增多;白血病组CD3+CD8+比例明显高于对照组,经BCG作用后两组CD3+CD8+比例均明显升高;白血病组CTL对HL-60细胞的杀伤力明显低于对照组。结论：BCG可协同IL-2、PHA体外促进CTL细胞增殖并提高其对HL-60细胞的杀伤力。     

肺癌患者血清促血管生成素2水平及其临床意义

目的 分析不同病理分型、不同临床分期的肺癌患者中促血管生成素-2(Ang-2)的表达水平,进一步探讨该病的发病机理,为临床诊断提供依据.方法 对112例肺癌患者,16例健康体检者进行血清Ang-2检测,同时进行血清中其他相关肿瘤标志物检测.比较不同病理分型、临床分期及远处转移患者血清Ang-2的不同.结果 非小细胞肺癌患者血清Ang-2水平高于正常对照组(与鳞癌比较Sig 值为0.049,P＜0.05;与腺癌比较Sig值为0.011,P＜0.05);非小细胞肺癌Ⅲ、Ⅳ期患者血清Ang-2水平高于对照(与Ⅲ期比较Sig值为0.013,P＜0.05;与Ⅳ期比较Sig值为0.000,P＜0.001);远处转移患者血清Ang-2水平非常显著高于非远处转移者(Sig值为0.008,P＜0.01);结论 分析血清Ang-2水平对肺癌患者的临床诊断、预测转移和预后判断均有临床价值,应用Ang-2与其他肿瘤标志物联合检测可提高患者诊断阳性率.     

Superficial pT1G3 bladder tumor: 24 case reports

The authors report 24 patients presenting a transitional tumor of bladder pT1G3 collected between January 1996 and December 2000. They represent 19% of the superficial tumors of bladder. Two patients had of straightaway a cystectomy after resection for an unverifiable tumor by endoscopy and another after a second resection discovering a real pT2. Only 5 patients received a BCG therapy is 24% of the cases. A recurrence without progression has been noted in 38% of the cases and a progression in 19% of the patients. These last patients had a cystectomy and with a follow-up to 28 months, no recurrence has been noted.     

Spontaneous epidural hematoma due to cervico-thoracic angiolipoma

Epidural angiolipomas are uncommon benign tumors of the spine. Their clinical presentation is usually a progressive spinal cord compression. We report the case of a 22-year-old patient who presented with an acute paraparesis and a spontaneous epidural hematoma, which revealed a epidural angiolipoma which extended from C7 to T3. The patient underwent a C7–T3 laminectomy, in emergency, with evacuation of the hematoma and extradural complete resection of a fibrous epidural tumor bleeding. The postoperative course was favorable with regression of neurological symptoms. Epidural angiolipomas can be revealed by spontaneous intratumoral hemorrhage without traumatism. The standard treatment is total removal by surgery.     

卡介菌多糖核酸治疗小儿咳嗽变异性哮喘

目的：观察卡介菌多糖核酸注射液在小儿咳嗽变异性哮喘治疗应用的疗效。方法：将本科40例咳嗽变异性哮喘患儿，随机分为治疗组和对照组（各20例）。治疗组给予BCG—PSN＋必可酮气雾剂，对照组：给予单用必可酮气雾剂吸入，连续吸入6周，观察疗效，并进行统计学处理。结果：治疗组总有效率为95％，对照组总有效率为70％，统计学处理总有效率有显著差异（P〈O．01）。结论：卡介菌多糖核酸（polysaccharide nucleic acidfraction of BCG，BCG—PSN）能有效地控制咳嗽变异性哮喘（CVA）的呼吸道的反复感染，提高免疫功能；与必可酮配合，能有效地控制CVA的复发。     

Le rétinoblastome

Résumé: Le rétinoblastome est la tumeur maligne intraoculaire la plus fréquente de l’enfant. Son incidence est de 1/15000 naissances. Soixante pour cent sont unilatéraux avec un age médian au diagnostic de deux ans, la plupart étant des formes non héréditaires. Le rétinoblastome est bilate ral dans 40 % des cas, l’age médian de survenue au diagnostic est alors d’un an. Toutes les formes bilatérales ou unilatérales multifocales sont héréditaires. Le rétinoblastome héréditaire constitue un syndrome de prédisposition génétique au cancer: un sujet porteur d’une mutation constitutionnelle du gène RB1 présente un risque supérieur à 90 % de développer un rétinoblastome et est par ailleurs exposé au risque de tumeur secondaire. Les deux sympt?mes les plus fréquemment rencontrés sont la leucocorie et le strabisme. L’examen du fond d’oeil permet le diagnostic, l’échographie, le scanner et l’IRM pouvant y contribuer. La prise en charge des patients doit prendre en compte divers facteurs: le potentiel visuel, la possible nature héréditaire de l’affection et le risque vital. Une énucléation est souvent nécessaire en cas de forme unilatérale, un traitement adjuvant étant indiqué en fonction des facteurs de risque histologiques. Un traitement conservateur pour au moins un oeil est possible dans la plupart des formes bilatérales: thermochimiothérapie, cryothérapie, laser (thermothérapie), curiethérapie par disque d’iode. On tente de limiter les indications de radiothérapie externe aux grosses tumeurs avec essaimage vitréen, en raison des effets tardifs dont les sarcomes secondaires. Un suivi à long terme et une information précoce des patients et de leur famille concernant les risques de transmission et de tumeurs secondaires sont nécessaires. Oncopédiatrie     

Malignant triton tumor of the sinonasal tract

INTRODUCTION: The combination of a malignant peripheral nerve sheath tumor with rhabdomyosarcomatous elements has been termed Malignant Triton Tumor (MTT). This tumor was first reported in 1932 and the prognosis was poor. Involvement of the sinonasal tract is rare with only 10 case reports. CASE: We report the case of a 80-year-old woman who presented an obstruction of the right nasal fossa which developed over several years without anosmia. She consulted because of recurrent epistaxis. The CT-scan revealed a tumor occupying the right ethmoid the right maxillary sinus and the homolateral nasal fossa. Resection was achieved via an extended mediofacial route. The histological diagnosis was low-grade schwannosarcoma with a discretely extended rhabdomyosarcomatous component, i.e. MTT. No complementary treatment was given. Eight months later, the tumor relapsed with cerebral involvement. Despite new surgery with two teams, a neurosurgical and a radiotherapy team, the tumor relapsed at the ethmoid-nasal level. After five years, the patient is alive with local progression without metastasis. DISCUSSION: MTT of the sinonasal tract is a rare disease that clinicians should be aware of and that must be included in the differential diagnosis of malignant lesions involving the sinonasal tract. Most of the reported cases involving localizations other than the ethmoidonasal cavities, are associated with von Recklinhausen neurofibromatosis and occurr in young subjects (mean age 35 years). There have however been sporadic cases, mainly in older women or after radiotherapy. The prognosis is somewhat better for ethmoidonasal localizations.     

Pindborg tumor: a poorly differentiated form without calcification

BACKGROUND: Pindborg tumor is a rare benign epithelial calcified odontogenic tumor. Radiological diagnosis is generally suspected because of the presence of calcifications. CASE REPORT: A 61-year-old man presented a polymorphous Pindborg tumor of the anterior maxillary. The diagnosis was hindered due to the nonspecific radiographic image and the lack of calcification. Pathology provided the positive diagnosis of poorly-differentiated young odontogenic epithelial tumor. DISCUSSION: Pindborg tumor is a rare lesions usually found in the posterior mandibular bone. Calcification is a characteristic feature. There are two historical forms, a squamous form with very favorable outcome and a clear-cell form with less favorable prognosis.