关于胃癌TNM分期系统中最少淋巴结检出数目的研究

目的研究国际抗癌联盟(UICC)和美国癌症联合会(AJCC)对胃癌TNM分期系统中准确分期的最少检出淋巴结数目。方法回顾性收集436例行胃癌根治术的患者淋巴结数目、生存率等临床和病理资料,通过卡方检验和q检验方法对其进行分析。结果在pN0病例中,送检淋巴结1～4个,5～9个的病例,比10～14个和15个以上的5年生存率低且差异具有统计学意义(P<0.05)。10～14个检出淋巴结的病例与15个以上的5年生存率差别无统计学意义。在pN1,pN2患者,送检1～4个,5～9个和10～14个淋巴结者与15个以上者的生存率差别具有统计学意义(P<0.05)。Ⅱ期中检出10～19个淋巴结的患者,其5年生存率明显低于20～29个及30个以上的患者,在Ⅲ期中,检出5～9,10～19,20～29个淋巴结者生存率显著低于30个以上的生存率(P<0.05)。结论淋巴结检出数目在胃癌pN分期中显著影响预后。pN0的最少检出数目应由原来的15个减至10个。而有淋巴结转移的病例至少应送检15个以上淋巴结。Ⅱ期病例最好检出20个淋巴结,而Ⅲ、Ⅳ期最好检出30个以上淋巴结。     

TGFβRII和Smad4在血管瘤组织中的表达

笔者采用免疫组织化学方法检测血管瘤和毛细血管畸形组织中TGFβ3RⅡ和Smad4的表达，以探讨血管瘤组织中两者的关系及其在血管瘤增生退化过程中可能的作用。结果示TGFβ3RⅡ和Smad4在增生期血管瘤组织中呈低-中度表达，退化期血管瘤组织中均呈中—高度表达，而在血管畸形组织中低表达或无表达。提示TGFβ信号通过Smad4依赖形信号转导通路在退化期血管瘤中发挥作用，可抑制血管增生和促进内皮细胞凋亡。     

伐地那非的药效学和药代动力学

伐地那非是一种强效、高选择性的5型磷酸二酯酶(PDE5)抑制剂，对PDE5的抑制作用约为西地那非的10倍：该药能显著增强阴茎勃起功能；而且起效迅速，患者口服后最早10min即可充分勃起完成性交，是迄今为止起效最快的PDE5抑制剂。伐地那非口服绝对生物利用度为15％，可被迅速吸收，血浆清除半衰期约为4～5h：药效学、药代动力学、安全性及耐受性研究表明，伐地那非是一个治疗ED的安全、有效的口服药物。     

干扰素-α2a加长春碱与干扰素-α2a加白介素-2加5-氟尿嘧啶治疗转移性肾癌的疗效比较

1992-2002年采用免疫化学治疗转移性肾癌(mRCC)患者105例,Ⅰ组70例使用干扰素(IFN)α2a加长春碱(VBL),Ⅱ组35例使用IFNα2a加白介素(IL)2加5氟尿嘧啶(5FU),2组患者有可比性,治疗前均未行免疫化疗。治疗方案:Ⅰ组:IFNα2a1000万单位/m2皮下注射,3次/周,>6周。VBL0.1mg/kg第1、22天静脉注射。Ⅱ组:IFNα2a600万单位/m2第1、4周的第1天,第2、3周第1、3、5天,900万单位/m2第5～8周第1、3、5天皮下注射。IL21000万单位/m2,第1、4周第3、4、5天,2/d,皮下注射,第2、3周第1、3、5天500万单位/m2皮下注射。5FU1000mg/m2第5～8周第1天静脉…     

5-杂氮-2′-脱氧胞苷诱导肝癌细胞株癌/睾丸抗原基因表达的研究

目的探讨使用5杂氮2′脱氧胞苷(5DC)诱导肝癌细胞株癌/睾丸抗原(cancer/testis,CT)基因的可行性。方法使用5DC处理前后,用RTPCR方法检测肝癌细胞株QGY7703、HepG2215、HepG2、SMMC7721、HLE、BEL7402、Huh7、BEL7404中CT抗原基因MAGEA1、A3、A6和A10表达;Southern杂交检测细胞株基因组DNA去甲基化状态。结果CT抗原家族中MAGEA1在QGY7703、SMMC7721、BEL7402、HLE、BEL7404中表达,MAGEA3在HepG2、HLE中表达,MAGEA4和MAGEA10表达均为阴性,而MAGEA6表达均为阳性;使用5DC后,MAGEA4在QGY7703、HLE中出现表达,MAGEA10在HepG2和HLE出现表达。去甲基化后基因组DNA相对去甲基化程度明显升高(t=-4.966,P<0.01)。结论尽管5DC使肝癌细胞株基因组去甲基化程度明显升高,但不能有效地诱导CT抗原基因广泛表达。     

30例大肠癌术后HDCF／5-FU化疗疗效分析

全组30例均经病理或细胞学证实。男22例，女8例，中位年龄53岁；乳头状腺癌10例，管状腺癌20例，其中高分化腺癌10例，中分化腺癌4例，印戒细胞癌2例，黏液腺癌4例；Duke’s如期10例，Duke’sB期16例，Duke‘s C期4例。     

CFP方案治疗晚期食管癌临床观察

我国是世界上食管癌发病率和死亡率最高的国家。早期患者首选手术治疗，晚期患者失去手术和放疗机会，有赖于化疗，同时，有些中期患者有条件者术前化疗亦可改善其手术条件及术后生存率。我科从2001年至今用CFP(卡铂、5-FU、平阳霉素)方案治疗晚期食管癌20例，现报告如下。     

组织特异性胞嘧啶脱氨酶和5-氟胞嘧啶热化疗对裸鼠结肠癌肝脏转移的影响

Objective To investigate the effects of tissue specific cytosine deaminase/5-fluorocytosine (CD/5-FC) thermotherapy on hepatic metastasis of colonic carcinoma in nude mice. Methods Forty-five nude mice were randomly divided into control group, 5-FC group and 5-FC thermotherapy group according to the random number table (15 mice in each group). Mice models of hepatic metastasis of colonic carcinoma were established by portal vein injection of LoVo/CEACD cells. The hepatic metastasis rate and number of metastatic nodules of the 3 groups were compared by ehi-square test and one-way ANOVA. The pathological changes in tumor tissues and apoptotic index of tumor cells were observed. The expression of the CD gene in tumor tissues was detected by fluorescent quantitative RT-PCR and Western blot. Results The number of metastatic nodules and liver metas-tasis rate were 4.6±1.3 and 100.0% in control group, 2.2±1.0 and 60.0% in 5-FC group, 0.5±0.8 and 13.3% in 5-FC thermotherapy group, with statistical difference among the 3 groups (F=25.898, χ2=5.208, 19.548, 5.168, P<0.05). The mean apoptotic indexes of tumor cells of the 3 groups were 4.6%, 9.9% and 17.4%, respectively. Vacuolar degeneration, cell necrosis, cytolysis and apoptotic bodies were mostly observed in the 5-FC thermotherapy group. The expression of CD gene in tumor tissue was detected in all the groups. Conclusion Tissue specific CD/5-FC thermotherapy has inhibitory effects on the hepatic metastasis of LoVo cells transfected with CD gene.     

不同浓度5-溴脱氧尿嘧啶核苷标记山羊骨髓基质干细胞的体外研究

Objective To explore the feasibility of labeling and tracing in vitro goat bone marrow mesenchymal stem cells (BMSCs) by bromodeoxyuridine (BrdU) on the basis of investigation of its optimal concentration, incubating time and cytotoxicity. Methods A healthy goat, aged 10 months old, male, weighing 32 kg, was used in this study. Bone marrow was aspirated. BMSCs were isolated and cultured using the adherence method in vitro. The fourth passage of BMSCs (P4) were incubated with BrdU at 5, 10, 15, 20 μmol/L as 5, 10, 15, 20 μmol/L BMSC groups. Cells were not labeled by BrdU as negative control. The following parameters were measured: induction, differentiation and determination of goat BMSCs; the optimal mass concentration and incubation time of 5-BrdU labeling; cell positive rate at 12, 24, 48 and 72 hours in each group using immunofluoreseenee; the cell survival rate after various concentrations of BrdU ladling by trypan-blue exclusion. Results The morphology of the primary and passage goat BMSCs was fusiform in shape. Goat BMSCs could differentiate into osteoblasts and chondrocytes following induction. BMSC nucleus showed green fluorescence under fluorescence microscope after being labeled by BrdU. The mean labeling rate increased with the increase in the concentration and incubation time of BrdU, and reached to (93.32± 3.25)% after incubation in 15 μmol/L, BrdU for 48 hours. There were no significant differences between 15 μmol/L BrdU for 72 hours, 20 μmol/L BrdU for 48 hours and 72 hours (P > 0.05), or between the other groups or time points (P < 0.05). The labeling rate of the blank control group was 0. The cell survival rate was all above 90% (P > 0.05). Conclusions BrdU can be used as a labeling marker for goat BMSCs. When the concentration is 15 μmol/L and the incubation time is 48 hours, the optimal labeling effect can be achieved. Goat BMSCs labeled with BrdU is of high efficiency and safety.     

膀胱尿路上皮癌中原肌球蛋白5的表达及其临床意义

目的研究原肌球蛋白5（TM5）在膀胱尿路上皮癌（BUC）中的表达,探讨TM5与膀胱癌生物学行为之间的关系。方珐采用免疫组化SP法和Western-blot技术,检测48例膀胱尿路上皮癌及8例正常膀胱黏膜组织中TM5的表达。结果①8例正常膀胱黏膜组织TM5蛋白全部阴性表达,48例膀胱癌标本中,TM5蛋白表达阳性者44例,阳性率为91．67％,二者比较差异有统计学意义（P〈0．01）;②TM5在膀胱癌中的表达水平与肿瘤的临床分期、分化程度、有无淋巴结转移等生物学行为显著相关。结论TM5在膀胱尿路上皮癌中过度表达,在膀胱癌的发生发展中起重要作用。