D1期前列腺癌的诊断

１９９０年１２月至１９９３年１２月，我们对临床Ａ－Ｃ期２７例病人进行盆腔淋巴结活检术，检出１２例Ｄ１期病人。临床Ａ期有５０％，Ｂ期有３７％，Ｃ期有７１％的病人发现盆腔淋巴结癌转移，其癌细胞的恶性程度也与淋巴结癌转移有关。近年，经腹腔镜盆腔淋巴结活检已成为诊断Ｄ１期前列腺癌的新方法。     

肿瘤抑制基因P53突变与肾细胞癌的关系

采用ＤＮＡ聚合酶链反应－单链构象多态性分析和直接序列测定技术，检测２５例肾细胞癌组织中Ｐ５３基因５－８外显子，２５例肾细胞癌仅有２例肿瘤组织存在Ｐ５３基因点突变，分别位于１５４和２７３密码子上，核苷酸序理分析突变形式分别为Ｇ→Ｔ，Ｃ→Ｔ。结果提示：肾细胞癌组织中Ｐ５３基因突变并不显著，表明肾细胞癌的发生可能是一个多基因变化的过程。     

Immunoreactive p53 and metallothionein expression in duct carcinoma in situ of the breast

 Immunocytochemically detectable MT and p53 have been found more commonly in comedo DCIS of the breast with high-grade cytology. The aim of this study is to confirm these findings and to investigate the relationship between MT and p53 in a single large series of cases of DCIS of the breast. To this end, 127 cases of DCIS were classified histologically according to architecture, cytonuclear differentiation (grade), presence and extent of intraduct necrosis, and using the Van Nuys system. Sections were immunostained for p53 and MT (E9) using established techniques, and the extent and intensity of staining were assessed semi-quantitively. The results confirmed that there was generally more MT and p53 positivity in poorly differentiated (grade 3) DCIS with extensive necrosis and that MT expression was greater in grade 2 lesions than p53 expression. However, overall there was no statistically significant correlation between p53 and MT staining. The results indicate that MT and p53 overexpression may arise from independent mechanisms in early breast neoplasia. Received: 3 July 1996 / Accepted: 5 November 1996     

原发性小肠恶性肿瘤的CT诊断

本文回顾性分析３４例经病理证实的原发性小肠恶性肿瘤的ＣＴ表现。病变包括腺癌１６例，平滑肌肉瘤１２例，淋巴瘤６例。ＣＴ扫描能明确肿瘤向腔内和腔外侵犯的程度，清晰显示肿瘤与邻近结构的关系，有无局部及远处转移等，为临床治疗提供帮助。鉴别诊断应包括小肠良性肿瘤、炎性病变和转移性肿瘤等。     

胃癌D17S261和D17S799位点二核苷酸重复序列不稳定性的意义

目的研究二核苷酸重复序列不稳定性〔ＤＲＳＩ〕在胃癌发生中的作用及其临床意义．方法采用ＰＣＲ方法检测了Ｄ１７Ｓ２６１和Ｄ１７Ｓ７９９位点二核苷酸重复序列不稳定性．结果胃癌总ＤＲＳＩ发生率为３４％（１７／５０），其中高中分化腺癌ＤＲＳＩ阳性率（６６７％，１０／１５）显著高于低分化癌（１９４％，６／３１，Ｐ＜００１）；肠型胃癌ＤＲＳＩ阳性率（５５６％，１０／１８）显著高于胃型胃癌（２０％，６／３０，Ｐ＜００５），ＤＲＳＩ与胃癌部位、大小、浸润、分期、淋巴结转移无显著相关．结论ＤＲＳＩ在胃癌的发生中可能起重要作用．     

Preoperative Chemotherapy Alone and Combined with Preoperative Radiotherapy in Small-Size Breast Cancer

Abstract: Breast conservation surgery is an effective and safe treatment for many breast carcinomas. It may be possible to further limit the extent of resection (or expand the indication for breast conservation) by the application of preoperative chemotherapy and radiotherapy. We explored the feasibility of this in a pilot study.
Seventy-three patients (mean age 48, 63% premenopausal) with confirmed breast cancer, less than 2.5 cm, received chemotherapy (Group A) or chemotherapy plus radiotherapy (Group B) prior to limited resection (tumorectomy). Axillary dissection was always performed. Results: In 6/31 (19%) Group A and 17/42 (40%) Group B patients the tumor was not palpable after preoperative treatment, with complete pathological remission in 1 and 3 cases respectively. Histologic grading, mitosis, cellular alteration, and cellularity evaluations indicated a consistently greater therapeutic effect with chemoradiotherapy than with chemotherapy alone.
In conclusion, radiotherapy appears useful in the preoperative treatment of breast cancer and its use in association with various drug combinations should be further explored.     

Neurosarcoma of the face: MRI

Neurosarcoma is a rare tumour originating from the sheath of peripheral nerves. Facial lesions have been reported in about 20 patients. We describe the MRI appearances of neurosarcoma with histological correlation in three patients. The lesions lay in the submandibular region, the left parapharyngeal space and the right orbit. MRI showed a well-defined mass with mixed components. The lesions were moderately heterogeneous on T1-weighted images in two cases and on T2-weighted images in all cases. Gadolinium enhancement occurred in all cases to variable degrees. In two cases, small high signal foci were seen on T2-weighted sequences. MRI appearances of neurosarcoma are not specific. Received: 3 September 1996 Accepted: 26 November 1996     

膀胱移行细胞癌中P16及Rb基因表达的关系

应用免疫组织化学方法对５９例膀胱移行细胞癌中Ｐ１６及Ｒｂ基因的表达进行研究。结果显示：５９例中Ｐ１６及Ｒｂ基因阳性表达率分别为４７４６％、７１１９％，其中１１例肿瘤组织（１８６４％）Ｐ１６及Ｒｂ基因均阳性表达，未发现同一肿瘤组织中同时存在Ｐ１６及Ｒｂ基因的表达缺失。Ｐ１６及Ｒｂ基因在膀胱移行细胞癌中的阳性表达率在肿瘤病理分级及临床分期的差异中均有显著性（Ｐ＜００５）。结果提示：Ｐ１６及Ｒｂ基因的异常表达在膀胱肿瘤的发生、发展过程中起重要作用，膀胱肿瘤中Ｐ１６及Ｒｂ基因同时表达缺失是少见现象     

卡介苗激活杀伤细胞抗膀胱肿瘤作用研究

为了进一步探讨ＢＣＧ抗膀胱肿瘤的作用机理，采取１５例膀胱肿瘤患者外周血单个核细胞（ＰＢＭＣ），置于含ＢＣＧ或ＩＬ２的培养基中培养，计算扩增倍数，检测培养细胞抗自体及异体膀胱癌细胞活性。结果：卡介苗激活杀伤细胞（ＢＡＫ）与淋巴因子激活杀伤细胞（ＬＡＫ）分别于培养第７和第３天达增殖高峰，对自体瘤杀伤率分别为３６．２％和３１．４％，差异有显著性（Ｐ＜０．０５）；对异体瘤杀伤率分别为２５．２％和２８．３％，差异无显著性。结果表明：ＢＡＫ细胞抗自体瘤活性高于ＬＡＫ细胞，死ＢＣＧ对ＰＢＭＣ无激活作用，ＢＡＫ细胞抗肿瘤效应可能是ＢＣＧ抗膀胱肿瘤重要作用机理之一。     

人卵巢癌中肿瘤转移抑制基因nm23-H1编码蛋白的表达

目的：探讨人卵巢癌标本中，肿瘤转移抑制基因ｎｍ２３－Ｈ１编码蛋白ＮＤＰＫ－Ａ表达的临床意义及其与预后的关系。方法：应用免疫组织化学抗生蛋白链菌素－过氧化酶结合（Ｓ－Ｐ）法，检测５８例人卵巢癌标本中ｎｍ２３－Ｈ１蛋白水平。结果：ｎｍ２３－Ｈ１蛋白的表达与患者手术时是否有淋巴结及大网膜转移相关（Ｐ〈０．０５），但原发灶与转移灶间的阳性表达率相差不显著；与患者术后生存时间密切相关（Ｐ〈０．０１），术后生