2型糖尿病可增加结直肠腺瘤的风险

来自于美国明尼苏达Mayo临床医学院的PaulJ．Limburg博士及其同事在近期出版的《美国胃肠病学杂志》（AJG）上报道的一项基于人口的研究显示。2型糖尿病与结直肠癌流行率增加关联，特别是男性。     

哨兵淋巴结活检对诊断结直肠癌微转移的临床意义

哨兵淋巴结活检(sentinel lymph node biopsy，SLNB)是结、直肠癌治疗中的有用技术，可提供有价值的结肠旁及左右结肠动脉及静脉淋巴结转移的分期信息，联合应用活性蓝染料和放射性标记胶体可做出淋巴结定位图，在公认哨兵淋巴结活检为一广泛采用的技术后，这些检查将可产生明显的社会效益。     

结直肠癌中雄激素受体及其与临床病理学特征关系的研究

应用放射性配基结合分析法，检测了４０例结直肠癌及部分癌旁正常粘膜组织中的雄激素受体（ＡｎｄｒｏｇｅｎＲｅｃｅｐｔｏｒ，ＡＲ），同时分析了ＡＲ水平与临床病理学变化的关系。证实结直肠癌ＡＲ数目（３３．７±２３．３ｆｍｏｌ／ｍｇ蛋白）明显低于癌旁５ｃｍ以外粘膜（５３．９±３２．４ｆｍｏｌ／ｍｇ蛋白），Ｐ＜０．０１，而其亲和力则无变化；结直肠癌时ＡＲ数目变化与女性、直肠癌、高分化癌及早期癌关系密切。提示ＡＲ与结直肠癌关系密切，本实验为临床上结直肠癌的诊断及内分泌治疗提供了初步资料。     

外伤性结直肠穿孔的诊断治疗(附26例分析)

结直肠外伤性穿孔术前诊断较困难，病死率较高。本院1990年至2006年共收治外伤性结直肠穿孔26例。现报告如下。     

淋巴结外窦组织细胞增生伴巨大淋巴结病3例

窦组织细胞增生伴巨大淋巴结病（Rosai—Dorfman disease，RDD）是一种病因不明的持续性组织细胞增生性疾病。RDD大多数发生于10～20岁以内的患者，但任何年龄均可发病，还可见同一家族内两个成员发病的情况。RDD大部分发生在淋巴结内，结外受累也有报道，约1/4以上的病例可累及结外组织剐，其结外表现可能是最突出甚至是唯一的表现。笔者收集了3例结外RDD病例作一分析，探讨其病理学和免疫组化特点。     

降结肠破裂误诊误治1例

降结肠破裂多由外伤等多种原因引起，目前自发性降结肠破裂已非常少见，就其解剖结构和内容物特点，临床上易误诊漏诊，笔者曾遇到1例，现报告如下。     

浆膜受侵的结直肠癌术后腹腔化疗联合静脉化疗的临床研究

Objective To compare the clinical efficacy of postoperative intraperitoneal chemotherapy combined with systemic chemotherapy to systemic chemotherapy alone for serosa-involved colorectal cancer. Methods According to the criteria of serosa-involving in colorectal cancer, 332 cases were divided into 2 groups prospectively without randomization. Study group (n=166) was treated with intraperitoneal chemotherapy combined with systemic chemotherapy, and control group (n=166) with systemic chemotherapy alone. Incidence of local recurrence, peritoneal metastasis, hepatic metastasis, other distant metastasis and 3-year, 5-year overall survival (OS) rate of two groups were compared. Results 3-year and 5-year OS rates of stage Ⅱ B in study group were similar to those in control group (χ2=0.612,P=0.434). The above rates of stage Ⅲ in study group were higher than those in control group (χ2=3.989,P=0.046). Either the study group or the control group, the 3-year and 5-year OS rates of patients undergone laparoscopic surgery or open surgery were similar (P=0.839, P=0.172). Incidences of local recurrence, peritoneal metastasis and hepatic metastasis in study group were 1.9%, 3.8% and 3.8% respetively, lower than those in control group (8.2%,9.5% and 10.1%,P<0.05). Distant metastasis rate in study group was similar to that in control group. In study group, intraperitoneal chemotherapy regimen with Oxaliplatin had lower rates of peritoneal metastasis and hepatic metastasis as compared to that with Cisplatin (0.9% vs 8.8% ,P=0.019), while the incidences of local recurrence and other distant metastasis were similar. Conclusions Postoperative intraperitoneal chemotherapy combined with systemic chemotherapy improves 3-year and 5-year overall survival rates in patients with stage Ⅲ serosa-involved colorectal cancer, and decreases local recurrence, peritoneal metastasis and liver metastasis rate, especially when intraperitoneal chemotherapy regimen contains Oxaliphtin. Comparing with open surgery, laparoscopic surgery dose not improve 3-year and S-year overall survival rates in patients receiving combined chemotherapy or systemic chemotherapy alone.     

47例左半结肠癌性梗阻行Ⅰ期肠切除吻合的临床观察

左半结肠癌性梗阻是晚期结肠癌的严重并发症，其手术方式尚有争议。１９９０～１９９６年我院对４７例左半结肠癌性梗阻病人在切除癌肿后行Ⅰ期肠吻合，疗效满意，现报道如下。１资料与方法１１临床资料本组男３１例，女１６例，年龄３１～７５（平均６０３±５２）...