癌胚抗原、糖链抗原72-4和胃蛋白酶原联合检测评价胃癌的诊断价值

目的探讨血清癌胚抗原(CEA)、糖链抗原72-4(CA72-4)和胃蛋白酶原(PG)在胃癌诊断中的价值。方法分别检测CEA、CA72-4、PGⅠ、PGⅡ和PGⅠ/Ⅱ在96名正常对照组、37例胃增生患者和107例胃癌患者的血清含量。结果当CA72-4、CEA、PGⅠ、PGⅡ和PGⅠ/Ⅱ单独评价胃增生和胃癌的诊断价值,诊断能力最好的是CA72-4,其敏感性和特异性分别为72.00%和59.50%。利用二元Logistic回归评价CEA和CA72-4联合诊断评价胃增生和胃癌的曲线下面积为0.715,其敏感性和特异性分别为70.10%和67.60%,与指标单独检测敏感性和特异性都有提高。多层感知器神经网络分析用来分析CEA和CA72-4联合诊断时,曲线下面积为0.711。结论本研究证明联合检测的诊断价值优于单独检测,为临床胃癌诊断提供一定的理论指导。     

芫花醇羊膜腔内注射死因探讨(附3例病理资料)

本文报告3例芫花乙醇液中期引产死亡尸检病理结果,并对死亡原因进行了分析。证实芫花乙醇浸剂可直接引起子宫肌、蜕膜、胎盘组织坏死、出血,伴有无菌性炎症,而且大量凝血活素及坏死物质进入血循环启动外源性凝血系统而导致 DIC。强调指出,子宫体炎或内膜结核;恶性葡萄胎或绒毛膜上皮癌治愈后;多胎妊娠或近期哺乳者均列为芫花引产禁忌症。在操作时应注意防止药液带入子宫肌层。     

胃肠外科感染的治疗策略

胃肠外科感染是一种急腹症,以急性阑尾炎最常见,其次为憩室炎,两者约占胃肠外科感染的80%以上[1]。相对少见的有新生儿坏死性小肠结肠炎、儿童或成人坏死性小肠炎、盲肠炎、肠系膜淋巴结炎等。这些疾病大多需要手术治疗,也有一些不需要手术治疗(如肠系膜淋巴结炎)或仅部分需要手术治疗[2]。合理的外科手术联合抗菌治疗对复杂性胃肠外科感染的临床预后起决定作用[3]。系统的抗菌治疗可消除导致感染的致病菌、降低细菌感染的可能     

联合检测癌胚抗原、糖链抗原19-9和C反应蛋白对结肠癌的诊断价值

目的 探讨联合检测血清癌胚抗原(CEA)、糖链抗原19-9 (CA19-9)、C-反应蛋白(CRP)对结肠癌诊断的临床应用价值.方法 分别利用电化学发光法检测CEA及CA19-9、乳胶颗粒增强免疫浊度法检测CRP在正常对照组、结肠息肉和结肠癌组中的表达量.结果 与正常对照组相比较,结肠癌组CEA、CA19-9和CRP均...     

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在过去的30年里,虽然胃癌的发病率有所下降,但仍是世界范围内病死率最高的疾病之一。手术仍是胃癌的最佳治疗手段。肿瘤的位置不仅影响手术方式,而且影响存活率。与远端胃癌相比,近端胃癌的TNM分期更高,整体存活率更差。淋巴结的侵犯程度与整体存活率密切相关,熟悉食管胃结合部腺癌(AEG)的淋巴结转移规律,选择合适的手术方式及淋巴结清扫范围,可明显提高AEG的整体存活率。     

Oncology: Review of clinical investigation of recurrence of gastric cancer following curative resection

The incidence and mortality of gastric cancer (GC) have dramatically declined for the last several decades, and the therapeutic outcomes of patients with GC continue to improve. Nonetheless, GC remains a major public health issue as the fourth most common cancer and a relevant problem as the second most common cause of cancer death worldwide.[1, 2] The highest incidence rates are in Eastern Asia, Eastern Europe, and South America.[3] Presently, the only potentially curative treatment for GC is radical gastrectomy. Despite curative resection (R0), recurrences are still common, occurring in approximately 60% of patients. The main reason for this is that GC is often advanced at the time of diagnosis.[4-6] Death from GC after curative resection is mostly due to recurrence as well. The GC recurrence rates after curative resection are not uniform as reported,[7] and the recurrence rates at different time points after surgery are quite different from one another. More than 90% of patients relapse within 5 years after surgery, and 70% relapse within 2 years. In a study by Wu et al.,[8] cumulative recurrence rates were 53.5%, 80%, 89.0%, 94.7%, 96.3%, 98%, and 99.5% at 1, 2, 3, 4, 5, 6, and 7 years, respectively. The long-term recurrence rate at 7 years was 15.8% for locoregional relapse and 34.5% for distant recurrence in a recent study.[4] These high rates of recurrence have been attributed to the abundant lymphatic channels within the gastric wall, providing channels for mucosal skip lesions and numerous potential pathways of lymphatic drainage away from the stomach.[9] Both the recurrence rate and recurrence pattern following laparoscopic gastrectomy were similar to those of conventional laparotomy according to a multicenter study.[10] This article reviews the current clinical status and progress of recurrence from GC following radical gastrectomy by concentrating on the patterns of recurrence, clinicopathologic factors affecting recurrence, detection of recurrence, prognosis, and treatment methods.     

口服避孕药引起的神经精神障碍

1966年全世界妇女应用口服避孕药者已达900多万。目前已大为增加。从1968年起,大约每天有5,000万至6,500万。1961年以来即有应用口服避孕药发生合并症的报导,其中包括神经精神障碍。脑血管病口服避孕药对脑血管的致病作用特别明显。美国学者调查21个国家年轻妇女脑卒中的原因后证实,应用口服避孕药的妇女脑缺血的发生率比对照组多9倍。至今文献中已报告200多例严重脑血管病与口服避孕药有关,其中包括脑梗塞、脑出血、颅内静脉窦和脑静脉血栓形成。可发生于任