多原发癌46例临床分析

目的探讨多原发癌的临床特点、治疗和预后。方法分析首都医科大学石景山教学医院北京市石景山医院肿瘤科和北京中西医结合医院肿瘤科收治的46例多原发癌的发病年龄、发病部位、首发癌与第2原发癌的间隔时间以及生存时间。结果本组46例多原发癌中,异时性多原发癌41例,同时性多原发癌5例。首发癌和第2原发癌的中位年龄分别为69岁和77岁,胃肠道为好发部位。肿瘤间隔时间5年组的中位生存期为240个月,肿瘤间隔时间≤5年组的中位生存期为84个月,两组间差异具有统计学意义(P=0.005)。首发癌术后5年的生存率为76.1%。第2原发癌治疗后5年生存率为21.7%。第2原发癌手术组的中位生存时间为60个月,非手术组的中位生存时间为48个月,两组比较,差异具有统计学意义(P=0.032)。结论对于多原发癌患者,根治性手术可延长其生存时间,肿瘤间隔时间愈长,生存期愈长。对多原发癌患者的治疗应持积极态度,只要肿瘤及患者情况允许,应尽量手术切除。     

异时性多原发结直肠癌临床特点分析31例

目的:探讨异时性多原发结直肠癌的临床特点, 为临床诊治提供参考.方法:回顾性总结31例异时性多原发结直肠癌的临床资料, 分析肿瘤发生、分布及治疗与预后.结果:31例患者, 平均5.1年出现次发癌, 平均3.8年后3例出现第3癌, 平均3.5年后2例再发第4癌. 45.2%的患者合并存在腺瘤. 59.5%的首发癌位于直肠、乙状结肠;大部分次发癌的分化程度、病理分期好于首发癌或与之相同;首发癌术后平均存活8.3年, 5年生存率84.8%.结论:大多数异时性多原发结直肠癌的首发癌位于直肠及乙状结肠. 合并存在腺瘤是发生该病的危险因素, 根治术后应进行定期复查.     

多原发肺癌4例临床分析

目的探讨多原发性肺癌的诊断和治疗。方法自2000年以来我科收治病理确诊的4例多原发肺癌患者进行回顾性分析。结果4例多原发肺癌中同时癌3例,异时癌1例,均为双侧肺,第一原发肺癌与第二原发肺癌间隔时间为35月。结论多原发肺癌发病率不高,早期诊断,积极以手术治疗为主的综合治疗仍可获得较长的生存时间。     

同时多原发大肠癌20例

同时多原发大肠癌２０例沈云志江苏省常州市第一人民医院２１３００３主题词结直肠肿瘤／病理学肿瘤，多原发性Ｓｕｂｊｅｃｔｈｅａｄｉｎｇｓｃｏｌｏｒｅｃｔａｌｎｅｏｐｌａｓｍｓ／ｐａｔｈｏｌｏｇｙｎｅｏｐｌａｓｍｓ，ｍｕｌｔｉｐｌｅｐｒｉｍａｒｙ分类号...     

多原发大肠癌微卫星不稳定性的研究

目的探讨微卫星不稳定性（ＭＳＩ）在多原发及单发大肠癌中的变化规律方法应用ＰＣＲ－ＳＳＣＰ技术对２４例多原发大肠癌和对照２１例单发大肠癌石蜡组织切片提取ＤＮＡ,并进行染色体不同位点微卫星不稳定性基因标志的检测结果多原发大肠癌中微卫星不稳定性的发生率为７１％（１７／２４）,单发大肠癌微卫星不稳定性的发生率为３８％（８／２１）,二者有明显差异（Ｘ２＝６．８２,Ｐ＜０．０２）ＭＳＩ阳性的多原发大肠癌主要发生在年轻的男性患者,与单发大肠癌相比（ｘ２＝４．６４,Ｐ＜０．０５）,有统计学意义．多原发大肠癌ＭＳＩ阳性癌肿在右半结肠发生率及分布在ＤｕｋｅｓＡ,Ｂ期居多,但与单发大肠癌相比并无明显差异结论微卫星不稳定性在多原发大肠癌的发生发展中起重要作用,可作为预测大肠癌多原发倾向的有用标志     

结直肠同时性+异时性多原发四重癌一例报道并文献复习

多原发结直肠癌（MPCC）又称重复性结直肠癌,在临床上的发病率呈逐年上升趋势,其发病原因及机制不详,目前尚无统一、规范的诊治指南,临床医师极易漏诊,延误病情。本文报道1例结直肠同时性+异时性多原发四重癌的病例并复习文献,旨在提高临床医师对MPCC诊治的警觉性。     

大肠多原发癌19例临床分析

大肠多原发癌是指发生于大肠的2个或2个以上的原发癌,根据第二癌距第一癌的发病问期,又可分为同时性多原发癌(SC)和异时性多原发癌(MC),临床易漏诊或误诊.1998～2006年,我们共收治19例大肠多原发癌患者,现进行回顾性分析.     

多原发大肠癌细胞增殖背景

大肠癌是严重威胁人类健康的恶性肿瘤之一。统计资料表明,在世界范围内大肠癌的发病率在恶性肿瘤中已升至第三位。与欧美国家相比,我国大肠癌的发病率也呈逐年上升趋势,且发病年龄明显提前,成为威胁人们健康的主要疾病。多原发大肠癌发生率占大肠癌的4％～13％。近年来,多原发大肠癌发病率有增多趋势,国外文献报告为4％～13.8％,国内报告为2.4％～15.7％。与单发大肠癌相似,多原发大肠癌起病隐匿,早期几乎无任何特征性临床表现,多数确诊时已届晚期。多原发大肠癌细胞增殖背景如何,与单发大肠癌相比是否有更高的恶性行为,目前并不十分清楚。本文旨在进一步分析多原发大肠癌细胞增殖状态,探寻早期确诊多原发大肠癌     

同时性多原发结直肠癌与散发性结直肠癌患者结肠镜随访的配对分析

目的研究同时性多原发结直肠癌与散发性结直肠癌患者异时性进展期腺瘤(MAA)的发生率。方法纳入2008年1月1日至2022年9月30日在首都医科大学附属北京世纪坛医院接受结直肠癌手术(外科手术或内镜切除)并进行3年结肠镜随访的结直肠癌患者。患者在术后6～36个月内完成≥2次结肠镜随访, 且2次结肠镜检查间隔时间>6个月。收集患者年龄, 性别, 肿瘤部位、分期、病理学特征, 合并基础疾病情况, 术前癌胚抗原、血红蛋白等实验室检查结果, 基线结肠镜检查结果, MAA检出情况等资料。根据年龄(±2岁)、性别、原发肿瘤部位(同一节段)和肿瘤分期将同时性多原发结直肠癌患者与散发性结直肠癌患者按照病灶数1∶1进行倾向性评分匹配法配对。计算同时性多原发结直肠癌和散发性结直肠癌患者MAA的累积发生风险。采用Cox比例风险回归模型分析MAA发生的影响因素。结果共纳入814例结直肠癌患者进行配对。配对后, 同时性多原发结直肠癌患者36例(78个癌灶), 散发性结直肠癌患者78例(78个癌灶)。同时性多原发结直肠癌组患者1、2、3年MAA的累积发生率分别为11.1%(4/36)、22.2%(8/36)、...     

多原发大肠癌误诊7例

目的通过对本病误诊原因的分析提出减少误诊及提高早期诊断率的措施．方法对本院近年来经手术证实的7例多原发大肠癌进行了回顾性分析．结果4例同时癌中3例术前仅作出一处诊断，1例诊为肠梗阻．异时癌5例次术前均误诊为肿瘤复发．结论对本病认识不足是本组误诊的主要原因：①术前满足于一处癌灶发现，忽视全面的术前检查及术中仔细探查是同时癌漏诊的主要原因；②肛肠癌术后再发肿瘤都归于肿瘤复发是异时癌误诊的主要原因．预防措施：①纤维肠镜术前检查作为常规；②术中仔细探查；③术后定期纤维肠镜检查是提高异时癌早期检出率的关键。     

Clinicopathological characteristics of colorectal carcinoma complicating ulcerative colitis.

This study examined three features associated with colorectal carcinoma complicating ulcerative colitis: (a) the distribution of 157 cancers in 120 patients with ulcerative colitis treated at St Mark''s Hospital between 1947 and 1992; (b) the frequency at which dysplasia was found at a distance from the tumour in 50 total proctocolectomy specimens in which an average of 27 histology blocks were reviewed, and (c) the five year survival rate according to Dukes''s stage and participation in a surveillance programme. Of 157 carcinomas, 88 (56%) occurred in the rectosigmoid, 19 (12%) in the descending colon or splenic flexure, and 50 (32%) in the proximal colon. Among the 120 patients, the rectum or sigmoid colon contained cancer in 81 (67.5%). Dysplasia was detected in 41 of 50 reviewed proctocolectomy specimens (82%). Dysplasia distant to a malignancy occurred in 37 (74%); two were classified indefinite, probably positive, 19 were low grade, and 16 were high grade; in 18 specimens there was an elevated dysplastic lesion. Survival was related to the Dukes''s stage: about 90% of patients with Dukes''s A or B cancer were alive at five years. The five year survival of 16 patients in whom cancer developed during surveillance was 87% compared with 55% of 104 patients who did not participate in surveillance (p = 0.024).     

Clinical features, diagnosis, treatment and prognosis of multiple primary colorectal carcinoma

AIM: To investigate the clinical features, diagnosis, treatment and prognosis of multiple primary colorectal carcinomas (MPCC). METHODS: A retrospective analysis of 37 patients with MPCC from 1974 to 1998 was carried out. RESULTS: The incidence of MPCC was 2.74%(37/1 348) in patients with primary colorectal carcinomas, 15 cases of them were patients with synchronous carcinomas (SC) and 22 cases were diagnosed as metachronous carcinomas (MC). Most tumors were located in the right colon and rectum. Fifty-five percent (12/22) of MC were diagnosed within 3 years after tumor resection and 41%(9/22) of MC occurred after 8 years. Radical resections were performed in all patients except for 1 case. The 5-year survival rate of SC was 72.7%(8/11) and that of MC after the first cancer and second cancer was 71.4%(15/21) and 38.9%(7/18), respectively. CONCLUSION: The results indicate the importance of complete preoperative examination, careful intraoperative exploration and periodic postoperative surveillance. Early diagnosis and radical resection can increase survival rate of MPCC.     

分化型早期贲门癌的临床病理特征及内镜治疗疗效观察

目的:分析分化型早期贲门癌的临床病理特点,并评价内镜黏膜下剥离术治疗的短期及长期疗效。方法:纳入2014年10月—2019年12月在南京鼓楼医院行内镜黏膜下剥离术治疗,且术后病理证实为分化型早期贲门癌的患者共329例（331个病灶）,并进行随访。回顾患者的内镜及病理资料,分析分化型早期贲门癌的临床病理特征,评价内镜黏膜...     

de novo早期结直肠癌的临床病理特征及内镜治疗效果观察

目的分析de novo早期结直肠癌的临床病理特征, 并评估内镜治疗的效果。方法纳入2020年6月—2022年5月在首都医科大学附属北京友谊医院行内镜切除且术后病理确诊为de novo早期结直肠癌的患者。回顾性收集患者的基本资料、内镜表现、治疗方式、术后病理结果以及转归等资料。结果共纳入33例de novo早期结直肠癌患者, 年龄(62.67±8.62)岁, 男女比例7.25∶1。病变长径(0.96±0.36)cm;病变形态以浅表型(0-Ⅱ型)为主, 占72.7%(24/33)。29例采用内镜黏膜下剥离术切除, 4例采用内镜黏膜切除术切除。术后病理显示, 11例(33.3%)为高分化管状腺癌, 其中2例侵及黏膜下浅层;20例(60.6%)为中分化管状腺癌, 其中5例侵及黏膜下浅层, 15例侵及黏膜下深层;2例(6.1%)为中-低分化管状腺癌, 均侵及黏膜下深层。病变浸润深度与病变分化程度有显著相关性(P<0.001), 中分化及中-低分化病变更容易发生黏膜下层深浸润。33例(100.0%)病变均达到整块切除, 97.0%(32/33)达到完全切除, 42.4%(14/33)达到治愈...     

老年结直肠癌的临床和病理特点及其预后分析

目的探讨老年结直肠癌患者的临床、病理及预后特点。 方法收集2005年1月至2009年12月间于湖南中医药大学第一附属医院普外科诊断为结肠癌且接受手术治疗的患者的完整资料,进行生存分析和预后的多因素分析。共选取84例老年患者,其中男性48例,女性36例,平均年龄71.38岁,与同期75例中青年结肠癌患者的临床和病理资料进行比较。应用SPSS 19.0统计学软件进行数据分析,以P<0.05有统计学意义。各组间相关因素比较采用χ²检验,应用Kaplan-Meier法进行生存分析,多因素分析采用Cox风险比例回归模型计算。 结果84例老年结直肠癌患者中,患者临床表现以血便为主。直肠是最常见出血部位。病理组织类型以腺癌为主(占86.90%)。多因素分析结果显示,年龄、手术方式、病理分型、组织学分化程度、TNM分期、化疗是影响预后重要的独立因素。与中青年结肠癌患者(年龄<65岁)相比,肿瘤大体分型(χ²＝10.652,P＝0.005)、组织学类型(χ²＝29.466,P<0.001)、分化程度(χ²＝26.806,P＝0.033)、淋巴结转移(χ²＝6.963,P＝0.031)、肿瘤浸润深度(χ²＝7.983,P＝0.018)、TNM分期(χ²＝9.720,P＝0.021)及远处转移方面(χ²＝5.165,P＝0.023),差异有统计学意义。 结论老年直肠癌患者的病程发展缓慢、肿瘤分化程度较高,早期根治性手术治疗可以取得较好的疗效及预后,化疗是保护性因素,早期诊疗是提高结直肠癌患者总体生存率的关键。     

肿瘤浸润淋巴细胞在结直肠癌中的临床病理分析

目的:探讨结直肠癌中肿瘤浸润淋巴细胞(TIL)的临床病理和免疫组织化学特征, 及大量TIL与各病理因素的关系.方法:利用光镜和免疫组织化学法对370例结直肠癌中的肿瘤浸润淋巴细胞进行组织病理学观察, 并分析对比其与各临床病理因素的相关性.结果:81.9%的结直肠癌中可见淋巴细胞散在分布, 数量少, 18.1%却可见大量的淋巴细胞,并有一定的临床病理特征. 大量的TIL部分侵入肿瘤实质而部分位于肿瘤组织周围. 免疫组织化学染色显示, 肿瘤浸润淋巴细胞主要是由CD3+ T细胞、CD20+、CD79α+B细胞、浆细胞和CD56+NK细胞构成, 其中细胞毒性TIA-1均有较高的表达, 并伴有大量淋巴细胞浸润与肿瘤组织的分化程度、浸润深度及淋巴结转移有关(χ2 = 4.954, 11.240及12.768; P = 0.026,0.001及0.000).结论:结直肠癌组织中TIL的病理形态差异较大并与临床病理因素相关. 在结直肠癌中伴有大量肿瘤浸润淋巴细胞存在时有积极的意义.     

Clinicopathological characteristics and prognosis of mucinous breast carcinoma

Purpose

The clinical features and prognosis of mucinous breast carcinoma (MBC) are unclear because of its rarity. The aim was to describe the clinicopathological features and prognosis of patients with MBC in comparison with nonmucinous breast carcinoma (NMBC). Furthermore, we described the biological behavior of pure mucinous breast carcinoma (PMBC) by comparing clinicopathological features and prognosis with mixed mucinous breast carcinoma (MMBC).

Methods

We reviewed the records of 5,872 consecutive patients diagnosed with breast carcinoma who were resected surgically from March 2003 to October 2010. Among them, 117 patients with MBC were compared to 5,575 patients with NMBC. Furthermore, 88 patients with PMBC were compared to 29 patients with MMBC.

Results

There were statistical differences in age, pN stage, ER level, and PR level between the patients with MBC and NMBC. There were statistical differences in pT stage and pN stage between the patients with PMBC and MMBC. The overall five-year survival of patients with MBC was 88.1 % as compared with 81.9 % for patients with NMBC. The overall five-year survival of patients with PMBC was 91.3 % as compared with 80.4 % for patients with MMBC. The overall five-year survival of patients with PMBC was 91.3 % as compared with 81.9 % for patients with NMBC.

Conclusions

PMBC tended to have a better prognosis in comparison with other types of breast carcinoma.     

Clinicopathological characteristics and prognostic factors of primary pulmonary lymphoma

BackgroundPrimary pulmonary lymphoma (PPL) is a rare extranodal lymphoma originating from the lung, accounting for 0.5–1.0% of primary lung malignant tumors. Previous case reports or cohort studies included a limited sample size; therefore, the understanding of the disease remains inadequate, and clinical data regarding PPL are limited.MethodsPatients with PPL diagnosed histologically and radiologically between January 2000 and December 2019 at our center were retrospectively analyzed.ResultsIn total, 90 consecutive cases were included in this research. Forty-seven (52.2%) patients were female, and the median age was 54 years old. Non-Hodgkin’s lymphoma (PPNHL) was the most common type of PPL (71/90, 78.9%), and mucosa-associated lymphoid tissue (MALT) lymphoma was the most common pathological subtype of PPNHL (56.3%) followed by diffuse large B-cell lymphoma (DLBCL) (32.4%). Thirty-nine (43.3%) patients underwent surgical treatment, and the others received chemotherapy alone or combined with radiotherapy. The estimated 5-year overall survival (OS) rates of MALT lymphoma and non-MALT lymphoma were 68.9% and 65.9%, respectively. Univariate analysis of PPL showed that clinicopathological features that significantly correlated with worse OS were age over 60 years (P=0.006<0.05), elevated LDH (P=0.029<0.05) and β2-MG (P=0.048<0.05) levels, clinical stage II2E and greater (P=0.015<0.05), and nonsurgical treatment (P=0.046<0.05). Age (P=0.013<0.05) was an independent prognostic factor for the 5-year OS of patients through multivariate analysis.ConclusionsAge over 60 years old, elevated LDH and β2-MG levels, clinical stage II2E disease or higher, and nonsurgical treatment were associated with poor prognosis in patients with PPL. Age can be used as a potential independent prognostic factor for PPL.     

miR-21在大肠癌与癌旁正常组织中的表达及临床病理意义

目的探讨miR-21在大肠癌及癌旁正常组织中的表达及与癌组织临床病理因素的关系。方法应用Real—time quantitatire PCR技术对20例大肠癌及癌旁正常组织中的miR-21进行相对定量,分析两者在不同组织的表达水平,并比较其在不同特征组织间的表达差异。结果miR-21在大肠癌组织中的表达明显高于癌旁正常组织,并在不同病理分化和临床分期的癌组织中的表达差异具有统计学意义。结论miR-21在大肠癌组织中的表达上调,恶性程度越高的癌组织中表达量越高,因此,miR-21的过高表达可能与大肠癌细胞的浸润和转移有关。