大肠癌术前化疗疗效的病理组织学对照研究

目的探讨大肠癌术前化疗的方法及疗效．方法本院同期手术治疗的１１４例大肠癌病例，根据术前化疗方法分为：Ａ动脉灌注化疗组６２例；Ｂ静脉化疗组１９例；Ｃ５氟脲嘧啶（５ＦＵ）保留灌肠组１２例；Ｄ对照组２１例．化疗后２ｗｋ～４ｗｋ行肿瘤切除术，肿瘤标本做病理切片组织学疗效观察．结果Ａ，Ｂ，Ｃ组化疗后切除的肿瘤其细胞变性、坏死数量及程度均明显高于对照组（Ｐ＜００１），其中动脉灌注化疗组高于静脉化疗组和５ＦＵ保留灌肠组（Ｐ＜００５）．４０例使用５ＦＵ的动脉灌注化疗组中８例出现化学性肠炎，其中２例出现肠缺血坏死．结论大肠癌术前化疗以动脉灌注化疗疗效最好，应作为首选；５ＦＵ作为大肠癌术前动脉灌注化疗用药疗效不显著而副作用明显，应避免使用．     

结直肠癌术前、后化疗与手术总体治疗的临床研究

目前，手术治疗仍为结直肠癌最有效的首选治疗方法，但五年成活率仍在５０％左右．为了提高结直肠癌的治愈率，我们对１９９００１／１９９３１２在我院住院的２４９例患者进行了化疗手术化疗的总体治疗对比研究，现报告如下．１　材料和方法１．１　材料　１９９００１／１９９３１２经病理证实为结直肠癌的住院患者，年龄在７０岁以下，无远处转移者，共２４９例．全部患者均接受了结直肠癌根治性切除术．术毕４０００ｍＬ无菌蒸馏水清洗腹腔后，腹内置入８０ｍｇ顺铂作腹腔化疗．切除的标本均行病理检查．对ＤｕｋｅｓＢ２和Ｃ期…     

结直肠癌术后局部复发与处理

１影响局部复发的因素１．１与肿瘤本身有关的因素那些已知的影响生存的许多因素在局部复发中同样有影响．Ｄｕｋｅｓ分期越差，局部复发的可能性越大．在大量经腹会阴切除术后的患者调查中，在ＤｕｋｅｓＡ期局部复发率约为９１％，，Ｂ期１６７％，Ｃ期４０８％［...     

促胃液素受体拮抗剂丙谷胺治疗大肠癌患者疗效观察

我们采用促胃液素受体拮抗剂丙谷胺对大肠癌根治术后患者进行辅助治疗，并对其术后生存率进行随访，以探讨丙谷胺对大肠癌患者的疗效１材料和方法１．１材料收集我院普外科１９９４－０６／１９９５－０７行大肠癌根治术的患者６５例，男４０例，女２５例，年龄３４岁～７７岁，平均５９．３岁．所有病例均排除消化性溃疡，恶性贫血及内分泌疾病，无长期服用Ｈ２受体阻滞剂病史，并经病理学检查确诊，随机选择其中的２０例为丙谷胺治疗组，其余４５例为对照组，两组在性别、年龄、组织学类型和临床分期方面均无显著性差异１．２方法丙谷胺治…     

湘西地区大肠癌354例临床病理分析

目的对湘西地区大肠癌进行临床病理探讨。方法１９７９＿１９９４年经手术治疗的大肠癌３５４例进行临床及病理分析。结果早期以慢性肠道炎症症状、腹痛为主，职业以务农为多，部位以直肠最多，组织学以腺癌最多。环境污染因素与慢性炎症是本地区大肠癌发病的主要因素。结论有肠道症状时要进行“一指四查”，必要时活检检查等，以尽早发现大肠癌     

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...     

健脾法对不同病理分期的老年肠癌化疗患者生活质量的影响

目的观察大肠癌术后患者中约干预对化疗期生活质量的影响。方法将90例肠癌术后化疗患者分为2组，中医组45例，采用香砂六君汤加减治疗，对照组45例不采用中药干预，观察两组生活质撼评分KPS、QOL并判定脾虚证候疗效。结果中医组在体力状态、生活质量评分均优于对照组，中医组脾虚证治疗总有效率达88．89％。结论老年大肠癌术后运用健膊扶正法能改善和提高化疗期生活质量。     

经肛门环扎式结直及结肛吻合术用于低位直肠癌的可行性探讨

目的报告一种治疗低位直肠癌的新型术式观察其疗效，以探讨该术式在低位直肠癌治疗上的可行性．方法采用支撑吻合管施行低位直肠癌根治术，保肛性环礼式结直、结肛吻合术，术后6mo以上在访病例358例．结果术后5a者59例，存活者48例，五年生存率81．36％；局部术后复发44例，复发率12．29％．术后并发症：吻合口瘘5例，吻合口感染5例，均占1．4％；膀胱尿道结肠瘘3例（0．84％）；结肠阴道瘘3例（0．84％），骶前感染并结肠瘘4例（1．12％）；吻合口出血16例（4．48％）．无手术死亡率．排便功能：术后最早出现便意是术后d4，多在术后5d～7d，一般术后3mo～6mo可接近或达到正常人水平．提出了新的肛门排便标准，分为优、良、一般、差四级，优233例（65．08％），良72例（20．11％），一般38例（10．62％），差15例（4．19％）．结论本手术在支撑管的支撑吻合性能、操作技术、吻合口愈合机制、肿瘤的根治性、术后患者的肛门功能等方面均是可行的，在直肠癌根治保肛手术方面具有创新性和多方面的优点．值得推广．     

MACC1在结直肠癌迁移及化疗耐药中的实验研究

目的探讨MACC1在结直肠癌迁移及化疗耐药中的作用。 方法采用SiRNA干扰技术沉默MACC1表达,利用Transwell迁移实验研究MACC1在结直肠癌迁移中的作用,应用MTT法研究MACC1在结直肠癌化疗耐药中的作用。Western Blot检测相关通路蛋白表达变化。 结果SW480细胞系MACC1表达极低,而SW620细胞系中MACC1蛋白呈高表达状态。SiRNA技术可显著抑制MACC1的表达水平。MACC1干扰后,SW620细胞发生迁移的数目显著减少(P<0.05)且对5-Fu处理表现更为敏感(P<0.05)。下调MACC1表达后提示p-ERK及p-Met蛋白表达水平随之显著减少。 结论MACC1在结直肠癌转移及耐药过程中发挥重要作用,并有可能成为潜在治疗靶点。     

中量醛氢叶酸和5－FU联合治疗胃肠道肿瘤

目的探讨生化调制剂醛氢叶酸（ＣＦ）和氟脲嘧啶联合应用治疗胃肠道肿瘤的效果。方法采用ＣＦ＋５＿ＦＵ＋ＤＤＰ或／和ＭＭＣ联合方案。ＣＦ用中剂量２００－３００ｍｇ／（ｍ２·ｄ）静脉滴注，２ｈ后接着用５－ＦＵ３７５ｍｇ／（ｍ２·ｄ）静脉滴注ＤＤＰ２０ｍｇ／（ｍ２·ｄ）静脉推注，以上药物连用５ｄ，ＭＭＣ６－８ｍｇ于化疗第１天静脉推注。结果３２例可评价的胃癌有效率（ＣＲ＋ＰＲ）为６２５％，治疗有效病例，治疗后生存３－１４个月，仍在继续观察中。３６例可评价的结直肠癌有效率为４１７％，有效病例中位生存期１３个月，无效病例８个月。毒副反应以骨髓抑制和消化道反应为主。结论本方案对晚期胃肠道肿瘤是一种疗效比较好的化疗方案，毒副反应可以忍受，值得推广。     

5-氟脲嘧啶腹腔化疗预防裸鼠人结肠癌细胞肝转移研究

目的探索预防大肠癌根治术后肝转移局部区域性辅助化疗新途径.方法利用裸鼠人结肠癌细胞肝转移模型观察术后早期大剂量大容积5-氟脲嘧啶腹腔化疗预防裸鼠经睥接种的人结肠癌细胞肝转移的疗效.结果术后早期5-氟脲嘧啶40 mg/生理盐水40 ml/kg,1次/d,连续2 d 的腹腔化疗可使裸鼠肝转移发生率降低40%,平均每只裸鼠肝转移瘤数目减少50.89%,平均每只裸鼠生存时间延长48.21%.结论腹腔化疗是一个预防大肠癌根治术后肝转移有效的辅助化疗新途径.     

Immunohistochemical study on endocrine-like tumor cells in colorectal carcinomas

ＩｍｍｕｎｏｈｉｓｔｏｃｈｅｍｉｃａｌｓｔｕｄｙｏｎｅｎｄｏｃｒｉｎｅｌｉｋｅｔｕｍｏｒｃｅｌｓｉｎｃｏｌｏｒｅｃｔａｌｃａｒｃｉｎｏｍａｓＷＡＮＧＤａｏＣｕｎ，ＷＡＮＧＬｉＤｏｎｇ，ＪＩＡＹｕｎＹｉｎｇ，ＬＩＵＹｉＱｉｎｇ，ＦＥＮＧＣｈ...     

Persistent Racial and Ethnic Disparities in Up-to-Date Colorectal Cancer Testing in Medicare Enrollees

OBJECTIVES: To assess whether greater colonoscopy use among white as compared with nonwhite Medicare enrollees since Medicare established coverage for colorectal cancer (CRC) screening has been associated with a widening in white versus nonwhite disparities in up-to-date CRC testing status.
DESIGN: Serial cross-sectional analysis of Medicare claims.
SETTING: Surveillance, Epidemiology, and End Results (SEER) regions in nine states, representing 14% of the U.S. population.
PARTICIPANTS: A 5% random sample of fee-for-service Medicare enrollees aged 70 to 79 within each 6-month period from mid-1995 through 2003.
MEASUREMENTS: Trends in up-to-date status (having a fecal occult blood test (FOBT) claim in the prior year or a sigmoidoscopy or colonoscopy claim in the prior 5 years) according to race or ethnicity, estimated using repeated-measures logistic regression adjusting for age, sex, rural versus urban residence, income, comorbidity, and SEER region.
RESULTS: From mid-1995 through 2003, the adjusted percentage of enrollees that were up-to-date increased by a similar magnitude in whites (from 39.4% to 47.3%), blacks (from 29.0% to 38.1%), Asians and Pacific Islanders (from 33.1% to 41.8%), and Hispanics (from 23.7% to 33.2%). Although white versus nonwhite disparities in up-to-date status via colonoscopy widened, this was counterbalanced by narrowing white versus nonwhite disparities in up-to-date status via FOBT and sigmoidoscopy.
CONCLUSION: White versus nonwhite disparities in up-to-date CRC testing status in Medicare enrollees largely persisted through 2003.     

Liver metastasis models of human colorectal carcinoma established in nude mice by orthotopic transplantation and their biologic characteristic

AIM To establish a liver metastasis model of human colorectal carcinoma in nude mice.METHODS Orthotopic transplantation of histologically intact colorectal tissues from patients into colorectal mucosa of nude mice. Tumorgenicity, invasion, metastasis and morphological characteristics of the transplanted tumors were studied by light microscopy, electron microscopy and immunohistochemistry.RESULTS Liver metastasis models of human colon carcinoma (HCA-HMN-1) and human rectal carcinoma (HRA-HMN-2) were established after screening from 34 colorectal carcinomas. They had been passaged in vivo for 18 and 21 generations respectively. There were lymphatic, hemotogenous and implanting metastasesis. CEA secretion was maintained after transplantation. The primary and liver metastatic tumors were similar to the original human carcinoma in histopathological and ultrastructural features, DNA content and chromosomal karyotype.CONCLUSION The liver metastasis models provide useful tools for the study of mechanism of metastasis and its treatment of human colorectal cancer.INTRUDUCTIONSome models of nude mice that fresh human colorectal carcinoma tissue or cells were successfully transplanted subcuteneously have been reported at home and abroad[1,2]. But until now there has been no report on a liver metastasis model of human colorectal carcinoma established by orthotopic transplantation in nude mice in China. Based on our previous models of human liver and pancreas carcinoma by orthotopic transplantation[3,4], we established liver metastasis models of colon and rectum carcinoma with a spontaneous metastasis rate of 100%.     

大肠癌患者围手术期免疫治疗的意义

目的研究大肠癌患者的细胞免疫功能及外科手术对它的影响.方法分别应用APAAP法和乳酸脱氢酶释放法测定了43例大肠癌患者手术前后的外周血T淋巴细胞亚群和NK细胞活性（NKCC），结果患者术前CD3，CD4，CD4／CD8比值和NKCC分别为53．8％±5．4％，35．7％±6．1％，1．21±0．14，17．1％±8．9％，较对照明显降低；CD8明显升高，为29．7％±5．3％；接受围手术期免疫治疗的10例患者，术后1wkCD3，CD4，CD4／CD8比值及NKCC较术前明显升高；而对照组术后2wk内各指标除NKCC有升高外，余无明显变化，至4wk～6wk各指标达正常水平．结论术后2wk内患者仍处于免疫抑制期，围手术期免疫治疗可提高患者的围手术期细胞免疫功能，缩短术后的免疫抑制期.     

Liver metastasis models of human colorectal carcinoma established in nude mice by orthotopic transplantation and their biologic characteristics

ＩＮＴＲＵＤＵＣＴＩＯＮＳｏｍｅｍｏｄｅｌｓｏｆｎｕｄｅｍｉｃｅｔｈａｔｆｒｅｓｈｈｕｍａｎｃｏｌｏｒｅｃｔａｌｃａｒｃｉｎｏｍａｔｉｓｕｅｏｒｃｅｌｓｗｅｒｅｓｕｃｃｅｓｆｕｌｙｔｒａｎｓｐｌａｎｔｅｄｓｕｂｃｕｔｅｎｅｏｕｓｌｙｈａｖｅｂｅｅｎｒ...