原发性胃恶性淋巴瘤的诊断和外科治疗

目的：探讨原发性胃恶性淋巴瘤的诊治方法。方法：1988年1月～1997年2月收治27例胃恶性淋巴瘤，全部经剖腹探查及病理检查证实。病变完全切除者20例，部分切除者7例，全部患者术后辅以CHOP(环磷酰胺、表阿霉素、长春新碱、强的松)化疗。结果：随访率92．6％(25／27)，全组总的5年生存率为72％(18／25)。结论：胃镜下活检最具确诊价值，治疗以根治性手术作为首选，辅以放化疗。     

The Effect-enhancing and Toxicity-reducing Action of the Extract of Herba Scutellariae Barbatae for Chemotherapy in Hepatoma H22 Tumor-bearing Mice

Objective： To investigate the effect-enchancing and toxicity-reducing action of the extract of Ban Zhi Lian （半枝莲 Herba Scutellariae Barbatae, EHSB） for chemotherapy in hepatoma H22 tumor-bearing mice. Methods： The tumor-bearing mice were divided into 6 groups randomly： a model group, a high dose EHSB group, a low dose EHSB group, a 5-fluorouracil （5-FU） group, a 5-FU＋high dose EHSB group and a 5-FU＋low dose EHSB group, and with a normal group set as the controls. All the groups were treated for 10 days. The life prolongation rate, toxic reactions of chemotherapy, WBC count, the body weight, tumor weight, thymus index and spleen index, and phagocytic function of intra-abdominal macrophages were investigated in the H22 tumor-bearing mice. Results： The increase of the body weight in both the 5-FU＋EHSB groups was significantly higher than that in the 5-FU group, with the toxic reactions such as anorexia, abdominal distension and emaciation significantly alleviated. Growth of the tumor was significantly inhibited in the high dose EHSB group, the 5-FU group, the 5-FU＋high dose EHSB group, and the 5-FU＋low dose EHSB group. The survival time in the 5-FU＋high dose EHSB group and the 5-FU＋low dose EHSB group was significantly prolonged as compared with that of the 5-FU group. The life prolongation rate was 98.72% in the 5-FU＋high dose EHSB group and 52.11% in the 5-FU＋low dose EHSB group. Growth of the transplanted tumor was significantly inhibited in the high dose EHSB group, the 5-FU group, the 5-FU＋high dose EHSB group, the 5-FU＋low dose EHSB group. The tumor inhibition rate in the high dose EHSB group, the 5-FU group, the 5-FU＋high dose EHSB group and the 5-FU＋low dose EHSB group was 36.98%, 42.26%, 65.28% and 52.45%, respectively. 5-FU combined with a high-dose EHSB could significantly enhance the tumor inhibition rate （P〈0.05）. The thymus index and the spleen index significantly increased in the high dose EHSB group, and atrophy of the immunological organs induced     

乳头血性溢液的诊断与治疗

目的:总结乳头血性溢液的诊断和治疗方法,为临床合理诊断治疗提供依据.方法:回顾性分析1998年至2006年本院收治的220例乳头血性溢液病例.结果:乳腺癌的细胞学诊断准确率50.85%,钼靶X线片诊断准确率76.27%,联合诊断准确率86.44%,冰冻活检准确率100%,联合诊断准确率优于乳头溢液涂片法和X线钼靶摄片法,差异具有统计学意义(P＜0.05).其中导管内乳头状瘤60.91%(134/220),乳腺癌26.82%(59/220),囊性增生、炎症、导管扩张症12.27%(27/220).结论:联合诊断可提高准确率,手术治疗及术中冰冻活检是合理治疗方式.     

^153钐-乙二胺四甲基膦酸联合伊班磷酸钠缓解骨转移性癌疼痛

目的 ^153钐-乙二胺四甲基膦酸(^153Sm-EDTMP)联合伊班磷酸钠控制多发性骨转移癌疼痛，探讨其疼痛缓解率。方法 106例多发性骨转移癌患用^153Sm-EDTMP联合伊班磷酸钠治疗，观察骨痛缓解及生活质量提高情况。结果 严重( )：CR23例，PR16例，MR3例，NR3例。中度( )CR18例，PR15例，MR3例，NR2例。轻度( )：CR14例，PR7例，NR2例。止痛有效率87．7％，生活质量明显提高，无严重毒副反应。结论 ^153Sm-EDTMP联合伊班磷酸钠治疗多发性骨转移安全有效。     

乳腺癌术前化疗后微血管计数的变化及临床意义

对 90例行术前化疗的乳腺癌和 76例未行术前化疗的乳腺癌病例术后标本经F - 相关抗原免疫组化染色 ,进行微血管计数 ,并结合 5年无病生存率进行分析。结果 :术前化疗组微血管计数 ( 48.86± 14 .2 0 )低于未行术前化疗的对照组 ( 5 9.95± 2 4.32 ) ,差异具有显著性 ( t=3.78,P<0 .0 1)。术前化疗组 5年无病生存率为 74.44 % ( 67/ 90 ) ,高于对照组( 45 / 76,5 9.2 1% ) ,差异具有显著性 ( χ2 =4.37,P<0 .0 5 )。术前化疗组低微血管计数病例所占比例为 77.78% ,高于对照组 ( 44 / 76,5 7.89% ) ,差异具有显著性 (χ2 =7.5 7,P<0 .0 1)。提示 :术前化疗降低肿瘤血管数 ,降低肿瘤转移、复发可能 ,提高 5年无病生存率。且可用于筛选高危患者 ,对于高微血管计数病例 ,尤其是化疗后微血管计数仍较高者 ,应加强治疗 ,提高生存率     

小儿卵巢肿瘤116例诊治分析

本院收治小儿卵巢肿瘤116例,其中良性100例,恶性16例。本组资料显示畸胎瘤随年龄增加其恶性率增高,强调了早期手术的重要性,并讨论了甲胎蛋白在恶性生殖细胞瘤诊治中的重要意义及化疗对提高生存率的重要作用     

乳腺浸润性导管癌磁共振表观扩散系数值与预后因子表达的相关性分析

目的 探讨乳腺浸润性导管癌磁共振扩散加权成像(DWI)表观扩散系数(ADC)值与淋巴结转移状态,雌激素受体(ER)、孕激素受体(PR)和cerbB2表达的关系.方法 选取自2008-04-2010-04采用b=800 s/mm2的DWI检出的49个乳腺浸润性导管癌病灶作为研究对象.测定病灶的ADC值,病灶切除后取相应标本,记录淋巴结转移情况,免疫组化技术测定病灶的ER、PR和cerbB2表达情况.对不同淋巴结转移状态和不同预后因子表达状态与病灶的ADC值的关系进行分析.结果本组49个浸润性导管癌病灶中,伴有淋巴结转移18个.ER、PR、cerbB2表达阳性率分别为55.1%、61.2%和51.0%.有无淋巴结转移的病灶平均ADC值之间比较无显著性差异(P=0.382).ER、PR和cerbB2表达阴性的病灶与表达弱阳性、阳性和强阳性的病灶的平均ADC值之间比较均无显著性差异(P值均<0.05).病灶平均ADC值与淋巴结转移状态、ER、PR和cerbB2的表达均不具有相关性(r值分别为0.063,-0.311,-0.261和0.333,P值均>0.05).结论 DWI的ADC值尚不能用于乳腺癌预后的间接评价和个体化治疗方案的选择.     

Clinical Effects of Shenqi Fuzheng Injection in the Neoadjuvant Chemotherapy for Local Advanced Breast Cancer and the Effects on T-lymphocyte Subsets

Objective： To evaluate clinical effects of Shenqi Fuzheng Injection （参芪抉正注射液） in the neoadjuvant chemotherapy for local advanced breast cancer and the effects on T-lymphocyte subsets. Methods： During the period from 2000 to 2005, 126 patients with local advanced breast cancer were treated with the neoadjuvant chemotherapy. They were randomly divided into the following two groups： a control group of 61 cases treated by chemotherapy alone and a study group of 65 cases treated by chemotherapy plus Shenqi Fuzheng Injection, All the cases of both groups were given the CEF （CTX 500 mg/m^2, d1, 8; EP140 mg/m^2, d1, 8; and 5-Fu 500 mg/m^2, d1,8） regimen. The clinical effects, the effects on T-lymphocyte subgroup and NK cells, and the toxic side effects were observed. Results： All the patients completed two cycles of the chemotherapy, and the efficacy and the toxic side effects were evaluated. For the primary tumor in the breast, the total effective rate was 69.2% （45/65） in the study group and 49.2% （30/61） in the control group with a statistically significant difference in the intergroup comparison （x^2=5.251, P=0.022, 〈 0.05）. There was no progression of the disease in both the groups, and there were no grade IV toxic side effects in the two groups. The major toxic responses were myelosuppression and gastrointestinal reaction, which were milder in the study group than the control group, and with a shorter recovery course in the former than the latter. Besides, an obvious rise of the T-lymphocyte subgroup and NK cells was found in the study group after the neoadjuvant chemotherapy, with a very significant difference from the controls （P〈0.01）. Conclusions： Shenqi Fuzheng Injection can improve and regulate immune function of the patients with local advanced breast cancer given the neoadjuvant chemotherapy, and therefore it can enhance the curative effect and reduce the side effect as well.     

抑癌基因PTEN在乳腺癌中的表达及其临床意义

目的:研究抑癌基因PTEN在乳腺癌中的表达并探讨其临床意义.方法:应用免疫组织化学方法检测92例乳腺癌以及 18例癌旁正常组织中PTEN表达并分析其与临床病理及预后的相关性.结果:乳腺癌组织中PTEN高表达率为54.3 %(50/92),明显低于癌旁正常组织(P<0.01).PTEN表达与淋巴结转移、临床分期、组织学分级以及雌激素受体相关(P<0.05).PTEN高表达的乳腺癌术后5 a无病生存率明显高于阴性表达者(P<0.05).结论:PTEN表达与乳腺癌发生、发展及预后密切相关.提示检测抑癌基因PTEN表达可作为判定乳腺癌恶性程度和预后的有效生物学指标.