后肾性腺瘤3例报道并文献复习

目的：探讨后肾性腺瘤的病理形态学特征及诊断要点。方法：采用常规HE染色及免疫组化染色，并复习文献。结果：组织学上主要由紧密而规则排列 的圆形小管和含有圆形细胞巢的实性区相间排列，偶见肾小球样结构。免疫组化以Leu7、vimetntin、keratin阳性及EMA阴性为特点。结论：后肾性腺瘤是肾胚胎残留发生的罕见良性肿瘤，常被误诊为恶性肿瘤，故与肾母细胞瘤、乳头状肾细胞癌鉴别尤为重要。     

食管癌或贲门癌nm23-H_1基因的表达

目的:本文的目的是探索nm23-H_1基因在食管癌贲门癌形成演化及转移方面的作用。方法:应用原位杂交技术检测129例食管癌、贲门癌组织中nm23-H_1基因表达情况。结果:人食管癌、贲门癌中nm23-H_1表达率高达58.1％(75/129),其中食管鳞癌为68.9％(42/61)、贲门腺癌为51.7％(31/60),食管小细胞癌为25％(2/8)。在鳞癌中表达率最高,小细胞食管癌中表达最低(P<0.05);伴有淋巴结转移者,阳性表达率为48.1(38/79),明显低于无淋巴结转移者,其阳性率为72％(36/50),差异显著(P<0.01);而且nm23-H_1表达与肿瘤分化程度高低及临床病理分期早晚呈显著正相关。结论:本组资料表明:nm23-H_1基因在食管癌、贲门癌的形成、演化及转移方面起重要作用,可望成为评价食管癌、贲门癌预后的一项新指标。     

尖锐湿疣鳞状细胞癌变的临床研究

目的探讨尖锐湿疣鳞状细胞癌变的临床特征。方法回顾性分析27例尖锐湿疣鳞癌变的临床特征,病理改变,病毒基因亚型分布,与同期首诊、单纯性尖锐湿疣相比较。结果尖锐湿疣鳞癌变病程长(平均31m),首诊、单纯性尖锐湿疣病程较短(平均3m);病理切片显示前者核硝酸银染色硝酸银颗粒/核面积比显著大于后者;首诊、单纯性尖锐湿疣感染的HPV基因亚型主要为低危型6/11型,尖锐湿疣鳞癌变感染的HPV基因亚型主要为高危型16/18型。结论尖锐湿疣鳞状细胞癌变在病程,病理,病毒基因亚型上显著区别于首诊、单纯性尖锐湿疣。     

原发性肝癌与肝局灶性增生结节的超声对比观察

目的观察原发性肝癌与肝局灶性增生结节的超声影像。方法原发性肝癌患者和肝局灶性增生结节患者均行二维彩超扫查和超声造影,比较两者结果。结果原发性肝癌与肝局灶性增生结节在时相、造影增强方式上有显著差异。结论在时相、造影增强方式上,超声造影可正确区分原发性肝癌与肝局灶性增生结节,这样有助于减少误诊,指导临床诊断。     

IL-17A对前列腺癌细胞迁移的促进作用及其机制

观察白细胞介素17A信号传导及转录蛋白3-血管内皮生长因子（IL-17A- Stat3-VEGF）信号通路激活对前列腺癌细胞迁移的作用,并探讨其相关机制。     

血管内皮生长因子与结肠及直肠癌淋巴结转移的关系

目的 :研究结肠及直肠癌活体组织中血管内皮生长因子 (VEGF)、p53蛋白和增殖细胞核抗原 (PCNA)表达与淋巴结转移的关系。方法 :应用病理学诊断的方法检查淋巴结有无癌细胞转移。直肠癌组织标本做VEGF、p53蛋白和PCNA免疫组织化学染色。结果 :VEGF阳性表达的结肠及直肠癌患者淋巴结转移率为 65 .91 % (2 9/ 4 4 ) ,VEGF阴性的患者淋巴结转移率为 1 9.2 8% (1 6/ 83) ,差异有极显著意义 (χ2 =1 2 .0 777,P <0 .0 0 1 ) ;而p53及PCNA阳性表达的患者淋巴结转移和阴性表达患者的淋巴结转移之间差异无显著意义。结论 :结肠及直肠癌组织中VEGF的表达可为患者的淋巴结转移情况的判断及预后提供重要的参考依据     

加热诱导结肠癌细胞Lovo凋亡的研究

目的：观察加热对人结肠癌细胞株Lovo的凋亡作用。方法：用Hochest33258荧光染色、凝胶电泳和流式细胞术观察不同时间一温度作用下Lovo细胞的变化。结果：不同温度一时间处理的细胞均发生凋亡，出现明显的形态学改变及凋亡特有的亚二倍体峰和DNA梯度。其中43℃处理3、4h和44℃处理1、2h时细胞凋亡最明显，细胞周期也发生变化。结论：加热可诱导人结肠癌细胞株Lovo发生凋亡，并具有一定的周期特异性。     

颈淋巴结阴性鼻咽癌患者颈部的放射治疗

本文分析１９８８年１月至１２月在我科放疗前有ＣＴ检查的Ｎ０鼻咽癌患者单纯分段放疗１９１例，上颈放疗剂量〉４５Ｇｙ－５０Ｇｙ，和〉５０Ｇｙ－５９Ｇｙ的颈淋巴结复发率在ＣＴ示颈动脉鞘区阳性者差异显著（Ｐ〈０．０１）；阴性者差异不显著。全组上颈放疗剂量〉５０－５９Ｇｙ和〉６０Ｇｙ者颈淋巴结复发率无显著差异，只行上半颈和行全颈预防放疗的颈淋巴结复发率亦无显著差异。因此，Ｎ０鼻咽癌患者颈部放疗剂量〉５０Ｇｙ     

Factors influencing adrenal metastasis in renal cell carcinoma

OBJECTIVES: We determine the incidence and characteristics of adrenal involvement in localized and advanced renal cell carcinoma, and evaluate the role of adrenalectomy as part of radical nephrectomy. MATERIAL AND METHODS: From 1993 to 1999, 210 patients with renal cell carcinoma (RCC), (139 men and 71 women, mean age 60.8 years, range 12-96) underwent radical nephrectomy with associated adrenalectomy. Patients were divided into two subgroups of 106 with localized (stage T1-2 tumor, groupl) and 104 with advanced (stage T3-4N01M01, group2) renal cell carcinoma. A retrospective review of preoperative computerized tomography (CT) of the abdomen was performed. Radiographic findings were subsequently compared to postoperative histopathological results to assess the predictive value of tumor characteristics and imaging in determining adrenal metastasis. RESULTS: Of the 210 patients, 15 (7.1%) had adrenal involvement. Tumor stage correlated with probability of adrenal spread, with T3-4 and T1-2 accounting for 13.4% and 0.9% of cases, respectively (p < 0.001). Upper pole intrarenal RCC most likely to spread was local extension to the adrenal gland, representing 53.3% of adrenal involvement. In contrast, multifocal, lower pole and mid region RCC tumors metastasized hematogenously, representing 21.4%, 7%, and 14% of adrenal metastasis, respectively. The relationship between intrarenal tumor size (mean 7.8 cm, range 4 to 21) and adrenal involvement was not statistically significant. Preoperative CT demonstrated 97.7% specificity, 98.4% negative predictive value, 87% sensitivity and 80% positive value for adrenal involvement by RCC. CONCLUSIONS: Ipsilateral adrenalectomy should only be performed if a lesion is seen preoperatively on CT scan or if gross disease is seen at the time of nephrectomy. The prognosis is poor for RCC with ipsilateral involvement even with complete removal. Because of this poor prognosis we believe that adrenal involvement should constitute a separate stage category.     

直肠癌旁移行粘膜电镜观察

对１６例直肠癌旁０～５ｃｍ粘膜采用粘蛋白组织化学与电镜的方法对比观察。结果表明，移行区细胞有早期亚微结构的病理改变，杯状细胞及未分化细胞增多，有轻度异形性，并出现“双重特征”细胞。证明癌旁移行粘膜细胞成熟迟缓，应视为潜在癌前期改变。