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1.
目的:探讨表皮生长因子受体(EGFR)基因突变与棘皮动物微管相关样蛋白4与间变性淋巴瘤激酶(EML4-ALK)融合基因共存(以下简称双基因异常)的非小细胞肺癌的临床病理特征及治疗策略。方法:回顾性收集并分析2012年1月至2016年12月我院收治的EGFR突变与EML4-ALK融合基因共存的非小细胞肺癌患者的临床资料及病理特点。结果:11例双突变非小细胞肺癌占医院同期入院非小细胞肺癌患者的0.68%(11/1620);男性6例,女性5例;年龄23-70岁,平均年龄51.6岁;11例患者均不吸烟;腺癌9例,肉瘤样癌2例;临床分期,ⅠA期3例,ⅡB期1例,ⅢA期1例,ⅢB期1例,ⅠV期5例;6例行手术治疗,4例使用传统化疗,最好疗效为稳定(SD),最长无进展生存期(PFS)为6月;5例患者使用表皮生长因子酪氨酸激酶抑制剂(EGFR-TKⅠ)治疗,使用EGFR-TKⅠ最好疗效为部分缓解(PR),PFS为3-23月,中位PFS为9月;截止2017年12月,死亡4例,11例患者的生存时间为1-67月,中位存活时间为21月。结论:EGFR基因突变与EML4-ALK融合基因共存型非小细胞肺癌临床少见,多见于不吸烟或少吸烟的肺腺癌患者,双基因异常的非小细胞肺癌的靶向药物的治疗缺乏统一性,有待进一步研究,基于EGFR及EML4-ALK的磷酸化水平或肿瘤突变负荷选择靶向药物的个体化精准治疗是非常重要的。  相似文献   

2.
摘要目的:探讨化疗联合树突状细胞(DC)和细胞因子诱导的杀伤细胞(CIK)方案治疗非小细胞肺癌的临床疗效。方法:随机选取 2008年10月份-2011 年02 月份因非小细胞肺癌就诊于我院进行治疗的患者120 例,随机分为治疗组60 例患者(采用化疗联合 树突状细胞(DC)和细胞因子诱导的杀伤细胞(CIK)方案治疗),对照组60 例患者(采用常规化疗),统计两组患者的治疗效果以及 生活质量情况,并对结果进行统计分析。结果:治疗组患者治疗总有效率为68.4%,生活质量提高率为88.4%,明显好于与对照组, 经统计分析,P<0.05,差异存在显著性。结论:化疗联合树突状细胞(DC)和细胞因子诱导的杀伤细胞(CIK)方案治疗非小细胞肺癌 能够显著改善患者的生活质量,是治疗非小细胞肺癌的有效方法。  相似文献   

3.
本研究通过厄洛替尼对老年非小细胞肺癌(NSCLC)患者的治疗,观察其临床治疗效果和治疗安全性。回顾性分析2013年1月到2015年1月入住我院的46例老年非小细胞肺癌为研究对象,随机分为观察组和对照组,对照组吉非替尼治疗,观察组厄洛替尼进行治疗,总结厄洛替尼治疗老年非小细胞肺癌临床治疗效果与安全性。治疗后,症状缓解率达到75%,咳嗽、气短症状缓解最为明显,中位时间15 d。19例患者口服厄洛替尼后CEA数值下降,其中4例患者自行缓解,7例患者CEA持续增长。临床症状部分缓解、病情稳定和疾病进展的患者分别有6例、9例和8例,治疗客观有效率和疾病控制率分别为26.09%和65.21%,患者中为无进展生存期和总生存期分别为27周和47周;治疗期间出现的皮疹、腹泻、口干、口腔溃疡、食欲下降等不良反应的患者分别有11例(47.83%)、6例(26.09%)、2例(8.70%)、2例(8.70%)和2例(8.70%),研究过程中未出现一例患者因不良反应而死亡或者退出本次研究。皮疹患者给予皮肤消毒、松软膏等后逐渐好转,不影响继续治疗。腹泻症状出现在服药后1周后,口服止泻药物后得到好转,多为Ⅰ度和Ⅱ度,不影响患者继续治疗。研究结果表明厄洛替尼治疗可以有效的控制老年非小细胞型肺癌患者的病情,治疗过程中毒副反应较轻微,可以作为老年非小细胞肺癌治疗药物之一。需要注意的是不同人群及个体对药物特异性不同,因此在采用厄洛替尼治疗中,需要个性化给药,减少不良反应的出现。  相似文献   

4.
目的:分析图像引导放射治疗(IGRT)对老年非小细胞肺癌患者的临床疗效.方法:30例老年非小细胞肺癌患者,全部采用医科达图像引导放射治疗系统,GTV:60Gy,参考剂量线为95%~98%,分割方式3~4Gy/次.结果:肿瘤完全缓解率为33%(10/30),部分缓解率为50%(15/30),总有效率为83%(25/30).1、2、3年生存率为85%、70%、67%.结论:图像引导放射治疗(IGRT)对老年非小细胞肺癌有较好的局部控制率,是治疗老年非小细胞肺癌患者的有效方法之一.  相似文献   

5.
肺癌EGFR突变与酪氨酸激酶抑制剂临床敏感性的关系   总被引:1,自引:0,他引:1  
王俊  郭燕  陈正堂 《生命的化学》2006,26(5):443-445
表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKI)是近年来在临床中使用的一类新的小分子靶向药物,主要用于晚期非小细胞肺癌(NSCLC)的治疗,然而并非所有的NSCLC患者对TKI敏感。近期研究发现,在NSCLC治疗过程中,EGFR突变与TKI临床敏感性密切相关,通过检测肺癌EGFR突变状况可以预测TKI治疗的效果。  相似文献   

6.
目的:比较青年和老年非小细胞肺癌手术患者,临床特点和术后生存率.方法:我院1997-2002年胸外科肺癌手术患者,根据初诊时的年龄随机选择非小细胞肺癌患者40例作为青年组(≤40岁)和50例作为老年组(≥70岁).对比两组患者的年龄、性别、吸烟史、伴随疾病、病理类型、临床分期、手术方式、术后并发症、5年生存率.结果:青年组的伴随疾病发生率(22.5%)明显低于老年组(50.0%)(P=0.034);青年组的腺癌发生率(52.5%)明显高于老年组(12.0%)(P=0.008),而青年组的鳞癌发生率(32.5%)明显低于老年组(78.0%)(P=0.016);青年组术后并发症发发生率(12.5%)明显低于老年组(32.0%)(P=0.026);青年组5年总生存率(32.2%)明显高于老年组(20.5%)(P=0.041).结论:青年非小细胞肺癌患者以腺癌多见,5年总生存率高于老年组,这可能与老年人伴随疾病和术后并发症较多有关.  相似文献   

7.
目的:研究livin 蛋白在非小细胞肺癌中的表达及其与非小细胞肺癌的生物学特性及临床预后的关系。方法:通过免疫组化 的方法检测和比较88 例非小细胞肺癌组织和20例癌旁正常肺组织中livin 蛋白的表达,并分析其与非小细胞肺癌的临床病理特 征和预后的相关性。结果:非小细胞肺癌组织及癌旁正常肺组织中livin 蛋白的阳性表达率分别为54.55%和5%,差异有显著统计 学差异(P<0.05)。非小细胞肺癌组织中livin 蛋白的表达水平与淋巴结转移、TNM分期显著相关(P<0.05),但与患者的性别、年龄、 分化程度及病理学类型无关(P>0.05)。Livin 高表达的非小细胞肺癌患者生存时间显著短于livin 低表达的患者(P<0.05)。结论: Livin 蛋白在非小细胞肺癌的发生及发展中起重要作用并与患者的预后相关,可能作为非小细胞肺癌新的防治靶点。  相似文献   

8.
肺癌(lung cancer)是全球发病率及死亡率最高的恶性肿瘤之一,非小细胞肺癌(non-small cell lung cancer,NSCLC)占肺癌的85%,其五年生存率只有15%,传统的抗肿瘤治疗方法(手术、放疗和化疗等)在抑制肿瘤进展中的作用有限,即使有手术机会,也有40%以上患者出现局部复发或远处转移。目前多学科治疗较大程度提高了晚期NSCLC的生存期,研究表明,免疫治疗(immunotherapy)可改善肺癌的预后,有望成为肺癌的重要辅助治疗方式。其中,治疗性肿瘤疫苗(vaccination)如MAGE-A3、L-BLP25、Belagenpum atucel-L等、免疫检查点抑制剂(immune checkpoint inhibition)如ipilimumab、nivolumab、pembrolizumab等得到广泛关注。一系列临床试验表明免疫治疗可以使非小细胞肺癌的死亡率得到缓解,本文就其原理、临床试验、不良反应及有待解决问题的临床研究作系统综述。  相似文献   

9.
非小细胞肺癌(NSCLC)为最常见的肺癌病理类型,约占肺癌总数的 85%。大多数肺癌患者在确诊时已属晚期,失去手术机会, 保守治疗成为其重要治疗手段,但晚期肺癌患者的预后仍不理想。近年来,分子靶向治疗在肿瘤治疗领域取得重要进展,亦有研究显示 其在 NSCLC 的临床实践中发挥显著疗效。除表皮生长因子受体(EGFR)和间变淋巴瘤激酶(ALK)等主要基因突变之外,血管内皮生 长因子(VEGF)、ROS1、c-MET、RET、K-RAS、BRAF 也是目前 NSCLC 分子靶向治疗的相关靶点。综述 NSCLC 分子靶向药物治疗 的研究进展,旨在为该疾病的治疗提供参考。  相似文献   

10.
目的:对比晚期非小细胞肺癌患者经三维适形放疗(3D-CRT)与调强放疗(IMRT)后,其血清肿瘤标志物及剂量学参数的变化。方法:选择2015年1月-2016年12月期间我院收治的非小细胞肺癌患者120例,根据放疗方案将其分为IMRT组60例与3D-CRT组60例。比较两组临床疗效、药物毒副反应、1年内的生存率、放射剂量参数,以及治疗前与治疗后血清肿瘤标志物的变化。结果:IMRT组治疗的总有效率与3D-CRT组对比差异无统计学意义(P0.05)。IMRT组血小板减少、Ⅲ度放射性食管炎、Ⅲ度消化道反应、Ⅲ度放射性肺炎、Ⅲ度白细胞减少的发生率均低于3D-CRT组(P0.05)。IMRT组1年内的生存率90.00%,高于3D-CRT组的75.00%(P0.05)。IMRT组CI值与HI值均高于3D-CRT组(P0.05),IMRT组与3D-CRT组平均剂量对比差异无统计学意义(P0.05)。治疗后两组鳞状细胞癌抗原(SCC)、细胞角蛋白19片段抗原21-1(CYFRA21-1)与肿瘤特异性生长因子(TSGF)水平均显著降低,且IMRT组低于3D-CRT组(P0.05)。结论:IMRT与3D-CRT对于晚期非小细胞肺癌患者的临床疗效相当,但IMRT药物毒副反应少、放射剂量低,可能通过控制肿瘤来降低肿瘤标志物水平。  相似文献   

11.
Bitter melon ( Momordica charantia Linnaeus) fruit extract was tested against 3,4 benzo(a)pyrene [B(a)P] induced forestomach papillomagenesis in Swiss albino mice. Extract of M. charantia in two concentrations, 2.5 and 5% of standard mice feed was used for the short-term and long-term studies. A significant decrease in tumour burden was observed in short and long-term treatment. Also, total tumour incidence reduced to 83.33% with 2.5% dose and 90.90% with 5% dose in short term treatment, while in long-term treatment tumor incidence decreased to 76.92% with 2.5% dose and 69.23% with 5% dose of M. charantia. The possible mechanism involved in the cancer chemoprevention has also been discussed.  相似文献   

12.
Zhu M  Fan XL  Yang WL  Jiang Y  Ma L 《生理学报》2004,56(5):559-565
G蛋白耦联受体激酶5(GRK5)在G蛋白耦联受体信号转导中起重要调节作用。本文研究了单次给予成瘾性药物吗啡、海洛因和可卡因对大鼠脑内GRK5mRNA水平的调控作用,并选取吗啡为代表,观察单次或多次给予吗啡后大鼠脑内GRK5蛋白含量的变化。结果发现:(1)单次给予吗啡(10mg/kg)、海洛因(1mg/kg)或可卡因(15mg/kg)均可引起大鼠大脑顶叶皮层、颞叶皮层和海马的GRK5 mRNA水平显著上升;(2)单次或多次给予吗啡注射可以显著上调大鼠大脑皮层GRK5蛋白含量,而多次给予吗啡显著下调丘脑GRK5含量。我们的结果首次证明成瘾性药物对大脑皮层、海马等脑区的GRK5在mRNA水平和蛋白水平都有调控作用,提示GRK5可能在精神活性物质的成瘾中起作用。  相似文献   

13.
Total 5-HT binding sites and 5-HT1A receptor density was measured in brain regions of rats treated with imipramine (5 mg/kg body wt), desipramine (10 mg/kg body wt) and clomipramine (10 mg/kg body wt), for 40 days, using [3H]5-HT and [3H]8-OH-DPAT, respectively. It was observed that chronic exposure to tricyclic antidepressants (TCAs) results in significant downregulation of total [3H]5-HT binding sites in cortex (42–76%) and hippocampus (35–67%). The 5-HT1A receptor density was, however, decreased significantly (32–60%) only in cortex with all the three drugs. Interestingly, in hippocampus imipramine treatment increased the 5-HT1A receptor density (14%). The affinity of [3H]8-OH-DPAT was increased only with imipramine treatment both in cortex and hippocampus. The affinity of [3H]5-HT to 5-HT binding sites in cortex was increased with imipramine treatment and decreased with desipramine and clomipramine treatment. 5-HT sensitive adenylyl cyclase (AC) activity was significantly increased in cortex with imipramine (72%) and clomipramine (17%) treatment, whereas in hippocampus only imipramine treatment significantly increased AC activity (50%). In conclusion, chronic treatment with TCAs results in downregulation of cortical 5-HT1A receptors along with concomitant increase in 5-HT stimulated AC activity suggesting the involvement of cortical 5-HT1A receptors in the mechanism of action of TCAs.  相似文献   

14.
Treatment of HeLa-S3 cells in suspension cultures with 60 microM 5,6-dichloro-1-beta-D-ribofuranosylbenzimidazole (DRB) for 18-30 hr stops the growth of the cell population when treatment is carried out at 37 degrees C in Eagle's spinner culture medium supplemented with 5% fetal bovine serum. The length of the period of no growth after termination of treatment is directly related to the duration of DRB treatment. Upon resumption of growth, the rate becomes exponential and is not distinguishably different from the control rate (doubling time: 19 hr). The growth of the progeny population of the previously DRB-treated cells is as sensitive to inhibition by DRB as the growth of control populations not treated with DRB. After treatment of cells with DRB for 30 hr at 39.5-40 degrees C, the population which grows out has a prolonged doubling time. DRB treatment at 37 degrees C for 5 hr markedly inhibits uridine uptake and cellular RNA synthesis in the presence either of 5 or 15% serum. After treatment for 48 hr in 15% serum, inhibition of RNA synthesis by DRB is significantly decreased. DRB treatment does not inhibit leucine uptake in HeLa cells growing in suspension cultures. Protein synthesis is moderately inhibited in 5% serum and only slightly inhibited in 15% serum after either 5- or 48-hr period of treatment.  相似文献   

15.
Various studies have implicated the involvement of noradrenaline (NA) and/or serotonin (5-hydroxytryptamine (5-HT)) in the pathogenesis and treatment of depression. The aim of the present study was to investigate the effects of acute and 7 days of administration of desipramine, a NA re-uptake inhibitor, on the rate of 5-HT synthesis in the rat brain. The study was done by an autoradiographic method using alpha-[14C]-methyl-L-tryptophan as a tracer. The acute (10mg/kg, i.p., 2h before i.v. infusion of the tracer) or 7 days of desipramine (10mg/kg per day, i.p.) did not affect plasma tryptophan (Trp) concentrations, as compared to control (saline treated) rats. Acute treatment with desipramine decreased the rate of 5-HT synthesis in the brain regions that contain 5-HT cell bodies between 19 and 28%, and increased the rate of 5-HT synthesis in the majority of areas containing 5-HT terminals between 21 and 65%. In contrast to the acute treatment, a 7-day administration increased 5-HT synthesis rates in the dorsal raphe (24%), but decreased it in raphe magnus (35%), superior olive (45%), caudate (31%), superior (38%) and inferior (53%) colliculus, and in the auditory cortex (35%). This suggests that the effect of desipramine on 5-HT synthesis rate is time-dependent and differs in the cell bodies and structures containing 5-HT nerve terminals.  相似文献   

16.
Yeast extract was produced from brewer's yeast of a beer factory by combined enzymatic treatments using endoprotease, exoprotease, 5'-phosphodiesterase, and adenosine monophosphate (AMP)-deaminase. Effects of enzyme combination, enzyme dosages and treatment sequence on the recovery of solid and protein, flavor and compositional characteristics were investigated. Exoprotease dosage strongly affected the recovery of protein and degree of hydrolysis (DH) and sensory characteristics. When the yeast cells were treated using optimal combination of endoprotease and exoprotease (0.6% Protamex and 0.6% Flavourzyme), high solid recovery (48.3-53.1%) and the best flavor profile were obtained. Among various treatment sequences using multiple enzymes, treatment with protease followed by nuclease resulted in the highest 5'-guanosine monophosphate (5'-GMP) content. The optimal concentrations of both 5'-phosphodiesterase and AMP-deaminase were found to be 0.03%. After treatments using optimal combination of enzyme, enzyme dosages and treatment sequence for four enzymes, a high solid yield of 55.1% and 5'-nucleotides content of 3.67% were obtained.  相似文献   

17.
Two trials were carried out to compare the effects of fat or starch inclusion in sow's diet on sow and litter performance. In each trial, sows were assigned to one of two treatments. In trial 1, the sows were fed diets containing either soybean oil (5%, treatment GL5) or cornstarch (11.3%, GL0) from day 35 of gestation to weaning. Daily net energy and nutrient allowance were equalised during gestation. In trial 2, the same treatments were applied only after farrowing (treatments L5 and L0, respectively). Within each trial, a batch of piglets was studied until slaughter. In trial 1, adipose cell development and total lipid content were determined on some pigs at weaning (n = 6/treatment) and at slaughter in dorsal subcutaneous adipose tissue (n = 13/group at least) and in muscle (n = 46/group at least). Piglets' birth weight was not affected by treatment in trial 1. Survival rates at birth and after 24 h of life were higher in treatment GL5 (4.0% v. 7.5% stillborn piglets in GL0 treatment, P < 0.05; 8.7% v. 12.6% of piglets alive at 24 h of age died in treatment GL0, P = 0.06). Subsequently, overall survival rate until weaning was higher in treatment GL5 (81.4% v. 75.7% of total born piglets, P = 0.03), but litter size at weaning was not significantly affected (11.3). Litter growth rate before weaning was increased when a fat-enriched diet was provided during gestation and lactation (+140 g/day per litter; P < 0.01) and to a lower extent when provided only after farrowing (+90 g/day; P < 0.05). Energy supply through fat did not decrease the mobilisation of the sow's body reserve and backfat thickness loss was even higher with treatment GL5 (P < 0.05). After weaning, pigs' average daily gain, feed : gain ratio and carcass lean content were not affected by the energy source supplied before and/or after farrowing. At weaning, the number of adipose cells in the dorsal subcutaneous adipose tissue and in the Longissimus dorsi muscle was higher in the GL5 pigs. Muscle lipid content at weaning did not differ between treatments, but it was higher at slaughter, around 110 kg, in the GL5 pigs (3.46% v. 2.58%, P < 0.001).  相似文献   

18.
Seed treatment with iprodione at 125 and 150 g a.i./kg was superior to calomel seed treatment at 500 g a.i./kg in reducing disease losses and increasing yields in field experiments with salad onions infected with white rot; iprodione at 50, 62·5 and 100 g a.i./kg and thiophanate-methyl at 150 g a.i./kg were as effective as calomel. Furrow treatment with iprodione or thiophanate-methyl at 0·05 and 0·15 g a.i./m row or calomel at 0·5 g a.i./m row gave similar control as equivalent rates of seed treatment. Neither seed nor furrow treatments gave adequate control with prolonged exposure of the crop to the disease. A single stem base spray of iprodione at 0·0625 g a.i./m row applied 5 wk after drilling, reduced losses from 46% with a standard calomel seed treatment to 20%; increasing the stem base spray concentration to 0·25 g a.i./m row did not improve the control but resulted in a doubling of yields. The most effective control was obtained with iprodione applied as a seed treatment at 62·5 g a.i./kg combined with a single stem base spray at 0·0625 g a.i./m row 5 wk after drilling and this reduced losses to 6% compared with losses of 46% with calomel treated seed and 88% with untreated seed; increasing the stem base spray concentration did not improve control but resulted in higher yields.  相似文献   

19.
Despite continuing research and the development of alternate therapeutic options, prostate cancer remains problematic. Chemotherapy has played a minor role as a treatment option due to its lack of efficacy. Whereas cryotherapy has received renewed attention as a treatment modality, it too fails to offer an absolute curative option. Previously, we reported on the utilization of a therapeutic model, which, in combination, increases cell death in a canine renal cell model. Based upon that study, we investigated a combination therapy model as an alternative for the treatment modality for prostate cancer. We hypothesized that the combination of chemotherapy and cryosurgery would result in enhanced cell death, thereby presenting a more effective treatment of prostate cancer. A human prostate cancer cell (PC-3) model was exposed to 5-fluorouracil (5-FU) for 2 and 4 days (prefreeze), freezing (-5 to -100 degrees C), or a combination of the two treatments, and each was assessed for effectiveness over a 2-week posttreatment period. Additionally, investigation into the mechanisms of cell death initiated by the respective therapies was performed through DNA cleavage analysis. For chemotherapy, cultures exposed to 5-FU (2-4 days) yielded a 15-25% loss in cell survival. For cryotherapy, cultures exposed to a temperature window of -5 to -20 degrees C yielded an initial 5-70% loss of viability but cells propagated over time. Cultures exposed to temperatures of -25 to -80 degrees C yielded a 90-99% (+/-4.5%) initial loss in viability with repopulation observed by 12 days postthaw. Cells frozen to -100 degrees C yielded 100% (+/-0.3%) loss of viability and exhibited no signs of propagation. For chemo-cryo therapy, combination treatment at milder temperatures (-5 to -25 degrees C) resulted in an enhanced loss of cell viability compared to that for either treatment alone. Combination treatment at lower temperatures (-40 to -80 degrees C) resulted in a complete loss of cell viability. DNA fragmentation analysis at 48 h posttreatment revealed that dead (detached) cells treated with 5-FU died primarily through apoptosis, whereas dead cells from freezing (-15 degrees C) alone died primarily through freeze-rupture and necrosis. Detached cell analysis from combination treatment at -15 degrees C revealed the presence of apoptotic, necrotic, and freeze-rupture cell death. Scanning electron micrographs of cells exposed to freezing contributing to cell death. These data demonstrate that the combination of 5-FU at sublethal doses and freezing temperatures improves human prostate cancer cell death efficacy. Further, we suggest that chemo-cryo therapy offers a potential alternative treatment for the control and eradication of prostate cancer.  相似文献   

20.
Total 5-HT binding sites and 5-HT1A receptor density was measured in brain regions of rats treated with imipramine (5 mg/kg body wt), desipramine (10 mg/kg body wt) and clomipramine (10 mg/kg body wt), for 40 days, using [3H]5-HT and [3H]8-OH-DPAT, respectively. It was observed that chronic exposure to tricyclic antidepressants (TCAs) results in significant downregulation of total [3H]5-HT binding sites in cortex (42–76%) and hippocampus (35–67%). The 5-HT1A receptor density was, however, decreased significantly (32–60%) only in cortex with all the three drugs. Interestingly, in hippocampus imipramine treatment increased the 5-HT1A receptor density (14%). The affinity of [3H]8-OH-DPAT was increased only with imipramine treatment both in cortex and hippocampus. The affinity of [3H]5-HT to 5-HT binding sites in cortex was increased with imipramine treatment and decreased with desipramine and clomipramine treatment. 5-HT sensitive adenylyl cyclase (AC) activity was significantly increased in cortex with imipramine (72%) and clomipramine (17%) treatment, whereas in hippocampus only imipramine treatment significantly increased AC activity (50%). In conclusion, chronic treatment with TCAs results in downregulation of cortical 5-HT1A receptors along with concomitant increase in 5-HT stimulated AC activity suggesting the involvement of cortical 5-HT1A receptors in the mechanism of action of TCAs.  相似文献   

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