彩色多普勒超声评估卵巢癌周围血管受侵程度及可切除性的应用价值

摘要 目的：探讨彩色多普勒超声评估卵巢癌周围血管受侵程度及可切除性的应用价值。方法：选择2018年2月至2019年8月在本院诊治的卵巢癌患者548例作为研究对象,所有患者都给予彩色多普勒超声,评估患者的周围血管受侵程度及可切除性,记录患者的超声血流频谱。结果：超声诊断为卵巢癌周围血管受侵犯78例,占比14.2 %,诊断敏感性与特异性为97.5 %和100.0 %, ROC曲线面积为0.963。超声诊断为卵巢癌可切除450例,占比82.1 %,诊断敏感性与特异性为99.1 %和90.4 %,ROC曲线面积为0.897。手术切除患者的年龄、体重指数、病理类型、病程等与未手术切除患者对比差异无统计学意义(P>0.05)。手术切除患者的搏动指数(pulsation index,PI)和阻力指数(resistance index,RI)高于非手术切除患者,血管舒张末期流速(end-diastolic velocity,EDV)、峰值流速(peak systolic velocity,PSV)低于非手术切除患者,差异均有统计学意义(P<0.05)。结论：彩色多普勒超声评估卵巢癌周围血管受侵程度及可切除性具有很好的敏感性与特异性,有利于指导卵巢癌患者的病情评估与治疗。     

Selection of 3LL tumor subline resistant to natural effector cells concomitantly selected for increased metastatic potency

Summary The numbers of strongly adherent monocytes in the peripheral blood of normal subjects and cancer patients were determined. The method used was to place peripheral blood mononuclear cells in microwells and culture them for 1 week. At the end of that period, adherent macrophages were counted in the Coulter counter after release. Adherent cells per milliliter of blood, per total cells, and per mononuclear cells or monocytes plated were markedly diminished in the peripheral blood mononuclear cells of 44 melanoma, 23 breast cancer, 18 lung cancer, nine colon cancer, and 27 leukemia patients. Median values were 14.8×10⁴ adherent cells per ml peripheral blood for 86 normal subjects, as against 2.5×10⁴ per ml in the peripheral blood of the 125 patients (P<0.001). There was a poor correlation between the adherent cell numbers and the peripheral blood leukocyte counts, but an excellent correlation of the different adherent cell counts with each other. The number of adherent cells in the peripheral blood varied inversely with age in the cancer patients, but not in the normal subjects (r=0.29, P<0.005). When patients under age 50 were compared to the controls, the deficiency of adherent cells was slightly more severe in patients with stage IV lung cancer than in those with stage III lung cancer. In contrast, there was no difference in the degree of deficiency between patients with stage III melanoma and no evident disease and patients with stage IV disseminated metastatic disease. The implications of these results are discussed.     

天麻素对全麻宫颈癌根治术患者术后认知功能及S-100beta影响

目的：探讨天麻素对全身麻醉下宫颈癌根治术患者术后认知功能及S-100beta的影响。方法：选取我院妇科收治的宫颈癌患者 86 例，随机数字表法分为两组，两组患者均在全身麻醉下行全子宫双附件切除联合盆腔淋巴结清扫术。对照组术后予以抗感染、 肠外营养支持等常规术后治疗，实验组术后常规治疗的基础上加用天麻素注射液。两组患者分别于麻醉前、手术后6 h、1 d、3 d及 7 d 测定MMSE 评分及血中S-100beta水平。结果：两组患者全麻宫颈癌根治术后均出现中度认知障碍，MMSE 评分较麻醉前下降， 与对照组同期比较，实验组术后3 天、7 天MMES 评分较高，差异具有统计学意义（P＜0.05）；两组患者宫颈癌根治术后血中 S-100beta蛋白水平升高，与对照组同期比较，实验组术后1 d、3 d与7d S-100beta水平较低，差异具有统计学意义（P＜0.05）。结论：天 麻素能够明显改善全麻宫颈癌根治术患者术后认知功能障碍，降低S-100beta蛋白水，提高术后恢复效果，对临床具有指导意义。     

Genotoxic effects of radiotherapy and chemotherapy on the circulating lymphocytes of breast cancer patients. I. Chromosome aberrations induced in vivo

Unstable chromosome aberrations were scored in peripheral blood lymphocytes (PBL) serially collected from 21 breast cancer patients before and after radiotherapy (RT), chemotherapy (CT) and combined treatments. Local radiotherapy as treatment for mammary cancer induced unstable chromosome aberrations in peripheral blood lymphocytes. Only a fraction of these lymphocytes were exposed to irradiation during treatment and the chromosomal damage observed in PBL was equivalent to that induced by irradiation in vitro with 2 Gy at high dose rate, i.e., about 4% of the total dose delivered locally. Chemotherapy alone did not induce such anomalies. Apart from the observed interindividual variations in either the level or the fate of dicentrics with time, different features of chromosome damage were found when chemotherapy was given before or after local cobaltotherapy: secondary chemotherapy did not alter the frequency and the overdispersed distribution of dicentrics observed after first-line radiotherapy; in contrast, when CT was given before radiotherapy, a lower dicentric frequency was scored, the distribution of dicentrics was not always found to be overdispersed and there was a time-dependent decrease in dicentrics after in vivo exposure.     

Analysis of mitochondrial DNA copy number variation in blood and tissue samples of metastatic breast cancer patients (A pilot study)

Changes in mitochondrial DNA (mt-DNA) copy number in blood/tissue have been linked to increased risk of several cancers; however, studies on their association in breast cancer is still lacking. In this pilot study, we investigated mt-DNA copy number variation in peripheral blood and tissue samples from metastatic breast cancer patients and compared their differences. For the study, peripheral blood samples from non-cancer individuals (control) and breast cancer patients, along with resected tissues from adjacent and tumor sites from same breast cancer patients were collected. Total genomic DNA was isolated and changes in mt-DNA copy number were measured by relative quantification using SYBR green based quantitative real time PCR method. Our results indicated a significant reduction in mt-DNA copy number in blood samples of breast cancer patients compared to control. However, a significantly higher mt-DNA copy number was observed in tumor tissue when compared with paired non tumor tissue. There was no significant difference in mt-DNA copy number between blood and adjacent tumor tissue samples of the breast cancer patients. Overall, our study reports for the first time a comparison of mt-DNA copy number in blood and paired tissue together and suggested that mt-DNA copy number is differentially regulated in blood and tumor tissues in breast cancer.     

Screening and genetic counselling for relatives of patients with colorectal cancer in a family cancer clinic.

OBJECTIVE--To introduce and monitor a screening programme for first degree relatives of patients with colorectal cancer based on their calculated lifetime risk. DESIGN--Lifetime risks were calculated for first degree relatives of patients with colorectal cancer and used to offer screening based on estimated risk. SETTING--A family cancer clinic was set up as part of the North East Thames Regional Genetic Service for relatives of patients who had developed colorectal cancer before the age of 45 and members of families in which multiple cancer had occurred. PATIENTS--Self referrals as well as patients referred by general and hospital practitioners. INTERVENTION--Relatives with a lifetime risk of 1 in 10 or greater (high risk group) were offered screening five yearly by colonoscopy, and those whose risk was between 1 in 10 and 1 in 17 were offered yearly screening for faecal occult blood. Women with family histories compatible with Lynch type II cancer family syndrome were offered screening for breast and pelvic tumours. RESULTS--In four years 715 patients were seen. Acceptance of screening was 90% (644 patients). Of 151 patients screened for faecal occult blood, two were found to have polyps. This screening test was unsatisfactory for the high risk group, having a negative predictive value of 78% in 59 patients tested. Regular screening by colonoscopy was offered to 382 high risk patients; 62 patients with polyps and five with colonic cancer were found. One hundred and ten pedigrees were identified with the Lynch type II cancer family syndrome, and four of 35 women screened were found to have breast cancer. Of 14 relatives aged over 65 with a 1 in 2 risk of site specific colonic cancer or Lynch type II cancer family syndrome, seven were found to have polyps, one of whom had carcinoma in situ. CONCLUSIONS--Family history can be used to identify those at risk of colonic cancer and to target appropriate screening. Colonoscopy detected a high number of premalignant colonic polyps, but faecal occult blood testing was unsatisfactory for those at high risk of colorectal cancer.     

肠内营养在直肠癌术后急性放射性肠炎中的临床应用研究

目的:研究肠内营养在直肠癌术后急性放射性肠炎中的临床应用。方法:选择2012年7月~2013年7月在我院接受治疗的104例直肠癌手术后发生急性放射性肠炎的患者作为研究对象。依照数字法随机分成观察组(51例)和对照组(53例)。对照组予以(半)流质食物,观察组则予以能全力肠内营养支持治疗。分别在治疗前以及治疗后7d测定血生化、营养以及电解质指标。结果:经7d治疗后,观察组的前白蛋白(PA)、白蛋白(Alb)、视黄醇结合蛋白(RBP)及体重(BW)水平均显著高于治疗前以及对照组,C反应蛋白(CRP)显著低于对照组,差异均有统计学意义(均P0.05);但两组治疗后的总蛋白(TP)水平差异无统计学意义(P0.05);两组治疗前后的谷丙转氨酶(ALT)、血清碱性磷酸酶(AKP)、凝血酶原时间(PT)、胆红素(BIL)、尿素氮(BUN)、肌酐(Cr)及血糖(Glu)等血生化指标以及钾离子(K+)、钠离子(Na+)、氯离子(Cl-)、钙离子(Ca2+)等电解质指标的差异均无统计学意义(均P0.05)。结论:通过肠内营养治疗直肠癌手术后发生的放射性肠炎,可改善患者的营养状况,效果显著,值得推广。     

CEAmRNA在大肠癌患者微转移早期预测中的意义

目的：大肠癌是最常见的恶性肿瘤之一,血行转移是大肠癌根治性手术失败的原因之一,在根治性切除肿瘤患者中,有大部分患者死于肿瘤的复发和转移,因此早期发现大肠癌微转移,对于延长患者预后指导下一步治疗具有重要意义。本研究已检测大肠癌患者外周血和引流静脉血中CEAmRNA的表达,以探索手术操作和微转移的关系,以及引流静脉血中微转移的发生与临床病理因素的关系,探讨早期发现大肠癌血循环微转移的意义。方法：应用逆转录多聚酶链式反应（RT-PCR）法检测大肠癌患者手术前,手术后外周血及引流静脉血液中的CEAmRNA水平。结果：（1）大肠癌患者术前外周血CEAmRNA阳性率26．7％（16／60）,引流静脉血阳性率48.3％（29／60）,引流静脉血明显高于外周静脉血（P〈0．05）。（2）大肠癌引流静脉血中CEAmRNA在肿瘤大于5厘米者、DukesC期、中低分化程度、有淋巴转移者、浸及浆膜者比外周静脉血更有统计学上的意义。（3）手术前后引流静脉血CEAmRNA阳性率具有显著差异（P〈O．05）,外周血CEAmRNA阳性率无显著差异。结论：大肠癌引流静脉血微转移是大肠癌肝转移的发生的早期阶段,引流静脉血CEAmRNA的表达能更早期反映出大肠癌患者微转移的发生,引流静脉微转移发生率与肿瘤分化程度、浸润深度、TNM分期、淋巴结转移、远处转移相关,是反映大肠癌生物学行为的指标之一,手术对大肠癌血循环微转移有促进作用。     

CEA mRNA在大肠癌患者微转移早期预测中的意义

目的:大肠癌是最常见的恶性肿瘤之一,血行转移是大肠癌根治性手术失败的原因之一,在根治性切除肿瘤患者中,有大部分患者死于肿瘤的复发和转移,因此早期发现大肠癌微转移,对于延长患者预后指导下一步治疗具有重要意义。本研究已检测大肠癌患者外周血和引流静脉血中CEA mRNA的表达,以探索手术操作和微转移的关系,以及引流静脉血中微转移的发生与临床病理因素的关系,探讨早期发现大肠癌血循环微转移的意义。方法:应用逆转录多聚酶链式反应(RT-PCR)法检测大肠癌患者手术前,手术后外周血及引流静脉血液中的CEA mRNA水平。结果:(1)大肠癌患者术前外周血CEA mRNA阳性率26.7%(16/60),引流静脉血阳性率48.3%(29/60),引流静脉血明显高于外周静脉血(P0.05)。(2)大肠癌引流静脉血中CEA mRNA在肿瘤大于5厘米者、Dukes C期、中低分化程度、有淋巴转移者、浸及浆膜者比外周静脉血更有统计学上的意义。(3)手术前后引流静脉血CEAm RNA阳性率具有显著差异(P0.05),外周血CEA mRNA阳性率无显著差异。结论:大肠癌引流静脉血微转移是大肠癌肝转移的发生的早期阶段,引流静脉血CEA mRNA的表达能更早期反映出大肠癌患者微转移的发生,引流静脉微转移发生率与肿瘤分化程度、浸润深度、TNM分期、淋巴结转移、远处转移相关,是反映大肠癌生物学行为的指标之一,手术对大肠癌血循环微转移有促进作用。     

经皮电穴位电刺激足三里穴对胃癌患者术后血清IgG、IgM水平的影响

目的:观察经皮穴位电刺激对胃癌根治术患者术后血清免疫球蛋白M(Ig M)、免疫球蛋白G(Ig G)水平的影响。方法:选择全麻择期行胃癌根治术的患者102例(男88例,女14例),年龄40~75岁,将其随机分为经皮穴位电刺激组、假电刺激组和对照组。经皮电刺激双侧"足三里"(ST 36)、"三阴交"(SP 6)穴,于手术当日、术后第1日和术后第2日进行经皮电刺激治疗。于术前30分钟、术后24 h、术后72 h采集静脉血标本,测定免疫球蛋白G(Immunoglobulin G,Ig G)、免疫球蛋白M(Immunoglobulin M,Ig M)的水平。术后监测和记录肛门的排气时间。结果:在术后第1天,对照组外周血Ig G水平显著低于术前30分钟(P0.05),TEAS组外周血Ig M水平显著高于术前30分钟(P0.05),TEAS组外周血Ig G和Ig M水平显著高于对照组(P0.05)。在术后第3天,对照组外周血Ig G、Ig M水平显著低于术前30分钟(P0.05),TEAS组外周血Ig G、Ig M水平均显著低于术后1天(P0.05)。三组患者术后肛门排气时间比较无统计学差异(P0.05)。结论:经皮穴位电刺激可以升高胃癌根治术患者术后1天降低的外周血Ig G和Ig M水平,减轻其术后免疫抑制。     

Relation between recurrence of cancer of the colon and blood transfusion.

Data suggest that blood transfusion can cause immunosuppression. The incidence of recurrence of tumours was examined retrospectively in patients who had undergone potentially curative operations for cancer of the colon during 1970-81. Tumours recurred in six of 68 patients (9%) who had not been given transfusions and in 56 of 129 patients (43%) who had (p much less than 0.0001). Transfusion was also found to be significantly associated with the time to recurrence after adjustment for other baseline prognostic factors (p less than 0.05). Perioperative transfusion may be a significant risk factor in the prognosis of cancer of the colon. Whether this association is causal is unknown.     

Relation between radiation dosage and blood indices in radioteletherapy

A tissue dose delivered to the focus during the course of distant radiotherapy of patients with the inoperable lung cancer was estimated with a reference to some blood indices. The most important parameters were found determining the dose for the pathologic focus. The regresion equations were obtained permitting, within the given accuracy, to determine the radiation dose to be delivered to the pathologic focus during the radiotherapeutic course with a reference to the considered localization and technique of irradiation.     

Use of black vulture (Coragyps atratus) in complementary and alternative therapies for cancer in Colombia: A qualitative study

ABSTRACT: BACKGROUND: Although Coragyps atratus has been used as a traditional therapy for patients with cancer, the scientific literature does not contain enough information on how this therapy is used or the mechanisms that explain this therapeutic practice. Objectives To understand the methods of use and the reasons given by patients and caregivers for the use of Coragyps atratus in cancer treatment. METHODS: This study used a qualitative design based on twenty in-depth interviews of patients with cancer or caregivers of patients with the disease. The analysis of the text was based on an inductive thematic approach. RESULTS: Resistance to disease and immune enhancement are properties attributed to Coragyps atratus when used for cancer treatment. The most recommended method of use is fresh blood ingestion, and the associated mechanism of action is transfer of immune factors to the individual who consumes it. CONCLUSIONS: Use of Coragyps atratus as a treatment for cancer is a popular alternative therapy in Colombia. More studies are needed to understand the clinical effects of this intervention in cancer patients.     

Selenium in the blood of patients with colorectal cancer and neoplastic polyp.

Samples of whole blood were obtained from 51 patients with newly diagnosed colorectal cancer as well as from 76 patients with neoplastic colorectal polyp, and from 30 healthy blood bank donors. Selenium was determined by the fluorimetric method. Significantly decreased selenium concentrations of blood samples from patients with colorectal cancer and villous adenoma were found. There was not any correlation between the blood selenium levels of patients with adenomatous polyp and the severity of dysplasia in removed polyps. The lowest mean selenium level in patients with villous adenoma indicates that selenium deficiency may be an important factor in the development of colorectal cancer arising from villous adenomas.     

Induction of endogenous tumor necrosis factor by OK-432 in ovarian cancer patients with ascites

To four ovarian cancer patients with malignant ascites, 10 KE of OK-432 was intraperitoneally administered four times at 2 day intervals for priming, and 40 KE of OK-432 was given on the 13th day after the first injection for triggering. The changes in blood monocyte and peritoneal macrophage levels and the production of tumor necrosis factor (TNF) by blood mononuclear cells (BMCs) and ascitic lymphoid cells (ALCs) were examined. In the two patients in whom TNF was induced in the ascites, TNF production by BMCs and ALCs was noted during priming. After triggering, increases in both the number of peritoneal macrophages and TNF production by ALCs were noted. In the other two patients, in whom TNF was not detected in the ascites, the ratio of peritoneal macrophages to ALCs did not change throughout the study period, and TNF production by the ALCs was not augmented. These findings suggest that OK-432 can exert a primary effect on both peritoneal macrophages and blood monocytes, and that OK-432 triggering can promote an increase in primed peritoneal macrophages and the release of TNF from these cells.     

Inhibition of systemic TNF-alpha cytotoxicity in cancer patients by D-peptidoglycan

The current study was designed to investigate direct inhibitory effects of N-acetylglucosaminyl-muramyldipeptide (GMDP) over the cytotoxic nature of TNF-α. A lactate dehydrogenase (LDH) assay of the inhibition of TNF-α cytotoxicity was donein vitro on the following cell lines: A549 (human lung carcinoma cells), A431 (human breast cancer cells) and L929 (mouse breast cancer cells). In a double-blind placebo-controlled trial, cancer patients with an elevated activity of all five LDH isoensymes were randomized to receive either a GMDP solution or a placebo; 63 patients were evaluated every third day for the mean daily number of episodes of nausea or vomiting, changes in clinical status, cell blood count and blood chemistry. A 95% inhibition of LDH release was noticed on A549 cells. Other cell lines were less sensitive to GMDP, with an observed 72% dose-dependent reduction in LDH activity.In vivo, LDH activity was decreased by 41% (+/−4%) (mean +/−SD) in all 21 subjects who were given 0.5–1.0 mg of GMDP daily. A lowering of LDH activity by 73.4% (+/−4%) was observed in 23 patients who received GMDP at a dosage of 1.5 mg/kg daily. Correspondingly, a 10% (+/−2%) increase in LDH activity was noticed in 19 patients who were given a placebo (P<0.01). During the follow-up period, the overall clinical condition of all patients treated with GMDP was improved. No side effects were observed. In nine patients who experienced nausea from tumor toxicity before treatment, the symptom subsided. In parallel, an extremely beneficial effect on lipids metabolism was noticed in all patients with elevated cholesterol and trigliceride levels. A dietary supplementation of GMDP has been shown to reduce systemic TNF-α cytotoxicity during tumor shock.     

不同化疗方案对非小细胞肺癌患者凝血纤溶功能及血小板参数的影响及其临床意义

目的:探讨不同化疗方案对非小细胞肺癌患者凝血纤溶功能及血小板参数的影响及临床意义。方法:回顾性分析2013年2月至2016年2月于我院进行治疗的96非小细胞肺癌患者的临床资料,按照化疗方案的不同分为TP组(50例)及GP组(46例),TP组患者给予多西他赛联合卡铂方案(TP方案)进行化疗,GP组患者给予吉西他滨联合卡铂方案(GP方案)进行化疗,另选择45例健康体检者作为对照组。比较三组治疗前者血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)、血浆纤维蛋白原含量(FIB)以及D-二聚体(D-dimer)、血小板数(PLT)、血小板比积(PCT)、血小板平均体积(MPV)、血小板体积分布宽度(PDW)以及大体积血小板比率(P-LCR)及TP组和GP组治疗后以上指标的差异。结果:TP组和GP组患者化疗前PT、APTT、TT、FIB、D-dimer、PLT、PCT、MPV、PDW以及P-LCR水平均明显高于对照组(P0.05),而TP组与GP组以上指标比较无显著差异(P0.05)。治疗后,TP组和GP组患者PT、APTT、TT、FIB、D-dimer、PLT、PCT、MPV、PDW以及P-LCR水平均较治疗前有所下降,且GP组TT明显长于TP组(P0.05),PLT、PCT明显低于TP组(P0.05)。结论:凝血纤溶功能及血小板参数对于评价不同化疗方案治疗非小细胞肺癌患者预后具有积极的临床价值,不同化疗方案选择对于患者凝血系统均具有一定的影响。