目的:探讨胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的临床诊断、治疗方式及预后因素.方法:回顾性分析华中科技大学同济医学院附属协和医院普外科2002-01/2008-10收治的GIST患者67例的临床病理及随访资料,采用Kaplan-meier...目的:探讨胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的临床诊断、治疗方式及预后因素.方法:回顾性分析华中科技大学同济医学院附属协和医院普外科2002-01/2008-10收治的GIST患者67例的临床病理及随访资料,采用Kaplan-meier法比较不同因素对生存率的影响,并用Cox多因素回归分析评价其预后.结果:间质瘤67例,位于胃31例、小肠23例、直肠7例、胃肠道外6例.免疫组织化学检测CD117分子阳性率为97.0%,CD34分子阳性率为85.1%.所有随访患者53例其1年、3年、5年生存率分别为96.2%、81.1%、70.5%.单因素分析显示美国国立卫生研究院(national institute of health,NIH)2008年关于GIST的危险度分级与生存率有密切关系(P<0.05).高风险组中甲磺酸伊马替尼辅助治疗者较单纯手术治疗者疗效显著提高(P<0.05).多因素分析显示危险分级和甲磺酸伊马替尼治疗是影响预后的因素.结论:GIST的NIH危险度分级和甲磺酸伊马替尼辅助治疗与患者术后生存率密切相关.肿瘤手术后复发主要发生于高风险组,高风险组患者给予甲磺酸伊马替尼治疗可获得更大收益.展开更多
This study examined the mRNA expression of NALP3 in the spleen of the mice with hypersplenism due to portal hypertension （PH）. The mouse hypersplenism models were established by oral administration of tetrachloromet...This study examined the mRNA expression of NALP3 in the spleen of the mice with hypersplenism due to portal hypertension （PH）. The mouse hypersplenism models were established by oral administration of tetrachloromethane （2 mL/kg/week for 12 weeks by oral gavage）. All the mice were randomly divided into a control group and an experimental group. The blood routine test was conducted, spleen index was calculated and spleen was histologically examined. Portal vein sera were taken for detection of the level of uric acid. The mRNA expressions of NALP3 and IL-1β in the spleen were detected by reverse transcriptase-polymerase chain reaction （RT-PCR）. The results showed that the platelet count was significantly lower in the experimental group [（674±102）× 10^9/L] than in the control group [（1307±181） × 10^9/L] （P〈0.05）, while the spleen index was significantly higher [（9.83 ±1.36） μg/g] in the experimental group than in the control group [（4.11 ±0.47） μg/g] （P〈0.05）. The histopathological changes of spleen followed the pattern of congestive splenomegaly. No significant difference was found in the uric acid level in the portal vein between the control group and the experiment group. The mRNA expressions of NALP3 and IL-1β were up-regulated significantly in the spleen in the experimental group as compared with those in the control group （P〈0.05）. It was concluded that NALP3 and IL-1β may play important roles in the pathogenesis of hypersplenism.展开更多
文摘目的:探讨胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的临床诊断、治疗方式及预后因素.方法:回顾性分析华中科技大学同济医学院附属协和医院普外科2002-01/2008-10收治的GIST患者67例的临床病理及随访资料,采用Kaplan-meier法比较不同因素对生存率的影响,并用Cox多因素回归分析评价其预后.结果:间质瘤67例,位于胃31例、小肠23例、直肠7例、胃肠道外6例.免疫组织化学检测CD117分子阳性率为97.0%,CD34分子阳性率为85.1%.所有随访患者53例其1年、3年、5年生存率分别为96.2%、81.1%、70.5%.单因素分析显示美国国立卫生研究院(national institute of health,NIH)2008年关于GIST的危险度分级与生存率有密切关系(P<0.05).高风险组中甲磺酸伊马替尼辅助治疗者较单纯手术治疗者疗效显著提高(P<0.05).多因素分析显示危险分级和甲磺酸伊马替尼治疗是影响预后的因素.结论:GIST的NIH危险度分级和甲磺酸伊马替尼辅助治疗与患者术后生存率密切相关.肿瘤手术后复发主要发生于高风险组,高风险组患者给予甲磺酸伊马替尼治疗可获得更大收益.
基金supported by grants from the National Program 863 (No. 2007AA022001)the Program of Research and Development of Hubei Province (2008BCC006)programs of Hubei Provincial Center of Research of Clinical Medicines (No. JX4D07 and No. JX4D08)
文摘This study examined the mRNA expression of NALP3 in the spleen of the mice with hypersplenism due to portal hypertension （PH）. The mouse hypersplenism models were established by oral administration of tetrachloromethane （2 mL/kg/week for 12 weeks by oral gavage）. All the mice were randomly divided into a control group and an experimental group. The blood routine test was conducted, spleen index was calculated and spleen was histologically examined. Portal vein sera were taken for detection of the level of uric acid. The mRNA expressions of NALP3 and IL-1β in the spleen were detected by reverse transcriptase-polymerase chain reaction （RT-PCR）. The results showed that the platelet count was significantly lower in the experimental group [（674±102）× 10^9/L] than in the control group [（1307±181） × 10^9/L] （P〈0.05）, while the spleen index was significantly higher [（9.83 ±1.36） μg/g] in the experimental group than in the control group [（4.11 ±0.47） μg/g] （P〈0.05）. The histopathological changes of spleen followed the pattern of congestive splenomegaly. No significant difference was found in the uric acid level in the portal vein between the control group and the experiment group. The mRNA expressions of NALP3 and IL-1β were up-regulated significantly in the spleen in the experimental group as compared with those in the control group （P〈0.05）. It was concluded that NALP3 and IL-1β may play important roles in the pathogenesis of hypersplenism.
