转移与未转移消化道恶性肿瘤患者部分血栓前状态指标检测结果比较

目的观察消化道恶性肿瘤患者血浆血管性血友病因子(vWF)、抗凝血酶(AT)、D-二聚体(DD)及全血组织因子促凝活性(TF-PCA)检测结果并进行比较。方法使用仪器法对50例消化道恶性肿瘤转移患者(C组)及59例消化道恶性肿瘤未转移患者(B组)的vWF、AT、DD和TF-PCA进行检测,并与60例健康体检者(A组)进行比较。结果与A组比较,B、C两组患者vWF、DD和TF-PCA水平明显增高(P<0.05),AT显著降低(P<0.05);C组较B组vWF、DD和TF-PCA水平增高(P<0.05),AT水平降低(P<0.05);B组及C组内各种疾病之间比较,差异无统计学意义(P>0.05)。结论消化道恶性肿瘤患者存在凝血及纤溶机制失衡,且转移较未转移消化道恶性肿瘤更加明显;其患者血栓前状态只与消化道恶性肿瘤本身有关,与肿瘤发生的消化道部位无明显关系。检测消化道恶性肿瘤患者vWF、AT、DD及TF-PCA水平,可为其病情监测和预后提供参考。

消化道肿瘤肝转移转化治疗研究进展

消化道肿瘤肝转移是指源自消化道(如胃、结肠、食管等)的恶性肿瘤细胞转移到肝脏的现象。在恶性肿瘤的发展过程中,肿瘤细胞有可能通过血液循环或淋巴系统传播到其他部位,其中肝脏是最常见的转移部位之一。消化道肿瘤肝转移常常是消化道原发肿瘤晚期的表现,表示肿瘤已经向远处器官转移,病情相对较严重,需要重视并加强消化道肿瘤肝转移治疗研究,在最大程度上提高治疗效果,降低患者死亡风险。文中分析了消化道肿瘤肝转移病理机制、消化道肿瘤肝转移常规转化治疗,并对消化道肿瘤肝转移转化治疗研究进展进行了分析,希望可以为消化道肿瘤肝转移转化治疗相关研究提供参考,如下。

介入治疗消化道肿瘤肝转移瘤临床效果探究

相关数据调查显示,我国消化道肿瘤在总体肿瘤疾病当中的发生率占比是40%,总体肿瘤死亡率当中,其占比达到50%,消化道肿瘤疾病的发生率极高,必须加强日常防治工作,本次就以消化道肿瘤肝转移瘤开展介入治疗方面进行了调研。方法 因调研目标需要从科室均选入的是典型消化道肿瘤疾病患者,给予患者进行临床查体,显示患者同时存在肝转移瘤情况,符合此次研究要求病例为60例,借助患者治疗手段完成小组分类,对照组30例患者具体实行全身化疗服务,剩余所有患者和上述治疗操作同步,并对患者实行肝动脉灌注化疗介入治疗操作。对患者治疗后近期疗效、肿瘤标志物、肝功能和其他血生化指标、毒副反应发生情况、生存指标方面进行小组比较分析。结果 近期疗效显示观察组有效病例居多;肿瘤标志物评估,对照组情况较差;观察组患者肝功能得到较大改善,而且其他血生化指标也逐渐好转;两组均有部分患者出现毒副反应情况,但小组间无明显区别;对两小组患者生存指标进行评估,对照组生存率较差(P<0.05)。结论 在对消化道肿瘤肝转移瘤治疗过程中,选择介入治疗能够更好地控制病情,有利于患者各指标的改善,近期疗效确切,有利于延长患者生存时间。

56例消化道来源卵巢转移性肿瘤的临床病理特征

目的探讨56例消化道来源卵巢转移性肿瘤的临床病理特征。方法选择56例消化道来源卵巢转移性肿瘤患者(印戒细胞癌30例,腺癌26例),对其资料行回顾式分析,总结临床病理特征。结果研究发现消化道的原发灶主要为胃与结直肠,腺癌主要来源结直肠,印戒细胞癌多来源胃,双侧卵巢转移以印戒细胞癌居多,腺癌较少,二者比较,差异经处理有显著统计学意义(P<0.05),免疫组化CK7表达阳性方面,印戒细胞癌与腺癌比较,差异有明显统计学意义(P<0.05),CK7(+)/CK20(+)方面,印戒细胞癌与腺癌二者比较,差异经分析有显著统计学意义(P<0.05),CK7(-)/CK20(+)方面,印戒细胞癌与腺癌二者比较,经统计学检验,差异无统计学意义(P>0.05)。结论由结果见,印戒细胞癌多来源胃,免疫组化多见CK7(+)/CK20(+),多发生双侧卵巢转移,腺癌多来源结直肠,免疫组化多见CK7(-)/CK20(+)。

消化道肿瘤腹膜转移治疗研究进展

消化道肿瘤进展往往导致腹膜转移而形成腹膜转移瘤（peritoneal carcinomatosis，PC），通常预后很差，其中位生存期小于6个月。目前应用包含OXA或CPT-11的化疗方案联合靶向治疗将中位生存期提高至18～20个月，但是总的生存期几乎没有超过18个月。腹腔化疗作为一种辅助治疗手段，已广泛用于恶性腹腔积液的治疗，

研究介入治疗消化道肿瘤肝转移瘤的临床应用效果

研究介入治疗消化道肿瘤肝转移瘤的临床应用效果。方法:选取2019年10月至2020年11月我院收治的26例已介入治疗消化道肿瘤肝转移瘤患者。对患者的近期疗效进行分析和对比,并对患者进行5年的随访记录,1-5年的存活率和平均存活时间。结果:相对于乏血供肿瘤组治疗的总有效率(40%)而言,富血供肿瘤组治疗的总有效率(81.82%)明显更高,两组对比P<0.05差异具统计学意义。乏血供肿瘤组1年、3年、5年的存活率非别为53.33%、13.33%、6.67%,平均存活时间为(15.04±1.70)个月;富血供肿瘤组1年、3年、5年的存活率非别为90.91%、54.55%、45.45%,平均存活时间为(29.73±2.66)个月,富血供肿瘤组治疗的远期疗效优于乏血供肿瘤组,两组对比P<0.05差异具统计学意义。结论:介入治疗消化道肿瘤肝转移瘤的临床应用中,富血供肿瘤的效果更为显著,疗效更加,值得临床应用和推广。

原发性肺癌消化道转移10例诊治分析

目的探讨原发性肺癌消化道转移患者的临床表现、病理类型、诊治方法及治疗效果.方法选取2010年7月至2022年3月苏州大学附属第一医院收治的原发性肺癌伴消化道转移的患者的临床资料进行回顾性分析.结果期间收治的原发性肺癌伴消化道转移患者共10例,均为男性患者,平均年龄(61.7±9.3)岁.7例出现消化道症状如穿孔、梗阻、黑便;3例无明显消化道症状,因行PET-CT于诊断肺癌时同期发现.非同时发现的时间间隔为(301.3±289.5)d.术后病理为腺癌5例,大细胞癌2例,腺癌合并大细胞癌2例,腺鳞癌1例.消化道病变部位为小肠4例,胃2例,结肠2例,小肠合并结肠2例.有6例患者同期伴有其他非消化道部位的转移.共8例患者行消化道手术,其中急诊手术3例.随访过程中,有5例患者仍存活,其余5例平均存活时间(59.2±50.3)d.结论原发性肺癌伴消化道转移临床较为少见,但整体发生率不低.原发性肺癌患者一旦出现相应的腹部体征,需警惕消化道转移的可能.经积极诊断后尽早干预,能减少相应急腹症的发生,改善患者预后.

原发性肺癌胃肠道转移2例报道并文献复习

原发性肺癌最常见的远处转移部位包括肺、肝、脑、骨、肾上腺等,胃肠道转移鲜有报道。北京大学肿瘤学院胸部肿瘤内科近期先后收治了经病理证实为原发性肺癌发生胃肠道转移的2例患者,本文将就其诊治及随访情况进行报告,并回顾国内外相关文献,以加深对肺癌少见部位转移的认识,避免漏诊和误诊。

胃癌转移3例临床报告

1病例 患者1,男,56岁,2010年7月17日因＂右下腹持续胀痛27d＂入院。患者于27 d前无明显诱因出现持续性右下腹胀痛,于2010年6月21日在外院住院治疗,诊断为＂急性阑尾炎＂,行阑尾切除术,术程顺利,但术后1周仍有腹部胀痛感。2010年7月3日再次因腹痛,腹胀,呕吐入住该院,

异体NK细胞治疗消化道恶性腹水的安全性与疗效(附3例)

目的:分析3例异体自然杀伤细胞(natural killer cells,NK)治疗转移性消化道肿瘤所致癌性腹水患者的安全性与临床有效性。方法:回顾性分析2018年我院肿瘤科进行的3例利用异体NK细胞治疗转移性消化道肿瘤所致癌性腹水患者。分析治疗前后患者腹水情况、外周血中各种细胞因子(IL-6、IL-8、IL-10、TNF-α)、肿瘤标志物(CEA、CA199)、淋巴细胞亚群、脱落癌细胞(exfoliated cancer cells,ECC)的变化以及患者腹水症状改善情况,观察其安全性与疗效。结果:转移性消化道肿瘤所致癌性腹水患者接受异体NK治疗后无严重不良反应。3例患者IL-8在异体NK细胞治疗后均有明显下降。1例患者在异体NK细胞治疗后腹水深度、腹水ECC、外周血CEA及CA199均有明显下降。但3例患者体内淋巴细胞亚群均无显著变化。结论:3例异体NK细胞治疗转移性消化道肿瘤所致癌性腹水患者安全无严重副作用。1例患者异体NK细胞治疗可能具有一定疗效。消化道恶性腹水异体NK细胞治疗的临床疗效有待进一步验证。

变劳动力优势为经济优势——关于农业大县农民增收问题的调查与思考

我县是农业大县.虽然自94年以来,农村人均纯收入以年平均450元的幅度增长,全县农村97年一举实现脱贫,98年实现以县为单位基本达小康,但农民收入的主要来源还是种植业和养殖业.在当前农副产品价格低迷、数量增长余地较小的情况下,如何继续保持农民收入的大幅增长?从调查情况看,我们觉得走劳动力资源开发之路,不失为一条重要渠道.我县107万人口,农业人口占91万,其中劳动力36万,而耕地面积只有112万亩,人均1亩地,劳均3亩地,按现有生产机械化程度和耕作集约化水平,加上半劳力和各类帮工的配合,全县剩余劳动力超过20万人.目前,常年在外打工折合劳动力接近10万人,每年收入50000万元,人均500元.如果能做足另一10万剩余劳动力这篇大文章,我县农村人均纯收入在其他方面不变的情况下,可提高500元.那么,如何转移消化这10万劳动力大军?

农产品调价对物价有何影响

国家今年出台了新的农产品收购价格政 策,提价幅度达42.3％,是继1994年提高粮食定购价44％以后的又一次保护农民利益的重大举措。由于这次调价的时机把握得比较好,条件也较成熟,预计不会引起整个物价水平的大幅度上涨,连锁影响效应显然要小于和低于1994年。理由如下:

Ghrelin improves delayed gastrointestinal transit in alloxan-induced diabetic mice

AIM: To investigate the effects of ghrelin on delayed gastrointestinal transit in alloxan-induced diabetic mice. METHODS: A diabetic mouse model was established by intraperitoneal injection with alloxan. Mice were randomized into two main groups: normal mice group and diabetic mice group treated with ghrelin at doses of 0, 20, 50, 100 and 200 μg/kg ip. Gastric emptying (GE), intestinal transit (IT), and colonic transit (CT) were studied in mice after they had a phenol red meal following injection of ghrelin. Based on the most effective ghrelin dosage, atropine was given at 1 mg/kg 15 min before the ghrelin injection for each measurement. The mice in each group were sacrificed 20 min later and their stomachs, intestines, and colons were harvested immediately. The amount of phenol red was measured. Percentages of GE, IT, and CT were calculated. RESULTS: Percentages of GE, IT, and CT were significantly decreased in diabetic mice as compared to control mice (22.9 ± 1.4 vs 28.1 ± 1.3, 33.5 ± 1.2 vs 43.2 ± 1.9, 29.5 ± 1.9 vs 36.3 ± 1.6, P < 0.05). In the diabetic mice, ghrelin improved both GE and IT, but not CT. The most effective dose of ghrelin was 100 μg/kg and atropine blocked the prokinetic effects of ghrelin on GE and IT.CONCLUSION: Ghrelin accelerates delayed GE and IT but has no effect on CT in diabetic mice. Ghrelin may exert its prokinetic effects via the cholinergic pathway in the enteric nervous system, and therefore has therapeutic potential for diabetic patients with delayed upper gastrointestinal transit.

Metastasis of primary gallbladder carcinoma in lymph node and liver

AIM: To evaluate the patterns with metastasis of gallbladder carcinoma in lymph nodes and liver. METHODS: A total of 45 patients who had radical surgery were selected. The patterns with metastasis of primary gallbladder carcinoma in lymph nodes and liver were examined histopathologically and classified as TNM staging of the American Joint Committee on Cancer. RESULTS: Of the 45 patients, 29 (64.4%) had a lymph node positive disease and 20 (44.4%) had a direct invasion of the liver. The frequency of involvement of lymph nodes was strongly influenced by the depth of the primary tumor (P= 0.0001). The postoperative survival rate of patients with negative lymph node metastasis was significantly higher than that of patients with positive lymph node metastasis (P= 0.004), but the postoperative survival rate of patients with Nl lymph node metastasis was not significantly different from that of patients with N2 lymph node metastasis (P= 0.3874). The postoperative survival rate of patients without hepatic invasion was significantly better than that of patients with hepatic invasion (P= 0.0177). CONCLUSION: Complete resection of the regional lymph nodes is important in advanced primary gallbladder carcinoma (PGC). The initial sites of liver spread are located mostly in segments IV and V. It is necessary to achieve negative surgical margins 2 cm from the tumor. In patients with hepatic hilum invasion, extended right hepatectomy with or without bile duct resection or portal vein resection is necessary for curative resection.

Association of cyclin D1, p16 and retinoblastoma protein expressions with prognosis and metastasis of gallbladder carcinoma

AIM: To investigate the role of cyclin D1, p16 and retinoblastoma in cancerous process of gallbladder carcinomas and to assess the relation between cyclin D1, p16, Rb and the biological characteristics of gallbladder carcinoma. METHODS: Forty-one gallbladder carcinoma, 7 gallbladder adenoma and 14 chronic cholecystitis specimens were immunohistochemically and histopathologically investigated for the relation of cyclin D1, p16 and Rb with Nevin staging and pathologic grading. RESULTS: The expression rates of abnormal cyclin Dl in gallbladder carcinoma (68.3%)and gallbladder adenoma (57.1%) were significantly higher than those in chronic cholecystitis (7.1%) (P<0.05). No significant difference was found both among the pathological grades G1, G2 and G3 and among Nevin stagings S1-S2, S3 and S4-S5 of gallbladder carcinoma. The positive rates of p16 (48.8%) and Rb (58.5%) in gallbladder carcinoma were significantly lower compared to those in adenoma (100.0%) and cholecystitis (100.0%) (P<0.05). The positive rates of p16 and Rb in Nevin stagings S1-S2 (80.0% and 90.0%) and S3 (46.2% and 61.5%) gallbladder carcinomas were significantly higher than those in S4-S5(33.3% and 38.8%) (P<0.05), and those in pathologic grades G1(54.5% and 81.8%) and G2 (50.0% and 62.5%) gallbladder carcinoma were significantly higher than those in G3 (28.6% and 35.7%) (P<0.05). The protein expression of p16 and Rb had a negative-correlation in gallbladder carcinoma (r= -0.2993, P<0.05), and this negative-correlation was correlated with Nevin staging (P<0.05). Moreover, the protein expression of p16 and cyclin Dl had a negative-correlation in gallbladder carcinoma (r = -0.9417, P<0.05). CONCLUSION: Cyclin Dl may play a role in the early stage of gallbladder carcinoma. Mutation of p16 and Rb genes might be correlated with progression of gallbladder carcinoma. Analysis of p16 and Rb can estimate the prognosis of gallbladder carcinoma. Expression of p16 and Rb may be correlated with Nevin staging and pathologic grading in gallbladder carcinoma.

注射用门冬氨酸鸟氨酸对消化道肿瘤肝转移癌化疗药物致肝损害的保护作用及不良反应

目的:探讨注射用门冬氨酸鸟氨酸在消化道肿瘤肝转移癌化疗中对肝脏的保护作用及不良反应。方法:将60例消化道肿瘤肝转移癌患者随机分为两组,患者均给予FOLFOX方案化疗。对照组30例:单用FOLFOX化疗;治疗组30例:FOLFOX方案化疗+注射用门冬氨酸鸟氨酸静脉滴注。所有患者在化疗前及化疗后第5天、14天检测血生化指标和血氨并观察不良反应。结果:治疗后对照组患者血清谷草转氨酶(AST)、丙氨酸转氨酶(ALT)、血清总胆红素(TBIL)及血氨水平明显升高(P<0.05),而治疗组患者血清指标和血氨水平在化疗前后无明显变化(P>0.05)。两组不良反应相似,但消化道反应治疗组Ⅲ°～Ⅳ°明显升高,与对照组相比,差异有统计学意义(P<0.05)。结论:门冬氨酸鸟氨酸在消化道肿瘤肝转移癌患者化疗过程中起到保护肝功能的作用,但增加了消化道不良反应。

Effects of thalidomide on angiogenesis and tumor growth and metastasis of human hepatocellular carcinoma in nude mice

AIM: To investigate the effects of thalidomide on angiogenesis, tumor growth and metastasis of hepatocellular carcinoma in nude mice.METHODS: Twenty-four nude mice were randomly divided into therapy group and control group, 12 mice in each group. Thalidomide dissolved in 0.5% sodium carboxyl methyl cellulose (CMC) suspension was administered intraperitoneally once a day at the dose of 200 mg/kg in therapy group, and an equivalent volume of 0.5% CMC in control group. Mice were sacrificed on the 30th d, tumor size and weight and metastases in liver and lungs were measured. CD34 and VEGF mRNA in tumor tissue were detected by immunohistochemistry and semi-quantitative RT-PCR respectively and microvessel density (MVD) was counted. Serum concentrations of TNF-α and ALT and AFP were also tested.RESULTS: MVD and VEGF mRNA in therapy group were less than those in control group (31.08±16.23 vessels/HP vs 80.00±26.27 vessels/HP, 0.0538±0.0165 vs 0.7373±0.1297,respectively, P＜0.05). No statistical difference was observed in tumor size and weight and metastases in liver and lungs.TNF-α was significantly lower in therapy group than in control group (28.64±4.64 ng/L vs42.69±6.99 ng/L, P＜0.05). No statistical difference in ALT and AFP was observed between groups.CONCLUSION: Thalidomide can significantly inhibitangiogenesis and metastasis of hepatocellular carcinoma.Italso has inhibitory effects on circulating TNF-α.