门静脉血K-ras和p53基因突变与胃癌骨转移的关系

目的：探讨门静脉血K-ras、053基因突变与胃癌骨转移的关系。方法：应用PCR-SSCP技术，对胃癌患者的门静脉血、外周静脉血分别进行K-ras、p53基因检测，术后随访1．2—3年，了解骨转移情况。结果：62例胃癌患者外周血和门静脉血中的p53和K-ras突变阳性率分别为8．06％、4．83％和38．71％、33．87％；其中11例发生了骨转移，有无骨转移p53和K-ras突变阳性率分别为81．82％、72．73％和19．92％和13．61％；剖腹后探查前或胃癌探查后门静脉血p53和K-ras突变阳性率分别为38．71％、33，87％和56．45％、62，90％，上述指标两组间比较，差异均有统计学意义（P〈0．05）。结论：检测门静脉血K-ras、p53基因突变对预测胃癌骨转移，判断预后有重要意义。

Portal vein thrombosis: Etiology and clinical outcome of cirrhosis and malignancy-related non-cirrhotic, non-tumoral extrahepatic portal venous obstruction

The etiology and pathogenesis of portal vein thrombosis are unclear. Portal venous thrombosis presentation differs in cirrhotic and tumor-related versus non-cirrhotic and non-tumoral extrahepatic portal venous obstruction (EHPVO). Non-cirrhotic and non-tumoral EHPVO patients are young and present with well tolerated bleeding. Cirrhosis and tumor-related portal vein thrombosis patients are older and have a grim prognosis. Among the 118 patients with portal vein thrombosis, 15.3% had cirrhosis, 42.4% had liver malignancy (primary or metastatic), 6% had pancreatitis (acute or chronic), 5% had hypercoagulable state and 31.3% had idiopathy, 12% had hypercoagulable state in the EHPVO group.