琐阳花色甙复合瘤苗免疫治疗肺肿瘤的实验研究

目的:研究琐阳花色甙复合瘤苗免疫治疗肺肿瘤的综合效应。方法:对肺肿瘤细胞系LCC,用琐阳花色甙对其进行系列生物修饰,构建琐阳花色甙复合瘤苗,用以治疗肺肿瘤。结果:经琐阳花色甙修饰构建的复合瘤苗,明显阻止LCC细胞的肺转移;显著抑制皮下肿瘤结节形成;明显延长荷瘤鼠的生存时间;治疗组小鼠脾细胞对小鼠肺癌的细胞毒活性显著增强。结论:琐阳花色甙修饰构建的LCC复合瘤苗,促进脾细胞的杀瘤活性,对肺癌有较好的实验治疗作用。

平阳霉素瘤腔内注射结合手术治疗颌面部血管瘤的护理

目的介绍平阳霉素瘤腔内注射结合手术切除治疗口腔颌面部血管瘤的护理措施。方法对22例患者口腔颌面部血管瘤瘤体内注射平阳霉素结合手术切除,术前针对不同患者的病情及其家属的心理状态,做好心理护理及健康教育,使他们了解治疗过程,消除心理顾虑,积极配合治疗;术后护理重点做好出血、感染、平阳霉素疗效的观察及其防治护理。结果 10例治愈,8例基本治愈,3例好转,1例血管瘤侧颜面部肿胀。少数患者有发热和胃肠道不适,无患者出现肺部症状、并发局部溃疡坏死或过敏反应。结论平阳霉素瘤腔内注射结合手术切除治疗口腔颌面部血管瘤应加强术前、术后护理,及早防治各种并发症的发生,这样有利于提高治疗效果。

平阳霉素局部注射治疗小儿颈部淋巴管瘤

我们在1991年10月～1997年10月期间,分别采用平阳霉素局部注射与手术切除治疗小儿颈部淋巴管瘤37例,并作半年至一年的随访观察,对两种治疗方法的疗效进行分析,现报告如下.……

基于“反激逆从”探讨肿瘤病证治思路

反激逆从法以其寒热并用、敛散并施、升降相因、补泻兼施、动静结合、清透并行、润燥互济等相反相逆配伍,在病机属阴阳交错、寒热错杂、虚实夹杂的肿瘤病中应用恰为适宜。该文对反激逆从法的概念、肿瘤病的病因病机及反激逆从法在肿瘤病辨治中的应用做了详细阐述,并据肿瘤病机中痰饮与血瘀的偏重及疾病进展的快慢不同提出阴瘤、阳瘤与阴阳瘤的概念。从温补肾气、通调脾胃,补泻兼施、寒热并用等思路进行辨治,并附医案一则,冀为反激逆从法指导肿瘤病的临证辨治提供理论与实践基础,指导反激逆从法在肿瘤病中的应用,丰富肿瘤病临证辨治思路。

Comparative Study of _(99m)TcN(NOEt)_2 and ^(99m)Tc-MIBI Imaging in Mice Bearing Ehrlich Ascites Tumor

Objective To evaluate and compare the ability to detect tumor by bis (N-ethoxy-N-ethyl dithiocarbamato) nitrido99mTc(V) [99mTcN(NOEt)2] and99mTc hexakis-2- methoxyisobutyl isonitrile [99mTc-MIBI]. Methods 99mTcN(NOEt)2 was prepared and quality control was performed using ascending thin-layer chromatography. Four mice bearing Ehrich ascites tumor cells underwent whole body planar imaging at 30 min, 2 h and 4 h after injection of99mTc-MIBI or99mTcN(NOEt)2. ROIs were drawn around the tumor, head, chest, and contralateral limbs in whole body planar images, and ratios of radioactivity in tumor in head (T/H), chest (T/C), and contralateral limbs (T/L) were calculated. The mice of99mTcN (NOEt)2 group were killed, then blood was collected, and the tumor and organs were excised, weighed and the radioactivity was measured. Results 99mTcN(NOEt)2 was stable after 4h at the room temperature.99mTcN(NOEt)2 was delivered to the tumor selectively and efficiently.99mTcN(NOEt)2 was found to provide excellent tumor-to-nontumor contrast for all the tissue except the abdomen. The T/L ratios increased to their maximums (4.87) at 2 h after injection. There was significant difference between the99mTcN(NOEt)2 imaging group and99mTc-MIBI imaging group. In vitro the radioactivity ratios per unit weight of tumor to blood, muscle, skeleton, lung, heart, and spleen were much higher than those of tumor to liver, instestine. Conclusion In mice bearing Ehrich ascites tumor,99mTcN(NOEt)2 exhibits a set of features essential for a good tracer for tumor imaging, including a rapid washout from blood, high uptake rate in tumor tissue, prolonged retention and high tumor-to-nontumor uptake ratio. The imaging quality of99mTcN(NOEt)2 was superior to that of99mTc-MIBI. These features indicate that99mTcN(NOEt)2 may be a better tracer to detect tumor than99mTc-MIBI. Key words tumor - radionuclide imaging - NOEt - MIBI

Effects of postmastectomy radiotherapy on prognosis in different tumor stages of breast cancer patients with positive axillary lymph nodes

Objective: To explore the effects of postmastectomy radiotherapy(PMRT) on the locoregional failure-free survival(LRFFS) and overall survival(OS) of breast cancer patients under different tumor stages and with one to three positive axillary lymph nodes(ALNs). Methods: We conducted a retrospective review of 527 patients with one to three positive lymph nodes who underwent modified radical or partial mastectomy and axillary dissection from January 2000 to December 2002. The patients were divided into the T1-T2 N1 and T3-T4 N1 groups. The effects of PMRT on the LRFFS and OS of these two patient groups were analyzed using SPSS 19.0, Pearson's χ2-test, Kaplan-Meier method, and Cox proportional hazard model. Results: For T1-T2 N1 patients, no statistical significance was observed in the effects of PMRT on LRFFS [hazard ratio(HR)=0.726; 95% confidence interval(CI): 0.233-2.265; P=0.582] and OS(HR=0.914; 95% CI: 0.478-1.745; P=0.784) of the general patients. Extracapsular extension(ECE) and high histological grade were the risk factors for LRFFS and OS with statistical significance in multivariate analysis. Stratification analysis showed that PMRT statistically improved the clinical outcomes in high-risk patients [ECE(+), LRFFS: P=0.026, OS: P=0.007; histological grade III, LRFFS: P<0.001, OS: P=0.007] but not in low-risk patients [ECE(–), LRFFS: P=0.987, OS: P=0.502; histological grade I-II, LRFFS: P=0.816, OS: P=0.296]. For T3-T4 N1 patients, PMRT effectively improved the local control(HR=0.089; 95% CI: 0.210-0.378; P=0.001) of the general patients, whereas no statistical effect was observed on OS(HR=1.251; 95% CI: 0.597-2.622; P=0.552). Absence of estrogen receptors and progesterone receptors(ER/PR)(–) was an independent risk factor. Further stratification analysis indicated a statistical difference in LRFFS and OS between the high-risk patients with ER/PR(–) receiving PMRT and not receiving PMRT [ER/PR(–), LRFFS: P=0.046, OS: P=0.039]. However, PMRT had a beneficial effect on the reduction of locoregional recurrence(LRR) but not in total mortality [ER/PR(+), LRFFS: P<0.001, OS: P= 0.695] in T3-T4 N1 patients with ER/PR(+) who received endocrine therapy. Conclusion: PMRT could reduce ECE(+), histological grade III-related LRR, and total mortality of T1-T2 N1 patients. T3-T4 N1 patients with ER/PR(–) could benefit from PMRT by improving LRFFS and OS. However, PMRT could only reduce LRR but failed to improve OS for T3-T4 N1 patients with ER/PR(+) who received endocrine therapy.

Efficacy of the revised Vienna Classification for diagnosing colorectal epithelial neoplasias

AIM： To prospectively investigate the efficacy of the revised Vienna Classification for diagnosing colorectal epithelial neoplastic lesions in cold biopsy specimens.METHODS： Patients were selected for inclusion if they had colorectal epithelial lesions that were not considered suitable for direct endoscopic resection,These included colorectal polyps ≥ 10 mm and lesions suspected of being carcinomas capable of invading the colorectal submucosa or beyond, including strictures, based on the cold biopsies obtained from each lesion prior to resection. We investigated the relationship between diagnoses based on cold biopsy samples using the revised Vienna Classification and resected specimens of the same lesions, and the therapeutic implications of diagnoses made using the revised Vienna Classification. The same cold biopsy specimens were also examined using the Japanese Group Classification guidelines, and compared with the resected specimens of the same lesions for reference.RESULTS： A total of 179 lesions were identified. The sensitivity, specificity, positive and negativepredictive values of the revised Vienna Classification for distinguishing between intramucosal lesions and submucosal invasive carcinomas in cold biopsy specimens was 22.2%, 100%, 100%, and 71.4%,respectively, and for distinguishing between intramucosal lesions and those invading the submucosa or beyond was 59.7%, 100%, 100%, and 37.6%,respectively. The sensitivity, specificity, positive and negative predictive values of the Japanese Group Classification for distinguishing between intramucosal lesions and submucosal invasive carcinomas in cold biopsy specimens was 83.3%, 91.4%, 83.3%. and 91.4%, respectively, and for distinguishing between intramucosal lesions and those invading the submucosa or beyond was 95.1%, 91.4%, 97.9%, and 82.1%, respectively. A total of 137 of 144 carcinomas that had invaded the submucosa or beyond and three high-grade intraepithelial neoplasias were diagnosed as ＂carcinoma＂ using the Japanese Group Classification system.CONCLUSION： The revised Vienna Classification for cold biopsy specimens has high positive predictive value in the diagnosis of colorectal carcinoma invasive to the subrnucosa or beyond.

“Anti-HBc alone” in human immunodefi ciency virus-positive and immuno-suppressed lymphoma patients

Hepatitis B virus (HBV) infection is endemic in various parts of the world. A proportion of patients have resolved prior exposure to HBV, as evidenced by the clearance of circulating hepatitis B surface antigen and the appearance of antibody to hepatitis B core antigen (anti-HBc), which could produce protective antibody to hepatitis B surface antigen (anti-HBs). With time, anti-HBs in some patients may become negative. Such patients are described as having occult HBV infection or "anti-HBc alone". In the context of immunodef icient patients, such as HIV patients or lymphoma patients undergoing immunosuppressive immunotherapy, the lack of protective anti-HBs may increase the risk of hepatitis B reactivation. Serum HBV DNA testing may be necessary in "anti-HBc alone" patients, to detect patients at a high risk of developing HBV infection allowing appropriate prophylactic management.

HER-2 expression after neoadjuvant chemotherapy of the breast cancers

Objective:The aim of this study was to study changes of HER-2 expression after neoadjuvant chemotherapy in the breast cancer cases.Methods:One hundred and thirty-seven female patients with primary breast cancers,who received neoadjuvant chemotherapy,underwent core needle puncture and Mammotome biopsy before chemotherapy,and the biopsy results were used as the basis of histological diagnosis,fluorescence in situ hybridization (FISH) was performed to test HER2 status of tumor tissues before and after chemotherapy.All patients underwent FEC,TE,or AC neoadjuvant chemotherapy of 2-6 cycles before surgery.Results:Twenty-two patients were positive according to FISH test among 137 preoperative patients,8 patients achieved pathological complete remission after chemotherapy (three HER-2 positive patients and five negative patients),91 patients achieved partial remission,24 patients were stable,and 14 cases were invalid.Twenty-two patients were positive according to FISH test (8 patients with pathological complete remission did not undergo test),and positive patients still expressed positively after chemotherapy before neoadjuvant chemotherapy.Three negative patients were converted to be positive,and changes before and after chemotherapy had no statistical difference (P>0.05).Conclusion:Neoadjuvant chemotherapy makes no influence on patients with HER-2 positive expression,while patients with negative expression can be converted to be positive,but without significant difference.

E-cadherin expression and its clinical significance in 41 cases of spinal plasma cell myeloma

Objective： To investigate the expression level of E-cadherin in spinal plasma cell myeloma and its relationship with the clinicopathological indexes of spinal plasma cell myeloma. Methods： The expression of E-cadherin was detected in 41 cases of spinal plasma cell myeloma and 14 cases of simple bone cysts by using S-P （streptavidin-perosidase） immunohistochemical staining. The relationship between E-cadherin expression and the clinicopathological features was analyzed. Results： In spinal plasma cell myelomas, the positive expression rate of E-cadherin （46.34%） was higher than that in simple bone cyst tissues （all negative） （P〈0.01）. And the expression of E-cadherin had no obvious relationship with patients＇ age, gender, clinical classification or M-component （P〉0.05）, but had relationship with the classification of light chain. The expression rate in lambda chain subgroup was lower than that in the others （P〈0.05）. We also found the E-cadherin negative patients had a higher overall survival rate than those who had strong E-cadherin expression （P〈0.05）. Conclusion： E-cadherin expressed higher in spinal plasma cell myelomas than in simple bone cyst tissues and its expression had relationship with the light chain classification in spinal plasma cell myeloma. The patients with no stain of E-cadherin may have a poor prognosis. Detecting the type of light chain associated with expression of E-cadherin might be helpful in evaluating the outcome of spinal PCM patients.

Expression of Hpa and CD222 in bladder carcinoma and analysis of clinico-pathologic correlation

Objective: Our study aimed to investigate the relationships between the clinico-pathologic features and the heparanase(Hpa) and CD222 expressions in bladder carcinoma. Methods: The expressions of Hpa and CD222 in 95 bladder carcinoma specimens and 20 paraneoplastic bladder tissues(controls) were assessed using the immunohistochemical staining method. Results: The positive expression rates of Hpa and CD222 in bladder carcinoma were 68.42% and 61.05%, respectively. The positive rate of Hpa was significantly higher in the carcinoma specimens than in the control specimens(P < 0.01). Similarly, the Hpa expression in the invasive bladder carcinoma was significantly higher than that in the non-invasive bladder carcinoma(P < 0.01). A positive correlation was observed between the expressions of Hpa and CD222(P < 0.05). The expressions of Hpa and CD222 were significantly correlated with lymphatic invasion and TNM staging(P < 0.05). The 5-year survival rate was significantly higher in negative expression of the Hpa group than that in the positive expression group(P < 0.05). Compared with the non-co-positive expression group, the 5-year survival rate in the co-positive expression of Hpa and CD222 group was significantly lower(P < 0.05). Conclusion: High Hpa and CD222 expressions in tumor tissues were associated with the occurrence and development of bladder carcinoma. Our results provide helpful information for the further diagnosis and therapy of bladder carcinoma.

Analysis of clinicopathological and immunohistochemical features of 15 cases with olfactory neuroblastoma

Objective:We studied the clinicopathological and immunohistochemical features of olfactory neuroblastoma(ONB).Methods:The clinic pathological data and immunohistochemical features of 15 cases with ONB were analyzed retrospectively,and the related literatures were reviewed.Results:The tumors were all located in the nasal cavity in 15 cases.According to Kadish's staging system,7 cases were in stage A,5 cases in stage B,and 3 cases in stage C.The morphological features showed small round or ovoid tumor cells divided into pieces or trabeculae by connective tissues which were rich in capillaries.The tumor cells had round or oval nuclei and fine chromatins and lack of cytoplasma.Flexner rosette and Homer-Wright rosette were found in some cases.Acidophilic fibrins were composed of cytoplasmic projection among tumor cells.All cases were positive for NSE,Syn,CgA,1 case was positive for Vimentin,2 cases were positive for S-100,while CKpan,LCA and HMB45 were all negative.Conclusion:ONB is a type of very rare malignant tumors,which could be diagnosed by pathology,and immunohistochemistry is helpful in the diagnosis and differential diagnosis.

Epithelioid haemangioendothelioma of the lung:one case report with positive pulmonary hilar lymph nodes

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare tumor that occurs among young women and typically presents as bilateral multiple nodules. In this report, we described an unusual case of PEH presented as a single mass in a 46-year-old man, with 6 positive pulmonary hilar lymph nodes. Histologic findings were compared with conventional PEH, except those features such as round to oval-shaped nodules, hypocellular/cellular peripheral zone, hyaline, myxomatous intercellular stroma and intracellular vacuoles, and we found the patient's pulmonary hilar lymph nodes were metastasis and cholesterol crystal were discovered in the focal infarction areas. Immunohistochemically, the tumor cells were strong positive for CD34, CD31, factor VIII related endothelial antigen and vimentin. The patient died 3 and half months after the surgery without receiving any radiotherapy or chemotherapy. This report may contribute to the data on clinical and histological finding of this rare tumour.

Therapy of Suppressing Yang and Astringing Yin for the Treatment of Cancer-Related Insomnia

The pathogenesis of can cer-related in som nia(CRI)mainly in eludes,first,the flow of cancerous toxin leading to the disorder of visceral qi;second,cancer-related radiotherapy and chemotherapy belonging to"exogenous pathogenic factors"to a certain extent,which can further aggravate visceral disorders.The therapeutic principle of Chinese medicine is to tranquilize the mind on the basis of regulating viscera,suppressing yang,and astringing yin.On this theoretical basis,Professor Zheng Yuling created a representative prescription of Zhenjing Anshen Granules(镇静安神颗粒)which can achieve the co-regulation of the heart,liver,and kidney,tranquilizing the mind and nourishing the blood.Clinically,the selection of prescriptions and medicines needs to be considered due to factors such as different treatment stages and differ-ences in patients'constitutions.

Primary cutaneous CD30-positive anaplastic large cell lymphoma analysis

OBJECTIVE: To examine 10 cases with primary cutaneous CD30-positive anaplastic large cell lymphoma (ALCL), analyze their clinical manifestations and pathological and immunohistochemical features, and improve early diagnosis of this disease. METHODS: We studied the morphological characteristics of primary cutaneous CD30-positive ALCL using histopathological methods. Leukocyte common antigen (LCA), CD20, CD30, CD45RO, CD68, epithelial membrane antigen (EMA), cytokeratin (CK) and HMB45 antibodies were used to determine the expression of their respective antigens from routine paraffin samples of the patients. RESULTS: Ten patients (7 men and 3 women, aged 31 to 84 years) complained of subcutaneous masses or papular eruptions over their lower trunks and extremities. Histopathologically, the lesions were composed of numerous large round or oval pleomorphic cells. The cytoplasm was usually abundant, amphophilic or basophilic, and finely vacuolated. Nuclei were commonly eccentrically localized and lobated or horseshoed in shape, and multinucleated giant cells and Reed-Sternberg-like cells were seen. Nucleoli were generally multiple and large. Of the 10 patients, tumor cells displayed positive antigen expression of CD30 in all cases, positive CD45RO in 6 cases, positive CD20 in only 1 case, but negative CD45RO and CD20 expressions in 3 cases. Two patients died at 7 weeks and 3.4 years of follow-up, respectively. CONCLUSION: Our study highlights the importance of histopathologic features and positive CD30 staining for differentiation of this disease from other malignant skin tumors.

Yin-yang Balance Therapy on Regulating Cancer Stem Cells

Researches have shown that cancer stem cells, regulated by the niche where they reside, are the roots of oncogenesis, relapse and metastasis. To date, very few treatments have targeted on cancer stem cells. The authors study that the regulated factors in the niche share the characteristics of yin-yang in the theory of traditional Chinese medicine, which has confirmed its therapeutic effects in the prevention and treatment of cancer. So the authors presume that the mechanisms of traditional Chinese medicine on the prevention and treatment of cancer may be related to the yin-yang balance of the niche of cancer stem cells.