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国际肿瘤学杂志

国际肿瘤学杂志

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Journal of International Oncology
1974年创刊，中华人民共和国卫生部主管，中华医学会、山东省医学科学院主办。本刊原《国外医学肿瘤学分册》，主要栏目有综述、论著、病例报道等。被IC、CA、CSA、Ulrich PD、CABI、WPRIM收录，为中国科技论文统计源期刊（中国科技核心期刊）。曾获卫生部首届医药卫生优秀期刊、中华医学会系列杂志优秀期刊三等奖、首届山东省科技情报科学技术一等奖、山东省学术类优秀期刊。
  • 发文量：5401
  • 被引量：818
  • H指数：1
  • 开始收录时间：1975(5)
  • CNKI综合因子：0.289
  • 维普期刊影响因子： 0.459
  • 万方期刊影响因子：0.65
  • 创刊时间：1974
  • 国内刊号/CN：37-1439/R
    国际刊号/ISSN：1673-422X
  • 发行周期：月刊
    邮发代号：24-64
  • 主管单位：中华人民共和国卫生部
    主办单位：中华医学会，山东省医学科学院
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  • 邮箱：gjzlxjn@126.com;gjzlxjn@163.com
  • 地址：济南市经十路18877号
  • 邮编：250062
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  • • 山东省自然科学优秀级期刊
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国际肿瘤学杂志 >2021年第12期

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  • 摘要：目的：探讨胶质瘤患者瘤周水肿（ PTBE）程度、肿瘤病理级别、Ki-67阳性表达率三者之间的相关性。方法收集新疆自治区人民医院神经外科2010—2013年经手术切除，病理证实的胶质瘤患者病历资料及标本74例，根据术前磁共振成像（ MRI ）资料判断肿瘤 PTBE程度，免疫组织化学检测Ki-67表达情况，HE染色区别肿瘤病理级别。结果本组研究中90.54%（67/74）伴发PTBE，其中Ⅰ、Ⅱ、Ⅲ、Ⅳ级别组PTBE发生率各为100%（3/3）、78.95%（15/19）、83.33%（15/18）及100%（34/34）；75.68%（56/74）Ki-67表达呈阳性；Ⅰ、Ⅱ、Ⅲ、Ⅳ级别组阳性率分别为0、36.84%（7/19）、94.44%（17/18）、94.12%（32/34）；无水肿、Ⅰ度水肿与Ⅱ水肿组中Ki-67表达阳性率分别为57.14%（4/7）、60.00%（6/10）、80.70%（46/57）。经Kruskal-Wallis H检验，PTBE在不同级别胶质瘤的总体差异有统计学意义（H＝11.304，P＝0.010）；Ki-67在不同级别胶质瘤中总体差异有统计学意义（H＝38.530，P﹤0.05）；Ki-67在不同PTBE组中表达的总体差异有统计学意义（ H＝6.478，P＝0.039）。Spearman等级相关分析显示胶质瘤PTBE程度随肿瘤病理级别增加而增加（ r＝0.385，P＝0.001）；Ki-67表达阳性率随肿瘤病理级别增加而增加（ r ＝0.692，P ﹤0.05）；Ki-67表达阳性率随胶质瘤 PTBE 增加而增加（ r ＝0.256，P＝0.028）。结论术前根据PTBE的大小可预测肿瘤的恶性程度与增殖活性，Ki-67既可作为肿瘤增殖活性的指标，也可当做病理分级的重要依据。%Objective To explore the correlation of peritumoral brain edema( PTBE)size,histologi-cal grades and the expression rate of Ki-67 in gliomas. Methods The data and specimens about 74 cases of gliomas in People's Hospital of Xinjiang Uygur Autonomous Region during 2010-2013 were collected. All cases were confirmed by surgery and pathology. According to preoperative MRI,PTBE was graded. Immunohisto-chemical discriminate the expression of Ki-67. HE coloration distinguish the histological grades. Results In this study,90. 54%(67/74)patients occured PTBE,the incidence of PTBE inⅠ,Ⅱ,Ⅲ,Ⅳlevel of groups were 100%(3/3),78. 95%(15/19),83. 33%(15/18),100%(34/34). Ki-67 expression was positive in 75. 68%(56/74)patients,and the rates were 0,36. 84%(7/19),94. 44%(17/18),94. 12%(32/34) in Ⅰ,Ⅱ,Ⅲ,Ⅳ level of groups. The expression rate of Ki-67 was 57. 14%(4/7),60. 00%(6/10),and 80. 70%(46/57)in normal group,Ⅰ-level groups of PTBE,Ⅱ-level groups of PTBE. The result of Kruskal-Wallis H showed that the PTBE from different grades was statistically significant(H=11. 304,P=0. 010). The expression rate of Ki-67 in different grade gliomas was statistically significant(H=38. 530,P﹤0. 05), The difference of expression Ki-67 in gliomas of different PTBE was statistically significant( H=6. 478,P=0. 039). The result of Spearman rank correlation analysis showed that the PTBE level increased with the histo-logical grade up in gliomas(r=0. 385,P=0. 001). The expression rate of Ki-67 increased with the histologi-cal grade up in gliomas(r=0. 692,P﹤0. 05),and the expression rate of Ki-67 increased with the degree of PTBE up in glomas( r =0. 256,P =0. 028 ). Conclusion Accorrding to the PTBE size,the histological grades and proliferation ability of glioma can be judged pre-operation. Ki-67 can be used as the indicator of pro-liferation activity of tumor,and also be used as the important basis of histological grades.
  • 摘要：Ubiquitin-proteasome pathway is one of the primary pathway in intracellular protein degrada-tion,therefore the ubiquitin conjugating enzyme D3(UbE2D3)which involved in the ubiquitin mineralization process can affect the biological effects accordingly to affect some protein and nucleic acid content and activity. The function that participate in modification and degradation of some cancer factors is vital in tumor cells,and followed by tumor biological behavior changing. Researches show that UbE2D3 correlates with human telomer-ase reverse transcriptase( hTERT),radiation sensitivity,aggressive,etc in breast cancer.%泛素化过程是内源性蛋白质降解的主要途径之一，因此参与泛素化过程的泛素交联酶UbE2D3会影响细胞内某些蛋白及核酸的含量、活性进而影响其生物效应。在肿瘤细胞中，这种作用显得尤其关键，可参与部分癌症因子的修饰与降解，从而影响肿瘤的生物学行为。研究表明，在乳腺癌中UbE2D3与人类端粒酶逆转录酶（ hTERT）、放射敏感性、侵袭性等相关。
  • 摘要：在非小细胞肺癌（ NSCLC）中，基因异常甲基化是其主要特征。原癌基因的低甲基化有致癌潜能，而抑癌基因的高甲基化也可诱发肿瘤。此外，组蛋白乙酰化和去乙酰化修饰的平衡与肿瘤的形成密切相关。组蛋白乙酰化酶能直接乙酰化增生相关基因，导致细胞的增殖转化；而组蛋白去乙酰化酶也能改变某些基因组蛋白的乙酰化水平，影响NSCLC的发生与发展。由此可见，这些表观遗传学的异常在NSCLC的形成和发展中起到了极为重要的作用。%In non-small cell lung cancer( NSCLC),a major characteristic is the abnormal methylation of some certain genes. The hypomethylation of proto-oncogene has the potential to promote carcinogenesis and the formation of neoplasm may also be induced by the hypermethylation of tumor suppressor genes. Meanwhile, the balance between histone acetylation and deacetylation is closely connected to the tumorigenesis. While the histone acetyltransferases can directly acetylate genes related to proliferation,causing cell growth and transfor-mation,histone deacetylase will also alter the level of acetylation of certain proteins,and eventually affect NSCLC. Hence,these abnormal epigenetic modifications play a fundamental role in the formation and develop-ment of NSCLC.
  • 摘要：The Ⅳ stage esophageal cancer refers to exist regional lymph nodes and distant organs in patients with metastases. Palliative chemotherapy and radiotherapy is the primary treatment. With the deepening of the clinical study,radiotherapy and chemotherapy are no longer single treatment,chemotherapy combined molecular targeted drugs,chemo-radiotherapy and some new treatment methods have been gradually recognized, and especially molecular targeted drugs began to establish its position in the treatment of tumor. Application of various methods individual or combined treatment can effectively prolong survival and improve the quality of life.%Ⅳ期食管癌是指存在区域外淋巴结或远处器官转移的患者，姑息放化疗是主要的治疗手段。随着临床研究的不断深入，单纯放疗和化疗不再是单一的治疗手段，化疗联合分子靶向药物、放化联合治疗以及一些新的治疗手段在临床上逐渐得到认可，尤其分子靶向药物开始确立其在肿瘤治疗中的地位，多种治疗手段的单独或联合应用可以有效延长患者的生存期和提高患者的生命质量。
  • 摘要：Cancer related anemia( CRA)is one of the ancer complications. The incidence rate of CRA is more than 70% in patients after receiving chemotherapy,radiation therapy,or both. CRA has severe clinical symptoms which significantly attenuate effectiveness of cancer treatment and the quality of patients' life. The current treatments for CRA,such as transfusion,recombinant EPO therapy,iron supplement and so on,could correct CRA in some sense. However,the present accepted therapeutic approaches could not be satisfied since there are complexity and diversity factors accounting for CRA. More effective and safety treatments of CRA are required in the near future.%肿瘤相关性贫血（ CRA）是肿瘤的常见并发症，尤其在接受放化疗的肿瘤患者中其发病率超过70%。CRA可以引起很多临床症状，同时对肿瘤治疗效果具有严重的负作用，所以它是严重危害肿瘤患者生命质量的因素之一。现有的CRA临床治疗措施，如输血、重组促红细胞生成素治疗和铁剂补充等都可以在一定程度上纠正和改善CRA的临床症状。但是由于CRA致病因素复杂多样，现有的临床治疗方案在治疗效果和使用安全上都存在局限性。因此CRA治疗亟待更为安全有效的治疗措施。
  • 摘要：目的：探讨DNA修复酶O6-甲基鸟嘌呤DNA甲基转移酶（ MGMT）、细胞增殖相关核蛋白Ki-67和P53蛋白在脑胶质瘤中的表达情况与分级的关系及其临床意义。方法采用免疫组织化学SP法检测61例脑胶质瘤标本和16例外伤内减压正常脑组织标本MGMT、Ki-67和P53蛋白的表达情况。结果 MGMT（19.67%∶0，χ2＝3.729，P＝0.062）、Ki-67（39.34%∶0，χ2＝5.722，P＝0.016）和P53蛋白（27.87%∶0，χ2＝9.146，P＝0.002）在胶质瘤中的表达和正常脑组织中的表达差异均有统计学意义，且Ki-67在高级别胶质瘤（Ⅲ~Ⅳ级）与低级别胶质瘤（Ⅰ~Ⅱ级）差异有统计学意义（14∶10，χ2＝11.718， P＝0.001）。MGMT、P53未发现明显差异。结论 MGMT蛋白表达可作为胶质瘤检测的生物学标志物；Ki-67蛋白与病理分级存在正相关，可作为脑胶质瘤病理分级的参考指标；P53蛋白可能为胶质瘤治疗的潜在靶点。%Objective To detect the expression of DNA repair enzyme O6-methylguanine DNA methyl-transferase(MGMT),cell proliferation-related nuclear protein(Ki-67)and P53 protein in gliomas,and inves-tigate the relationship and clinical significance among them and gloma grade. Methods 61 cases of brain glio-ma specimes and 16 cases of internal decompression of brain trauma were used to detect the expression of MGMT,Ki-67 and P53 by using immunohistochemical SP method. Results MGMT protein expression (19. 67%∶0,χ2 =3. 729,P=0. 062),Ki-67 protein expression(39. 34% ∶0,χ2 =5. 722,P=0. 016)and P53 protein expression(27. 87% ∶0,χ2 =9. 146,P=0. 002)showed significant differences in gliomas com-pared to normal brain tissues,the expression of Ki-67 was significantly higher in high-grade gliomas(Ⅲ-Ⅳ) than that in low-grade gliomas(Ⅰ-Ⅱ)(14 ∶10,χ2 =11. 718,P =0. 001). No significant difference was found between the MGMT and P53. Conclusion MGMT protein can be used as a biomarker in gliomas detec-tion;Ki-67 has a positive correlation with tumor grade,and can be used as a reference indicator of pathological grade;P53 protein expression may be used as a potential target for the treatment of gliomas.
  • 摘要：Selective COX-2 inhibitors can promote the apoptosis of tumor cells and block the growth of new blood vessels through the inhibition of ring oxidase,vascular endothelial growth factor,microvessel and so on. Research shows that COX-2 is overexpressed in vascular and endothelial cells of lung cancer,select COX-2 inhibitors to adjuvant chemotherapy,not only can directly inhibit the tumor proliferation,but also can reduce the adverse reaction of chemotherapy drugs,and enhance the curative effect. To investigate the effects of selec-tive COX-2 inhibitors and cisplatin in lung cancer angiogenesis and its mechanism,will be a hope for the clini-cal treatment of tumor.%选择性环氧合酶-2（COX-2）抑制剂，可通过抑制环氧合酶、血管内皮生长因子、微血管等，促进肿瘤细胞凋亡和阻断新生血管生长。研究显示，在肺癌的血管和内皮细胞中COX-2高表达，选用COX-2抑制剂辅助化疗，不仅可以直接抑制肿瘤增殖而且可以减轻化疗药物不良反应，提高疗效。探讨选择性COX-2抑制剂联合顺铂对肺癌新生血管的影响及机制，将有希望用于肿瘤临床治疗。
  • 摘要：Helicobacter pylori is one of causes of gastric cancer. It can cause mucosal inflammation cytokines aggregation,gastric mucosal damage;and through a variety of ways to activate epithelial cells multiple oncogenic pathways,including phosphatidylinositol 3 kinase( PI3K)pathway,Wnt-β-catenin and epoxidized synthase-2(COX-2)-prostaglandin E2 antibody(PGE2)pathway,so as to change the gastric stem cell micro-environment and disrupt the gastric stem cell differentiation and proliferation,making the normal gastric stem cells evolved into cancer stem cells.%幽门螺杆菌是引起胃癌的病因之一。幽门螺杆菌能引起胃黏膜炎症因子聚集，损伤胃黏膜；并通过多种途径激活上皮细胞内多个致瘤通路，包括磷脂酰肌醇3激酶（ PI3K）途径、Wnt-β连环蛋白和环氧化合酶-2（COX-2）-前列腺素E2抗体（PGE2）途径等，从而改变胃干细胞的微环境并扰乱胃干细胞的分化和增殖，使正常胃干细胞演变为癌症干细胞。
  • 摘要：Objective To retrospectively study the relationship between several risk factors such as cirrhosis,Child-Pugh classification,tumor size,portal vein tumor thrombus,intraoperative transfusion,hepatic portal occlusion time and the prognosis of hepatic cellular cancer( HCC ) patients after hepatic resection. Methods The clinical data of 123 patients who received hepatic resection for HCC at Tongji Hospital between 2007 and 2009 were retrospectively analyzed. Log-Rank test and Cox proportional hazard model were used in the univariate and multivariate analyses of risk factors. Results 1,2,3,5 year recurrence and survival rates were 54. 17%,66. 67%,81. 40%,87. 50% and 93. 50%,73. 17%,58. 54%,27. 64%,respectively. The mean recurrence time and survival time were 19. 5 months and 42. 9 months. In univariate analysis,presence of cirrhosis(χ2 =11. 159,P=0. 005),Child-Pugh classification(χ2 =7. 715,P=0. 028),tumor size(≥5cm)(χ2 =11. 483,P=0. 004),presence of portal vein invasion(χ2 =22. 271,P=0. 001)were risk factors affecting HCC recurrence. In multivariate analysis,presence of cirrhosis(χ2 =8. 993,P=0. 003),tumor size (≥5cm)(χ2 =4. 022,P=0. 039),presence of portal vein invasion(χ2 =5. 023,P=0. 027)were inde-pendent risk factors affecting HCC recurrence. In univariate analysis,presence of cirrhosis(χ2 =7. 339,P=0. 025),AFP﹥400 ng/ml(χ2 =5. 431,P=0. 042),Child-Pugh classification(χ2 =13. 389,P=0. 002), tumor size(≥5cm)(χ2 =11. 342,P=0. 003),presence of portal vein invasion(χ2 =52. 167,P﹤0. 001), hepatic portal occlusion(χ2 =5. 801,P=0. 037),intraoperative blood transfusion(χ2 =14. 959,P=0. 001) were risk factors affecting a shorter overall survival. In multivariate analysis,presence of cirrhosis(χ2 =9. 133, P=0. 003),Child-Pugh classification(χ2 =4. 799,P=0. 028),tumor size(≥5 cm)(χ2 =9. 101,P=0. 004),presence of portal vein invasion(χ2 =11. 126,P=0. 001),hepatic portal occlusion(χ2 =3. 985, P=0. 046)were independent prognostic factors affecting shorter overall survival. Conclusion Cirrhosis, Child-Pugh classification,tumor size(≥5 cm),presence of portal vein invasion,and hepatic portal occlusion were independent prognostic factors for HCC patients after hepatic resection.%目的：回顾性研究肝硬化、Child-Pugh分级、肿瘤大小、门脉癌栓、术中输血、肝门阻断时间等与肝癌切除术预后的关系。方法回顾性分析2007—2009年华中科技大学同济医学院附属同济医院进行肝癌切除术的123例原发性肝癌患者临床资料，用Log-Rank检验和Cox风险比例模型分析肝癌切除术预后的相关危险因素。结果患者术后1、2、3、5年复发率分别为54.17%、66.67%、81.40%、87.50%，平均复发时间为19.5个月。1、2、3、5年生存率分别为93.50%、73.17%、58.54%、27.64%，平均生存时间为42.9个月。单因素分析显示肝硬化（χ2＝11.159，P ＝0.005）、Child-Pugh 分级（χ2＝7.715，P＝0.028）、肿瘤≥5 cm（χ2＝11.483，P＝0.004）、门脉癌栓（χ2＝22.271，P＝0.001）与肝癌复发有关；多因素分析显示肝硬化（χ2＝8.993，P＝0.003）、肿瘤≥5 cm（χ2＝4.022，P＝0.039）、门脉癌栓（χ2＝5.023，P＝0.027）与肿瘤复发有关。单因素分析显示肝硬化（χ2＝7.339，P＝0.025）、血清甲胎蛋白AFP﹥400 ng/ml（χ2＝5.431，P＝0.042）、Child-Pugh分级（χ2＝13.389，P＝0.002）、肿瘤≥5 cm（χ2＝11.342，P＝0.003）、门脉癌栓（χ2＝52.167，P﹤0.001）、肝门阻断（χ2＝5.801，P ＝0.037）、术中输血（χ2＝14.959，P＝0.001）等与患者术后生存率有关；多因素分析显示肝硬化（χ2＝9.133，P＝0.003）、Child-Pugh分级（χ2＝4.799，P＝0.028）、肿瘤≥5 cm（χ2＝9.101，P＝0.004）、门脉癌栓（χ2＝11.126，P＝0.001）、肝门阻断（χ2＝3.985，P＝0.046）与患者术后生存率相关。结论肝硬化、Child-Pugh分级、肿瘤大小≥5 cm、门脉癌栓、肝门阻断是影响肝癌患者切除术预后的独立因素。
  • 摘要：COX-2 is the inducible form of cyclooxygenase,which is overexpressed in non-small cell lung cancer,especially in the adenocarcinoma,and is involved in the production of lung cancer drug resistance, reducing the sensitivities of tumor cells to chemotherapy drugs. COX-2 inhibitors have the effects of antitumor and prevention of tumor formation. Therefore,in order to reverse the drug resistance of tumor cells,improve the sur-vival rate and the prognosis of patients with tumor,the application of COX-2 inhibitors as adjuvant chemotherapy and combined with chemotherapy drugs has become a new direction in the treatment of lung cancer.%环氧合酶-2（COX-2）是环氧合酶的可诱导形式，在非小细胞肺癌尤其是腺癌中过度表达，并参与肺癌耐药性的产生，降低肿瘤细胞对化疗药物的敏感性。COX-2抑制剂有抗肿瘤并预防肿瘤形成的作用，因此，为逆转肺癌的耐药性，提高肺癌患者的生存率并改善其预后，将COX-2抑制剂作为辅助化疗药物并与化疗药物联合的应用成为了肺癌治疗的新方向。
  • 摘要：胃癌患者的预后与营养不良密切相关，导致胃癌患者营养不良的机制目前并不十分明确，除了厌食、进食困难等，胃癌患者营养不良可能与宿主-肿瘤相互作用产生具有代谢活性的因子如肿瘤坏死因子-α、白细胞介素-1、白细胞介素-6、干扰素、瘦素、核因子-κB等。相关因子之间关系复杂，相互调控，构成一个精密的调控网络。因此，进一步探索胃癌患者营养不良与相关因子之间的关系，可能为改善患者营养状况及预后提供一定的研究基础。%Malnutrition is one of the most important factors for the prognosis of patients with gastric cancer,but the mechanism of malnutrition is unclear at present. These patients are at risk of nutritional deple-tion from anorexia,dysphagia,and may be associated with the presence of two or more of the following cyto-kines with metabolic activity such as TNF-α,IL-1,IL-6,interferon,leptin,nuclear factor-κB and so on, which are secreted by the host-tumor interaction. The cytokines constitute a sophisticated regulatory network. Therefore,the study of the relationship between malnutrition and related factors in patients with gastric cancer may improve the nutritional status and prognosis of these patients.
  • 摘要：多学科综合治疗结直肠癌肝转移已成为临床研究的热点，其包含了手术治疗、局部治疗、转化治疗、化疗及分子靶向药物治疗等措施。然而，在临床应用中，常需要多种治疗方法联合使用，并根据患者病情制定全程治疗策略方能使患者生存获益最大化。因此，明确目前临床常用治疗方法的最新研究进展对临床治疗选择十分重要。%The multidisciplinary synthetic therapy for the colorectal liver metastases has been a hot spot in clinical research,which includes operative therapy,tumor local therapy,conversion therapy,chemotherapy, molecular targeted therapy and so on. It is need to choose multiple therapies for the patients and make the whole treatment strategy in accordance with the condition of patients to maximize the survival benefit in clinical prac-tice. So,it is important to comprehend the newest research process of the clinical therapy to make a good choice for the colorectal liver metastases patients.
  • 摘要：Objective To explore the value of combined detection with MMP-9 and uPA in the progno-sis of pancreatic carcinoma. Methods By immunohistochemistry PV methods,the expression of MMP-9 and uPA was respectively studied in 63 surgical specimens of primary pancreatic carcinoma and the survival time of patients with pancreatic carcinoma was analysed. Results The expressions of MMP-9 and uPA were positively related(r=0. 573,P=0. 000). The expression of MMP-9 and uPA significantly correlated with differentiation (r= -0. 271,P=0. 032;r= -0. 333,P=0. 008),TNM stages(r= -0. 449,P=0. 000;r= -0. 430,P=0. 000)and lymph node metastasis(r=0. 329,P=0. 009;r=0. 400,P=0. 001),separately. The expression of MMP-9 had also a significant correlation with tumer size(r= -0. 297,P=0. 018)and distant metastasis(r=0. 320,P=0. 011). Univariate analysis identified that tumor size(χ2 =8. 766,P=0. 012),differentiation(χ2 =29. 050,P=0. 000),clinical stage(χ2 =24. 940,P=0. 000),distant metastasis(χ2 =12. 846,P=0. 000), lymph node metastasis(χ2 =15. 457,P=0. 000),MMP-9(χ2 =32. 700,P=0. 000)and uPA(χ2 =41. 495,P=0. 000)were significantly associated with prognosis. Kaplan-Meier survival analysis showed that 1-year survival rate of patients with MMP-9 ( -),uPA ( -)were significantly longer than that of the patients with MMP-9( ﹢),uPA( ﹢),respectively(χ2 =32. 700,P=0. 000;χ2 =41. 495,P=0. 000);1-year survival rate of patients with MMP-9( -)/uPA( -)was significantly longer than the others( Log-rank test,χ2 = 54. 892, P=0. 000). COX regression revealed that differentiation(RR=2. 315,P=0. 004),clinical stage(RR=1. 694, P=0. 002),MMP-9(RR=0. 165,P=0. 000)and uPA(RR=0. 244,P=0. 007)was independent prognostic factors in pancreatic carcinoma. Conclusion They may have a synergistic function in the the process of growth and invasion in pancreatic cancer between MMP-9 and uPA,and the posssible mechanism is that uPA activate degradation of MMP-9,which is not favorable to prognosis. Combined analysis of MMP-9 and uPA may lead to a more reliable prognostic estimation,as the beneficial supplement of the differentiation,and clinical stage to judge the prognosis of pancreatic cancer.%目的：探讨基质金属蛋白酶-9（MMP-9）、尿激酶型纤溶酶原激活剂（uPA）二者联合检测在胰腺癌预后判断中的价值。方法采用免疫组织化学二步法检测63例手术切除的原发性胰腺癌组织中MMP-9、uPA的表达，分析二者对预后的价值。结果 MMP-9与uPA的表达呈正相关（ r＝0.573， P＝0.000），MMP-9和uPA表达与胰腺癌的分化程度（r＝－0.271，P＝0.032；r＝－0.333，P＝0.008）、TNM分期（r＝－0.449，P ＝0.000；r ＝－0.430，P ＝0.000）及淋巴结转移（ r ＝0.329，P ＝0.009；r ＝0.400，P＝0.001）相关，而 MMP-9与肿瘤大小（ r ＝－0.297，P＝0.018，）及远处转移（ r＝0.320，P ＝0.011）也存在明显相关性。单因素预后分析结果显示，肿瘤大小（χ2＝8.766，P ＝0.012）、分化程度（χ2＝29.050，P＝0.000）、临床分期（χ2＝24.940，P＝0.000）、远处转移（χ2＝12.846，P＝0.000）、淋巴结转移（χ2＝15.457，P＝0.000）、MMP-9（χ2＝32.700，P＝0.000）及uPA（χ2＝41.495，P＝0.000）与预后密切相关。Kaplan-Meier法生存分析表明，MMP-9阳性表达及阴性表达患者1年累计生存率（χ2＝32.700， P＝0.000）与uPA阳性表达及阴性表达患者1年累计生存率差异均有统计学意义（χ2＝41.495，P＝0.000）；MMP-9阴性并uPA阴性组患者1年累计生存率（100%）明显高于其他组，差异有统计学意义（χ2＝54.892，P＝0.000）。多因素分析结果表明，分化程度（ RR＝2.315，P＝0.004）、临床分期（ RR＝1.694，P＝0.002）、MMP-9（RR＝0.165，P＝0.000）及uPA过表达（RR＝0.244，P＝0.007）是胰腺癌预后相关的独立影响因子。结论胰腺癌侵袭转移过程中MMP-9和uPA蛋白之间存在某种协同关系，uPA可能通过激活MMP-9加强胶原及弹性蛋白等的降解而促进胰腺癌细胞侵袭和转移，不利于胰腺癌预后。MMP-9和uPA的联合表达模式更准确反映胰腺癌的预后，可以作为分化程度、临床分期判断胰腺癌预后的有益补充。
  • 摘要：EGFR-TKI plays an important role in the treatment of non-small-cell lung cancer. However, some researchers find that there are still some patients with primary or acquired resistance to EGFR-TKI. The present known mechanisms of acquired drug resistance finally lead to the re-activation EGFR downstream signa-ling pathways. Liver X receptor agonist has inhibition function to several critical steps of EGFR downstream sig-naling pathways PI3K-Akt-NF-κB,which makes it possible to overcome the drug resistance.%表皮生长因子受体酪氨酸激酶抑制剂（ EGFR-TKI）在非小细胞肺癌的治疗中具有重要地位，但有研究发现患者会对EGFR-TKI产生原发性耐药或获得性耐药。目前发现获得性耐药的多种机制最终都导致表皮生长因子受体的下游信号通路被重新激活。肝X受体激动剂对表皮生长因子受体最重要的下游通路PI3K-Akt-NF-κB的多个主要环节均有不同程度的抑制作用，有望逆转EGFR-TKI的继发耐药。
  • 摘要：Protein kinase B( Akt)is an intermediate signal molecule in PI3K-Akt-mTOR signaling pathway which plays an important role in development and incidence of colorectal cancer when activated by phosphorylation. As target of drugs,Akt has become a focus in the treatment of colorectal cancer. Clinical trials research proves that many kinds of Akt inhibitors have good antitumor activity. In recent years,the Akt inhibi-tors are more and more be taken seriously in colorectal cancer treatment.%蛋白激酶B（ Akt）是PI3K-Akt-mTOR信号通路中的一个中间信号分子，其异常活化在结直肠癌的发生发展中起到重要的作用，以此为靶点的药物已成为结直肠癌治疗的研究热点，临床试验研究证明，针对Akt为靶点的多种抑制剂具有较好的抗肿瘤活性。近年来，有关Akt抑制剂和其在结直肠癌治疗中的研究也越来越受到重视。
  • 摘要：放疗已经成为宫颈癌的主要治疗手段之一，近年来在体外精确放疗技术治疗期间，器官运动、摆位误差、解剖学变化等因素可能导致实际接受剂量与初始计划不一致，从而造成靶区剂量不足及危及器官受照剂量过多。自适应放疗（ ART）可根据治疗过程中所得到的位置、体积、剂量等参数的反馈信息，利用图像引导及个体化建模等方法对后续治疗计划进行相应的优化和调整，从而在提高局部控制率的同时降低放疗不良反应的发生率。%Radiotherapy has become one of the most important treatments for cervical carcinoma. In recent years,because of the organ motion,anatomical changes and setup errors et cetera,the accurate external beam radiotherapy( EBRT)may regard to the difference between the actual dose delivery and the pre-treatment plan,which not only causes target less,but also brings additional doses to the organs at risk( OAR). By using of image guidance and individual modelling,adaptive radiotherapy( ART)can analyze the parameters of target position,volume and dose and adjust optimized plans for the follow-up treatment based on aforesaid feedbacks and enable the enhancement of the local control rate while reducing the incidence of the side reaction.
  • 摘要：Objective To investigate the effect of miR-27a mimic and inhibitor on proliferation and apoptosis in melanoma cell line WM239. Methods The miR-27a mimic,inhibitor and its negative control were transfected into WM239 cells. The transfection efficiency was evaluated by fluorescence microscope. The expres-sion of miR-27a was detected by real-time fluorescent quantitative PCR. The proliferation of cells was detected by MTT. The cell apoptosis and cell cycle were analyzed by flow cytometry. Results The transfection efficiency in WM239 cells was 80% to 90%. The expression of miR-27a was markedly up-regulated in miR-27a mimic group (2-△△CT value is 26. 98 ± 0. 01),with statistically significant difference(t= -1 123. 67,P=0. 00);and the miR-27a inhibitor group showed lower expression of miR-27a(2-△△CT value is 0. 96 ± 0. 02),there was no statisti-cally significant difference compared with normal control group(t=0. 04,P=0. 06). The proliferation of cells was obviously inhibited in miR-27a mimic group,and there was statistically significant difference compared with normal control group[absorbance of 72 h(0. 45 ± 0. 02)∶(0. 72 ± 0. 01),F=129. 56,P﹤0. 05]. The percent-age of WM239 cells in G0-G1 phase was increased[(74. 83 ± 1. 46)∶(63. 73 ± 1. 25),F=30. 33,P﹤0. 05], and the percentage of WM239 cells in S phase and G2-M phase were decreased[(21. 33 ± 1. 75)∶(27. 50 ± 1. 25),F=14. 98,P﹤0. 05;(3. 90 ± 1. 31)∶(8. 80 ± 2. 10),F=3. 66,P﹤0. 05]. The apoptosis rate of cells was significantly increased in miR-27a mimic group compared with normal group[(29. 67 ± 0. 91)%∶(1. 44 ± 0. 85)%,F=530. 90,P﹤0. 01],but the inhibitor group had no obvious effect on cell cycle and cell apoptosis. Conclusion MiR-27a can suppress melanoma cell proliferation and act as a tumor suppressor gene,which is rel-evant to induce cell apoptosis and block cell cycle in G0-G1 phase.%目的：探讨微小RNA-27a（ miR-27a）模拟物和抑制物转染黑色素瘤WM239细胞后对细胞增殖和凋亡的影响。方法将miR-27a模拟物、抑制物及其阴性对照转染WM239细胞，荧光显微镜观察转染效率，实时荧光定量PCR检测相应的微小RNA，四甲基偶氮唑盐（ MTT）法检测细胞增殖，流式细胞仪检测细胞凋亡和细胞周期。结果细胞转染效率为80%~90%。转染miR-27a模拟物后，细胞内miR-27a表达量明显上升（2-△△CT值为26.98±0.01），与正常对照组相比差异有统计学意义（ t＝－1123.67，P＝0.00）；转染miR-27a抑制物后，细胞中miR-27a的表达量下降（2-△△CT值为0.96±0.02），与正常对照组相比差异无统计学意义（t＝4.04，P＝0.06）。转染miR-27a模拟物后，细胞增殖受到明显抑制，与正常对照组相比差异具有统计学意义[72 h吸光度（0.45±0.02）∶（0.72±0.01），F＝129.56，P﹤0.05]。miR-27a模拟物组G0-G1期的细胞比例升高[（74.83±1.46）∶（63.73±1.25），F＝30.33，P﹤0.05]，S期和G2-M期细胞比例减少[（21.33±1.75）∶（27.50±1.25），F＝14.98，P﹤0.05；（3.90±1.31）∶（8.80±2.10），F＝3.66，P﹤0.05]；模拟物组细胞凋亡率与正常对照组相比明显增加[（29.67±0.91）%∶（1.44±0.85）%， F＝530.90，P﹤0.01]；而抑制物组对细胞周期和凋亡无明显作用。结论 miR-27a抑制黑色素瘤细胞增殖，具有抑瘤作用，这与其促进细胞凋亡，阻滞细胞周期于G0-G1期相关。
  • 摘要：目的：系统评价经导管肝动脉化疗栓塞术（ TACE ）单用与联合应用体部立体定向放疗（ SBRT）治疗原发性肝癌的疗效和不良反应，为临床实践提供参考。方法检索PubMed、Cochrane Library、EMBase、Ovid、MEDLINE、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库、医学期刊全文数据库，查找关于TACE和SBRT治疗原发性肝癌的临床对照试验研究。按照Cochrane协作网的RevMan 5.2软件进行Meta分析。分析TACE单用与联合应用SBRT两组间的近期疗效，肿瘤局部控制率，1、2、3、5年生存率的差异。结果共有10篇文献，1143例患者满足纳入标准。Meta分析结果显示， TACE联合SBRT组比单纯TACE组近期疗效，肿瘤局部控制率，1、2、3、5生存率均高（RR＝1.43，95%CI为1.32~1.56，P﹤0.00001；RR＝2.09，95%CI为1.63~2.69，P﹤0.00001；RR＝1.31，95%CI 为1.21~1.42，P﹤0.00001；RR＝1.46，95%CI为1.23~1.72，P﹤0.00001；RR＝1.76，95%CI为1.14~2.71，P＝0.01；RR＝2.29，95%CI为1.22~4.32，P＝0.01）。白细胞减少（ RR＝0.97，P＝0.61）、血小板减少（ RR＝0.99，P＝0.85）、血红蛋白减少（RR＝0.95，P＝0.63）、恶心呕吐（RR＝1.00，P＝0.98）、肝功能损害（RR＝0.98，P＝0.87）的发生率两组之间差异无统计学意义。结论与TACE相比，TACE联合SBRT能明显提高患者近期疗效，提高肿瘤局部控制率和1、2、3、5生存率，同时不增加不良反应发生率，但其长期疗效和安全性尚需开展更多大样本、高质量的临床对照试验加以验证。%Objective To compare the clinical efficacy and the adverse reaction of transcatheter arteri-al chemoembolization( TACE)alone and combined with stereotactic body radiation therapy( SBRT)in patients with primary hepatic carcinoma by a Meta-analysis. Methods PubMed,Cochrane Library,EMBase,Ovid, MEDLIN,CNKI,CBMdisc,VIP and Wanfang were searched to identify the controlled clinical trials of TACE and SBRT for primary hepatic carcinoma. The obtained data were analyzed using Review Manager version 5. 2 provided by Cochrane Collaboration. To analysis the short-term effect of TACE alone or combined with SBRT, the rate of local tumor control and the difference of one,two,three and five-year survival rate. Results A total of 1 143 patients from 10 controlled clinical trials were involved according to the inclusion criteria. The Meta-analysis showed that TACE and SBRT group significantly increased the short-term effective rate,the rate of local tumor control,l-,2-,3-and 5-year overall survival rates(RR=1. 43,95%CI:1. 32-1. 56,P﹤0. 000 01;RR=2. 09,95%CI:1. 63-2. 69,P﹤0. 000 01;RR=1. 31,95%CI:1. 21-1. 42,P﹤0. 000 01;RR=1. 46, 95%CI:1. 23-1. 72,P﹤0. 000 01;RR=1. 76,95%CI:1. 14-2. 71,P=0. 01;RR=2. 29,95%CI:1. 22-4. 32, P=0. 01). There was no statistically significant difference between the two groups on adverse events such as leucopenia(RR=0.97,P =0. 61),thrombocytopenia(RR =0. 99,P =0.85),hemoglobin decrease(RR =0. 95,P=0. 63),nausea and vomiting(RR=1. 00,P=0. 98),liver function damage(RR=0. 98,P=0. 87). Conclusion Compared with TACE,TACE combined with SBRT can increase the short-term effective rate,the rate of local tumor control,the 1-,2-,3-and 5-year overall survival time of the patients,and does not increase the incidence of adverse reaction. However high-quality trials with large sample sizes are still needed to verify the long-term efficacy and safety.
  • 摘要：颅底恶性肿瘤发病率低、病理类型复杂、临床表现常不特异。治疗方案因病理类型、部位、分期等不同而迥异，且治疗过程中常需要多学科共同参与方能取得较好的疗效。更好地了解颅底恶性肿瘤将有助于其规范化治疗。%Malignant tumors of the skull base are rare,present with a variation of histologic stypes, and don't have specific symptoms. Their treatment paradigms differ with histology,location and stage. Many times it is essential to need multidisciplinary cooperation for dealing them. A better understangding of malignant tumors of the skull base will be beneficial for standardized treatment.
  • 摘要：手术联合放化疗是肺癌常规治疗手段，但术后复发十分常见，患者死亡率高，生命质量较低。而术后免疫治疗可充分调动患者的机体防御机制，激活免疫细胞，杀灭残留癌细胞。目前关于肺癌免疫治疗的研究成果主要包括4大类：过继性免疫治疗、树突状细胞疫苗、非特异性抗原免疫治疗和抗原特异性疫苗。这些研究成果均表明肺癌术后免疫治疗干预可有效减少癌细胞残留，降低术后复发率，延长患者生存时间，显著改善预后，值得临床推广。%Surgery in combination with chemotherapy and radiotherapy is the standard of lung cancer treatment,but postoperative recurrence is very common which usually leads to higher mortality and lower life quality. Immunotherapy on post-operative patients fully mobilizes the body's defense mechanisms,activates the immune cells,and kills residual cancer cells. Current research on lung cancer immunotherapy mainly includes four categories:adoptive immunotherapy,dendritic cell vaccine,non-specific antigen immune therapy and anti-gen-specific vaccine. These studies show lung cancer immunotherapy intervention can effectively reduce postop-erative residual cancer cells,reduce postoperative recurrence rate,prolong survival,significantly improve the prognosis,and is worth spreading in clinical practice.
  • 摘要：白血病是一种造血干细胞的恶性克隆性疾病。其发病机制与白血病细胞增殖失控、分化障碍、凋亡受阻等有关。研究证实白血病细胞表达CD44，它通过参与细胞黏附、增殖、迁移、浸润等行为促进白血病的发生发展。体外试验表明，以CD44为靶点的治疗能有效杀伤白血病细胞，并降低对正常组织的细胞毒性。因此，针对CD44抗癌药物的设计有望用于白血病的临床治疗。%Leukemia is a kind of cloning disease from malignant hematopoietic stem cells. Its patho-genesis may have relationship with proliferation out of control,dysdiffreentiation and inhibition of apoptosis about leukemia cells. The study confirms that CD44 is expressed in leukemia cells,promoting the occurrence and development of leukemia through participation in cell adhension,proliferation,migration and invasion behavior. In vitro experiment shows that CD44 targeted therapies can effectively kill leukemia cells,and reduce the toxicity to normal tissue cells. Therefore,aiming at the design of the anticancer drugs targeted for CD44 is expected to be used in clinical treatment of leukemia.
  • 摘要：Objective To evaluate the efficacy and toxicity of capecitabine combined with intensity modulated radiotherapy( IMRT)for postoperative mediastinal lymph node metastasis in esophageal cancer. Methods A total of 62 esophageal cancer patients with postoperative mediastinal lymph node metastases were randomly divided into the irradiation group(A group,31 cases)and the capecitabine combined with IMRT group( B group,31 cases). Both of two groups received IMRT radiotherapy with a total dose of 60-66 Gy, 30-33 times in 6-6. 5 weeks. The patients in B group were treated with capecitabine(1 250mg/ m2 ,2 f/ d, d1-d14,21 d × 2 cycle). Results Group A:there were 7 cases of complete response(CR),12 of partial response(PR),10 of stable disease(SD),and 2 of progressive disease(PD);the effective rate was 61. 3%(19 / 31). Group B:there were 10 cases of CR,16 of PR,4 of SD,and 1of PD;the effective rate was 83. 9%(26 / 31). There was a statistical significance between the effective rates of A group and B group(χ2 = 3. 971, P < 0. 05). Our experiment showed that the rates of grade Ⅱand Ⅲ myelosuppression in group A and group B were 29. 0% and 38. 7%(χ2 = 0. 648,P = 0. 421). The rates of Ⅰ and Ⅱ level radioactive pneumonia in group A and were 19. 4% and 25. 8%(χ2 = 0. 369,P = 0. 544). The different incidence of the two adverse reactions between group A and B had no statistical significance. Conclusion Compared with IMRT alone,IM-RT combined with capecitabine may have better curative efficacy without increasing toxicity to esophageal cancer patients with postoperative mediastinum lymphonode metastasis.%目的：观察卡培他滨联合调强放疗治疗食管癌术后纵隔淋巴结转移的近期疗效及不良反应。方法62例食管癌术后纵隔淋巴结转移的患者按随机数字表法随机分为2组，单纯调强放疗组（A 组）31例，卡培他滨联合调强放疗组（B 组）31例。A 组仅采用调强放疗，B 组采用调强放疗联合口服卡培他滨化疗。两组放疗方案、计划相同：总剂量60~66 Gy，（30~33）次/（6~6.5）周，卡培他滨1250 mg/ m2，每日2次，连续14 d，21 d 为1周期，共应用2疗程。治疗期间观察放化疗相关不良反应，放疗结束后1个月复查胸部 CT 评价疗效。结果 A 组：完全缓解（CR）7例，部分缓解（PR）12例，无效（SD）10例，进展（PD）2例，有效率为61.3%（19/31）；B 组：CR 10例，PR 16例，SD 4例，PD 1例，有效率为83.9%（26/31），两组有效率差异有统计学意义（χ2=3.971，P <0.05）。A、B 组的骨髓抑制发生率分别为29.0%、38.7%（χ2=0.648，P =0.421），放射性肺炎发生率分别为19.4%、25.8%（χ2=0.369，P =0.544），差异无统计学意义。结论卡培他滨联合调强放疗治疗食管癌术后纵隔淋巴结转移近期疗效满意，未增加放化疗相关不良反应。
  • 摘要：目的：比较单用曲妥珠单抗与曲妥珠单抗和拉帕替尼两药联合在 HER2阳性乳腺癌新辅助治疗中的有效性和安全性。方法检索 PubMed、MEDLINE、The Cochrane Library、Web of Science、中国期刊全文数据库、万方医药期刊全文数据库和近5年重要国际肿瘤学会议记录，严格按照纳入与排除标准收集 HER2阳性乳腺癌患者使用新辅助化疗联合曲妥珠单抗对比新辅助化疗联合曲妥珠单抗、拉帕替尼双重抗 HER2治疗的有效性和安全性的前瞻性随机对照研究，按 Cochrane 系统评价方法进行质量评价，资料提取后运用 Rev-Man 5.0软件进行 Meta 分析。结果最终纳入4项临床随机对照试验，共779例患者符合条件。Meta分析结果显示，曲妥珠单抗联合拉帕替尼组较单独使用曲妥珠单抗组病理完全缓解率显著升高（53.3%：38.8%， RR =1.39，95%CI 为1.20~1.63，P <0.001）；Ⅲ~Ⅳ级不良反应方面，除了联合组的腹泻发生率更高（25.6%：2.2%，RR =11.54，95%CI 为5.69~23.41，P <0.001）以外，其他差异均无统计学意义。结论在 HER2阳性乳腺癌患者的新辅助治疗中采用新辅助化疗联合曲妥珠单抗、拉帕替尼的双重抗 HER2靶向治疗效果较好，且除了腹泻外并不提高其他不良反应发生率，是一种高效、安全的治疗选择。%Objective To compare the efficacy and safety of trastuzumab versus the combination of tras-tuzumab and lapatinib added to neoadjuvant chemotherapy in HER2-positive breast cancer. Methods We searched PubMed,MEDLINE,The Cochrane Library,Web of Science,CNKI,Wanfang datebase and the abstracts of major international conferences in recent 5 years to identify randomized controlled trials which met the inclusion and exclusion criteria. Study selection and analyses were undertaken according to the Cochrane Hand-book. Meta-analysis was performed using RevMan 5. 0 software. Results Four trials were identified with 779 eli-gible patients. The results of meta-analyses showed that the rate of pathological complete response was significant-ly higher in the group receiving rastuzumab and tlapatinib than that in the group with trastuzumab alone(53. 3%vs 38. 8% ,RR =1. 39,95 % CI:1. 20-1. 63;P < 0. 001). No statistical differences were observed in regarding adverse events among patients receiving trastuzumab or the combination of trastuzumab and lapatinib,except the grade Ⅲ-Ⅳ diarrhea(2. 2% vs 25. 6% ,RR =11. 54,95% CI:5. 69-23. 41;P <0. 001). Conclusion The com-bination of trastuzumab and lapatinib added to neoadjuvant chemotherapy in HER2-positive breast cancer is more effective,without more adverse reactions except diarrhea;it ia an effective and safe treatment.
  • 摘要：二甲双胍作为一种廉价安全高效的糖尿病药物已应用多年，近年来研究显示其对各种肿瘤细胞都有不同程度的抑制作用。二甲双胍的抗肿瘤机制尚未完全明确，可能与糖代谢及蛋白激酶途径有关，也可能与炎症因子介导肿瘤杀伤有关。二甲双胍对不同肿瘤细胞杀伤效果不同，对其他抗肿瘤治疗也有一些辅助作用。%Metformin as a cheap,safe and effective diabetes drug,has been used for many years. Recently,many studies have shown its variety inhibition of tumor cells. Its antitumor mechanism is not entirely clear;may be related to glucose metabolism and protein kinase or inflammatory cytokines mediating tumor kill-ing. Metformin has different cytotoxic effects to various tumor cell,as well as playing some auxiliary roles on other antitumor methods.
  • 摘要：循环肿瘤细胞（CTC）是非小细胞肺癌（NSCLC）发生复发转移的重要原因。随着检测技术的不断发展，近期研究结果提示，CTC 水平不仅可以用来判断肿瘤临床分期、评估患者预后及治疗反应，还可以用于早期 NSCLC 的风险评估。另外，作为一种非侵入性的“液体活检”，CTC 检测能反映原发肿瘤的分子生物学及遗传学特征，有助于患者获得最佳的个体化治疗。%Circulating tumor cells(CTCs)are essential for establishing metastasis and recurrence in non-small cell lung cancer(NSCLC). With the development of detection technique,results from recent studies suggest that CTC level could be a supplement for TNM staging system and a prediction marker of prognosis and therapeutic efficacy,and even could be applied for risk assessment of early NSCLC. Furthermore,as a non-invasive"liquid biopsy",detection of CTC can reflect the molecular biology and genetics characteristics of the primary tumor,and subsequently assist in selecting an optimal individualized treatment.
  • 摘要：Survivin is the strongest member of the inhibitor of apoptosis protein(IAP)family. Smac is the second mitochondria-derived activator of cysteine proteases,which can promote apoptosis by combining with IAP. Abnormal expression of them is closely related with occurrence,development,treatment tolerance and prognosis of ovarian cancer. It is prompted that Survivin and Smac are expected to play important roles in the early diagnosis and targeted therapy of ovarian cancer.%Survivin 是凋亡抑制蛋白（IAP）家族中抗凋亡作用最强的成员。Smac 是半胱氨酸蛋白酶的第2个线粒体激活因子，可以通过与 IAP 的结合，来发挥促凋亡作用。二者在卵巢癌组织中的异常表达均与卵巢癌发生发展、治疗耐受及预后密切相关。两者有望在卵巢癌早期诊断及靶向治疗方面发挥重要作用。
  • 摘要：目的：评价三维适形放疗同步化疗治疗进展期食管癌的近期疗效及不良反应。方法回顾性分析我科2008年1月至2011年1月的127例进展期食管鳞状细胞癌患者，分为同步放化疗组（69例）和单纯放疗组（58例）。观察两组的不良反应、生命质量及近期疗效。结果同步放化疗组白细胞下降和放射性食管炎的严重比例均明显高于单纯放疗组（29.0%：12.1%，χ2=5.387，P =0.020；24.6%：10.3%，χ2=4.341，P =0.037）；生命质量，尤其是消化道不良反应（恶心、呕吐、腹泻）及进食量下降方面，同步放化疗组的患者的比例均明显高于单纯放疗组（73.9%：12.1%，χ2=48.574，P =0.000；43.5%：25.9%，χ2=4.274，P =0.039）；同步放化疗组有效率91.30%，单纯放疗组72.41%，差异有统计学意义（χ2=7.852，P =0.005）。结论三维适形放疗同步化疗治疗进展期食管癌有较好的近期疗效，但不良反应也有所增加，长期疗效有待进一步观察。%Objective To evaluate the clinical efficacy and toxicities of three dimensional conformal radiotherapy combined with chemotherapy for advanced esophageal carcinoma. Methods We retrospectively reviewed 127 patients with advanced esophageal squamous carcinoma in our department from January 2008 to January 2011,who were divided into two groups:conformal radiotherapy combined with chemotherapy(RCT) group,69 patients and radiotherapy(RT)group,58 patients. The side effects,quality of life and effective rates of them were compared. Results The severe rate of the marrow toxic effect and the incidences of radia-tion-induced esophagitis were higher in the RCT group(29. 0% vs 12. 1% ,χ2 = 5. 387,P = 0. 020;24. 6% vs 10. 3% ,χ2 = 4. 341,P = 0. 037). Patients in the RT group had better quality of life than those in the RCT group in gastrointestinal side effects(nausea,vomiting,diarrhea)and food intake(73. 9% vs 12. 1% ,χ2 =48. 574,P = 0. 000;43. 5% vs 25. 9% ,χ2 = 4. 274,P = 0. 039). In the RCT group,the effective rate was 91. 30%(63 / 69)and 72. 41 %(42 / 58)in the RT group,with a statistical significance(χ2 = 7. 852,P =0. 005). Conclusion Three dimensional conformal radiotherapy combined with chemotherapy for advanced esophageal carcinoma can improve the short-term curative effects,but it also increase the acute toxic effect. Further follow-up studies are needed for its long-term effect.
  • 摘要：本刊不接受一稿两投或重复发表的论文,读者在本刊所阅读的论文都是原始的、首发的,除非声明是按作者和编辑的意图重新发表的。这一立场符合中国和国际版权法、道德规范及资源使用的成本效益原则。但这一政策并不妨碍下列论文向本刊投稿:①已经被其他刊物退稿的论文;②发表初步报告后再发表完整的论文,如已在其他刊物或专业学术会议的论文汇编上发表过摘要;③在专业学术会议上宣读过,但并未在其他刊物或会议汇编上全文发表或准备全文发表。因此,作者在向本刊投稿时,必须就以前是否投寄过或发表过同样或类似的文稿向编辑部作充分的说明,以免造成一稿两投或重复发表。如果文稿中部分内容已经发表,作者应在新的文稿中明确指出有关内容并列出相应的参考文献,同时将以前发表的文稿寄给编辑部,以便编辑部决定如何处理新的文稿。
  • 摘要：Tumor-stroma ratio is the ratio of tumor cells and stromal tissue. It can be evaluated through HE-stained sections. Usually a 50% cut-off value is taken. TSR is stratified as stroma rich(TSR < 50% )and stroma poor(TSR≥50% ). The different prognosis between the two groups can be assessed. Several previous studies show that TSR is an independent prognostic factor for colon carcinoma,breast cancer,esophageal squa-mous cell carcinoma,cervical carcinoma and non-small cell lung cancer;patients with stroma-rich tumor suffer worse prognosis. The cause might be that tumor cells could activate stroma cells while activated stroma cells could promote the growth,infiltration and metastasis of tumors. And tumor stroma should be recognized as an indispensible participant in progression and invasion of carcinoma.%肿瘤间质比（TSR）指肿瘤组织内肿瘤细胞与间质部分的比例，可通过对苏木素-伊红染色的病理切片进行评估得到。通常以50%作为截断值，将病例分为间质丰富组（TSR <50%）及间质稀少组（TSR≥50%），从而比较两组患者的预后差异。当前研究结果表明，在结直肠癌、乳腺癌、食管癌、宫颈癌和非小细胞肺癌中，TSR 是肿瘤预后的独立影响因子，肿瘤间质丰富的患者预后更差，原因可能为肿瘤细胞能活化间质细胞，而活化的间质细胞又能促进肿瘤的生长、浸润及转移，间质组织在肿瘤的进展及侵袭过程中起着必不可少的作用。

    国际肿瘤学杂志的期刊信息

    • 曾用名：国外医学.肿瘤学分册;国外医学：肿瘤学分册;国外医学:肿瘤学分册;国外医学(肿瘤学分册);国外医学（肿瘤学分册）;国外医学-肿瘤学分册)
    • 创刊时间：1974
    • 地区：CN
    • 语言：中文
    • 热门主题：中华医学会;山东省医学科学院
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