目的 探讨胃癌组织中刺猬信号通路(Hedgehog signaling pathway, Hh)中的音猬因子(Sonic hedgehog, Shh)和胶质瘤相关癌基因同源物-1(Glioma-associated oncogene homolog -1, Gli-1)与金属基质蛋白酶-2(Matrix metalloproteinase-2, MMP-2)的表达和临床意义。方法 采用免疫组织化学方法检测40例人胃癌组织、人胃息肉组织和40例正常胃黏膜组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2蛋白的表达。结果 胃癌组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2的阳性表达率分别为62.5%、67.5%、72.5%,高于胃息肉组织(阳性表达率分别为27.5%、37.5%、32.5%)和正常胃黏膜组织(阳性表达率分别为22.5%、17.5%、12.5%)(P<0.05);以上三者的表达与患者性别、年龄、组织学类型无关(P>0.05);而与分化程度、浸润深度、淋巴结转移相关(P<0.05);音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2表达呈正相关。结论 刺猬信号通路可能通过某些机制可上调金属基质蛋白酶-2的表达,从而增强胃癌的侵袭性。联合检测胃癌组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2的表达水平在一定程度上可以作为胃癌预后的客观参考指标。

Objective To investigate the expression and clinical significance of Sonic hedgehog(Shh), Glioma-associated oncogene homolog -1(Gli-1) and Matrix metalloproteinase-2(MMP-2) in gastric cancer.Shh and Gli-1 are the molecules of Hedgehog(Hh) signaling pathway. MMP-2 is the member of matrix metalloproteinase family. Methods The expression of Shh,Gli-1 and MMP-2 proteins was examined by immunohistochemistry in the human gastric cancer tissues and the human gastric polyp and the normal gastric mucosa tissues of 40 cases. Results The positive expression rates of Shh,Gli-1 and MMP-2 in gastric cancer were 62.5%,67.5% and 72.5% respectively, which were significantly higher than those in the gastric polyp tissues (the positive expression rates were 27.5%,37.5% and 32.5% respectively) and normal gastric mucosa tissues (the positive expression rates were 22.5%,17.5% and 12.5% respectively),P<0.05.The expression of Shh,Gli-1 and MMP-2 was not correlated with the sex,age or histological type(P>0.05),but was correlated with depth of invasion,differentiation level and lymphonode metastasis in gastric cancer(P<0.05). The expression of Shh and Gli-1 was positive correlated with MMP-2. Conclusion Hedgehog(Hh)signaling pathway may have great effects on enhancing the invasive ability of gastric cancer by upregulating MMP-2 protein through some unknown mechanisms.The combined detection of the expression level of Shh,Gli-1 and MMP-2 in gastric cancer tissues might be used as an Objective references for assessing the prognosis of gastric cancer.

目的 比较榄香稀和顺铂胸腔灌注治疗肺癌恶性胸腔积液的疗效。方法 肺癌合并恶性胸腔积液患者56例,榄香稀组29例:胸腔内注射榄香烯400 mg+地塞米松10 mg+2%普鲁卡因10 mL;顺铂组27例:顺铂80 mg+地塞米松10 mg。每周1次,治疗4周。同时记录不良反应。结果 56例均可评价疗效,榄香稀组完全缓解11例,部分缓解14例,有效率86.2%。顺铂组完全缓解6例,部分缓解10例,有效率59.3%,差异有统计学意义,榄香稀组生活质量较顺铂组改善。结论 榄香稀治疗恶性胸腔积液疗效好,可提高生活质量,毒副反应小。

目的 探讨延续性护理干预对癌痛患者服药依从性及疼痛治疗效果的影响。方法 选取105例住院治疗的中度至重度癌痛患者,均需服用阿片类药物止痛治疗,单日出院的患者(48例)设为对照组,双日出院的患者(57例)设为干预组。对照组在出院前由责任护士给予常规的用药指导;实验组则在此基础上,于出院后提供延续性护理干预,对患者每周进行电话回访1次,每个出院患者至少回访4次,比较两组患者出院4周后服药依从性及疼痛治疗效果的差异。结果 实验组服药依从性、疼痛治疗效果高于对照组(P＜0.05)。结论 延续性护理干预能提高出院癌痛患者服药依从性及疼痛治疗效果,改善患者的生存质量。

Objective To investigate the impact of continuing nursing on the medication compliance and effect of pain treatment in patients with cancer pain. Methods 105 cases of hospitalized patients with medium to severe cancer pain were selected,need to take opioid analgesic therapy,they were divided into the control group who were single-day discharged(n=48)and intervention group who were double-day discharged(n=57),when discharged,the control group was received conventional health education of medication by the specialized nurses;on this basis,the experimental group was received continuing nursing after discharge,the patients had a return visit by telephone once a week,each patient were visited 4 times at least. After 4 weeks,the medication compliance and effect of pain treatment in the two groups were compared. Results In the experimental group,the medication compliance of patients and effect of pain treatment were significantly higher than those of the control group(P＜0.05). Conclusion The continuing nursing intervention can significantly improve the medication compliance and effect of pain treatment for discharged patients with cancer pain,and improve the quality of life.

目的 对乳腺癌中血管内皮生长因子－C(VEGF－C)的表达与淋巴结转移及预后的关系展开研究分析。方法 随机选取我院接收救治的50例乳腺癌患者,采用免疫组化法检测50例患者乳腺癌中VEGF－C的表达情况,研究乳腺癌VEGF－C的表达与淋巴结转移及预后的关系。结果 50例乳腺癌患者中,淋巴结节转移组,VEGF－C阳性23例,阳性率92.0%;未见淋巴结节转移组,VEGF－C阳性10例,阳性率40.0%;淋巴结节转移组VEGF－C阳性表达率高于未见淋巴结节转移组;不同年龄、肿瘤直径以及病理分型的乳腺癌,VEGF－C阳性表达率差异无统计学意义(P均＞0.05);不同临床分期乳腺癌中,I~II期乳腺癌VEGF－C阳性表达率(58.1%)低于III~IV期VEGF－C阳性表达率(84.2%),数据差异有统计学意义(P＜0.05)。结论 早期检测乳腺癌中VEGF－C表达情况,能够为临床早期判定乳腺癌是否转移提供一项可测参考指标,对临床治疗、预后评估可起到一定参考价值。

Objective To make expand research and analysis for breast cancer and vascular endothelial growthfactor-C(VEGF-C)expression and lymph node metastasis and prognosis. Methods 50 cases of breast cancer patients were random collected in our hospital to detect the expression of VEGF-C in patients with breast cancer using immunohistochemical staining,the relationship between breast cancer VEGF-C expression and lymph node metastasis and prognosis. Results In 50 cases of breast cancer,lymph node metastasis group,VEGF-C positive in 23 cases,the positive rate is 92.0%;no lymph node metastasis group,VEGF-C positive in 10 cases,the positive rate is 40.0%;lymph node metastasis group VEGF-C positive expression rate was significantly higher than that no lymph node metastasis group;different age,tumor size and histological type of breast cancer,the VEGF-C positive expression rate difference was not statistically significant(P＞0.05);different clinical stages of breast cancer,I ~ II breast cancer VEGF-C positive expression rate(58.1%)was significantly lower than the III ~ IV of VEGF-C positive expression rate(84.2%),the data were statistically significant differences(P<0.05). Conclusion Early detection of breast cancer in the expression of VEGF-C can determine for early clinical metastasis of breast cancer,can provide a reference index for clinical treatment and prognosis.

目的 调查结直肠癌患者癌因性疲乏状况,研究其动态变化趋势,为临床护理提供理论依据。方法 选用癌症疲乏量表(CFS)对96例结直肠患癌患者于术前一周、术后3~4天、出院前1~2天进行调查分析。结果 三次调查患者的癌因性疲乏水平有差异(P＜0.01),术后3~4天疲乏程度最重,出院前1~2天次之,术前一周最轻;三次调查结肠癌患者的疲乏水平均高于直肠癌患者,两组疲乏水平有差异(P＜0.05)。结论 结直肠癌患者于住院不同时期存在不同程度的疲乏,应针对疾病各时期特点为患者量身裁定护理干预措施,改善其疲乏症状。

Objective To investigate the dynamic changes of cancer-related fatigue (CRF) in patients with colorectal cancer. Methods Totally 96 patients with colorectal cancer were investigated by Cancer Fatigue Scale in three times: a week before patients' surgery, 3~4 days after patients' surgery and 1~2 days before discharge, respectively. Results Scores of fatigue of colorectal cancer patients were significantly different among three measurement points(P＜0.01). The scores of fatigue in the second survey were the highest. The third survey took second place and the first survey was the lowest. The score of fatigue in colon cancer patients were higher than rectal cancer patients in survey, with significant difference(P＜0.05). Conclusion There were obvious differences of fatigue in different periods for colorectal cancer patients in hospital. Inventions should tailor for patients according to characteristics of different periods to improve fatigue.

目的 调查I-IIa期宫颈鳞状细胞癌患者术后随诊和复发情况,并探索随诊和复发的相关因素。方法 分析2011年1月—2012年6月中山市妇幼保健院收治的128例宫颈鳞状细胞癌患者的临床资料,分析他们的术后随诊情况及其影响因素。将有液基薄层细胞学(TCT)及盆腔检查者视为有效随诊的患者,分析肿瘤复发情况及其影响因素。结果 128例患者中,有效随诊104例(占总人数的81.25%)。年龄组越小,随诊率越高(P=0.034);城市患者较农村患者,随诊率高(P=0.028);文化程度越高,随诊率越高(P=0.028);职业为公务员、教师、公司职员或自由职业、个体,随诊率比职业为家庭妇女和工人更高(P=0.030)。在104例随诊者中,2年复发8例(占7.7%)。临床分期较晚,肿瘤直径>4cm,病理类型,脉管内瘤栓阳性,淋巴结转移阳性是影响患者2年复发的危险因素(P<0.05)。结论 临床分期,肿瘤直径,脉管内瘤栓阳性,淋巴结转移等临床病理特征与患者复发密切相关。应针对宫颈癌患者社会人口学特点制定措施,提高随诊率。

Objective To investigate the follow-up rate after surgical treatment and the recurrence rate among patients with cervical squamous cell carcinoma in I-IIa stage, and identify associated factors. Methods The clinical data of 128 cases of cervical squamous cell carcinoma from January 2011 to June 2012 in Zhongshan maternal and child health hospital was collected. Follow up record of these cases was analyzed and factors associated with follow up were identified. Patients having taken thinprep liquid-based cytology test (TCT) and pelvioscopy were treated as cases being followed effectively, and their recurrence and associated factors were analyzed. Results Among the 128 patients, 104(81.25%) were effectively followed. Patients with younger age(P=0.034), living in city (P=0.028), with higher education level(P=0.028) had higher follow-up rate. Civil servants, teachers and freelancers had higher follow-up rate than housewives and workers (P=0.030).Eight of the 104 effectively followed cases recurred within two years after surgery, accounting for 7.7%. The associated factors of recurrence included clinical stage, tumor diameter, larger than 4cm, the depth of myometrial invasion, deeper than 2/3, vascular tumor thrombus positive, and lymph node metastasis positive (P<0.05). Conclusion Clinical stage, tumor size, vascular tumor thrombus positive, lymph node metastasis positive were associated with recurrence. Tailored strategies should be developed to improve the follow up rate based on the social and demographic characteristics of patients.

目的 观察鼻咽癌患者癌组织中RhoA蛋白-Rho激酶蛋白表达情况。方法 收集增城市人民医院2009年2月—2014年6月耳鼻喉科住院治疗,进行活检的鼻咽癌患者切除标本共62例,包括癌组织及癌旁组织。通过SABC免疫组织化学法检测患者癌组织及癌旁组织中RhoA蛋白-Rho激酶蛋白表达情况。结果 鼻咽癌组织RhoA蛋白阳性表达率及Rho激酶蛋白阳性率高于癌旁组织(P=0.00);鼻咽癌癌组织RhoA及Rho激酶表达在年龄及性别分布上无差异,而TNM分期中Ⅲ期+Ⅳ期RhoA及Rho激酶表达阳性率高于Ⅰ期+Ⅱ期患者,同时存在淋巴结转移患者其RhoA及Rho激酶表达阳性率高于未转移患者。结论 鼻咽癌患者癌组织中RhoA蛋白及Rho激酶表达阳性率高,TNM分期越高及存在淋巴结转移者其RhoA蛋白及Rho激酶表达阳性率越高。RhoA-Rho激酶信号通路参与了鼻咽癌发生发展的过程。

Objective To observe the expression of RhoA-Rho kinase protein in patients with nasopharyngeal carcinoma tissue. Methods Collecting 62 cases of patients with nasopharyngeal carcinoma who hospitalized and hadbiopsyof specimens, including carcinoma tissues and adjacent tissues in department of otolaryngology-head and neck surgery from February 2010 to October 2014. The expression of RhoA-Rho kinase protein in carcinoma tissues and adjacent tissues was detected with SABC immune histochemical method. Results Positive expression rate of nasophryngeal carcinoma tissue RhoA protein and Rho kinase protein was significantly higher than that of adjacent tissues, and there was no obvious difference in age and sex between the expression of nasopharyngeal carcinoma tissue RhoA and Rho kinase(P=0.00), while patients being in the third and fourth periods of TNM stage had a higher positive expression rate of RhoA and Rho kinase than those being in the first and second periods. At the same time, RhoA and Rho kinase positive expression rate in patients with lymph node metastasis was higher than that in those without lymph node metastasis. Conclusion Positive expression rate of RhoA protein and Rho kinase in patients with nasopharyngeal carcinoma. The higher TNM stage is, the higher positive expression rate of RhoA protein and Rho kinase in lymph node metastasis is. RhoA-Rho kinase signaling pathways involved in the occurrence and development of nasopharyngeal carcinoma.

目的 探索复发性卵巢癌放射治疗临床的效果和副作用。方法 采用回顾性分析中山大学肿瘤防治中心放射治疗中心2002年1月—2014年9月收治的复发性卵巢癌采用放射治疗的临床资料和治疗结果。结果 23例患者5年生存率为48.6%,中位生存期为54,局部无瘤生存期中位数为11.9。结论 对于局限性复发性卵巢癌放射治疗有较好的疗效和较少的副作用。

Objective To explore the clinical efficacy and side effects of radiation therapy for recurrent ovarian cancer. Methods We performed a retrospective analysis of clinical data and treatment outcomes from recurrent ovarian cancer patients who received radiation therapy from January 1999 to December 2012 at radiation treatment center of Sun Yat-sen university Cancer Center. Results Among 23 patients, the five-year survival rate was 48.6%, the median survival time was 54, and the local median disease-free survival was 11.9. Conclusion Radiation therapy has better efficacy and less side effects for non-metastatic recurrent ovarian cancer.

目的 观察改良INP方案对肺腺癌伴有脑转移患者的临床疗效及毒副作用,并探讨该方案疗效与Ⅲ型β微管蛋白(β-tubulin-Ⅲ)在肺癌组织中表达水平的关系。方法 收集2010年4月—2013年1月广州医科大学附属第一医院胸外科收治的15例肺腺癌伴有脑转移患者的临床资料。所有患者均采用改良INP方案治疗,使用RECIST 1.0标准进行判定。结果 脑转移瘤取得CR 1例(1/15),PR 5例(5/15),SD 4例(4/15),PD 5例 (5/10),该方案对脑转移瘤的总缓解率(overall response rate,ORR)为40%,疾病控制率(disease control rate,DCR)达66.7%,毒副作用轻度可控;Ⅲ型β微管蛋白低表达对该方案的疗效有优于高表达的趋势。结论 肺腺癌伴有脑转移患者采用改良INP方案进行化疗,脑转移瘤临床疾病控制率较高,耐受性良好;肿瘤组织β-tubulin-Ⅲ表达水平可能与该方案的疗效相关。

Objective To investigate the efficacy and toxicity of chemotherapy of modified INP regimen in the treatment of adenocarcinoma with brain metastases. At the same time,to explore the relationship between expression of β-tubulin-Ⅲ in NSCLC biopsies and sensitivity to this modified INP regimen. Methods The clinical data of 15 adenocarcinoma with brain metastases patients who had been admitted to the first affiliated hospital of Guangzhou medical university from April 2010 to January 2013 were retrospectively analyzed. All patients received modified INP regimen.RECIST 1.0 was taken to know the result. Results For brain metastasis of the 15 patients, complete response (CR) and partial response(PR) were 1 and 5 patients, respectively. 4 patients were stable disease (SD) and progression disease(PD) in 5 patients. The overall response rate(ORR) was 40% and the disease control rate(DCR) was 66.7%. The toxicity was mild. Furthermore, we found NSCLC patients with low β-tubulin-Ⅲexpression had better ORR than those with high expression. Conclusion The modified INP regimen is effective and well-tolerable for brain metastases of adenocarcinoma. The β-tubulin-Ⅲ expression may be associated with the efficacy of this regimen.

神经元特异性烯醇化酶(neuron-specific enolase, NSE)是糖酵解途径中一种重要的同工酶;特异性位于神经元和神经内分泌细胞中。小细胞肺癌(small cell lung cancer,SCLC)细胞浆内含有神经内分泌颗粒,具有神经内分泌分化的特征,为恶性程度高的神经内分泌系统肿瘤。因此,NSE是SCLC诊断中最敏感的肿瘤标志物,在SCLC的临床诊断、治疗、预后均有重要应用价值,科学合理联合检测肿瘤标记物,将能为临床诊疗工作提供有力的帮助。