目的:研究Survivin蛋白在非小細胞肺癌(NSCLC)中表達的臨床意義。方法:運用免疫組化(IHC)方法檢測51例NSCLC組織、21例癌旁組織和11例良性肺病變組織中Survivin的表達,并采用SPSS13.0軟件進行統計分析。結果:Survivin在胞漿和/或胞核均有表達,其在NSCLC、癌旁和良性肺病變組織中的陽性率之間存在顯著統計學差異(Plt;0.001),腫瘤組表達(76.5%,39/51)高于癌旁組織(19.0%,4/21)(P=0.000)。Survivin表達與分化程度有關(Ρlt;0.05),其生存曲線及復發轉移風險曲線均沒有意義(Ρ＞0.05)。多因素COX回歸分析提示臨床分期和復發轉移狀態為影響生存的因素。結論:Survivin可能與NSCLC的發生發展相關,還不能支持它作為判斷預后和復發轉移的指標。
Objective To evaluate the role of topotecan in the treatment of small cell lung cancer (SCLC). Methods Up to 2006, we searched The Cochrane Library, MEDLINE, EMbase, Cancerlit, CBM, CNKI and VIP. Handsearch and additional search were also conducted. The quality of included studies was evaluated and meta-analyses were performed for the results of homogeneous studies by RevMan 4.2.8 software. Results Fourteen studies involving 2 099 participants with SCLC were included. All included studies were adequate in reporting randomization, while inadequate in allocation concealment and blinding. Meta-analyses showed that the response rate of TP (topotecan + cisplatin) regimen had no significant difference compared with EP regimen (etoposide + cisplatin) with OR 0.83 and 95%CI 0.63 to 1.09, but myelo-suppression such as leucopenia and thrombopenia was more severe with TP regimen; the response rate of monotherapy with topotecan was similar with that of CE (carboplatin + etoposide) regimen with OR 0.59 and 95%CI 0.22 to 1.60; the response rate of TEP (topotecan + etoposide + cisplatin) regimen was comparable with that of EP regimen with OR 1.37 and 95%CI 0.82 to –2.28, but myelosuppression and anemia were more severe with TEP regimen; the response rate with OR 0.97 and 95％CI 0.60 to –1.57, median time to progression with WMD –2.32 and 95％CI –5.72 to 1.09 and median survival time with WMD –1.65 and 95％CI –7.13 to 3.83 of IV topotecan were similar to those of oral topotecan, while neutropenia was more severe with IV topotecan. Forty-five treatment-related deaths were reported in all included studies. Conclusions Topotecan is an effective agent for SCLC when used as monotherapy or in combined treatment, but myelosuppression such as leucopenia and thrombopenia was relatively severe. Although it has been recommended as a second-line agent for recurrence of sensitive SCLC, more clinical trials are needed to define its role in first-line treatment. Due to a high risk of selection bias and detection bias in included studies, the evidence is insufficient to determine the effect of topotecan. Further large-scale trials are required to define the role of topotecan in the treatment of SCLC.
Objective To analyze the reason of tumor treatment-related premature ovarian failure, and to review the progress of ovarian functional reconstruction. Methods The l iterature about the effects of radiotherapy and chemotherapy on ovarian function and reconstruct ovarian function was reviewed, analysed and summarized. Results Radiotherapy and chemotherapy can both affect ovarian function. The ovarian function reconstruction included fresh ovarian transplantation and ovarian cryopreservation and transplantation. Frequent ovarian cryopreservation was procedure slow-freezing protocols and vitrification protocols. Some laboratory and animal models of ovarian function reconstruction have come to gratifying results. Conclusion Ovarian function reconstruction has a potential cl inical value and provides a promising future.
Objective To investigate the feasibil ity, safety and operative techniques of percutaneous vertebroplasty (PVP) in treating osteolytic bone metastasis of cervical vertebra and reconstructing the function of cervical vertebra. Methods From March 2005 to December 2007, 10 patients with osteolytic bone metastatic carcinoma in single cervical vertebral body received PVP, including 5 males and 5 females aged 38-75 years (mean 54.5 years). Among them, 5 patients had primary lung tumor, 1 primary renal tumor, 1 primary breast tumor, 1 primary cervical tumor and 2 unknown primary lesion. The course of disease was 2-4 years. All the patients suffered from obviously cervical pain and l imitation of activity, including 4 cases of metastatic tumor of the C2 vertebral body, 2 of C3, 2 of C6 and 2 of C7. The general condition of patients was stable before operation, and no blood coagulation dysfunction, radiculalgia and spinal cord compression were detected. Lateral PVP was performed on 6 cases, approaching between the vertebral artery and the carotid sheath under CT guidance and anterolateral PVP was performed on the rest 4 cases, approaching between the trachea and the internal carotid artery under continuously X-ray fluoroscopy. The amount of bone cement injected was 3-4 mL, and the fill ing rate was 50%-100%. Results Without obvious bleeding or organ injury, the puncture was performed successfully on all the patients. Without symptom of spinal cord compression, patients suffered from pain during operation (1 case) and such compl ications noted by immediate CT or X-rays examination after operation as paravertebral epidural cement leakage (2 ases),transverse foramen cement leakage (1 case) and pinhole reflux (3 cases). The pain of patients was improved to various degree postoperatively, the visual analogue scales score was (5.9 ± 1.2) points before operation, which was changed to (2.6 ± 1.2) points at 1 hour after PVP and (1.6 ± 1.3) points at 1 week after PVP, indicating there was a significant difference between pre- and postoperation (P lt; 0.05). During the regular follow-up at 1 week, 3 and 12 months after PVP, all patients had no dislocation of cervical vertebra body, spinal cord compression and paralysis. Five patients died from multiple organ failure due to primary tumor progression, including 3 cases at 6 months after PVP and 2 at 12 months after PVP, and the rest 5 patients’ cervical pain were under control, with sound functional recovery. Conclusion PVP can rel ieve pain quickly and reinforce the stabil ity of the vertebral body, and has sl ight compl ications; the lateral approach is safe and effective.