目的 总结手术治疗中央型非小细胞肺癌(NSCLC)的临床效果.方法 回顾性分析160例中央型NSCLC患者的临床资料.术前均经纤维支气管镜检查,病理确诊.其中,肿瘤位于主支气管11例,肿瘤侵及叶支气管开口35例.结果 常规肺叶切除术100例,支气管袖状肺叶切除29例,全肺切除31例.术后未发生支气管胸膜瘘的并发症.149例获得随访8～72个月;手术切除病例的1年生存率86.8％,3年生存率45.8％,5年生存率24.5％.结论 手术是治疗中央型NSCLC的主要手段.手术方式应依据支气管受肿瘤侵及的程度和患者肺功能情况选择常规肺叶切除、袖状肺叶切除或全肺切除术.

回顾我院2006～2009年住院手术并术后病理证实为非小细胞肺癌(NSCLC)患者,按照是否合并慢性阻塞性肺病(COPD)分为两组临床资料,进行临床特征分析和总结.

目的:探讨纵隔肿瘤的临床特点和安全、有效的外科治疗方法。方法:回顾我院自2003年1月～2008年6月住院纵隔肿瘤的105例临床病例资料。结果:完全肿瘤切除101例,切除率96.2%,其中使用电视胸腔镜(VATS)或辅助小切口(VAMT)行完全肿瘤切除39例,使用率达37.1%,4例行纵隔肿瘤部分切除或者活检术。总的手术并发症发生率5.7%。结论:原发纵隔肿瘤的诊断主要依赖胸部X线和胸部CT检查。手术治疗是其首选治疗方法,包括传统开胸手术和电视胸腔镜或辅助小切口,安全可靠,同时注意手术并发症的防治。

Objective To investigate the modulation of anticancer drugs on the expression of Fas in tumor cells.Methods RT-PCR was used to detect the expression of Fas in tumor cells before and after co-incubated with adriamycin (ADM).Apoptosis of tumor cells was assayed by FCM.Results All the 3 tumor cell lines used in this study (gastric cancer cell lines SGC-7901,MGC-803,lung cancer cell line A-549 expressed Fas protein to varing degrees.ADM could enhance the expression of Fas gene in tumor cells (P0.05),elevate the apoptosis rate ( 40.3 %, 43.6 %, 54.4 % respectively) and increase the susceptibility of them to anti-Fas antibodies.Conclusion ADM could up-regulate the expression of Fas in tumor cells.The combined use of ADM with Fas MoAb could sensitizes tumor cells to Fas-mediated apoptosis.

Objective To investigate the effect of ginseng radix aconiti praeparata injection on neonatal cardiomyocyte apoptosis induced by hypoxia. Methods The cultured cardiomyocytes from 2-3d newborn SD rats were randomly divided into 3 group: control group, ischaemia 72h group and ginseng radix aconiti praeparata injection group (addition of ginseng radix aconiti praeparata injection at 72h before ischaemia 72h). Cardiomyocyte apoptosis was determined by TUNEL and flow cytometry. The caspase-3 activity was detected by caspase-3 fluorescent assay kit . Results TUNEL methlod and flow cytometry analysis showed that apoptosis indexes and the percentage of apoptosis cells in ginseng radix aconiti praeparata injection group were (14.10±2.56)% and (14.93±2.47)% respectively, which were significantly lower than those in ischaemia 72h group [(46.49±4.93)%and(48.43±4.18)%](P0.01). Caspase-3 activity analysis showed that caspase-3 activity in ginseng radix aconiti praeparata injection group was reduced by 52.85% relative to ischaemia 72h group. Conclusion Ginseng radix aconiti praeparata injection can efficiently inhibit apoptosis of neonatal cardiomyocytes after hypoxia. The inhibition of caspase-3 activity may be one of the mechanisms for that.

我们通过构建了携带肿瘤免疫相关基因B7-1的重组腺病毒,并将其感染肺癌细胞,观察了转染基因的表达,同时检测了体外诱导自体外周血淋巴细胞生成肿瘤杀伤性的细胞毒性T淋巴细胞(CTL).

Objective To investigate the relationship between caspase-3 expression and apoptosis in lung adenocarcinoma cell line A-549 which was transfected with Adenovirus-mediated FasL gene.Methods Human lung adenocarcinoma cell line A-549 was transfected with Adenovirus-mediated FasL gene.The expression of caspase-3,apoptosis morphological changes were measured using flow cytometry,RT-PCR assays,the activity of caspase-3 and clevage of poly ADP-ribose polymerase(PARP)were determined with Western blot analysis.Results The expression of caspase-3 was low in lung adenocarcinoma cell line A-549,but transfection of lung adenocarcinoma cells with Ad-FasL enhanced cell expression of caspase-3 gene and induced susceptibility to Fas/FasL mediated apoptosis(44.08% vs 18.15%, P 0.01).Apoptosis had positive relationship with the activity of caspase-3(γ=0.647, P 0.01).Conclusions Down-regulation of caspase-3 expression and resistance to Fas/FasL-mediated apoptosis in lung adenocarcinoma cells were found to be related to the development and progression of lung adenocarcinoma cells.FasL gene transfer may increase caspase-3 in lung adenocarcinoma cells and enhance their apoptosis.

Objective To observe the correlation of apoptosis with active caspase to the clinical characters of elderly non-small cell lung cancer(NSCLC).Methods M30 CytoDEATH,an antibody specific for the human Caspase family,was used to display apoptosis cells in 50 NSCLC tissues.The apoptosis index (AI) was calculated.Results The expression of M30 in squamous carcinomas(41.7%) was higher than that in adenocarcinomas(15.3%) and the difference was significant.AI in squamous carcinomas was also higher than that in adenocarcinomas and the difference was significant.AI in the poorly differentiated carcinomas was significantly higher than that in the middle- and well-differentiated carcinomas.Conclusion Spontaneous apoptosis cells mainly occur in the tissues of squamous carcinoma and poorly differentiated carcinoma.

目的:探讨老年贲门癌FasL表达上调与肿瘤浸润性淋巴细胞(TIL)凋亡的关系.方法:采用免疫组织化学S-P法,检测50例老年贲门癌组织中FasL表达及TIL的数量.采用脱氧核糖核酸末端转移酶介导的缺口末端标记技术(TUNEL),对其中40例贲门癌组织中凋亡的TIL及肿瘤细胞进行观察.结果:50例贲门癌组织FasL蛋白表达程度不等.FasL表达程度高的组织TIL计数低于FasL表达低的组织,同时其TIL凋亡指数高于FasL表达低的组织,P<0.05;而贲门癌细胞的凋亡指数低于FasL表达程度低的组织,P<0.01;TIL凋亡指数与贲门癌细胞的凋亡指数呈负相关,γ=-0.51,P<0.01.结论:老年贲门腺癌有不同程度的FasL表达,其表达程度与TIL的浸润程度和凋亡相关,可能是老年贲门癌免疫逃逸的重要机制之一.

尽管机体内具有一系列的免疫监视,但仍难以阻止肿瘤的发生和发展,因为肿瘤细胞有多种机制可以逃避人体免疫系统监视,如肿瘤表面抗原缺失,致使免疫细胞不能识别肿瘤细胞,还可以产生多种免疫抑制因子以降低宿主免疫力等,特别是老年患者,随着衰老和免疫抵抗力的下降,肿瘤细胞更易逃避免疫的监视从而导致肿瘤的发生.

Purpose:To study the effect of FasL gene on human lung adenocarcinoma cell lines and possibility of ex- ogenous FasL gene for gene therapy of lung cancer.Methods:An adenoviral expression vector with full length cDNA of FasL gene insert was constructed(Ad-FasL) and transfected into A549 cells.The effect of exogenous FasL gene on the growth of A549 cells was examined in vitro and in vivo.Results:Expression of FasL gene in A549 cells was confirmed by FCM and RT-PCR.The in vitro growth of the Ad-FasL transfected A549 cells was significantly inhibited (inhibition rate: 84%) as compared to mock (Ad-LacZ) transfected A549 cells.Colony-forming activity in vitro of the Ad-FasL transfected A549 cells was completely inhibited.The Ad-FasL transfected cells became apoptotic which was confirmed by the appear- ance of pre-G_1 on flow cytometry (FCM).The growth of A549 xenografts in nude mice was retarded by intra-tumol injection of Ad-FasL.Conclusions:FasL gene participates in the induction of cell apoptosis.Its use in gene therapy of cancer is promising.