<正> 肝切除是原发性肝癌(简称肝癌)的首选治疗方法,也是最有效的治疗措施。肝癌的发生与复发同乙型肝炎和(或)丙型肝炎病毒所致的肝硬化有密切关系,保留正常的肝组织是预防术后肝功能衰竭的重要措施。近年来,我们应用解剖分离肝门联合超声染色指导下肝段切除术和术中灌注化疗对我院收治的210例肝癌进行治疗,并与传统的肝癌切除术进行了比较,疗效满意,现报道如下。

Objective To explore the clinical evaluation on hepatic segmentectomy under segmental staining and intraoperative chemotherapy for primary liver cancer(PLC) by hepatic portal anatomic dissection.Methods The clinical data of 460 PLC patients admitted from July 2001 to October 2006 were analyzed retrospectively.210 cases underwent hepatic segmentectomy under segmental staining and intraoperative chemotherapy by anatomic dissection(group A),250 cases underwent routine hepatectomy(group B).Liver function,AFP and radiographic examination were regularly used after surgery.Results There were significant differences between two groups with respect to intraoperative blood loss,postoperative liver function and postoperative complications(P0.05),group A was better than group B.The overall 3-and 5-year survival rates in group A were 58.27% and 31.41% respectively,which were significantly higher than those of group B(42.28% and 20.13%,P0.05).The local recurrence rates of 1-,3-and 5-year in group A were 20.24%,34.62% and 44.20% respectively,which were significantly lower than those of group B(43.21%,70.21% and 89.24%,P0.05).Conclusions The hepatic segmentectomy under segmental staining and intraoperative chemotherapy for PLC by hepatic portal anatomic dissection may reduce postoperative complications,lower postoperative relapse rates and improve survival rates.

Objective To explore the correlation between up-regulation of cyclooxygenase-2(COX-2) (expression) and hepatocellular carcinoma(HCC) angiogenesis.Methods The expression of COX-2,vascular endothelial growth factor(VEGF)、basic fibroblast growth factor(bFGF) and angiopoientin-2(Ang-2) were examined in eighty matched sets of HCC specimens using immunohistochemistry and reverse (transcription-polymerase) chain reaction(RT-PCR).Results In HCC,the expression rate of COX-2,VEGF,bFGF and Ang-2 was 75.0%,62.5%,60.0% and 61.25%,respectively.(Immunohistochemical) staining scores of VEGF、bFGF and Ang-2 were 5.98±1.16,4.57±0.26 and(5.87)±0.12,respectively in strongly postive group of COX-2;and were 3.30±0.22,2.61±0.16 and 2.63±0.13,respectively in moderately weak postive group of COX-2.The expression rates of VEGF,(bFGF) and Ang-2 were 100.0%(95/95),94.29%(33/35) and 97.14%(34/35),respectively in strongly postive group of COX-2;and were 60.0%(15/25),60.0%(15/25) and 60.0%(15/25),respectively in moderately weak postive group of COX-2.There was significant difference in HCC(angiogenesis) between the two groups(P(0.01)),and COX-2 expression was significantly correlated with VEGF,bFGF and Ang-2(r=0.857,0.706,0.901,respectively and all P0.01).MVD was 73.18±12.43 and 33.42±7.52 in strongly postive group of COX-2 and moderately weak postive group of COX-2,(respectively)(P0.01),and COX-2 was significantly correlated with HCC MVD(r=0.812,P0.01).Conclusions Up-regulation of COX-2 expression correlates with tumor angiogenesis in HCC.

Objective To investigate COX-2 expression in HCC and its clinical application. Methods The COX-2 expression was examined in 38 matched sets of HCC specimens and adjacent liver, and seven normal liver tissues using immunohistochemistry and reverse transcription-polymerase chain reaction(RT-PCR). Results The COX-2 expression was significantly higher in well differentiated HCC than moderated HCC and poor differentiated HCC (P 0.01 respectively), and adjacent non-tumoral liver tissues(P 0.01). The COX-2 was not expressed in normal liver tissues. There was no significant difference among adjacent nontumors tissues, moderated HCC and poor differentiated HCC (P 0.05, respectively). Conclusions The overexpression of COX-2 may involve in carcinogensis of well differentiated HCC, it may play a role in the early stages of hepatocarcinogensis.

环氧合酶-2(cyclooxygenase-2)是前列腺素合成的限速酶,在许多恶性肿瘤中均有表达,并参与肿瘤的形成和复发转移.本文就COX-2的结构、在肝细胞癌中的表达及其抑制剂对肝细胞癌的作用作一综述.

目的:探讨肝切除加化疗治疗原发性肝癌的疗效.方法:回顾性分析我院1996年1月～2003年12月收治的380例肝癌患者的临床资料,根据不同方法分成2组:手术切除组(A组)130例,手术切除加化疗组(B组)250例.结果:手术切除加化疗组1、3和5年的复发率分别为21.2%、35.1%和45.3%,其1、3和5年累积生存率分别为68.2%、50.1%和21.8%,明显高于单纯手术切除组.术后化疗次数是影响手术切除疗效的重要因素.结论:肝切除术后加区域性化疗可降低肝癌术后复发率,提高了患者的生存率.

建立院领导接待日的作用与方法谌忠友史百高作者单位：４１０００６长沙市，湖南省肿瘤医院为了解情况、交流思想、沟通意见、增进理解，我院建立了领导接待日制度，从１９９５年至今，坚持在每月最后一个周３，由一名院级领导专门接待来访职工，听取他们对医院领导及管理...