目的:探索分析肺癌高风险人群参与筛查意愿的影响因素.方法:招募具有肺癌高风险因素的受试者1955例,开展问卷调查人口学特征、疾病认知情况和参与筛查意愿,采用Logistic回归分析筛查意愿的影响因素.结果:在1955例具有肺癌高风险因素的受试者中,1136例(58.12％)愿意参与肺癌筛查.疾病认知中预防相关知识(OR=1.519,95％CI=1.401～1.648,P<0.001)、筛查相关知识(OR=1.246,95％CI=1.094～1.418,P=0.001)与筛查意愿正相关;治疗相关知识(OR=0.785,95％CI=0.704～0.875,P<0.001)、当前吸烟状态(OR=0.609,95％CI=0.450～0.825,P=0.001)与筛查意愿负相关.结论:本研究发现疾病认知是高风险人群参与肺癌筛查实践的重要影响因素,为进一步寻找特定人群开展针对性健康宣教,提高筛查参与度提供相关信息.

目的 探讨进展期胃癌D2根治术中No.8p淋巴结转移与临床病理参数的相关性.方法 回顾性分析安徽医科大学附属六安医院2018年1月至2020年12月70例进展期胃癌患者的临床资料,采用多因素logistic回归分析肿瘤大小、发生部位、组织类型、组织学分级、Borrmann分型、浸润深度、肿瘤N分期、No.8a组淋巴结转移情况与No.8p组淋巴结转移的关系.结果 No.8p组淋巴结转移率为11.43％.单因素分析显示,病灶位于胃大弯侧和小弯侧、低分化和高中分化、浸润型和局限型、No.8a组淋巴结转移与否之间,No.8p组淋巴结转移情况差异存在统计学意义(P<0.05).logistic多因素分析显示,肿瘤位于小弯侧、低分化、No.8a组淋巴结转移,No.8p组淋巴结转移的危险因素(P<0.05).结论 进展期胃癌No.8p组淋巴结转移率较高,肿瘤位于小弯侧、低分化、No.8a组淋巴结转移时需重视No.8p组淋巴结转移.

目的 探讨结直肠癌术后化疗对患者肠道屏障功能的损害及丙氨酰谷氨酰胺、双歧杆菌三联活菌胶囊对肠道屏障功能的影响.方法 将安徽医科大学附属六安医院接受术后辅助化疗的结直肠癌患者120例,随机分为3组,每组40例.对照组:使用奥沙利铂+卡培他滨(CapeOX)化疗.谷氨酰胺组:化疗方案与对照组相同,在化疗开始前1天静脉滴注丙氨酰谷氨酰胺注射液,连续用5 d.益生菌组:化疗方案与对照组相同,在化疗前1天口服双歧杆菌三联活菌胶囊,口服5 d.3组患者在化疗前后分别检测血液中二胺氧化酶、D-乳酸、细菌内毒素等肠道屏障功能指标,并评价3组患者化疗后恶心、呕吐、腹泻、腹胀、肠鸣音减弱、食欲不振等化疗不良反应.结果 谷氨酰胺组及益生菌组化疗后二胺氧化酶、D-乳酸、细菌内毒素等指标水平较对照组低(P<0.05);对照组化疗前后二胺氧化酶、D-乳酸及细菌内毒指标水平比较,差异有统计学意义(P<0.05),化疗后较化疗前升高;化疗后谷氨酰胺组腹泻及腹胀症状评分较对照组低(P<0.05).结论 CapeOX方案化疗对肠道屏障功能具有损伤作用;丙氨酰谷氨酰胺及双歧杆菌三联活菌胶囊对结直肠癌患者CapeOX方案化疗后肠道屏障功能具有一定改善作用;丙氨酰谷氨酰胺对CapeOX方案化疗所致腹泻及腹胀症状具有改善作用.

Objective: To explore the prognostic value of nucleotide excision repair cross-complementation gene 1 (ERCC1) expression in patients receiving oxaliplatin adjuvant chemotherapy with colorectal cancer (CRC) . Methods: A total of 84 patients undergoing m FOLFOX6 chemotherapy after radical resection of CRC from Lu'an Hospital Affiliated to Anhui Medical University from January 2011 to January 2013 were selected. The expression of ERCC1 in CRC tissues was evaluated by immunohistochemistry and the correlation between ERCC1 expression and prognosis was analyzed. Results: ERCC1 was highly expressed in 30 patients (35. 7％) . Kaplan-Meier curves showed a reduction in disease-free survival (DFS) and overall survival (OS) in CRC patients with high ERCC1 expression (P < 0. 001) . Multivariate COX analysis showed that high expression of ERCC1 (DFS HR = 4. 645, 95％ CI: 2. 045 ～10. 548, P < 0. 001. OS HR = 4. 898, 95％ CI: 1. 971 ～ 12. 170, P < 0. 001) was a poor prognostic factor. Analysis of the correlation between ERCC1 expression and survival in similar subgroups was similar. Among the 16 patients with high expression and recurrence of ERCC1, liver and lung metastasis was 68. 8％ (11/16) . In 10 patients with low expression of ERCC1 and recurrence, 70. 0％ (7/10) of the patients had peritoneal metastasis. ERCC1 expression was significantly associated with the first recurrence pattern (P = 0. 006) . Conclusion: ERCC1 expression can be used as an important indicator to evaluate the prognosis of CRC patients and may help predict the first relapse pattern after adjuvant chemotherapy in CRC patients. The prognostic value of ERCC1 expression needs further study.

探讨胃蛋白酶原和4种肿瘤标志物CEA、CA50、CA199、CA242联合检测对胃癌诊断的临床意义.102例胃癌患者(胃癌组)、87例胃部良性病变患者(胃良性病变组)和71例健康体检患者(对照组).应用全自动电化学发光免疫分析仪,测定不同临床分期患者血清肿瘤标志物含量水平,分析检测结果.结果 显示,胃癌组血清胃蛋白酶原Ⅰ和CEA、CA50、CA199、CA242水平高于良性病变组和对照组患者(P＜0.05),良性病变组上述指标高于对照组(P＜0.05);胃癌Ⅲ、Ⅳ期组患者血清胃蛋白酶原Ⅰ和CEA、CA50、CA199、CA242含量明显高于胃癌Ⅰ、Ⅱ期组;指标联合检测的阳性率高于单项检测阳性率(P＜0.05).结果 表明,胃癌患者血清胃蛋白酶原Ⅰ和CEA、CA50、CA199、CA242含量较高,转移后上述指标血清含量增加,联合检测比单一检测更具诊断价值.

Objective To investigate the expression of thymidylate synthase (TS),and the correlations with the clinicopathologcal factors and the prognosis of postoperative fluorouracil chemo-therapy in gastric cancer.Methods 42 patients with gastric cancer who underwent radical gastrectomy were collected from April 2011 to April 2014 in Lu'an Hospital of Anhui Medical University,and the chemotherapy regimen was Cisplatin + Capecitabine or Cisplatin + Teggio.The levels of TS in tumor tissues of 42 patients with gastric cancer were detected by immunohistochemical method.The relationships between TS expression level,clinical features and the prognosis of patients treated with fluorouracil chemotherapy were analyzed.Results In 42 patients with gastric cancer,19 patients (45.2％) have TS high expressions,23 patients (54.8％) have TS low expressions.There were no significant correlations between the expression of TS and age,sex,clinical stage,differentiation degree,tumor location,depth of invasion,lymph node metastasis,vascular tumor thrombus and nerve bundle invasion (all P ＞0.05).There were significant differences between low TS expression and high TS expression in median progression-free survival and 3-year survival rate of patients [35 months vs.17 months,73.9％ (17/23) vs.42.1％ (8/19)],and the differences were statistically significant (x2 =4.788,P =0.029;x2 =4.369,P =0.037).In patients with stage Ⅲ gastric cancer,the median progression-free survival of patients with low TS expression was significantly prolonged compared to that with high TS expression (33 months vs.9 months),and the difference was statistically significant (x2 =4.731,P =0.030).Conclusion TS expression levels have no significant correlations with the clinicopathologcal factors,but closely relate to the prognosis of gastric cancer patients treatment with fluorouracil chemotherapy.The chemotherapy prognosis of TS high expression is worse than that of TS low expression in gastric cancer.

Objective:To investigate effects of neoadjuvant chemotherapy in patients with gastric cancer,and to analyze its influence on disease related indexes.Methods:A total of 42patients with gastric cancer who were treated with neoadjuvant chemotherapy in our hospital from July 2011to March 2013 were selected as observation group,and 42cases who were treated with routine operation were enrolled as control group,then the total effective rates and serum disease related indexes before and after the treatment of two groups were compared.Results:For stageⅢand stageⅣpatients in the two groups,the total effective rates of observation group were significant higher than those of control group;while for stageⅢ and stageⅣ patients,serum disease related indexes at forth and twelfth week after the operation were all significantly lower than those of control group,and those indexes were all lower than those before undergoing the treatment(Pall0.05).After treatment,evaluated indexes of two groups were all significant different from each other.Conclusion:The application effect of neoadjuvant chemotherapy in patients with gastric cancer is better,and it has greater influence on the disease related indexes.

原发性肝癌(简称肝癌)根治性切除术后的复发甚为常见，且多为肝内复发，肝内复发又分为单发、多发或肝内弥漫性播散，肝癌复发后的再治疗方法的选择是目前肝癌外科治疗研究的重点和难点。现将复发后的再治疗方法综述如下。

腺样囊性癌是生长缓慢但恶性度高的上皮性肿瘤,好发于腮腺、颌下腺、舌下腺、腭腺等小涎腺及皮肤等组织,其具有局部侵袭性强、远处转移率高、长期预后较差等典型生物学特征.目前,治疗腺样囊性癌主要是采用以手术为主,辅以术后化学治疗、放射治疗和基因分子治疗等综合治疗手段,能显著提高患者疗效及改善患者预后.我们近期诊断皮肤腺样囊性癌1例,现报道如下.