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 探讨术前外周血中性粒细胞淋巴细胞比(NLR)、血小板淋巴细胞比(PLR)对cT1-2N0 M0乳腺癌腋窝淋巴结转移的预测价值.方法 回顾性分析2018年12月至2020年9月安徽医科大学附属六安医院乳腺外科行手术治疗的162例cT1-2 N0 M0乳腺癌患者术前外周血NLR、PLR和临床病理资料,根据腋窝淋巴结术后病理判断是否有转移,分为转移组与无转移组.分析两组患者NLR、PLR、年龄、绝经状态、肿瘤位置、病理类型、T分期、组织学分级、雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体-2(HER-2)、细胞核增殖抗原Ki-67的差异.采用多因素分析腋窝淋巴结转移的影响因素.利用受试者工作特征(ROC)曲线评价术前外周血NLR和PLR对判断腋窝淋巴结有无转移的预测能力并寻找最佳截断值.结果 61例(37.7％)患者术后病理提示腋窝淋巴结转移.转移组术前NLR和PLR平均值为(2.73±1.19)和(166.11 ±60.12),高于无转移组的(1.95±0.82)和(128.05 ±42.57),差异均有统计学意义(P＜0.001).转移组T分期、ER阳性率、HER-2阳性率、Ki-67高表达率、脉管癌栓阳性率及神经侵犯阳性率均高于无转移组,差异有统计学差异(P＜0.05).logistic回归分析显示,NLR(P=0.002,OR=2.212,95％ CI:1.329～3.681)、PLR(P=0.004,OR=1.015,95％ CI:1.005 ～1.025)、脉管有癌栓(P＜0.001,OR =24.087,95％ CI:6.856～84.619)、ER阳性(P=0.006,OR=5.200,95％ CI:1.623～16.663)及HER-2阳性(P=0.007,OR=4.504,95％ CI:1.503～13.493)为cT1-2N0M0乳腺癌腋窝淋巴结转移的危险因素.ROC曲线分析显示,NLR的曲线下面积(AUC)为0.723,最佳截断值为2.285,PLR的AUC为0.712,最佳截断值为136.25.结论 术前外周血NLR、PLR是cT1-2N0 M0乳腺癌腋窝淋巴结转移的危险因素,可作为cT1-2N0M0乳腺癌腋窝淋巴结转移的预测指标.

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.

目的:探讨奥沙利铂致过敏反应的发生机制、临床表现及其预防和处理对策.方法:对6例奥沙利铂过敏患者的临床资料进行回顾性分析,并结合相关文献进行讨论.结果:1例患者自第2周期出现发热,体温最高38℃,无其他不适,1例患者在第10周期出现发热症状,并于第15周期出现Ⅱ度过敏反应,2例患者主要表现为全身瘙痒、皮疹,1例患者主要表现为腹痛,1例患者出现过敏性休克症状.结论:奥沙利铂过敏临床并不罕见,患者出现过敏反应的临床表现及严重程度个体差异性较大,部分患者出现严重过敏反应,临床上需引起足够重视.

Objective:To report 5 patients with malignant tumor appeared curly hair after chemotherapy treatment and analyze the cause.Methods:From December 2007 to June 2011 in 3440 patients,5 patients with malignant tumor after chemotherapy appear curly hair,their medical history,genetic history,disease types,chemotherapy regimens,curly hair appear time were summarized.Results: Of 5 cases appear curly hair patients there was no family history,acute promyelocytic leukemia in 2 cases,2 cases of breast cancer,cervical cancer in 1,time for the shortest time appear curly hair was nine months,the longest 20 months and the median time of occurrence 14.2 months.Conclusion:Many kinds of chemotherapy medications can cause curl,specific reasons are still not clear,but chemotherapy medications may cause genetic mutations.

Objective:To evaluate the efficacy and side effects of chemotherapy with GDP regimen in patients with relapsed or refractory Non-Hodgkin's lymphoma. Methods: Twenty-three patients with relapsed or refractory non-Hodgkin's lymphoma were enrolled from January 2008 to March 2010. They received gemcitabine 1000mg/m2 ,d1,d8 and cisplatin 25mg/m2,d1-d3, in combination with dexamethasone 20-40mg d1-d3 every 21 days. Efficacy assessment was conducted after two cycles therapy. Results: Among 23 patients,5 cases achieved complete response (21.7%) and 9 cases achieved partial response (39.1%).The median time to progression (TTP) was 5 months (95%CI:3-8 months).The major adverse events were mild to moderate gastrointestinal reaction and myelosuppression which included 2 cases of grade 3-4 leukopenia and 1case of grade 4 thrombopenia with hemorrhage and 1 case of grade 3-4 hemophthisis. Conclusion: GDP regimen is effective and well-tolerated for relapsed or refractory non-Hodgkin's lymphoma.