目的 探讨结直肠癌肿瘤组织中跨膜丝氨酸蛋白酶4(TMPRSS4)、间质表皮转化因子(c-Met)、驱动蛋白家族成员18A(KIF18A)表达水平与其病理特性和生存状态的关系.方法 选取该院于2015年3月至2017年6月确诊的102例结直肠癌患者作为研究对象,比较癌变组织和癌旁组织TMPRSS4、c-Met阳性率及KIF18A水平的差异,不同病理状态及生存状态患者的TMPRSS4、c-Met阳性率及KIF18A水平的差异,分析患者的病理状态及生存状态与TMPRSS4、c-Met阳性率和KIF18A水平的相关性.结果 癌变组织TM-PRSS4、c-Met阳性率及KIF18A水平明显高于癌旁组织(P<0.05);不同性别、年龄患者TMPRSS4、c-Met阳性率及KIF18A水平比较差异均无统计学意义(P>0.05),而不同病程、TNM分期、临床分型患者之间比较差异有统计学意义(P<0.05);通过对患者的随访,生存患者61例,死亡患者41例,生存组TMPRSS4、c-Met阳性率及KIF18A水平明显低于死亡组(P<0.05);患者的TNM分期、临床分型、病程及生存状态与TM-PRSS4、c-Met阳性率及KIF18A的水平呈正相关(r=0.165～0.998,P<0.05).结论 结直肠癌肿瘤组织中TMPRSS4、c-Met阳性率及KIF18A水平与其病理特性和生存状态存在一定的相关性,可作为结直肠癌患者诊断辅助参考之一.

Objective:To explore the clinicopathological characteristics and prognosis of colorectal cancer with liver and lung metastases according to different T stage.Methods:The information of 2 602 patients with colorectal cancer with liver and lung metastases registered in the surveillance, epidemiology and end results (SEER) database from 2010 to 2015 was collected. All the patients were divided into three groups according to T stage: T0/T1 group ( n=545), T2/T3 group ( n=1 138), and T4 group ( n=919). The clinicopathological characteristics (including age, sex, race, primary tumor site, histology, differential stage, T/N stage, distant metastatic site, carcinoembryonic antigen, surgery, and overall survival) were compared across the three groups and the impact of T stage on the overall survival was detected by Kaplan-Meier method and COX logistical analysis. Results:The proportion of N2 in T0/T1 group was significantly lower than those in T2/T3 group and T4 group [3.5% (19/545) vs. 29.3% (333/1 138), χ2=379.911, P<0.05; 3.5% (19/545) vs. 32.4% (298/919), χ2=379.911, P<0.05]. The proportion of rectum location in T4 group was significantly lower than those in T0/T1 group and T2/T3 group [18.6% (167/899) vs. 32.8% (165/503), χ2=64.569, P<0.05; 18.6% (167/899) vs. 33.9% (382/1 127), χ2=64.569, P<0.05]. Among the three groups, the proportion of grade Ⅳ in T0/T1 group was the lowest, and the proportion of grade Ⅲ and Ⅳ in T4 group was the highest. COX logistical analysis indicated that T0/T1 group [hazard ratio ( HR)=1.130, 95% confidence interval ( CI): 1.001-1.275, P<0.05] and T4 group [ HR=1.190, 95% CI: 1.085-1.305, P<0.01] showed a significantly poorer prognosis compared with T2/T3 group. Conclusion:Patients with colorectal cancer with liver and lung metastases in the different T stage presented significantly different clinicopathological characteristics and prognosis, especially for T0/T1 stage that has lower proportion of N2 and poorer prognosis.

Objective To compare with the effect of improved small incision and traditional thyroidectomy surgery treatment of thyroid adenoma. Methods 76 cases of thyroid adenoma patients treated in our hospital in July 2013- August 2014 were randomly divided into two groups, each of 38 cases. Observation group were given small incision surgery, control group were given traditional thyroidectomy surgery, hospital time, operation time, incision length, blood loss and postoperative compli-cations of two groups were compared. Results Hospitalization time, operation time, incision length blood loss intraoperative of observation group compared with control group significantly reduced (P﹤0.01);Postoperative complication rate of observa-tion group was 15.79%, compared with control group was significantly lower (P﹤0.05) . Conclusion Effect of small incision surgery in the treatment of thyroid adenoma is significant, with few complications,worthy of application.

目的:观察卡培他滨联合奥沙利铂治疗晚期结肠癌的疗效.方法:将我院2013年3月~2014年3月收治的42例晚期结肠癌患者,采用双色球分组法分为对照组和观察组.对照组单纯采用卡培他滨治疗,观察组在此基础上使用奥沙利铂治疗.对比两组治疗效果,并对所有患者随访两年,对比两组治疗后1年、2年的生存率.结果:观察组治疗有效率明显高于对照组,存在显著差异(P<0.05);治疗后随访2年,发现观察组1年、2年生存率均明显高于对照组,差异显著(P<0.05).结论:卡培他滨联合奥沙利铂治疗晚期结肠癌具有良好的效果,两年期生存率比单一使用卡培他滨治疗高,值得在临床推广.

胃癌的浸润深度与预后关系密切,其根治术后转移的形式有多种,腹膜种植性转移多见,给治疗带来一定困难.我科1993～1998年收治胃癌浆膜外浸润患者60例,均行根治性切除术,其中加腹腔置管腔内给药30例,术后随访3年、5年与同期其余30例进行临床对照观察,现报告如下.