>患者男,48岁,因"自觉排便后有无痛性肿块脱出肛门,便血间歇性发作10年,肛门流脓3个月"前来检查。患者于10年前发现便后有无痛性坠胀物,并伴有里急后重感,于当地医院诊断为痔疮并行手术治疗,1年后复发再次手术。3个月前直肠指检发现直肠占位,于2011年7月19日行内镜检查发现距肛门4 cm处齿状线上方巨大球形增殖性病灶,病灶表面黏膜较粗糙(图1a);并于距肛门10 cm处见另一环形狭窄伴结节状增生病灶,局部可见不规则溃疡性改变,表面覆坏死物质(图1b)。EUS提示齿状线起至距肛门10 cm范围内肠壁明显增厚及结构消失,最厚处达1.5 cm,呈不均匀中-低回声,肌层部分残留,外膜不规则(图1c);病变肠段与前列腺包膜分界清楚,精囊腺等邻近器官未累及,肠外未见明显肿大淋巴结,内外括约肌分界欠规则(图1d)。

结肠癌干细胞是一小部分存在于结肠癌中具有自我更新、无限增殖和多项分化潜能的肿瘤干细胞,它与结肠癌的复发、转移和治疗耐受有着密切的联系。通过结肠癌细胞表面表达的标志分子如CD133、CD44、CD29、ALDH1和Wnt等从结肠癌中分离得到少部分具有干细胞特性的结肠癌细胞即结肠癌干细胞,以这部分肿瘤干细胞作为肿瘤治疗靶点将为肿瘤治疗带来新的治疗方向。此文就标志分子在结肠癌干细胞筛选及生物学中的功能研究作一回顾,并探讨其作为肿瘤干细胞治疗靶点的可能性。

Objective To analyze the efficacy and safety of Infliximab in treatment of ulcerative colitis(UC).Methods Randomized controlled trials of IFX in patients with UC were searched by electronic retrieve and hand retrieve.Seven studies and seven RCTs were enrolled into the analysis.The information of the trial design,characters of the subjects,results of the studies were analyzed by Revman 4.2 software.Results The long-term and short-term effects in IFX group were significantly different compared with the control group.The long-term and short-term effects in IFX 5 mg/kg group and IFX 10 mg/kg group were significantly different compared with the control group.There was no difference in long-term and short-term effect between IFX group and control group.There was no difference in side effect of medicine between IFX group and control group.Conclusion Infliximab could not only maintain the clinical remission in UC patients,but also decrease the colon resection rate for patients with moderate to severe refractory UC.It could also improve the life qualities.RCT of multiplicity centers is necessary to confirm the conclusion with large samples.