目的 探討腹腔鏡對(duì)小腸大出血的診斷和治療。方法 對(duì)15例懷疑小腸大出血的患者進(jìn)行腹腔鏡探查。結(jié)果 探查陽(yáng)性率100%，其中小腸腫瘤7例，小腸憩室5例，小腸憩室并套疊1例，小腸血管畸形2例，均在腹腔鏡輔助下行小腸部分切除或憩室切除術(shù)。結(jié)論 腹腔鏡對(duì)小腸出血的診斷尤其是治療方面有較高的價(jià)值。
【摘要】 目的 探討葡萄糖轉(zhuǎn)運(yùn)蛋白Ⅰ型（glucose transporter 1，GLUT1）和腫瘤增殖細(xì)胞核抗原Ki-67在卵巢上皮性腫瘤組織中的表達(dá)及其臨床意義?！》椒ā∈占?000年1月-2008年6月不同卵巢上皮性腫瘤病變患者119例的組織標(biāo)本，采用免疫組織化學(xué)SP二步法檢測(cè)腫瘤組織中GLUT1和Ki-67的表達(dá)情況?！〗Y(jié)果 卵巢交界性、惡性上皮性腫瘤灶性或廣泛高表達(dá)GLUT1和Ki-67，其表達(dá)強(qiáng)度有差異。卵巢良性上皮性腫瘤不表達(dá)GLUT1和Ki-67。在卵巢癌中GLUT1及Ki-67的表達(dá)強(qiáng)度與病理分級(jí)、臨床分期、預(yù)后有關(guān)。GLUT1表達(dá)強(qiáng)度與病理分型無(wú)關(guān)，Ki-67表達(dá)強(qiáng)度與病理分型有關(guān)?！〗Y(jié)論 卵巢上皮性腫瘤組織中GLUT1和Ki-67的表達(dá)具有相關(guān)性，其表達(dá)強(qiáng)度與腫瘤的良惡性質(zhì)和增殖狀態(tài)有關(guān)，二者同時(shí)檢測(cè)可以全面了解卵巢上皮性腫瘤的性質(zhì)、卵巢癌惡性程度和生物學(xué)行為，對(duì)于判斷腫瘤的性質(zhì)和預(yù)后有一定價(jià)值。【Abstract】 Objective To investigate the expression and clinical significance of glucose transporter-1 (GLUT1) and tumor proliferating karyon antigen Ki-67 in epithelial ovarian tumor tissue. Methods Immunohistochemistry SP method was used to detect the expression of GLUT1 and Ki-67 protein in epithelial ovarian tumor tissues from 119 patients diagnosed in our hospital from January 2000 to June 2008. Results The expressions of GLUT1 and Ki-67 had local or abroad higher expressions in the borderline and malignant epithelial ovarian tumor, and the expressive intensity was different. In benign tumors, the expression was negative. The expressive intensity of GLUT1 and Ki-67 had correlation with the grade, stage, and prognosis in malignant tumors. The expressive intensity of GLUT1 had no correlation with the type of malignant tumors, while Ki-67 related to the pathological types. Conclusion The expressions of GLUT1 and Ki-67 have relativity. The expressive intensity of GLUT1 and Ki-67 relates to the character and proliferation of epithelial ovarian tumors. The combined detection GLUT1 and Ki-67 is helpful to know the character of epithelial ovarian tumors, the malignant degree and biologic behavior of ovarian carcinoma, which is useful in estimating the character and prognosis of epithelial ovarian tumors.
目的 評(píng)價(jià)腹腔鏡和同期開腹直腸癌根治術(shù)在腫瘤學(xué)結(jié)果方面的差異。方法 分析南方醫(yī)院2003年1月至2008年12月期間520例行直腸癌根治術(shù)的TNM Ⅰ～Ⅲ期病例的臨床隨訪資料，其中腹腔鏡組186例，開腹組334例，對(duì)2組術(shù)后復(fù)發(fā)、生存等腫瘤學(xué)結(jié)果進(jìn)行比較。結(jié)果 腹腔鏡組和開腹組基本臨床病理特征及輔助治療情況具有均衡可比性。2組平均隨訪30.3個(gè)月。腹腔鏡組與開腹組比較，3年累積生存率為83%比80%，遠(yuǎn)處轉(zhuǎn)移率為12.5%比15.6%，戳孔/切口癌轉(zhuǎn)移率為0.6%比0，差異均無(wú)統(tǒng)計(jì)學(xué)意義(Pgt;0.05)； 局部復(fù)發(fā)率為4.8%比10.7%，3年累積無(wú)病生存率為81%比68%，差異均具有統(tǒng)計(jì)學(xué)意義(Plt;0.05)。生存分析顯示，累積生存率2組差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.142)，而累積無(wú)病生存率腹腔鏡組則顯著高于開腹組(P=0.010)。Ⅰ或Ⅱ期病例中2組局部復(fù)發(fā)率、遠(yuǎn)處轉(zhuǎn)移率、累積生存率及累積無(wú)病生存率的差異均無(wú)統(tǒng)計(jì)學(xué)意義(Pgt;0.05); Ⅲ期病例遠(yuǎn)處轉(zhuǎn)移率、累積生存率差異亦無(wú)統(tǒng)計(jì)學(xué)意義(Pgt;0.05)，但Ⅲ期病例腹腔鏡組局部復(fù)發(fā)率顯著低于開腹組(6.8%比17.7%，P=0.047)，累積無(wú)病生存率則顯著高于開腹組(P=0.045)。結(jié)論 腹腔鏡直腸癌根治術(shù)可以達(dá)到甚至優(yōu)于同期開腹根治術(shù)的腫瘤學(xué)結(jié)果，提示針對(duì)直腸癌的腹腔鏡外科前瞻性隨機(jī)對(duì)照研究的可行性和必要性。