目的 观察乳腺癌术后辅助化疗联用槐耳颗粒对内分泌激素及生存期的影响。方法 选取我院肿瘤科于2016年7月—2019年7月进行乳腺癌治疗术的80例乳腺癌患者,将患者按照随机数表法分为观察组与对照组,两组各40例。两组患者均给予预防性止吐等常规治疗,对照组予以表柔比星联合紫杉醇静脉注射,观察组在对照组的基础上给予槐耳颗粒,两组患者均治疗6个月,对比两组患者治疗3个月后血清黄体生成素(LH)、卵泡雌激素(FSH)、雌二醇(E₂),对比两组患者生存时间、无疾病进展生存期及1年生存率。结果 观察组与对照组LH、FSH、E₂水平对比均P＜0.05。在治疗后通过电话、视频等对所有患者进行随访,随访期间两组患者均无失访,生存时间、无疾病进展生存期、1年生存率对比均有P＜0.05。结论 在乳腺癌术后辅助化疗期联用槐耳颗粒可有效改善内分泌激素指标,并使生存时间获益。

Objective To observe the effect of adjuvant chemotherapy combined with Huaier granule on endocrine hormone and survival time after breast cancer operation. Methods A total of 80 cases of breast cancer patients underwent breast cancer treatment in the oncology department of our hospital from July 2016 to July 2019 were selected and divided into two groups according to the random number table method. The control group and the observation group had 40 cases each.Two groups of patients were given preventive anti-nausea and other conventional treatment, the control group was treated with epirubicin and paclitaxel intravenous injection, the observation group was treated with Huaier granuleon the basis of treatment of the control group, two groups of patients were treated for 6 months.The serum luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E₂) were compared between the two groups after 3 months of treatment. The survival time, progression free survival and 1-year survival rate of the two groups were compared. Results The levels of LH, FSH and E₂ in the comparison between two groups were all P<0.05.After treatment, all patients were followed up by telephone or video. During the follow-up period, there was no loss of follow-up in the two groups. The survival time, progression free survival and 1-year survival rate of the two groups were all P<0.05. Conclusion Huaier granule can effectively improve endocrine hormone indexes and survival time in adjuvant chemotherapy period after breast cancer surgery.

目的 回顾性分析因化疗需要行完全植入式输液港的乳腺癌患者相关血栓形成的因素。方法 收集广州市第一人民医院乳腺外科2018年5月—2019年4月期间行植入式输液港置入术的60例乳腺癌患者相关资料,采用SPSS 26.0软件进行统计学分析。结果 输液港相关血栓形成(catheter related thrombosis,CRT)发生率为21/60(35%)。BMI≤24的患者CRT发生率为30.3%,BMI＞24则为40.74%;行4、6、8次化疗的CRT发生率分别为20%、33.34%、44.12%,导管末端位于T5-T8的CRT发生分别为:66.67%, 26.09%, 28.57%, 50%;Ki-67高表达的血栓发生率为27.5%,低Ki-67表达则为50%;导管材质为聚氨酯的血栓发生率为47.62%,硅胶材质则为28.21%,但差异均无统计学意义(P＞0.05)。雌激素受体/孕激素受体(estragen receptor/progesterone receptor,ER/PR)阴性的CRT发生率为60%,ER/PR阳性则为23.8%(P＜0.05);人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)阳性CRT发生率为50%,HER-2阴性CRT发生率则为23.53%(P＜0.05)。多因素分析:相对于ER/PR阳性,ER/PR阴性将增加CRT的发生(OR=4.482, 95%CI:1.116～17.998, P＜0.05);Ki-67的表达对血栓形成的影响具有统计学意义(OR=7.051, 95%CI:1.513～32.858, P＜0.05);HER-2表达对CRT的形成均无统计学意义(OR=0.254,95%CI:0.058～1.115, P＞0.05)。结论 血栓形成是植入式输液港术后常见的并发症,与肿瘤ER/PR表达相关,临床上应得到重视。

Objective To analyse the factors that lead to venous thrombosis among breast cancer patients who need totally implantable access port(TIAP) for chemotherapy. Methods Collecting the clinical data of 60 breast patients admitted to Guanzhou First People's Hospital from May 2018 to April 2019, analysed with SPSS 26.0. Results Catheter-related thrombosis(CRT) occurred in 21 out of 60(35%) patients with TIAP. 30.3% patients with BMI≤24 and 40.74% patients with BMI＞24 had CRT, and incidences of CRT were 20%, 33.34%, 44.12% at the fourth, sixth, eighth therapy respectively. The access terminal position at T5-T8 had 66.67%, 26.09%, 28.57%, 50% of incidence for CRT respectively. 27.5% CRT was with high Ki-67 expression and 50% CRT was with low Ki-67 expression; 47.62% patients with polyurethane catheter and 28.21% patients with silicone catheter got CRT. There were no significant differences in the comparisons above. CRT incidence in ER/PR negative patients was 60%,while 23.08% in ER/PR positive patients (P＜0.05). In HER-2 positive and negative patients, the incidences of CRT were 50% and 23.53% (P＜0.05). Logistic regression noticed that ER/PR negative would increase the incidence of CRT(OR=4.482, 95%CI:1.116～17.998, P＜0.05), low Ki-67 expression would accelerate CRT(OR=7.051, 95%CI:1.513～32.858, P＜0.05). There was no significant difference in the formation of CRT with HER-2 expression(OR=0.254, 95%CI:0.058～1.115, P＞0.05). Conclusion CRT was a common complication of TIAP, which related with ER/PR expression, and should pay attention to during clinical practices.

目的 评估中性粒细胞与淋巴细胞比值(NLR)在晚期结直肠癌(CRC)患者化疗疗效及预后的意义。方法 回顾性收集2016年1月—2019年4月期间接受以奥沙利铂为基础的标准一线化疗的晚期不可切除结直肠癌患者50例临床病历资料,并在2个化疗周期后评估化疗疗效;根据入组患者化疗前血液学数据计算中性粒细胞与淋巴细胞比值(NLR),运用受试者工作特征曲线确定的NLR最佳截断值,将患者分为高NLR(≥3.785) 组和低NLR(＜3.785) 组,比较高、低NLR与临床病理特征、化疗疗效及无进展生存期(PFS)、总生存期(OS)差异;采用COX回归分析模型分析影响晚期结直肠癌患者PFS、OS的因素。结果 高、低NLR两组肿瘤分化程度(P=0.030)、ECOG评分(P=0.003)、CEA(P=0.011)、CA19-9(P=0.047)比较,差异有统计学意义;高低NLR两组间化疗疗效比较,差异有统计学意义(P＜0.001),高NLR组化疗疗效较差;两组中位PFS分别为3.44个月和12.84个月,差异有统计学意义(χ²=39.730,P＜0.001),两组中位OS分别为7.59个月和22.32个月,差异有统计学意义(χ²=40.505,P＜0.001);Cox回归分析提示NLR高低、CEA水平是PFS、OS的独立预后因素(P＜0.05)。结论 高水平NLR与晚期结直肠癌患者化疗疗效不佳和预后不良相关,可作为其化疗疗效及预后监测的指标。

Objective To evaluate the value of neutrophil-lymphocyte ratio (NLR) in the chemotherapy curative effect and prognosis of patients with advanced colorectal cancer (CRC). Methods Retrospective collection of clinical data from 50 patients with advanced unresectable colorectal cancer who received oxaliplatin-based standard first-line chemotherapy between January 2016 and April 2019. Chemotherapy curative effect was evaluated following 2 chemotherapy cycles. Calculation of neutrophil to lymphocyte ratio (NLR) based on pre-chemotherapy hematology data. The receiver operating characteristic curve was used to determine the optimal cutoff value of NLR,according to patients who were divided into groups of high NLR(NLR≥3.785)and low NLR(NLR≥3.785).The differences between high and low NLR and clinicopathological features, efficacy of chemotherapy, progression-free survival (PFS), and total survival (OS) were compared. COX regression analysis mode was used to analysis of factors affecting PFS and OS in patients with advanced colorectal cancer. Results The differences in tumor differentiation (P=0.030), ECOG score (P=0.003), CEA (P=0.011), CA19-9 (P=0.047) in the high and low NLR groups were statistically significant. The differences in chemotherapy between the two groups was statistically significant (P<0.001), and the high NLR group was less effective. The median PFS of the high and low NLR groups were 3.44 months and 12.84 months, respectively, and the difference was statistically significant (χ²=39.730, P<0.001). The median OS of the high and low NLR groups was 7.59 months and 22.32 months, respectively, and the difference was statistically significant (χ²=40.505, P<0.001). Cox regression analysis suggested that NLR levels and CEA levels were independent prognostic factors for PFS and OS(P＜0.05). Conclusion High-level NLR is associated with poor chemotherapy response and poor prognosis in patients with advanced colorectal cancer, and was used as an indicator of chemotherapy efficacy and prognosis.

目的 评价贝伐单抗联合肝动脉化疗栓塞治疗原发性肝癌的疗效及不良反应。方法 2名评价员通过独立地检索中英文数据库,纳入随机对照研究,其中治疗组为肝动脉灌注贝伐单抗联合肝动脉化疗栓塞组、对照组为单独肝动脉化疗栓塞组,并通过Jadad量表对纳入文献质量进行评分,最后采用Review Manager 5.2软件进行Meta分析。结果 纳入6篇文献,466例病例。结果显示:在疗效方面,治疗组的3、6个月疾病有效率及疾病控制率,12个月的生存率均高于对照组且差异有统计学意义(P<0.05);在安全性方面,两组间关于发热、转氨酶升高、恶心、黑便的发生率之间的比较无统计学意义(P＞0.05)。结论 肝动脉灌注贝伐单抗联合肝动脉化疗栓塞治疗原发性肝癌与单独肝动脉化疗栓塞比较,能有效提高肝癌患者近期及远期疗效,且并不增加不良反应发生率。

Objective To evaluate the efficacy and side effects of bevacizumab combined with thanscatheter artierial chemoembolzation in the treatment of primary liver cancer. Methods Two reviewers collected data about clinical trials that the combination of bevacizumab and thanscatheter artierial chemoembolzation for treatment of primary liver cancer from data bases. Jadad Score and Review Manager 5.2 software were respectively used to assess the quality of included studies and analyze the obtained data. Results Six randomized controlled trials involving 466 patients were included in this paper. The results of the meta-analysis showed that compared with thanscatheter artierial chemoembolzation group alone, bevacizumab combined with thanscatheter artierial chemoembolzation improved the response rate and disease control rate, prolonged 12 month survival rate (P<0.05). As for side effects, there were no statistically different of those about fever, level of transaminase, nausea and melena between two groups(P>0.05). Conclusion Compared with simple thanscatheter artierial chemoembolzation group, and Bevacizumab combined with thanscatheter artierial chemoembolzation group, the later may improve short-term and long-term effects, and side effects were under control.

目的 探讨C反应蛋白(CRP)、降钙素原(PCT)、中性粒细胞计数(NC)及中性粒细胞/淋巴细胞比值(NLR)在肺癌患者化疗后合并细菌感染早期诊断中的意义。方法 收集本院肿瘤科2019年1月—2019年12月肺癌化疗后合并细菌感染患者78例,肺癌化疗后未感染患者64 例,同期健康体检人群39例,采用固相免疫色谱法和速率散射比浊法测定血清中的PCT及CRP 的含量,采用mindray cal8000血细胞分析仪进行血细胞分类计数检查,计算N及NLR。结果 化疗后感染组CRP、PCT、NC及NLR均高于化疗未感染组及健康对照组,差异均有统计学意义(P＜0.01);化疗未感染组与健康对照组CRP、PCT、NC及NLR差异有统计学意义(P＜0.01)。CRP、PCT、NC及NLR联合使用时,其灵敏度为97.507%,而特异度升高为97.15%。细菌感染患者治疗前的PCT、CRP、NC及NLR 与治疗后相比较差异有统计学意义(P<0.05),治疗后低于治疗前。结论 PCT、CRP、NC及NLR联合检测能够提高对肺癌患者化疗后合并细菌感染早期诊断的敏感度和特异度。

Objective To explore the significance of C-reactive protein (CRP), procalcitonin (PCT), neutrophil count (NC) and neutrophil / lymphocyte ratio (NLR) in the early diagnosis of bacterial infection in lung cancer patients after chemotherapy. Methods From January 2019 to December 2019, 78 cases of lung cancer patients with bacterial infection after chemotherapy, 64 cases of uninfected patients after chemotherapy and 39 cases of healthy people in the same period were collected. the contents of PCT and CRP in serum were detected by solid phase immunosorbent assay and rate nephelometry.The NC and NLR were classified and counted by mindray cal8000 hematology analyzer. Results After chemotherapy, CRP, PCT, NC and NLR in the infected group were higher than those in the uninfected group and the healthy control group (P<0.01), while CRP, PCT, NC and NLR in the uninfected group were higher than those in the healthy control group (P<0.01). When CRP, PCT, NC and NLR were used together, the sensitivity was 97.507%, while the specificity increased by 97.15%. The PCT, CRP, NC and NLR of patients with bacterial infection before treatment were lower than those after treatment (P<0.05). Conclusion PCT, CRP, NC and NLR may improve the sensitivity and specificity of early diagnosis of bacterial infection in patients with lung cancer after chemotherapy.

目的 随着治疗水平和疗效的不断提高,急性白血病患者的生存质量越来越受到广泛的关注,本研究旨在探讨急性白血病(AML)患者化疗后生活质量及其相关因素。方法 采用癌症患者生存质量测定量表(European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30)中文版、患者一般状况调查问卷,对268例按照AML患者治疗后1年生活质量进行调查,并将EORTC-QLQ-C30各领域评分与患者的特征进行相关性分析。结果 AML患者年龄、FAB分型、是否恢复工作、ECOG评分、婚姻状态、生存质量评分比较上,差异有统计学意义(P>0.05);不同年龄组AML患者PF、RF、EF、SF、QL、FI评分比较上,差异有统计学意义(P<0.05);不同分型AML患者患者RF、EF、SF、QL、DY、SL、FI评分比较上,差异有统计学意义(P<0.05),恢复工作的AML患者PF、RF、SF、QL评分高于未恢复工作的AML患者,恢复工作的AML患者FA、DY、FI评分则低于未恢复工作的AML患者(P<0.05),结婚AML患者PF、RF、SF、QL评分高于未结婚患者,结婚AML患者FA评分低于未结婚患者(P<0.05);逐步多元回归分析发现,年龄、分型、ECOG评分、婚姻状况与AML生存质量有关。结论 高龄、非M3型、ECOG评分高、未婚是AML生存质量差危险因素,可能作为改善AML患者生活质量预期指标。

Objective With the continuous improvement of treatment level and efficacy, the quality of life of patients with acute myeloid leukemia (AML) has attracted more and more extensive attention. This study aimed to explore the quality of life and related factors of patients with acute leukemia (AML) after chemotherapy. Methods The Chinese version of the quality of life scale for cancer patients(European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30, and the general situation questionnaire were was used to investigate quality of life for 268 AML patients one year after treatment.And then the correlation between the EORTC-QLQ-C30 scores in various fields and the characteristics of patients were analyzed. Results There were statistical differences in the scores of age, AML types, work(yes or no),ECOG scores, and marital status in patients (P<0.05).The differences of PF, RF, EF, SF, QL, FI score of AL in different age groups were statistically significant (P<0.05), The PF, RF, EF, SF, QL and FI scores of AML patients in different age groups were statistical different (P<0.05).The scores of PF, RF, SF and QL in AML patients who returned to work were higher than those in AML patients who did not returned to work,while FA, DY and FI scores were the opposite(P<0.05).The PF, RF, SF and QL scores of married AML patients were higher than those of unmarried AML patients,while FA scores were the opposite(P<0.05).Age, classification, ECOG score, marital status were found to be associated with quality of life of AML patients by stepwise multiple regression analysis (P<0.05). Conclusion Old age, non-M3 type, high ECOG score, and unmarried are risk factors for poor quality of life for AML, which may serve as expected indicators for improving the quality of life of patients with acute leukemia.

目的 分析人脑胶质瘤组织中O6—甲基鸟嘌呤—DNA甲基转移酶(MGMT)、DNA拓扑异构酶Ⅱ(TopoⅡ)基因的表达情况及其对化疗敏感性的影响。方法 收集医院2012年4月—2018年6月期间进行开颅手术切除的新鲜人脑胶质瘤标本80例和同期经颅脑手术治疗的脑外伤或脑出血内减压切除的正常脑组织30例。采用免疫组化法检测两种标本中MGMT和TopoⅡ基因表达情况,并通过脑胶质瘤U251和U87细胞培养、体外药物(替莫唑胺)干预、Transwell体外侵袭实验分析其对化疗敏感性的影响。结果 胶质瘤标本、正常脑组织MGMT和TopoⅡ基因表达程度分布比较差异均有统计学意义(P＜0.05),且二者MGMT基因阳性表达率分别为63.75%、3.33%,TopoⅡ基因阳性表达率分别为55.00%、0.00%,差异有统计学意义(P＜0.05)。MGMT、TopoⅡ基因均在细胞核显示为阳性染色。体外药物干预的实验组、未进行药物干预的阴性对照组干预前U251、U87细胞穿膜细胞计数比较无统计学意义(P＞0.05),但干预后实验组U251、U87细胞穿膜细胞计数高于阴性对照组(P＜0.05),干预后实验组U251、U87细胞有更强的侵袭力。结论 MGMT和TopoⅡ基因在人脑胶质瘤标本中阳性表达率高,且可能参与促进脑胶质瘤细胞侵袭,影响肿瘤化疗敏感性。

Objective To analyze the expression of O6-methylguanine-DNA methyltransferase (MGMT) and DNA topoisomerase II (Topo II) genes in human brain gliomas and its influence on the chemosensitivity. Methods A total of 80 fresh human brain glioma specimens resected by craniotomy and 30 normal brain tissues resected by craniocerebral operation for traumatic brain injury or decompression for cerebral hemorrhage during the period from April 2012 to June 2017 were collected. The expression of MGMT and Topo II genes in the two kinds of specimens was detected by immunohistochemical method, and the influence on chemosensitivity was analyzed through brain glioma U251 and U87 cell culture, in vitro drug (temozolomide) intervention and Transwell invasion in vitro. Results There was a significant difference in the expression of MGMT and Topo II genes in glioma specimens and normal brain tissues (P<0.05). The positive expression rates of MGMT gene in the two kinds of specimens were 63.75% and 3.33% respectively while the positive expression rates of Topo II gene were 55.00% and 0.00%, respectively (P<0.05). Both of MGMT and Topo II genes were displayed in the nucleus as positive staining. There was no significant difference in transmembrane cell count of U251 and U87 cells between the experimental group given drug intervention in vitro and negative control group without drug intervention before the intervention (P>0.05). However, the transmembrane cell count of U251 and U87 cells in the experimental group after intervention was higher than that in the negative control group (P<0.05). After intervetion, U251 and U87 cells were with stronger invasiveness in the experimental group. Conclusion The positive expression rates of MGMT and Topo II genes are high in human brain glioma specimens. They may be involved in promoting glioma cell invasion, affecting tumor chemosensitivity.

目的 观察重组人血管内皮抑素注射液（恩度） 联合化疗治非小细胞肺癌（NSCLC）的近期疗效和安全性。方法 对2015年3月—2017年10月经病理组织学或细胞学检查确诊的Ⅲ-Ⅳ期NSCLC74例患者,采用随机数字法把受试者随机分为联合治疗组（n=35）和对照组（n=39）,联合治疗组接受恩度联合化疗的方案治疗;对照组单纯行常规化疗治疗。近期疗效评价采用RECIST标准,生活质量（QOL）采用Karnofsky评分（KPS）,抗癌药物急性与亚急性毒性反应分度标准分0~Ⅳ度。比较两组患者的近期疗效指标（疾病完全缓解（CR）、疾病稳定（ SD）、疾病进展（ PD）、客观有效率（RR）、疾病控制率（DCR ）;QOL评分及毒副反应情况。结果 联合治疗组近期疗效指标RR及DCR高于对照组（P < 0.05）;联合治疗组KPS评分高于对照组（P < 0.05）;两组间的毒副作用包括恶心/呕吐、腹泻、疲乏、脱发、血小板下降及白细胞下降等,两组间毒副反应出现数量比较,差异无统计学意义（P > 0.05）。结论 恩度与化疗药物联合使用可以提高NSCLC疗效和改善患者生活质量,未增加患者不良反应发生率。

Objective To observe the curative effect and the side effects of recombinant human vascular endostatin （Endostar） combined with the chemotherapy on nonsmall cell lung cancer（NSCLC）. Methods Seventy-four NSCLC patients confirmed by histopathology or cytopathology were randomly distributed to combined therapy group （n=35, with Endostar combined with chemotherapy） and control group （n=39, with conventional chemotherapy）. The recent efficacy of drug was evaluated according to the RECIST criteria. The quality of life （QOL） was assessed by usingto the Karnofsky scores, and the safety of drug was evaluated according to WHO side effects criteria. Results The therapeutic effectiveness was better in the combined therapy group than that in the control group（P<0.01）. The KPS was better in co-therapy group than that in the control group（P<0.05）. The common adverse reactions in both groups included neutropenia, thrombocytopenia, nausea/vomiting, diarrhea, lassitude, alopecia, thrombocytopenia and leukocytopenia. However, the incidence rates of adverse reactions between the two group was not significant （P>0.05）. Conclusion Endostar combined with the related chemotherapy may improve the curative effect and QOL of NSCLC.

目的 探讨非霍奇金淋巴瘤(NHL)合并HBV感染患者化疗过程中肝功能监测的临床意义。方法 以2014年3月—2016年6月我院21例NHL合并HBV感染患者为研究对象,所有患者采用CHOP方案进行化疗,治疗2~6周期。 分别于化疗前后对患者肝功能进行检查,采用荧光定量PCR法进行乙肝病毒DNA复制情况检测;肝功能出现中重度异常患者进一步测定凝血酶原活动度(PTA)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fb)等,同时对NHL辅助性标志物进行监测,主要包括β₂微球蛋白(β₂-MG)及乳酸脱氢酶(LDH)。结果 随着化疗进行,患者ALT、GLB、胆红素水平逐渐增高(P<0.05),ALB、PA水平逐渐降低(P<0.05);相比于化疗进行2个周期,进行4～6周化疗者肝功能损害率和重症肝炎发生率均升高,差异有统计学意义(P<0.05)。结论 NHL合并HBV感染患者化疗过程中对肝功能监测,有助于防止重症肝炎发生,并降低病死率,具有重要临床意义。

目的 研究新辅助化疗联合保肢手术治疗骨肉瘤的临床效果。方法 根据既往治疗骨肉瘤方法的不同,将56例患者分为对传统保肢组（A组）和现代保肢组（B组）,各28例。A组用采用传统保肢方案,即保肢手术+术后化疗方案进行;B组采用现代保肢方案,即新辅助化疗+保肢手术+术后化疗方案进行。化疗方案均采用CTX + VCR +MTX+ ADM方案,比较两组转移/复发率、术后1 年、2年及 3 年生存率、肢体功能、临床疗效情况。结果 比较两组的转移/复发率及3年后的死亡率,B组低于A组(P<0.05);肢体功能优良率及临床疗效,B组高于A组(P<0.05)。结论 新辅助化疗联合保肢手术能够降低骨肉瘤患者转移/复发率、死亡率,改善肢体功能,提高临床疗效。

Objective To study the clinical effect of neoadjuvant chemotherapy combined with limb salvage surgery for osteosarcoma. Methods Based on the previous methods of treating osteosarcoma, 56 patients were divided into the traditional limb salvage group (A group) and the modern limb salvage group (B group), 28 cases for each. The traditional limb salvage surgery + postoperative chemotherapy regimen were used in group A, and modern limb salvage regimen was performed in group B, ie neoadjuvant chemotherapy + limb salvage surgery + postoperative chemotherapy. The CTX + VCR +MTX+ ADM protocol was used in the chemotherapy regimens. The metastasis/recurrence rate, the 1-year, 2-year and 3-year survival rates, limb function, and clinical efficacy were compared between the two groups. Results The metastasis/recurrence rate and the mortality rate after 3 years in the two groups were compared. The B group was lower than that of the group A (P<0.05). The excellent rate of limb function and clinical efficacy were higher in the B group than that of in the group A (P<0.05). Conclusion Neoadjuvant chemotherapy combined with limb salvage surgery may reduce the metastasis/recurrence rate and mortality of osteosarcoma patients, improve limb function and increase clinical efficacy.