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DMBT1的分子生物学特性及其在肿瘤中的研究进展
DMBT1(deleted in malignant brain tumors,DMBT1)基因为近年来新发现的一种候选的抑癌基因[1],它的表达下调、缺失、突变失活被认为和多种肿瘤,特别是上皮细胞肿瘤的发生、发展、以及浸润、转移有密切的关系.现就DMBT1基因的分子生物学特性及其与肿瘤的关系进行综述.
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准确预测人脑肿瘤变异的首例无创技术
宾夕法尼亚大学医学院神经外科副教授Donald O'Rourke博士表示,"肿瘤领域的研究目前已进展到了确定导致肿瘤发生的变异改变了我们对多种癌症患者的治疗.我们相信采用MRI确定肿瘤变异的潜在可行性.以往确定肿瘤突变的惟一方法是:取出组织,通过两种实验方法之一检测变异是否存在.在本研究中,我们是用无创性方法进行确定.就我所知,这是采用MRI(或者其他影像技术)来准确预测人类肿瘤变异类型的首例报道."
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赖氨酰氧化酶与DMBT1基因在上消化道癌组织中表达的意义
上消化道恶性肿瘤(食管癌、贲门癌和胃癌)一直位居我国恶性肿瘤死亡率前4位,而肿瘤转移又是大多数患者的致死因素。本研究旨在观察与结缔组织成熟有关的赖氨酰氧化酶(lysyl oxidase, LO)[1]和候选抑癌基因DMBT1(deleted in malignant brain tumors)基因[2]在食管癌、贲门癌和胃癌组织中的表达,探讨LO、DMBT1基因表达与上消化道恶性肿瘤发生发展的关系,以及与肿瘤临床病理特点之间的关系。
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老年脑肿瘤手术患者的临床分析
随着老年人口的大幅度上升,老年脑肿瘤患者亦越来越多.近年来许多研究报道显示,原发性颅内肿瘤发病率在65以上老年人群中明显增加.由于患者高龄,全身脏器包括脑的生理机能都有不同程度的改变和衰退,其临床表现及诊断、治疗均具有一定的特点[1].
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Gliomas are malignant primary brain tumors and yet incurable. Palliation and the maintenance or improvement of the patient's quality of life is therefore of main importance. For that reason, health-related quality of life (HRQoL) has become an important outcome measure in clinical trials, next to traditional outcome measures such as overal and progression-free survivals, and radiological response to treatment. HRQoL is a multidimensional concept covering physical, psychological, and social domains, as well as symptoms induced by the disease and its treatment. HRQoL is assessed by using self-reported, validated questionnaires. Various generic HRQoL questionnaires, which can be supplemented with a brain tumor-specific module, are available. Both the tumor and its treatment can have a negative effect on HRQoL. However, treatment with surgery, radiotherapy, chemotherapy, and supportive treatment may also improve patients’ HRQoL, in addition to extending survival. It is expected that the impact of HRQoL measurements in both clinical trials and clinical practice wil increase. Hence, it is important that HRQoL data are col ected, analyzed, and interpreted correctly. Methodological issues such as selection bias and missing data may hamper the interpretation of HRQoL data and should therefore be accounted. In clinical trials, HRQoL can be used to assess the benefits of a new treatment strategy, which should be weighed careful y against the adverse effects of that treatment. In daily clinical practice, HRQoL assessments of an individual patient can be used to inform physicians about the impact of a specific treatment strategy, and it may facilitate the communication between the physicians and the patients.
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ADC 值测量在颅脑 DWI 高信号肿瘤诊断中的应用
磁共振扩散加权成像(diffusion weighted imaging,DWI)是目前唯一能够检测活体组织内水分子扩散运动的无创性方法,常用表观扩散系数(apparent diffusion coefficient,ADC)值来评价组织的扩散性,该技术在中枢神经系统应用较为广泛[1],对脑肿瘤有重要的诊断价值[2]。本研究通过分析颅脑 DWI 高信号脑肿瘤特点,并测量其 ADC 值,探讨 ADC 值测量在颅脑DWI 高信号肿瘤中的诊断价值。
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动脉自旋标记技术在颅内肿瘤中的临床应用进展
灌注是指血流通过毛细血管网,将携带的氧和营养物质输送给组织细胞的一种基本生物功能。磁共振灌注成像凭借其对微血管灌注的敏感性,已经广泛应用于临床各方面,包括对肿瘤的鉴别,脑梗死区域的界定,以及其他疾病的诊断。磁共振灌注成像可分为2大类,即对比剂首过磁共振灌注成像法和动脉自旋标记(arterial spin labeling,ASL)法。前者需要静脉注射顺磁性对比剂,如 Gd-DTPA 或 SPIO,然后进行快速 MR 扫描,在其分类中,动态磁敏感对比成像(dynamic susceptibility contrast,DSC)不仅拥有较高的空间分辨率,还能同时测量大脑血流量(cerebral blood flow, CBF)和脑血容积(cerebral blood volume,CBV),因而在临床上广泛应用。然而,ASL 却无须注射外源对比剂就能够测量脑血流量,是近年发展起来的一种 MRI灌注新技术。由于 ASL 技术具有安全无创、成本低廉、简单方便、可重复性好等优点,并且可对肿瘤的血管生成进行准确评估,已逐渐成为颅内肿瘤病变诊断、治疗及预后评估研究的新热点。本文就 ASL 技术的工作原理、分类及其在颅内肿瘤的应用做一综述。