摘要
目的探讨如何延长食管恶性肿瘤患者术后生存期。方法回顾性分析 1961～ 1992年我院 1 098例食管恶性肿瘤患者的临床资料，并采用 PCR及 RT- PCR方法检测 1996年 30例食管癌新鲜标本的抑癌基因脆性组氨酸三联体 (FHIT)的缺失情况。结果食管恶性肿瘤手术切除率不断提高，手术并发症和手术死亡率不断降低，但术后 5年生存率无明显改变，延误诊断及非根治性切除影响了术后长期生存。 FHIT基因的 cDNA缺失在食管癌组织为 64 2％，在癌旁组织为 20％。结论食管上皮高度不典型增生和 FHIT基因在食管癌及其癌旁组织的缺失分别是早期食管癌诊断的病理学及分子生物学指标，后者也可作为食管癌切除范围的指标之一。早期诊断和治疗、根治性切除及术后营养支持对延长术后生存期十分重要。
To study how to prolong the postoperative survival time of the patients with malignant esophageal tumors.Methods The clinical data of 1 098 patients with malignant esophageal tumors from 1961 to 1992 were retrospectively analyzed.The deletion of fragile histimine triplet(FHIT)gene(a tumor suppressor gene)in 30 fresh esophageal samples obtained in 1996 was detected with PCR and RT- PCR.Results The resectability was raised gradually and the operative morbidity and mortality decreased year- by- year,but there was no significant improvement on the postoperative 5- year survival rate.Delayed diagnosis and irradical resection influenced the long term survival.The deletion of cDNA of FHIT gene was 64.2％ in esophageal cancer and 20％ in the resected margin of the cancer.Conclusions High atypical hyperplasia in esophageal epithelium and deletion of FHIT gene in esophageal cancer and its resected margin are pathological and molecular markers for early diagnosis of esophageal cancer respectively,and the latter may be one of the molecular markers for the resection.Early diagnosis and treatment,radical resection,and postoperative nutritional support are essential for the improvement of the postoperative survival time of the patients.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2000年第6期548-550,共3页
Acta Academiae Medicinae Sinicae
