RESUMO
Chronic myelocytic leukemia (CML) can occasionally occur after long-term chemotherapy for solid tumors; solid tumors secondary to chemotherapy and biotherapy for CML have also been reported. However, concurrence of these two phenomena in an untreated patient has seldom been reported. Herein, we describe the case of a female patient in her early 60 s who was transferred to the liver surgery department after the discovery of a large liver mass and elevated plasma alpha-fetoprotein levels. She was initially diagnosed with liver cancer. Blood tests indicated an increased platelet count (2464 × 109/L). Chromosomal examination from a bone marrow biopsy indicated the presence of the t(9;22) translocation, and subsequent fluorescence in situ hybridization and PCR were positive for the BCR-ABL rearrangement. A diagnosis of CML was made. The patient received hydroxyurea and imatinib to treat CML and underwent subsequent platelet-lowering therapy and a liver biopsy, which suggested moderately poorly differentiated adenocarcinoma or potentially hepatic metastatic carcinoma. However, the patient refused further pathological examination or screening for the site of the primary tumor. She died 6.5 months after discharge. The exact relationship between the two tumors remains unclear, and more patients need to be evaluated.
Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva , Neoplasias Hepáticas , Trombocitose , Feminino , Proteínas de Fusão bcr-abl/genética , Humanos , Hidroxiureia/uso terapêutico , Mesilato de Imatinib/uso terapêutico , Hibridização in Situ Fluorescente , Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Neoplasias Hepáticas/complicações , Trombocitose/complicações , alfa-FetoproteínasRESUMO
<p><b>OBJECTIVE</b>To study 3 different strategies of urine drainage following hypospadias urethroplasty, the clinical nursing in their application, and their effects.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 595 cases of hypospadias treated by urethroplasty. After surgery, 133 of the patients underwent urine drainage by suprapubic cystostomy (group A), 202 by urethral stent- tube indwelling (group B), and 260 by early initiative micturition with the urethral stent-tube (group C). All the patients received routine postoperative nursing care required for hypospadias repair.</p><p><b>RESULTS</b>Operations were successfully completed in all the cases. Group C showed a remarkably shorter hospital stay and lower incidence rates of urinary fistula and urethral stricture than groups A and B (P<0.05), but there were no significant differences in the three indexes between A and B (P<0.05).</p><p><b>CONCLUSION</b>For urine drainage following hypospadias repair, early initiative micturition with the urethral stent-tube can significantly reduce postoperative complications, decrease difficulties and workload of nursing care, and shorten the hospital stay of the patient.</p>
Assuntos
Humanos , Masculino , Cistostomia , Drenagem , Métodos , Hipospadia , Cirurgia Geral , Tempo de Internação , Complicações Pós-Operatórias , Procedimentos de Cirurgia Plástica , Estudos Retrospectivos , Stents , Uretra , Cirurgia Geral , Estreitamento Uretral , Fístula Urinária , Urina , Procedimentos Cirúrgicos Urológicos MasculinosRESUMO
<p><b>OBJECTIVE</b>To analyze the incidence and profile of mutations in epidermal growth factor receptor (EGFR) in Chinese patients with non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>A total of 176 cases of NSCLC tissue was enrolled in this study, among which 123 normal lung samples were also included. The tissue DNA was extracted and the EGFR gene in exon 19 to 21 was subjected for PCR amplification and direct sequencing.</p><p><b>RESULTS</b>The EGFR gene in exon 19-21 was of wild type in all normal lung tissues detected. Mutations were found in 57 cases of 176 lung cancer samples, with an incidence of 32. 4%. Mutations were mainly detected in the exon 19 (37/57 cases, 64. 9% ) and exon 21 (18/57 cases, 31. 6% ) , while that in the exon 20 was rare (2/57 cases, 3. 5% ). There were 7 types of EGFR mutation in the exon 19, resulting in the deletion of codon 746 to 753. A missense mutation was detected in exon 20, dealing with codon 789 to 793. The mutation in exon 21 belonged to the single missense substitution in codon 858. The EGFR mutations were more frequent in female patients than male ones, in adenocarcinoma and adenosquamous cell carcinoma versus cancer of other histologies.</p><p><b>CONCLUSION</b>EGFR mutation is a tumor-specific somatic abnormality. Some one third of Chinese NSCLC tumors harbor EGFR mutations, especially in exons 19 and 21. These mutations are more frequently detected in female, adenocarcinoma and adenosquamous cell carcinoma.</p>
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adenocarcinoma , Genética , Sequência de Aminoácidos , Sequência de Bases , Carcinoma Pulmonar de Células não Pequenas , Genética , Carcinoma de Células Escamosas , Genética , Códon , Análise Mutacional de DNA , Éxons , Deleção de Genes , Neoplasias Pulmonares , Genética , Mutação , Mutação de Sentido Incorreto , Receptores ErbB , Genética , Fatores SexuaisRESUMO
Objective To explore the significance of urine deoxypyridinoline to diagnosis on osseous metastasis of lung neoplasms.Methods.182 cases with lung carcinoma was divided into two groups.One group was case with osseous metastasis,the other group was case without osseous metastasis,uDPD/uCr, uCa/Cr,sCa and sAKP in two groups were respectively compared.Sensitivity and specificity of these indexes to diagnosis on osseous metastasis of lung cancer were also acalculated and compared.80 cases without osseous metastasis were follow-up for 6 months.Results The ratio of uDPD/uCr with osseous metastasis group[(12.35?2.65)nmol/mmol]was significantly higher than that of without osseous metastasis group [(7.76?2.11)nmol/mmol](t=2.46,P
