目的:探索肿瘤患者门诊化疗流程中存在的问题及其可能的原因,为门诊化疗的流程重组奠定基础。方法:参照业务流程重组(business process reengineering,BPR)的理论和方法,采用定性与定量研究相结合的方法对现有门诊化疗流程进行分析。结...目的:探索肿瘤患者门诊化疗流程中存在的问题及其可能的原因,为门诊化疗的流程重组奠定基础。方法:参照业务流程重组(business process reengineering,BPR)的理论和方法,采用定性与定量研究相结合的方法对现有门诊化疗流程进行分析。结果:绘制了门诊化疗流程图,较深入地了解了该医院门诊化疗流程的现状、存在问题及可能的原因。结论:现有门诊化疗流程存在很大的重组空间。展开更多
目的:比较国际抗癌联盟(International Union Against Cancer,UICC)和美国癌症联合会(American Joint Committeon Cancer,AJCC)于1997年公布的第6版非小细胞肺癌TNM分期方案(以下简称第6版方案),与国际肺癌研究会(International Associa...目的:比较国际抗癌联盟(International Union Against Cancer,UICC)和美国癌症联合会(American Joint Committeon Cancer,AJCC)于1997年公布的第6版非小细胞肺癌TNM分期方案(以下简称第6版方案),与国际肺癌研究会(International Association for the Study of Lung Cancer,IASLC)2007年提出的非小细胞肺癌TNM分期的修改方案(以下简称新方案)对中国非小细胞肺癌患者预后预测的不同点。方法:根据2003年9月至2005年10月北京大学临床肿瘤学院胸外科手术治疗的136例非小细胞肺癌患者的存档资料,分别按照第6版方案和新方案进行病理分期,主要观察目标为不同分期下的两年无复发转移生存率和无复发转移生存期,用Kaplan-Meier和Log-rank法进行统计学检验。结果:(1)第6版方案中Ⅰ、Ⅱ、Ⅲ和Ⅳ期患者例数分别为56、23、53和4例;在新方案中Ⅰ、Ⅱ、Ⅲ和Ⅳ期患者例数分别为50、31、54和1例,其中第6版方案中有6例Ⅰ期在新方案中变成Ⅱ期,1例Ⅱ期变成Ⅲ期,3例Ⅲ期变成Ⅱ期,1例Ⅲ期变成Ⅳ期,4例Ⅳ期变成Ⅲ期。(2)第6版方案中Ⅰa、Ⅰb、Ⅱa、Ⅱb、Ⅲa、Ⅲb和Ⅳ期患者的两年无复发转移生存率分别为95.5%、82.4%、100.0%、63.6%、52.1%、80.0%和50.0%;新方案中Ⅰa、Ⅰb、Ⅱa、Ⅱb、Ⅲa、Ⅲb和Ⅳ期患者的两年无复发转移生存率分别为95.5%、89.3%、68.4%、63.6%、52.8%、50.0%和0.0%。(3)按照第6版方案,经Log-rank法分析后显示,Ⅰ期和Ⅱ期患者的2年无复发转移生存期差异无统计学意义(P=0.232),Ⅱ期和Ⅲ期患者的无复发转移生存期差异有统计学意义(P=0.023);按照新方案,Ⅰ期和Ⅱ期,以及Ⅱ和Ⅲ期患者之间的无复发转移生存期差异均有统计学意义(P值分别为0.023和0.014)。(4)新方案中新增的2和5cm这两个节点上下的患者的无复发转移生存期差异有统计学意义(P值分别为0.025和0.023)。结论:IASLC2007版非小细胞肺癌TNM分期方案较UICC和AJCC的第6版非小细胞肺癌TNM分期方案显示了更好的分期特异性,且新方案一样适用于中国非小细胞肺癌患者。展开更多
Non-small cell lung cancer(NSCLC)is now regarded as the most common cause of cancer-related mortality in China.Despite continuous efforts to improve the therapeutic response,the overall five-year survival rate for NSC...Non-small cell lung cancer(NSCLC)is now regarded as the most common cause of cancer-related mortality in China.Despite continuous efforts to improve the therapeutic response,the overall five-year survival rate for NSCLC is still less than 15%.Now we have known that the growth of neoplastic tumors is maintained exclusively by a small subpopulation called "cancer stem cells" which posseses ability of self-renew and differentiation.It has been widely accepted that cancer stem cells are chemoresistant and radioresistant.Therefore,a major challenge in treating this and other cancers is the intrinsic resistance to conventional therapies demonstrated by the stem/progenitor cell that is responsible for the sustained growth,survival,and invasion of the tumor.Identifying these stem cells in non-small cell lung cancer and defining the biologic processes necessary for their existence are paramount in developing new clinical approaches with the goal of preventing disease recurrence.This review summarizes our update understandings of the cellular and molecular mechanisms operating within the putative cancer-initiating cells at the core of non-small cell lung cancer.展开更多
文摘目的:探索肿瘤患者门诊化疗流程中存在的问题及其可能的原因,为门诊化疗的流程重组奠定基础。方法:参照业务流程重组(business process reengineering,BPR)的理论和方法,采用定性与定量研究相结合的方法对现有门诊化疗流程进行分析。结果:绘制了门诊化疗流程图,较深入地了解了该医院门诊化疗流程的现状、存在问题及可能的原因。结论:现有门诊化疗流程存在很大的重组空间。
文摘目的:比较国际抗癌联盟(International Union Against Cancer,UICC)和美国癌症联合会(American Joint Committeon Cancer,AJCC)于1997年公布的第6版非小细胞肺癌TNM分期方案(以下简称第6版方案),与国际肺癌研究会(International Association for the Study of Lung Cancer,IASLC)2007年提出的非小细胞肺癌TNM分期的修改方案(以下简称新方案)对中国非小细胞肺癌患者预后预测的不同点。方法:根据2003年9月至2005年10月北京大学临床肿瘤学院胸外科手术治疗的136例非小细胞肺癌患者的存档资料,分别按照第6版方案和新方案进行病理分期,主要观察目标为不同分期下的两年无复发转移生存率和无复发转移生存期,用Kaplan-Meier和Log-rank法进行统计学检验。结果:(1)第6版方案中Ⅰ、Ⅱ、Ⅲ和Ⅳ期患者例数分别为56、23、53和4例;在新方案中Ⅰ、Ⅱ、Ⅲ和Ⅳ期患者例数分别为50、31、54和1例,其中第6版方案中有6例Ⅰ期在新方案中变成Ⅱ期,1例Ⅱ期变成Ⅲ期,3例Ⅲ期变成Ⅱ期,1例Ⅲ期变成Ⅳ期,4例Ⅳ期变成Ⅲ期。(2)第6版方案中Ⅰa、Ⅰb、Ⅱa、Ⅱb、Ⅲa、Ⅲb和Ⅳ期患者的两年无复发转移生存率分别为95.5%、82.4%、100.0%、63.6%、52.1%、80.0%和50.0%;新方案中Ⅰa、Ⅰb、Ⅱa、Ⅱb、Ⅲa、Ⅲb和Ⅳ期患者的两年无复发转移生存率分别为95.5%、89.3%、68.4%、63.6%、52.8%、50.0%和0.0%。(3)按照第6版方案,经Log-rank法分析后显示,Ⅰ期和Ⅱ期患者的2年无复发转移生存期差异无统计学意义(P=0.232),Ⅱ期和Ⅲ期患者的无复发转移生存期差异有统计学意义(P=0.023);按照新方案,Ⅰ期和Ⅱ期,以及Ⅱ和Ⅲ期患者之间的无复发转移生存期差异均有统计学意义(P值分别为0.023和0.014)。(4)新方案中新增的2和5cm这两个节点上下的患者的无复发转移生存期差异有统计学意义(P值分别为0.025和0.023)。结论:IASLC2007版非小细胞肺癌TNM分期方案较UICC和AJCC的第6版非小细胞肺癌TNM分期方案显示了更好的分期特异性,且新方案一样适用于中国非小细胞肺癌患者。
文摘Non-small cell lung cancer(NSCLC)is now regarded as the most common cause of cancer-related mortality in China.Despite continuous efforts to improve the therapeutic response,the overall five-year survival rate for NSCLC is still less than 15%.Now we have known that the growth of neoplastic tumors is maintained exclusively by a small subpopulation called "cancer stem cells" which posseses ability of self-renew and differentiation.It has been widely accepted that cancer stem cells are chemoresistant and radioresistant.Therefore,a major challenge in treating this and other cancers is the intrinsic resistance to conventional therapies demonstrated by the stem/progenitor cell that is responsible for the sustained growth,survival,and invasion of the tumor.Identifying these stem cells in non-small cell lung cancer and defining the biologic processes necessary for their existence are paramount in developing new clinical approaches with the goal of preventing disease recurrence.This review summarizes our update understandings of the cellular and molecular mechanisms operating within the putative cancer-initiating cells at the core of non-small cell lung cancer.
