Breast Cancer as Trauma: Posttraumatic Stress and Posttraumatic Growth

Diagnosis and treatment of cancer has been associated with both posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG). This cross-sectional study sought to assess the frequency, common predictors, and interrelationships of PTSD symptoms and PTG in breast cancer survivors (n = 65). In this sample, symptoms of PTSD and reports of PTG were common and were not significantly related to one another. Greater social constraints on talking about breast cancer and perception of cancer as a traumatic stressor were associated with greater PTSD symptomatology. Younger age and perception of cancer as a traumatic stressor were associated with greater PTG. Findings suggest the central role of subjective appraisal in adjustment to cancer. Psychosocial interventions should be sensitive to the potential for PTG, both in treatment design and in assessment of outcomes.     

Neuroticism and responses to social comparison among cancer patients

The present study examined how the effects of three audiotapes containing different types of social comparison information on the mood of cancer patients depended on the level of neuroticism. On the procedural tape, a man and woman discussed the process of radiation therapy, on the emotion tape, they focussed on emotional reactions to their illness and treatment, while on the coping tape they focussed on the way they had been coping. A validation study among 115 students showed that the tapes were perceived as they were intended. The main study was conducted among 226 patients who were about to undergo radiation therapy. Compared to patients in the control group, as patients were higher in neuroticism, they reported less negative mood after listening to the procedural and the coping tape. Furthermore, as patients were higher in neuroticism, they reported less negative mood after listening to the coping tape than to the emotion tape. Copyright © 2009 John Wiley & Sons, Ltd.     

癌痛治疗指南解析

对多国成人癌痛指南进行检索、回顾,发现近年癌痛治疗领域新进展和各国普遍遵循的共同原则,为临床医生改进癌痛治疗提供参考。采用现有的互联网临床实践指南检索平台,对成人癌痛指南进行检索,分析各国指南的异同之处,重点对疼痛评估、WHO三阶梯药物治疗及辅助治疗进行比较、归纳。全面的癌痛评估是指痛治疗的必要前提,也是众多癌痛指南强调的重点;按疼痛程度选择三阶梯镇痛药物仍是药物止痛的基本原则;口服途径是止痛治疗的首选给药途径;第一阶梯药物中阿司匹林的应用逐渐淡化,NSAIDs的毒性反应受到关注;第二阶梯药物的选择更灵活。应根据疼痛性质、患者的具体情况合理选择复合制荆。吗啡仍是强阿片类药物中的首选,可用于中、重度疼痛的治疗。因此,我国成人癌痛治疗需要改进,应重点推广全面的疼痛评估,提倡根据患者的具体情况合理、灵活的选择三阶梯药物,个体化治疗是止痛治疗的关键。     

探讨人乳头瘤病毒L1蛋白功能及其临床意义

高危型别人乳头瘤病毒（HPV）感染在宫颈癌发生发展中具有重要作用。由于HPV L1蛋白结构特征及其精确的抗原特性,在粘附宿主细胞、识别病毒受体、协助病毒DNA的入胞转运中均发挥重要作用。检测患者宫颈损伤组织中L1蛋白的表达将有助于对患者是否具有传染性进行评估。本文将深刻思考HPV L1功能及其在感染机体并引发癌变的机制,以期更好的解读宫颈癌发病原理并最终应用于,强床治疗。     

CD4＋CD25＋Foxp3＋调节性T细胞与肺癌的临床分期及化疗关系的研究

为了研究Treg与肺癌的临床分期及化疗的关系,分离52例初治肺癌患者化疗前后PBMC,以12例正常者为对照,荧光标记的单抗染色,流式细胞仪检测Treg占CD4＋T细胞的比值。结果显示肺癌患者该比值高于对照组,Ⅲ＋Ⅳ期的高于Ⅰ＋Ⅱ期。化疗疗效（SD＋PD）高于PR。因此,肺癌患者Treg比例较正常人升高,且分期越高该比值增加越明显;疗效差的该比值高于化疗有效病例。推测Treg升高与肺癌的发生、发展有关。     

非小细胞肺癌靶向药物治疗争论热点

非小细胞肺癌作为全球和我国发病率最高、死亡人数最多的恶性肿瘤,其药物治疗始终是临床肿瘤学界高度关注的焦点之一。肿瘤的药物治疗模式从单纯以细胞毒药物杀伤肿瘤逐步向调节信号传导通路转变,分子靶向药物日益成为治疗肿瘤的重要武器。回顾肺癌靶向治疗的进展,诸多问题需要解决。     

血管内皮生长因子与结直肠癌的研究

血管内皮生长因子（vascular endothelial growth factor,VEGF）是一高度特异作用于内皮细胞的糖蛋白,是目前发现的最重要的肿瘤血管生长因子之一。结直肠癌的生长、侵袭和转移与血管内皮生长因子有密切的关系,VEGF在结直肠癌治疗中的作用日益突出。本文就VEGF的功能、在结直肠癌中的表达和治疗的作用作一综述。     

肿瘤标记物在大肠癌临床诊治中的应用进展

总结肿瘤标记物在大肠癌临床诊治中的应用进展。对有关大肠癌临床诊治中肿瘤标记物的文献进行综述,重点讨论血清、基因和急性期蛋白三类标记肿瘤物对大肠癌临床诊治方面的价值和潜力。结果是恰当选择肿瘤标记物有助于大肠癌临床诊治。目前,基因和急性期蛋白为大肠癌肿瘤标记物探索的新方向,有望成为提高大肠癌诊治效率的新检查方法。三类肿瘤标记物对大肠癌诊治有临床意义,联合检测可提高大肠癌诊治的准确性和有效性。     

老年非小细胞肺癌治疗策略

非小细胞肺癌被认为是老年疾病。迄今为止尚无专门针对治疗老年NSCLC的指导原则。作者就当今对老年NSCLC的治疗策略进行论述,并指出年龄不是影响NSCLC患者实施手术治疗、放射治疗以及化学治疗的单一因素。     

血管内皮生长因子与结直肠癌的研究

血管内皮生长因子(vascular endothelial growth factor,VEGF)是一高度特异作用于内皮细胞的糖蛋白,是目前发现的最重要的肿瘤血管生长因子之一.结直肠癌的生长、侵袭和转移与血管内皮生长因子有密切的关系,VEGF在结直肠癌治疗中的作用日益突出.本文就VEGF的功能、在结直肠癌中的表达和治疗的作用作一综述.