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自 Ashworth(1869)在1例皮肤癌患者血中发现异常大细胞后,文献上偶见血中瘤细胞检查的报导。Engell(1955)首先全面复习有关文献,报告123例癌瘤患者手术前、后周围静脉与肿瘤回流静脉血中瘤细胞检查结果。是后,学者们对血中瘤细胞检查进行了多方面研究,以期阐明肿瘤血行转移的规律和寻找预防措施。本文综述文献中对血内瘤细胞的检查方法,并附一简易方法的初步经验。本法将5毫升枸橼酸钠处理的血液加入等量生理盐水,离心沉淀(每分钟千转)30分钟,吸取红血球层上的“白膜”,以10毫升1%醋酸生理盐水溶解其中混在的红血球,再离心10分钟,用沉淀作涂片,苏木素—伊红染色。本组对30例癌瘤患者(乳腺15例,食管5例,胃8例,直肠及肺各1例)检查术前和术中肘前静脉,术中肿瘤回流静脉及术后肘前静脉血液,各阳性率依次为30%,37%,30%及50%。本法简捷易行,瘤细胞尚清楚,可作检查血中瘤细胞之用。阳性率与文献报导者(10—68.5%)相似;其中以术后周围静脉血最高,说明手术操作可增加瘤细胞血行散播。至于手术是否增加肿瘤转移率及其预防问题,尚待进一步研究。
Since Ashworth (1869) found abnormal large cells in the blood of a patient with skin cancer, reports of hematologic neoplasms were occasionally reported in the literature. Engell (1955) reviewed the literature first and reported the results of tumor cells in peripheral blood and tumor venous blood before and after surgery in 123 patients with cancer. Afterwards, scholars conducted a variety of studies on tumor neoplasms in blood in order to elucidate the regularity of blood metastasis and to find preventive measures. This article reviews the methods for the examination of intrahepatic neoplastic cells in the literature and attaches a preliminary experience of a simple method. In this method, 5 ml of sodium citrate-treated blood is added to an equal volume of physiological saline, centrifuged (thousands per minute) for 30 minutes, and the “white film” on the red blood cell layer is aspirated and dissolved in 10 ml of 1% physiological saline solution. The red blood cells were centrifuged for another 10 minutes, smeared with a pellet, and stained with hematoxylin-eosin. This group of 30 patients with cancer (15 cases of breast, 5 cases of esophagus, 8 cases of stomach, 1 case of rectum and 1 case of lung) preoperative and intraoperative elbow vein, intraoperative tumor reflux vein and postoperative elbow venous blood The positive rates were 30%, 37%, 30% and 50% respectively. This method is simple and easy, tumor cells are still clear, can be used for the examination of tumor cells in the blood. The positive rate was similar to that reported in the literature (10-68.5%). Among them, peripheral venous blood was the highest after surgery, indicating that surgical operations can increase the hematopoietic spread of tumor cells. Whether surgery increases the rate of tumor metastasis and its prevention remains to be further studied.