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1、 一、食道癌早期症状1.咽下梗噎感最多见,可自行消失和复发,不影响进食。常在病人情绪波动时发生,故易被误认为功能性症状。2.胸骨后和剑突下疼痛较多见。咽下食物时有胸骨后或剑突下痛,其性质可呈烧灼样、针刺样或牵拉样,以咽下粗糙、灼热或有刺激性食物为著。初时呈间歇性,当癌肿侵及附近组织或有穿透时,就可有剧烈而持续的疼痛。疼痛部位常不完全与食管内病变部位一致。疼痛多可被解痉剂暂时缓解。4.咽喉部干燥和紧缩感咽下干燥粗糙食物尤为明显,此症状的发生也常与病人的情绪波动有关。5.其他症状少数病人可有胸骨后闷胀不适、前痛和喛气等症状。二、食道癌中期症状1.咽下梗噎感最多见,可自选消失和复发,不影响进食。常在

2、病人情绪波动时发生,故易被误认为功能性症状。2.胸骨后和剑突下疼痛较多见。咽下食物时有胸骨后或剑突下痛,其性质可呈灼热样、针刺样或牵拉样,以咽下粗糙、灼热或有刺激性食物为著。初时呈间歇性,当癌肿侵及附近组织或有穿透时,就可有剧烈而持续的疼痛。疼痛部位常不完全与食管内病变部位一致。疼痛多可被解痉剂暂时缓解。4.咽喉部干燥和紧缩感咽下干燥粗糙食物尤为明显,此症状的发生也常与病人的情绪波动有关。5.其他症状少数病人可有胸骨后闷胀不适、前痛和喛气等症状。中期食道癌的典型症状:进行性吞咽困难.可有吞咽时胸骨后疼痛和吐黏液样痰。三、食道癌晚期症状1.咽下困难进行性咽下困难是绝大多数患者就诊时的主要症状,但

3、却是本病的较晚期表现。因为食管壁富有弹性和扩张能力,只有当约2/3的食管周径被癌肿浸润时,才出现咽下困难。因此,在上述早期症状出现后,在数月内病情逐渐加重,由不能咽下固体食物发展至液体食物亦不能咽下。如癌肿伴有食管壁炎症、水肿、痉挛等,可加重咽下困难。阻塞感的位置往往符合手癌肿部位。2.食物反应常在咽下困难加重时出现,反流量不大,内含食物与粘液,也可含血液与脓液。3.其他症状当癌肿压迫喉返神经可致声音嘶哑;侵犯膈神经可引起呃逆或膈神经麻痹;压迫气管或支气管可出现气急和干咳;侵蚀主动脉则可产生致命性出血。并发食管-气管或食管-支气管瘘或癌肿位于食管上段时,吞咽液体时常可产生颈交感神经麻痹征群。四

4、、体征早期体征要缺如。晚期可出现打呃、吞咽困难。并且由于患者进食困难可导致营养不良而出现消瘦、贫血、失水或恶病质等体征。当癌肿转移时,可触及肿大而坚硬的浅表淋巴结,或肿大而有结节的肝脏。还可出现黄疸、腹水等。其他少见的体征尚有皮肤、腹白线处结节,腹股沟淋巴结肿大。 乙酰肝素酶-癌症转移治疗的靶点作者:赵华军, 章雄文, 丁健, ZHAO Hua-jun, ZHANG Xiong-wen, DING Jian作者单位:赵华军,ZHAO Hua-jun(中国科学院,上海生命科学研究院,上海药物研究所,国家新药研究重点实验室,肿瘤药理组,上海,201203;中国科学院,研究生院,上海,201203,

5、 章雄文,丁健,ZHANG Xiong-wen,DING Jian(中国科学院,上海生命科学研究院,上海药物研究所,国家新药研究重点实验室,肿瘤药理组,上海,201203刊名: 药学学报英文刊名:ACTA PHARMACEUTICA SINICA年,卷(期:2005,40(10被引用次数:2次参考文献(33条1.Pikas DS.Li JP.Vlodavsky I Substrate specificity of heparanases from human hepatoma and platelets 1998(302.Parish CR.Freeman C.Brown K J Identi

6、fication of sulfated oligosaccharide-based inhibitors of tumor growth and metastasis using novel in vitro assays for angiogenesis and heparanase activity 1999(143.Okada Y.Yamada S.Toyoshima M Structural recognition by recombinant human heparanase that plays critical roles in tumor metastasis. Hierar

7、chical sulfate groups with different effects and the essential target disulfated trisaccharide sequence 2002(454.Vlodavsky I.Friemann Y.Elkin M Mammalian heparanase: gene cloning, expression and function in tumor progression and metastasis 1999(075.Miao HQ.Ornitz DM.Aingorn E Modulation of fibroblas

8、t growth factor-2 receptor binding, dimerization,signaling, and angiogenic activity by a synthetic heparinmimickling polyanionic compound 1997(076.Walch ET.Marchetti D Role of neurotrophins and neurotrophins receptors in the in vitro invasion and heparanase production of human prostate cancer cells

9、1999(047.Hulett MD.Freeman C.Hamdorf B J Cloning of mammalian heparanase, an important enzyme in tumor invasion and metastasis 1999(078.McKenzie E.Tyson K.Stamps A Cloning and expression profiling of Hpa2, a novel mammalian heparanase family member 2000(039.Uno F.Fujiwara T.Takata Y Antisense-mediat

10、ed suppression of human heparanase gene expression inhibits pleural dissemination of human cancer cells 2001(2110.Zhang YL.Fu ZR.Zhang J Inhibition of invasiveness of human mammary carcinoma cell line MDA435 by heparanase antisense oligodeoxynucleotide期刊论文-中华医学杂志 2003(0311.Edovitsky E.Elkin M.Zchari

11、a E Heparanase gene silencing, tumor invasiveness, angiogenesis, and metastasis 2004(1612.Friedmann Y.Vlodavsky I.Aingorn H Expression of heparanase in normal, dysplastic and neoplastic human colonic mucosa and stroma. Evidence of its role in colonic tumorigenesis 2000(0413.Koliopanos A.Friess H.Kle

12、eff J Heparanase expression in primary and metastatic pancreatic cancer 2001(12antimetastatic factors by nuclear factor kappaB 2000(2315.Marchetti D.Li J.Shen R Astrocytes contribute to the brain-metastatic specificity of melanoma cells by producing heparanase 2000(1716.He X.Brenchley PE.Jayson GC H

13、ypoxia increases heparanase-dependent tumor cell invasion,which can be inhibited by antiheparanase antibodies 2004(1117.Parish CR.Freeman C.Brown KJ Identification of sulfated oligosaccharide-based inhibitors of tumor growth and metastasis using novel in vitro assays for angiogenesis and heparanase

14、activity 1999(14 18.Vlodavsky I.Elkin M.Pappo O Mammalian heparanase as mediator of tumor metastasis and angiogenesis 2000(zk19.Elkin M.Ilan N.Ishai-Michaeli R Heparanase as mediator of angiogenesis: mode of action 2001(0920.Zcharia E.Metzger S.Chajek-Shaul T Transgenic expression of mammalian hepar

15、anase uncovers physiological functions of heparan sulfate in tissue morphogenesis,vascularization,and feeding behavior 2004(0221.Kelly T.Miao HQ.Yang Y High heparanase activity in multiple myeloma is associated with elevated microvessel density 2003(2422.Bingley JA.Hayward IP.Campbell JH Arterial he

16、paran sulfate proteoglycans inhibit vascular smooth muscle cell proliferation and phenotype change in vitro and neointimal formation in vivo 1998(02 23.Bitan M.Mohsen M.Levi E Structural requirements for inhibition of melanoma lung colonization by heparanase inhibiting species of heparin 1995(2-324.

17、Vlodavsky I.Mohsen M.Lider O Inhibition of tumor metastasis by heparanase inhibiting species of heparin 1994(1-625.Miao HQ.Elkin M.Aingorn E Inhibition of heparanase activity and tumor metastasis by laminarin sulfate and synthetic phosphorothioate oligodeoxynucleotides 1999(0326.Hoffman R.Paper DH.D

18、onaldson J Inhibition of angiogenesis and murine tumour growth by laminarin sulphate 1996(1027.Hoffman R.Paper DH.Donaldson J Characterisation of a laminarin sulphate which inhibits basic fibroblast growth factor binding and endothelial cell proliferation 1995(1128.Guvakova MA.Yakubov LA.Vlodavsky I Phosphorothioate oligodeoxynucleotides bind to basicfibroblast growth factor, inhibit its bindi

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