前列腺癌组织卵泡刺激素受体表达临床意义的研究

目的:探讨卵泡刺激素受体在前列腺癌组织中的表达及其临床意义.方法:采用SP免疫组化方法,分析12例正常前列腺(NP)、14例前列腺增生(BPH)、45例前列腺癌(PCa)标本中FSHR的阳性表达情况和45例PCa标本中雄激素受体(AR)的表达情况.结果:NP组仅2例FSHR表达阳性,BPH组4例表达阳性,PCa组38例表达阳性,NP组与BPH组比较差异无统计学意义,BPH组与PCa组比较差异有统计学意义;FSHR在PCa组的表达程度与不同病理分级、临床分期和Gleason分级呈正相关.结论:FSHR在前列腺癌组织中的表达明显强于良性增生和正常的前列腺组织;FSHR与前列腺癌的发生、发展、转移等生物学行为有密切关系.     

多层螺旋CT灌注成像评价非小细胞肺癌分化程度的价值及其机制

目的 探讨多层螺旋CT(MSCT)灌注成像评价非小细胞肺癌(NSCLC)分化程度的价值及机制.方法 应用MSCT对44例NSCLC行灌注成像,其中22例构建微血管构筑二维表型(2D-TMAP).用Spearman相关分析和趋势检验,探讨不同区域血流量(BF)、血容量(BV)、强化峰值(PEI)、平均通过时间(MTT)、达峰时间(TTP)与NSCLC分化程度、2D-TMAP指标的关系.结果 趋势检验和相关分析结果均显示,总BF、总BV和总PEI随NSCLC分化程度降低而减低,r分别为-0.613(P=0.000)、-0.309(P=0.042)和-0.350(P=0.020).总PEI与总微血管密度(MVD)呈正相关(r=0.441,P=0.046),周围区BF、总BF、总BV、总PEI与未形成完整管腔的MVD、鼠抗人增殖细胞核抗原(PCNA)的表达强度均呈负相关(均P<0.05).NSCLC的分化程度与未形成完整管腔的周围区MVD、PCNA和血管内皮生长因子(VEGF)的表达强度均呈正相关,r分别为0.477(P=0.034)、0.656(P=0.002)和0.430(P=0.048),而与总MVD无关.未形成完整管腔的周围区MVD与VEGF、PCNA、ephrinB2和EphB4表达强度均呈正相关,r分别为0.586(P=0.005)、0.430(P=0.048)、0.634(P=0.002)和0.634(P=0.002).结论 灌注成像能有效评价NSCLC的分化程度,其机制在于通过检测微血管的管腔化程度来评价NSCLC的血流模式.     

肾癌中EphA2和EphrinA1的表达及其与微血管密度的关系

目的 探讨EphA2和EphrinA1在肾癌组织中的表达,及其与肿瘤血管生成的关系.方法 应用用免疫组化法检测68例肾癌组织、24例正常肾组织中EphA2和EphfinA1的表达,采用CD34抗体标记微血管内皮细胞,计算微血管密度(MVD).结果 肾癌组织中EphA2和EphrinA1蛋白的表达明显高于正常肾组织(均P<0.01).正常肾组织中MVD为25.23±7.09,肾癌组织中MVD为39.68±7.24,差异有统计学意义(P<0.01).在肾癌组织中,分化程度为2、3级组的EphA2和EphrinA1蛋白表达水平高于分级为1级组(P<0.01,P<0.05),分期为Ⅲ、Ⅳ期组高于Ⅰ、Ⅱ期组(P<0.01,P<0.05),有淋巴结转移组高于无淋巴结转移组(P<0.05);肿瘤直径≥7 cm组的MVD高于<7 cm组(P<0.05),分化程度为2、3级组高于1级组(P<0.01),分期为Ⅲ、Ⅳ期组高于Ⅰ、Ⅱ期组(P<0.05),有淋巴结转移组高于无淋巴结转移组(P<0.01).相关分析结果显示,EphA2、EphrinA1的表达与MVD呈正相关(r分别为0.555和0.485,均P<0.01).结论 EphA2和EphrinA1在肾癌组织中高表达,并与肿瘤的分化程度、临床分期、肿瘤血管生成有关.     

结直肠癌中CD133的表达与血管生成相关性的研究

目的:研究结直肠癌组织中肿瘤干细胞标记物CD133的表达与临床病理特征之间的关系,并探讨CD133表达与肿瘤微血管密度(microvessel density, MVD)及血管内皮生长因子(vascular endothelial growth factor, VEGF)表达之间的相关性.方法:采用免疫组织化学法和组织芯片技术检测94例结直肠癌标本中CD133、VEGF和CD31的表达.结果: CD133的表达与组织分化程度(P<0.01)密切相关,而与淋巴结转移接近存在相关性(P=0.05);与VEGF表达及MVD均呈负相关(P<0.01).MVD按CD133(-)/VEGF(-/+)→CD133(+)/VEGF(-/+) →CD133(+)/VEGF(++/+++) →CD133(-)/VEGF(++/+++)的顺序逐渐增加,后两者与前两者比较,差异有统计学意义(P<0.05).结论:结直肠癌组织中癌干细胞与肿瘤MVD相关,提示前者可能通过VEGF的间接表达促进血管新生,后者密度增加则促进前者的分化成熟.     

子宫内膜癌组织中PCNA、MVD的检测及其意义

背景与目的:子宫内膜癌发病率呈逐年上升趋势,但其确切发病机制及预后因素尚不明确。本实验旨在研究增殖细胞核抗原(proliferating cell nuclear antigen.PCNA)指数、微血管密度microvessel density.MVD雪在子宫内膜癌组织中的表达,并结合肿瘤的手术病理分期、病理分级,进一步判断其价值。方法:采用免疫组织化学SP法,检测62例子宫内膜腺癌、22例正常子宫内膜组织的PCNA指数和MVD,结合肿瘤的临床分期、病理分级,对结果进行统计学分析。结果:子宫内膜癌组织中PCNA指数(54.49±9.29)和MVD(48.97±8.56)较正常子宫内膜明显增高(P<0.05);子宫内膜癌的期别越晚、分化越差,PCNA指数和MVD越高(P<0.05);在子宫内膜癌组织中,PCNA指数与MVD呈正相关。结论:PCNA指数、MVD增高与子宫内膜癌的发展有关;血管生成促进肿瘤细胞增殖。     

非小细胞肺癌组织中期因子蛋白表达及其临床意义的研究

目的:探讨中期因子蛋白(midkine, MK)和微血管密度(microvessel density, MVD)在非小细胞肺癌(non-small cell lung cancer, NSCLC)组织中的表达及其与NSCLC临床病理特征、血管生成的关系.方法:运用免疫组织化学SP法,检测MK蛋白和由CD34标记的MVD在60例NSCLC组织及10例癌旁组织中的表达.结果:MK蛋白在NSCLC组织中表达,在癌旁组织不表达;NSCLC中MK表达与临床分期及有无淋巴转移有关,P<0.05;而与组织类型、分化程度、性别及年龄无关,P>0.05; MVD在NSCLC中表达明显高于癌旁组织,并与临床分期及淋巴转移有关,P均<0.05,而与性别、年龄、组织类型及分化程度无关,P>0.05;MK蛋白与MVD在NSCLC中的表达有相关性,P<0.05.结论:MK蛋白可作为肺癌新的标志,并可作为NSCLC转移的分析指标.     

环氧化酶-2在胃癌中的表达及其与血管生成和细胞增殖的关系

目的：探讨环氧化酶－2（COX－2）在胃癌中的表达及其与血管形成和细胞增殖的关系。方法：用免疫组化S－P法检测43例胃癌的COX－2表达，采用抗Ⅷ因子相关抗原单克隆抗体和PCNA单克隆抗体分别进行微血管内皮细胞和肿瘤细胞增殖核抗原染色，计算微血管密度（MVD）和PCNA指数，分析其相关性。结果：COX－2在胃癌组织表达的阳性率为60．5％，高于对照组（P＜0．01），COX－2的高表达与胃癌淋巴结的转移和临床分期有关，与肿瘤大小，浸润深度，分化程度均无关，COX－2表达阳性组的MVD和PCNA指数明显高于COX－2表达阴性组（P＜0．05），COX－2表达与MVD和PCNA指数呈丰关（P＜0．05），结论：COX－2的表达对胃癌细胞的增殖和血管形成可能起重要作用，是判断预后和指导治疗的有效指标。     

前列腺癌组织中肿瘤血管生成的研究

为探讨前列腺癌（PCa）细胞转移的机制，应用免疫组织化学SP法在36例良性前列腺增生（BPH）及34例PCa组织中对第Ⅷ因子相关抗原进行表达，计数微血管（MV），发现PCa组织中MV数显著高于BPH组（P＜0.01），浸润性PCa组MV数明显高于局限性PCa组（P＜0．05），伴淋巴结转移者MV数显著高于无淋巴结转移者（P＜0．05），未分化PCa组MV数显著高于高分化组及低分化组（P＜0．05），提示肿瘤血管生成与PCa分期、分级密切相关，癌细胞的浸润及转移有赖于肿瘤血管的生成。     

胶质瘤MRI增强与微血管密度和肿瘤增殖活性的相关性

目的探讨胶质瘤MRI增强程度与微血管密度、肿瘤增殖活性的关系.方法回顾分析62例胶质瘤的MRI增强程度和用免疫组化法分析MVD和PCNA标记指数,研究MRI增强程度与MVD和PCNA标记指数的关系.结果62例中45例有增强,并与MVD和PCNA标记指数明显相关(P＜0.01).MVD和PCNA标记指数也明显相关(P＜0.01).结论术前胶质瘤MRI增强与其微血管密度和细胞增殖活性明显相关,提示MRI增强能较好的反映胶质瘤的血管新生化和肿瘤增殖活性.     

微血管密度、p53蛋白和PCNA与肝细胞癌的关系

目的研究肝细胞癌(HCC)内微血管密度(MVD)、p53蛋白与增殖细胞核抗原(PCNA)表达之间的关系.方法采用免疫组化SABC法检测47例人HCC组织的MVD值、PCNA指数和p53蛋白表达情况.结果生存期≥5年者的MVD值(41.19±15.31)明显低于生存期＜5年者的MVD值(54.73±24.72).MVD值与患者的年龄、性别、肿瘤的大小、Edemondson分级无关,也与PCNA指数和p53蛋白表达无直接相关性(P＞0.05).p53蛋白在生存期≥5年及＜5年的2组患者中的异常表达率分别为10.5%和50.0%,有非常显著性差异(P＜0.01),但其与MVD值无关(P＞0.05).低分化HCC的PCNA指数(54.14±14.26)高于高分化HCC的PCNA指数(34.62±6.16),有显著性差异(P＜0.05),但与MVD值无关(相关系数γ=0.082,P＞0.05).结论MVD值和p53基因异常表达均与HCC的5年生存率直接相关,但MVD值、PCNA指数和p53蛋白异常表达相互之间无直接相关性.     

Cytologic classification of precancer and cancer of the endometrium and esophagus and of malignant lymphomas

The paper discusses cytological classifications of precancer and cancer of the endometrium, esophagus and malignant lymphomas presented by cytologists from five Soviet research institutes of oncology. The classifications were based on the data of 4400 cases in conformity with WHO histologic classifications.     

E-钙粘蛋白及PTEN基因编码蛋白与胃癌浸润转移

目的:观察抑癌基因PTEN蛋白和ECD在胃癌组织中的表达,探讨其与胃癌生物学行为及预后的关系。方法:以兔抗人PTEN多克隆抗体、鼠抗人ECD单克隆抗体,采用SABC免疫组化法,检测100例胃癌手术切除标本中拟测指标的表达。以χ2和Logrank检验对结果做统计学分析。结果:ECD、PTEN蛋白在非癌胃粘膜中均见表达;在胃癌组织中表达下调或缺失。ECD异常表达率为42.0%;弥漫型胃癌异常表达率(48.57%),明显高于肠型胃癌(26.67%),(P<0.05);ECD异常表达与浸润深度有关(P<0.05)。胃癌组织中PTEN蛋白缺失率为59%;弥漫型胃癌缺失率(65.71%)明显高于肠型胃癌(43.33%),(P<0.05);伴淋巴结转移的胃癌缺失率(64.47%)明显高于无淋巴结转移者(41.67%),(P<0.05);PTEN蛋白缺失的患者比阳性表达者预后差(P=0.0066)。65.85%PTEN阳性表达者同时伴ECD正常表达。结论:两种标志物与胃癌浸润转移有关,PTEN表达与胃癌患者预后密切相关。将两种指标联合检测,可作为正确判断胃癌患者预后,指导临床治疗的分子生物学指标。     

Schwannomas of Head and Neck and Review of Literature

Benign nerve cell tumours have been given various names like schwannoma, neurilemmoma, neurinoma, neurofibroma, spindle cell tumours etc. Extra cranial head and neck schwannomas usually present as solitary and well-demarcated lesions. The lesion can cause secondary symptoms, such as nasal obstruction, dysphasia, and hoarseness, depending upon the location of the lesion. Fine needle aspiration cytology, CT scans, and MRI may be of limited help in the diagnosis of schwannomas. The treatment is complete surgical excision of the benign tumour and postoperative histopathological examination establishes the final diagnosis.     

世界卫生组织骨质疏松症防治工作报告和防治建议

引 言 作为对第51号综合处理非传染性疾病预防与控制的世界卫生组织决议的反应,1998年7月WHO成立了致力于不断完善对骨质疏松预防和治疗策略的工作小组。小组成员来自世界各国致力于骨质疏松研究的知名专家。Harry K.Genant为本届主席。这一项世界范围内的骨质疏松教育计划旨在通过世界范围的研究,不断改善对骨质疏松的诊断水平和发展并完善对骨质疏松病人的合理治疗。其重点将以发展中国家为主。并为各国政府及其卫生部门和病人群体提供世界性有关骨质疏松症的总体的、完整的指导性资料。该项研究、教育计划的实施将由世界各国的骨质疏松症研究和治疗机构共同完成,并经权威学术机构、政府和非政府组织进行有针对性的回顾研究,最终由WHO审议通过。     

Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers

BACKGROUND: Frequent consumption of fruit and vegetables has been associated with a reduced risk of colorectal cancer in many observational studies. METHODS: We prospectively investigated the association between fruit and vegetable consumption and the incidence of colon and rectal cancers in two large cohorts: the Nurses' Health Study (88 764 women) and the Health Professionals' Follow-up Study (47 325 men). Diet was assessed and cumulatively updated in 1980, 1984, 1986, and 1990 among women and in 1986 and 1990 among men. The incidence of cancer of the colon and rectum was ascertained up to June or January of 1996, respectively. Relative risk (RR) estimates were calculated with the use of pooled logistic regression models accounting for various potential confounders. All statistical tests were two-sided. RESULTS: With a follow-up including 1 743 645 person-years and 937 cases of colon cancer, we found little association of colon cancer incidence with fruit and vegetable consumption. For women and men combined, a difference in fruit and vegetable consumption of one additional serving per day was associated with a covariate-adjusted RR of 1.02 (95% confidence interval [CI] = 0.98-1.05). A difference in vegetable consumption of one additional serving per day was associated with an RR of 1.03 (95% CI = 0.97-1.09). Similar results were obtained for women and men considered separately. A difference in fruit consumption of one additional serving per day was associated with a covariate-adjusted RR for colon cancer of 0.96 (95% CI = 0.89-1.03) among women and 1. 08 (95% CI = 1.00-1.16) among men. For rectal cancer (total, 244 cases), a difference in fruit and vegetable consumption of one additional serving per day was associated with an RR of 1.02 (95% CI = 0.95-1.09) in men and women combined. None of these associations was modified by vitamin supplement use or smoking habits. CONCLUSIONS: Although fruits and vegetables may confer protection against some chronic diseases, their frequent consumption does not appear to confer protection from colon or rectal cancer.     

A comparative study of knowledge and awareness of colorectal and breast cancerA comparative study of knowledge and awareness of colorectal and breast cancer

Aims: To assess and compare knowledge and awareness of colorectal cancer and breast cancer in a sample of the general population. Methods: Eleven hundred visitors to six different outpatient clinics, in a University Hospital, were given a study-specific questionnaire, based on educational material from the British Association of Cancer United Patients (CancerBACUP). The questionnaire consisted of 12 statements on the incidence, presentation, detection, treatment and prognosis of colorectal and breast cancer. Results: One thousand and sixty-eight individuals returned the questionnaire. One thousand and four completed questionnaires were analysed. The mean age (SD) of respondents was 50.1 (17.2) years, and the male to female ratio was 2:3. Respondents had read more about breast than about colorectal cancer (60.3%vs 32.4%,P <0.0001, McNemar's test). The proportion of correct answers for each statement on breast cancer was higher than for answers to corresponding items on colorectal cancer. Mean overall scores (95% CI) for breast and colorectal cancer were 88.1 (86.9, 89.2) and 64.4 (62.5, 66.3) respectively, the mean difference (95% CI) being 23.7 (22.0, 25.5). Scores were higher for breast cancer irrespective of age or gender. Conclusion: There is a low level of understanding of colorectal cancer in the general population when compared to breast cancer. This highlights the importance of public education in this common cancer.     

Quality of life and care in leukemia,myeloma and non-malignant disease. Opinions of patients and relatives,and effects of geography and time

In a questionnaire study 140 subjects answered 4200 questions in 1980 and 1986. They consisted of patients with myeloma, acute leukemia, lung carcinoma, and non-malignant disease and their relatives. In 22 additional cases the questionnaire was not answered. The results show that myeloma patients are less content with the general care than leukemia patients (P < 0.05). Similarly, relatives of deceased myeloma patients are less satisfied with the information given to them than relatives of deceased leukemia patients (P < 0.001). The information has improved with time, however, since the patients were more satisfied in 1986 than in 1980 (P < 0.001) and relatives of myeloma patients still alive were more satisfied than relatives of patients who had died earlier (P < 0.001).     

甲状腺手术的技巧及副损伤的预防和处置

鉴于甲状腺手术是普外科的常见手术，为求其日渐完美，以有益于病人，现根据作者的体会，并结合阅读相关文献，就其手术操作、喉返神经处理、甲状旁腺处理进行扼要阐述。