放疗前后食管鳞状细胞癌组织中Fas和Survivin蛋白的表达

目的:探讨食管鳞状细胞癌术前放疗前后,Fas和Survivin蛋白的表达变化及其与放疗敏感性的关系.方法:采用免疫组织化学SP法检测56例食管鳞状细胞癌放疗前胃镜活检标本及放疗后食管癌根治性切除术后标本Fas和Survivin蛋白的表达水平,分析二者放疗前后表达的差异及其与放疗后病理反应分级的关系.结果:放疗前胃镜活检标本中Fas蛋白表达为0.47±0.23,放疗后食管癌根治性切除术后标本中Fas蛋白表达为0.61±0.17,放疗前后阳性率相比较差异有统计学意义(P<0.01);放疗前胃镜活检标本中Survivin蛋白表达为0.43±0.23,放疗后食管癌根治性切除术后标本中Survivin蛋白表达为0.37±0.40,放疗前后阳性率比较差异不具有统计学意义(P=-0.49).放疗前Fas蛋白表达与放疗后病理反应呈正相关,并有统计学意义(P<0.01),放疗后Fas蛋白表达与放疗后病理反应的相关性无统计学意义(P>0.05),放疗前后标本中Survivin蛋白表达与放疗后病理反应的相关性均无统计学意义(P>0.05).结论:放疗前Fas蛋白表达与放疗后病理反应呈正相关,提示术前Fas蛋白表达可以代表肿瘤细胞的放射敏感性,Fas蛋白不但可以直接诱导肿瘤细胞的凋亡,而且可以预测肿瘤细胞的放射敏感性,Fas蛋白可作为中晚期食管鳞状细胞癌术前放疗的筛选指标之一.     

3种肿瘤标记物联合检测对肝细胞癌切除术后再次复发的预测价值

目的：研究肿瘤标记物α-甲胎蛋白（AFP）、甲胎蛋白抑制体（AFP-L3）及脱-γ-羧基-凝血酶原（DCP）对肝细胞癌（ HCC）患者行肝切除术后复发的预测价值。方法收集行HCC肿瘤病灶根治性切除术的患者58例,考察患者的基本情况以及血清DCP、AFP及AFP-L3水平与HCC术后复发率的关系。结果术后血清AFP、DCP及AFP-L3水平均升高的患者复发率均明显提高。多因素分析结果显示：HCC患者肝切除术前血清AFP、DCP及AFP-L3联合检测与术后复发率无相关性[1．13（0．804～1．479）,P＞0．05],而术后血清AFP、DCP及AFP-L3联合检测则是影响术后复发率的独立因素[3．68（1．711～3．798）,P＜0．01]。结论血清中肿瘤标记物AFP、DCP及AFP-L3联合检测对HCC患者肝切除术后复发监测敏感有效,为HCC术后疗效评估及追踪复查提供了一条新途径。     

Survivin在Dukes''''C期结直肠癌中的表达及其生物学意义

目的:探讨Survivin在Dukes'C期结直肠癌中的表达情况及其对辅助化疗疗效的预测作用.方法:应用免疫组化法检测85例根治性术后,行标准辅助化疗的Dukes'C期结直肠癌患者的癌组织和14例正常结直肠组织中Survivin的表达,分析与临床病理因素的相关性,并进行生存分析.结果:肿瘤组织Survivin阳性率为51.76%,正常组织中无Survivin表达,两组阳性率差异有显著性(P＜0.05).Survivin的表达与患者的年龄、性别、病程、肿瘤部位、肿瘤最大径、大体类型、组织分型、分化程度、肠壁浸润深度、淋巴结转移部位之间均无显著相关性(P均＞0.05).Survivin蛋白的表达与肿瘤的复发转移显著相关,Survivin阳性者复发转移率54.52%,显著高于Survivin阴性者(26.83%)(P=0.009).Survivin阳性患者3年、5年无病生存率和总生存率显著低于阴性患者,Cox模型多因素分析,Survivin是影响肿瘤复发转移和生存的独立的预后因素.结论:Survivin在Dukes'C期结直肠癌中表达上调,与辅助化疗的疗效相关,可作为预测辅助化疗疗效的分子指标.     

凋亡抑制因子Survivin在肝细胞肝癌的表达及临床意义

目的:探讨Survivin蛋白表达与肝细胞肝癌(HCC)临床病理特征相关性及临床意义.方法:应用链霉菌抗生物素-过氧化物酶免疫组织化学法(SP法),检测67例HCC中Survivin、血管内皮生长因子(VEGF)的蛋白表达.结果:67例肿瘤组织中35例Survivin呈阳性表达,阳性率为52.2%.肿瘤组织表达阳性率高于癌旁组织(P＜0.05).Survivin的表达与HCC肿瘤镜下门静脉癌栓发生密切相关(P＜0.05).VEGF阳性表达者为41例,阳性率为61.1%.VEGF的表达与HCC肿瘤大小、门静脉癌栓发生以及肿瘤TNM分期密切相关(P＜0.05).应用Kaplan-Meier法制作累积生存曲线并经Long-rank检验,结果显示Survivin表达阳性与阴性组患者术后累积生存率有显著性差异(P=0.0018).结论:HCC中Survivin、VEGF蛋白表达上调,Survivin和VEGF均与HCC门静脉癌栓发生密切相关.HCC患者Survivin表达者预后不良,应密切随访.     

胸腺素β10在肝细胞癌中的表达及其临床意义

目的 探讨人肝细胞癌(hepatocellular carcinoma,HCC)患者组织胸腺素β10 (Thymosin beta-10,Tβ10) mRNA的表达及其临床意义.方法 采用逆转录聚合酶链反应(RT-PCR)检测70例HCC患者癌组织、癌旁肝组织及18例正常肝组织中Tβ10 mRNA的表达情况,分析Tβ10 mRNA表达水平与肝癌患者的临床分期、有无术后复发、有无肝外转移、有无门静脉癌栓、肿瘤个数、肿瘤直径、血清AFP水平和病理分级等指标的关系.结果 Tβ10 mRNA在正常肝组织(1.30±0.53)及癌旁肝组织(1.21±0.50)中的表达水平明显高于在HCC组织(1.01±0.41)中的表达水平(P＜0.05),而在正常肝组织及癌旁肝组织中的表达水平差异无统计学意义(P＞0.05).Tβ10 mRNA在人HCC组织中的表达与门静脉癌栓、肿瘤个数及肿瘤直径明显相关(P＜0.05),而与临床分期、肝外转移及术后复发、血清AFP 水平及分化程度无明显关系(P＞0.05).结论 Tβ10 mRNA在HCC组织中低表达,可能与HCC的发生、发展的早期阶段有关.     

CD146 mRNA在人肝细胞癌组织中的表达及其临床意义

目的:探讨CD146mRNA在人肝细胞癌(hepatocellularcarcinoma,HCC)组织中的表达及其临床意义。方法:用荧光实时定量聚合酶链反应(realtimePCR)技术定量检测70例HCC患者癌组织、癌旁肝组织及18例非癌肝组织中CD146mRNA的表达情况。结果:CD146mRNA在肝癌组织(0.044±0.0178)明显高于在癌旁肝组织(0.0367±0.0121)中的表达水平(P<0.01),癌旁肝组织中的表达水平明显高于非癌肝组织(0.0263±0.0102)中的表达水平(P<0.05)。CD146mRNA在人肝癌组织中的含量与临床分期、门静脉癌栓、肝外转移及术后复发明显有关,而与肿瘤个数、肿瘤直径、血清AFP水平及分化程度无明显关系。结论:本研究结果提示CD146可能与肝癌的发生、发展及术后转移复发有关;可作为预测肝癌转移复发的参考指标之一。     

原发性肝癌患者外周血AFP mRNA和MAGE-1mRNA水平的联合检测与术后复发转移的关系

目的寻找一种敏感的用于早期发现原发性肝癌患者术后复发与转移的检测方法.方法应用巢式逆转录聚合酶链反应(nested RT-PCR)分别在术前、术后1周和术后两个月检测85例行根治性切除的原发性肝癌患者外周血中MAGE-1 mRNA和AFP mRNA的表达.结果外周血中MAGE-1 mRNA和(或)AFP mRNA的阳性率与肿瘤的病理分期呈正相关:肿瘤病期越晚,外周血中微转移灶的检出率越高(P<0.01).1年的随访中,有23例患者出现复发,MAGE-1和(或)AFP mRNA的阳性率为78.3%(18/23),而62例无复发患者阳性率为46.8%(29/62),二者比较差异有显著性(P<0.01).复发患者中,15例外周血中MAGE-1 mRNA和(或)AFP mRNA持续阳性,5例术前阴性者分别于术后5个月及8个月转为阳性,另外3例术前、术后均保持阴性.经术后1年随访,无肿瘤复发的62例患者中有24例MAGE-1 mRNA和(或)AFP mRNA由术前阳性转为术后阴性.AFP mRNA阳性率与血浆AFP水平呈正相关(P<0.01),MAGE-1 mRNA阳性率与血浆AFP水平无相关性(P>0.05).外周血AFP mRNA和MAGE-1 mRNA阳性率与肿瘤直径均无相关性(P>0.05).结论联合检测外周血MAGE-1和AFP mRNA的表达是早期发现肝癌术后复发、评估预后的一项敏感可信的指标.     

乳腺癌保留乳房治疗局部复发风险因素回顾性分析

目的:探讨早期乳腺癌保留乳房术后局部复发的临床病理危险因素。方法:收集我院1998-09-01-2011-07-31收治的临床0～Ⅱ期行保留乳房手术的146例早期乳腺癌患者的病例资料,采用Cox检验对患者年龄、肿瘤大小、淋巴结状态、雌激素受体(ER)表达、孕激素受体(PR)表达、人类表皮生长因子受体2(HER-2)表达和分子分型与术后局部复发的相关性进行单因素和多因素分析。结果:中位随访61个月,9例患者首发出现患侧乳房局部复发,生存分析显示3年和5年累积局部复发率分别为6.3%和7.5%。患者年龄、肿瘤大小、ER/PR表达状态和分子分型与术后局部复发无明显相关性,P>0.05。HER-2阳性(P=0.002 1)和淋巴结阳性(P=0.03)与局部复发有相关性,且是独立影响因素。结论:HER-2阳性和淋巴结阳性是乳腺癌保留乳房术后局部复发的独立预后高危因素,而患者年龄、肿瘤大小、激素受体表达状态和局部复发无显著相关性。     

Survivin和Livin在Dukes''B期结直肠癌中的表达及其临床意义

背景与目的:Survivin和Livin是新发现的凋亡抑制蛋白(inhibitors of apoptosis proteins,IAPs)家族成员,特异性表达于肿瘤细胞和胚胎细胞,在正常细胞中较少表达,其表达与部分肿瘤预后不良相关.本研究检测Survivin及Livin在Dukes'B期结直肠癌组织中的表达并分析其临床意义.方法:收集81例根治性手术切除后的Dukes'B期结直肠癌组织,利用免疫组化SP法检测Survivin及Livin的表达并分析两种蛋白与临床特征的关系及对患者生存的影响.结果:Survivin和Livin在Dukes'B期结直肠癌组织中的阳性率分别为58.0%和45.7%,明显高于正常对照组的16.7%和8.3%(P值均＜0.05);两者表达不具有相关性(P＞0.05);Survivin及Livin在结直肠癌组织中的表达与性别、肿瘤部位、肿瘤大小、T分期、大体类型、组织分化程度均无显著性相关(P值均＞0.05);≥50岁患者Survivin的阳性率高于＜50岁患者(70.6%vs.36.7%,P＜0.05);Survivin和Livin的表达均与肿瘤复发和/或转移(P=0.02,P=0.001)、总生存不佳有关(P=0.039,P=0.001);Cox多因素分析显示T4及Livin阳性为Dukes'B期结直肠癌独立不良预后因素(P=0.002,P=0.047).结论:Survivin及Livin高表达于Dukes'B期结直肠癌组织中,Livin与根治性手术后的复发转移和患者预后关系密切.     

老年肝癌根治性切除术后肝癌复发的高危因素分析

目的:探讨老年肝癌根治性切除术后肝癌复发的高危因素。方法:选择我院于2015年1月至2017年1月期间收治的行肝癌根治性切除术的老年肝癌患者300例作为研究对象。所有研究对象均完成术后12个月随访，观察患者复发情况，其中肝癌术后复发时间以影像学检查有明确的肿块存在为确诊依据。运用多因素分析术后复发危险因素。结果:老年肝癌根治性切除术患者300例，术后随访12个月肝癌复发58例，复发率为19.33%。经单因素分析显示，两组性别、合并基础疾病、术前ALT、术前AST和手术时间比较无统计学差异（P>0.05）；两组肿瘤直径、血管侵犯、肿瘤包膜和术中失血比较具有统计学差异（P<0.05）。将上述单因素分析具有统计学意义的纳入多因素分析显示，肿瘤直径、血管侵犯、肿瘤包膜和术中失血为影响老年肝癌根治性切除术后复发危险因素。结论:老年肝癌根治性切除术后肝癌复发影响因素较多，而肿瘤直径、血管侵犯、肿瘤包膜和术中失血为其危险因素。     

Bacteria and cancer--antagonisms and benefits

There is considerable historical and recent evidence concerning the antagonisms between acute bacterial infections or their toxins and cancer and allied diseases. These data provide renewed incentives to undertake clinical programmes with mixed bacterial vaccines in many countries at the present time.     

Religiosity and physical and emotional functioning among African American and White colorectal and lung cancer patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

Renal irradiation and the pharmacology and toxicity of methotrexate and cisplatinum

We used a rat model to study the effects of renal irradiation on the pharmacology of methotrexate (MTX) and cisplatinum (cis-Pt). Unanesthetized rats were given bilateral kidney irradiation (20 Gy in 9 fractions). At 9 months after irradiation, 3% of the animals had died and survivors showed moderately impaired renal function. At 15 months, 30% of the animals had died and survivors showed severely impaired renal function. Some animals were given i.v. MTX 1 week to 15 months after irradiation. In irradiated rats, the area under the MTX plasma clearance curve equaled that of controls through 6 months, and was significantly above controls from 9 months on. Other animals were given i.p. cis-Pt 1 week to 9 months after irradiation. The acute toxicity of cis-Pt was the same in control and irradiated rats when cis-Pt was given immediately before or after irradiation. Beginning 3 months after irradiation there was a progressive increase in cis-Pt toxicity and a simultaneous decrease in urinary platinum excretion. Irradiated animals that survived cis-Pt treatment showed increased radiation nephritis; the greatest effect occurred when cis-Pt was given 3 months or more after irradiation. MTX and cis-Pt clearance decreased when renal dysfunction was first observed and changes in renal function preceded changes in drug clearance and toxicity.     

Salivary and serum proteomics in head and neck carcinomas: before and after surgery and radiotherapy

Several body fluids have been evaluated as new sources for cancer biomarker discovery. In this context, salivary and serum proteomics seem promising diagnostic and predictive tools for head and neck diseases. In the present study, we performed a proteomic analysis of saliva and serum from patients presenting head and neck squamous cell carcinoma (HNSCC) and compared the results before and after therapy. In saliva of cancer patients, we observed an altered protein profile, including over-expression of PLUNC and zinc-alpha-2-glycoprotein. Both proteins may contribute to control tumor growth and, therefore, represent targets for new analysis. We also detected serotransferrin and a modified transthyretin form with altered levels in serum from patients. Comparing preoperative and postreatment samples, the results showed that the protein profile after treatment reverted to a pattern closer to those observed for controls. These results add information on the role of secreted proteins in the cancer process and emphasize the potential of saliva and serum analysis for diagnosis and monitoring of HNSCC.     

Morphine and tumor growth and metastasis

Morphine is an analgesic widely used to alleviate cancer pain. In addition, the perioperative management of pain in cancer surgery patients most often includes opioids. However, there are reports that these drugs may alter cancer recurrence or metastasis. Several mechanisms have been proposed, such as the modulation of the immune response or cellular pathways that control the survival and migratory behavior of cancer cells. The published literature, however, presents some discrepancies, with reports suggesting that opioids may either promote or prevent the spread of cancer. It is of great importance to determine whether opioids, in particular the most widely used, morphine, may increase the risk of metastasis when used in cancer surgery. This review examines the available data on the effects of morphine which influence cancer metastasis or recurrence, including immunomodulation, tumor cell aggressiveness, and angiogenesis, with special emphasis on recently published clinical and laboratory based studies. We further discuss the parameters that may explain the difference between reports on the effects of morphine on cancer.