前列腺癌,非典型增生的AgNOR数量变化的初步研究

对４３例前列腺癌、３０例前列腺非典型增生及１９例良性前列腺增生症的石蜡包埋标本，应用核仁组成区染色技术系统地观察了核仁组成区（ＡｇＮＯＲ）的数量变化。结果显示：前列腺癌平均ＡｇＮＯＲ计数显著高于良性前列腺增生症者；前列腺非典型增生的ＡｇＮＯＲ计数介于良性增生症与癌组织之间，说明前列腺非典型增生具有潜在的恶性病变。前列腺癌平均ＡｇＮＯＲｓ计数与组织学分级关系密切，随肿瘤组织的分级增高而增高，不同的组织分级之间其平均ＡｇＮＯＲ计数有显著的差异，提示ＡｇＮＯＲ颗粒与前列腺癌的分化程度有关。     

肾盂癌增生活性研究的临床意义

采用免疫组化技术和银染色技术对３１例肾盂癌及９例慢性肾盂炎症组织中增殖细胞核抗原、核仁组成区嗜银蛋白进行研究。结果发现肾盂癌ＰＣＮＡ增殖指数和ＡｇＮＯＲ颗粒计显著高于炎症组，且与肿瘤病理分级、临床分期及预后有关；肾盂癌ＰＣＮＡ增殖指数与ＡｇＮＯＲ计数间存在显著正相关性；还发现ＰＣＮＡ增殖指数＞７５％者术后易再发膀胱肿瘤。提示ＰＣＮＡ免疫染色和ＡｇＮＯＲ计数在鉴别肾盂良恶性病变和判断肾盂癌生物学行为     

膀胱肿瘤病人血淋巴细胞染色体畸变和脆性位点表达

通过对１３例膀胱移行上皮癌病人和１２例正常对照健康志愿者的外周血淋巴细胞染色体畸变及脆性位点的观察，结果提示，膀胱移行上皮癌病人外周血淋巴细胞染色体畸变率，脆性位点表达率显著高于对照组，可以作为诊断膀胱移行上皮癌和监测肿瘤复发的依据之一，但与肿瘤恶性程度，肿瘤浸润浓度无明显关系。     

结直肠癌核仁组成区嗜银蛋白的预后价值

本作者采用银染技术和流式细胞分析技术分别对８３例结直肠癌细胞的核仁组成区嗜银蛋白（ＡｇＮＯＲ）和ＤＮＡ含量进行测定，并结合临床随访和病理学资料评估其预后价值及相互关系。结果显示：结直肠癌组ＡｇＮＯＲ平均计数（９．７９±３．６７０）明显高于正常结肠粘膜组（２．９３７±０．８１２）。不同组织学分级的ＡｇＮＯＲ有显著性差异（ｐ＝０．０２３），分化好的肿瘤ＡｇＮＯＲ计数低。术后生存≥５年组的ＡｇＮＯＲ数（８．１７７±３．２９６）低于＜５年组（１１．６２２±３．１２３），二组间差异显著（Ｐ＜０．００１）。高ＡｇＮＯＲ（≥１０）组患者的术后生存率亦明显低于ＡｇＮＯＲ＜１０组的患者。结合ＤＮＡ倍体进行分析，ＡｇＮＯＲ＜１０的二倍体肿瘤患者的预后最好，而ＡｇＮＯＲ≥１０的异倍体肿瘤的预后最差，提示ＡｇＮＯＲ是一项预后参考指标，与ＤＮＡ从不同水平影响结直肠癌的恶性潜能，联合检测ＡｇＮＯＲ和ＤＮＡ可较好地反映结直肠癌患者的预后。     

膀胱癌c—erbB—2癌基因蛋白表达与Ag—NORs定量计数的关系

采用免疫组化方法和胶质银染色技术对５６例膀胱移行上皮癌组织的ｃ－ｅｒｂＢ－２癌基因蛋白表达产物进行检测和对嗜银蛋白核仁组成区（Ａｇ－ＮＯＲｓ）进行定量计数，结果显示：ｃ－ｅｒｂＢ－２蛋白产物表达与膀胱癌的分化程度有关，高分级肿瘤的表达水平高于低分级肿瘤。在ｃ－ｅｒｂＢ－２表达阳性的肿瘤标本中的Ａｇ－ＮＯＲｓ计数（５．２３±０．６５）明显高于ｃ－ｅｒｂＢ－２表达阴性的标本（３．３４±０．４２）（Ｐ〈     

尿脱落细胞学嗜银染色技术在膀胱移行细胞癌筛选中的应用

尿脱落细胞学嗜银染色技术在膀胱移行细胞癌筛选中的应用张庆江唐孝达魏强张秀辉本研究通过揭示尿脱落细胞中ＡｇＮＯＲ颗粒与疾病良恶性的关系，试图寻找新的膀胱移行细胞癌筛选方法。材料和方法（１）观察对象：来源于１９９５年１０月～１９９６年５月间华西医科大学附...     

食管鳞状细胞癌核仁组成区嗜银蛋白的研究

采用银染技术对根治切除的５０例食管鳞癌进行核仁组成区嗜银蛋白＊ＡｇＮＯＲ）染色，探讨ＡｇＮＯＲ与临床病理及预后的关系，结果发现ＡｇＮＯＲ计数越高，肿瘤分化越差（Ｐ＜）．０１），淋巴结转移率越高）Ｐ＜０．０５），预后也越差（Ｐ＜０．０１）。表明ＡｇＮＯＲ可作为阉断食管鳞癌恶性程度的客观定量指标，也是估计预的可靠指标。     

纤溶酶原激活物在膀胱移行细胞癌中的表达及其意义

采用免疫组化法检测３２例膀胱移行细胞癌组织及１０例正常膀胱组织中尿激酶型纤溶酶原激活物（ｕＰＡ）表达，另用底物发色法测定２４例膀胱移行细胞癌组织和１０例正常膀胱组织中组织型纤溶酶原激活物（ｔＰＡ）活力。结果显示膀胱肿瘤组织中ｕＰＡ呈不同程度阳性染色，并与膀胱肿瘤分期分级有关（Ｐ＜０．０５），正常膀胱组织染色阴性。正常膀胱组织和膀胱肿瘤组织之间及不同分期、分级的膀胱肿瘤组织之间ｔＰＡ活力无显著性差异（Ｐ＞０．０５）。结果表明，ｕＰＡ可作为判断膀胱肿瘤恶性程度指标之一。     

膀胱癌患者血及肿瘤组织尿激酶含量的检测

目的　了解尿激酶型纤溶酶原激活剂（ｕＰＡ） 与膀胱肿瘤恶性程度及浸润深度之间的关系。　方法　采用酶联免疫吸附实验（ＥＬＩＳＡ） 检测５１ 例膀胱移行细胞癌病人术前、术后静脉血及肿瘤组织ｕＰＡ 含量。　结果　Ｇ３ 肿瘤组织ｕＰＡ 含量明显高于Ｇ１ 和Ｇ２（ Ｐ 均＜ ０ ．０１） ，Ｇ１ 与Ｇ２ 间ｕＰＡ差异无显著性；浸润癌肿瘤组织ｕＰＡ 含量明显高于表浅肿瘤组织（ Ｐ＜ ０ ．０５） 。病人术前及术后静脉血ｕＰＡ 含量与正常人静脉血ｕＰＡ 含量差异无显著性。　结论　肿瘤组织ｕＰＡ 含量可以反映膀胱肿瘤的恶性程度和肿瘤浸润深度。     

AgNOR在肾盂癌中的表达及临床意义

为探讨细胞核仁组成区相关嗜银蛋白在肾盂癌中的表达，对２９例肾盂癌和１０例正常肾盂组织标本进行了银染色。结果表明，肾盂癌ＡｇＮＯＲ计数明显高于正常肾盂组织；ＡｇＮＯＲ计数随肿瘤病理分级和分期的上升而增加。     

肝细胞癌肝移植89例预后分析

目的　总结肝细胞癌(HCC)肝移植临床经验,探讨HCC肝移植的预后影响因素。方法　应用单因素分析和逐步Logistic回归多因素分析方法,回顾性分析自1999年1月至2003年12月我单位施行的89例HCC肝移植患者的生存情况及各项临床病理指标对预后的影响。结果　移植后6个月、1年和2年累积生存率分别为81. 8%、55. 3%和43 .7%, 6个月、1年和2年无瘤生存率分别为62 .4%、35. 6%和24 .9%;随访期间肿瘤转移复发的总发生率为52 8%;Log rank检验结果显示,影响HCC患者肝移植术后累积生存率的因素为门静脉主干或分支癌栓形成(PVTT) (χ2 =15 14,P=0. 0001)、肿瘤大小(χ2 =15. 05,P=0 .0001 )、肝硬化背景(χ2 =6 14,P=0 .0132 )、术前甲胎蛋白(AFP)水平(χ2 =5 .82,P=0. 0159)和组织学分级(χ2 =4. 61,P=0 .0319);影响无瘤生存率的因素包括PVTT(χ2 =26 .30,P<0. 0001 )、肿瘤大小(χ2 =25 .25,P<0 0001 )、AFP水平(χ2 =14. 83,P=0 .0001)、组织学分级(χ2 =12 54,P=0. 0004 )、肿瘤分布(χ2 =12 73,P=0. 0004 )、肿瘤数目(χ2 =9 81,P=0 0017)以及肝硬化背景(χ2 =9 .76,P=0 .0018)。多因素分析结果显示,与累积生存率显著相关的因素是PVTT(RR=4. 721,P=0. 001 )、年龄(RR=3. 282,P=0 .007 )和组织学分级(RR=2. 368,P=0.     

Computerized nuclear morphometry: a reproducible cytopathologic marker of head and neck cancer

Computerized nuclear morphometry (CNM) has been compared with the standard histopathologic grading of squamous cell carcinoma in patients who have undergone chemotherapy for head and neck cancers. Statistics were significant between the histopathologic and CNM readings that were done. CNM represents an objective method of quantitating the histopathologic readings of nuclear pheomorphism and cancer differentiation to allow these criteria to be used as prognostic indicators in squamous cancers. CNM readings of individual biopsy specimens from patients were shown to characterize each tumor. This may represent a cytopathologic method for tracking a cancer through whatever course of therapy is given.     

前列腺癌Gleason分级评分与血清PSA、原位PSA的变化和34βE12、P504S免疫表型的研究

目的 :探讨前列腺癌Gleason分级评分与血清前列腺特异抗原 (PSA)、原位PSA及基底细胞角蛋白(34βE12 )、α 甲酰基辅酶A(P5 0 4S)免疫组织化学表达的关系。 　方法 :检测 4 0例前列腺癌患者血清PSA值 ,并根据苏木精 伊红切片进行Gleason分级评分 ,其中免疫组化标记PSA 35例 ,34βE12 12例 ,P5 0 4S 10例。 　结果 :前列腺癌Gleason分值越高 ,血清PSA值越高 (P <0 .0 1) ,原位表达PSA阳性越弱 (P <0 .0 5 ) ;肿瘤组织阳性表达P5 0 4S ,但不表达 34βE12。　结论 :前列腺癌Gleason分值与患者血清PSA呈明显的正相关性 ,与原位PSA阳性表达呈明显的负相关性 ;34βE12、P5 0 4S免疫组织化学表达对前列腺癌的病理诊断具有重要价值。     

Transrectal fine-needle aspiration biopsy for cytologic diagnosis and grading of prostatic carcinoma

In this article, the Karolinska experience of transrectal fine-needle aspiration biopsy of prostatic carcinoma, which now extends over more than twenty years, is evaluated. The cytologic criteria for diagnosing prostatic carcinoma in aspirates are well defined. While accuracy for cytodiagnosis is similar to that of histopathologic diagnosis, fine-needle aspiration is a less traumatic, cheaper procedure compared with histologic biopsy methods. Accuracy depends very much upon the skill of the examiner taking the cell samples and on the alertness of the cytopathologist for possible diagnostic pitfalls. Cytologic grading of prostatic carcinoma into well, moderately, and poorly differentiated types has been shown to be correlated significantly not only to histopathologic grading, but also to clinical stage, response to hormonal therapy and survival. The degree of tumor differentiation is well reproduced by independent observers. Cytochemical parameters, such as DNA measurement, constitute a potential refinement of cytologic grading, especially in moderately differentiated carcinomas. In medical centers with long experience of fine-needle aspiration biopsy, the method has a central role in diagnosis and management of prostatic carcinoma, including posttherapy follow-up.     

Neoadjuvant radiochemotherapy of oral cavity and oropharyngeal cancer: evaluation of tumor response by CT differs from histopathologic response assessment in a significant fraction of patients

BACKGROUND: Our aim was to compare and assess the predictive value of CT and histopathologic grading of tumor regression at primary tumor sites in patients with squamous cell carcinoma of the oral cavity and oropharynx after neoadjuvant (preoperative) radiochemotherapy (RCT). METHODS: We investigated 55 patients with carcinomas of the oral cavity and oropharynx who underwent RCT before curative surgery. Two blinded observers measured RCT-induced reduction of tumor volume in pretherapeutic and posttherapeutic CT scans. Volume changes were compared with histopathologic findings obtained at surgery. RESULTS: Histopathologic response evaluation revealed 31 complete remissions, 12 cases of partial response, and 12 nonresponders. We performed a logistic regression analysis to evaluate whether measured volume reduction could predict the likelihood of belonging to a certain response group. Taken together, we found 35 correct, 12 false-negative, and seven false-positive predictions. CONCLUSIONS: The extent of remission as assessed by CT scans 4 to 5 weeks after completion of neoadjuvant RCT leads to false predictions in a significant percentage of patients.     

Cox-2和VEGF在胃肠道间质瘤中的表达及其相关性研究

目的：探讨环氧合酶-2（Cox-2）和血管内皮生长因子（VEGF）在胃肠道间质瘤（GIST）中的表达及其与临床病理特征的关系,分析两者在GIST中的作用及相关性。方法：用免疫组织化学染色检测104例GIST中Cox-2和VEGF的表达．分析Cox-2和VEGF的表达与GIST临床病理特征的关系及其相关性。结果：①104例GIST中Cox-2和VEGF的阳性表达率分别为76．0％、68.3％。②Cox-2和VEGF的表达与病人的性别、年龄、肿瘤部位、大小等临床病理特征无关．而与组织学分级有关。③Cox-2和VEGF的表达呈正相关。结论：Cox-2和VEGF的表达与组织学分级相关,提示Cox-2和VEGF在GIST的发生、发展中发挥重要作用,可作为GIST组织学良恶性评价的潜在指标.     

Oligodendroglioma

Opinion statement Before treatment can be initiated, an accurate histopathologic diagnosis must be made. There is still some controversy regarding histologic criteria for the diagnosis of oligodendroglioma and which grading system is best. Molecular diagnosis is becoming an important adjunct to traditional histopathologic diagnosis. For low-grade oligodendrogliomas, maximal surgical resection should be attempted if technically feasible. Radiation therapy or chemotherapy should be deferred unless the patient has significant neurologic symptoms or growth of tumor. Aggressive or anaplastic tumors should also be treated with maximal surgical resection. Increasingly, chemotherapy is replacing radiation therapy as the initial postoperative treatment, with radiation therapy being either delayed until after completion of chemotherapy or, in select patients, deferred until recurrence.     

Mode of spread in the early phase of lymphatic metastasis in pancreatic ductal adenocarcinoma: prognostic significance of nodal microinvolvement

BACKGROUND: The aim of this study was to assess the prognostic significance of nodal microinvolvement as well as the mode of spread in the early phase of lymphatic metastasis in patients with node-negative pancreatic ductal adenocarcinoma. METHODS: Lymph nodes from 48 node-negative patients with R0 resected pancreatic ductal adenocarcinoma were sampled from 3 different compartments: 1) distal hepatoduodenal ligament, 2) superior-anterior compartment, and 3) posterior-inferior. Tissue sections of 148 lymph nodes classified as tumor free by routine histopathology were examined, using a sensitive immunohistochemical assay with the antiepithelial monoclonal antibody Ber-EP4 for tumor cell detection. With regard to histopathologic tumor staging and grading, 26 (54.2%) of the patients were staged as pT1/pT2, 22 (45.8%) as pT3/pT4, while 31 (64.6%) as G1/G2 and 17 (35.4%) patients as G3.Of the 148 "tumor free" lymph nodes, 56 contained Ber-EP4-positive tumor cells. These 56 lymph nodes were from 28 of the 48 patients. The multivariate Cox regression analysis revealed the independent prognostic impact of nodal microinvolvement on relapse-free and overall survival. Analysis by compartment, from which the lymph nodes were collected, revealed that overall survival time (P = 0.006) and time to local recurrence (P = 0.015) depend on the presence of nodal microinvolvement in the superior-anterior compartment. CONCLUSIONS: The influence of occult tumor cell dissemination in lymph nodes of patients with histologically proven pancreatic ductal adenocarcinoma supports the need for further tumor staging through immunohistochemistry. This could be a helpful tool in proper selection of patients for adjuvant chemotherapy.     

Fluorescence investigations to classify malignant laryngeal lesions in vivo

BACKGROUND: The extent of surgical resection for malignant laryngeal lesions influences voice quality. An instrument to estimate histopathologic grading of dysplasia in vivo may spare normal tissue without increasing the risk of local failure. METHODS: Laryngeal lesions (N = 39; 21 after administration of delta-aminolevulinic acid (ALA)) were investigated with laser-induced fluorescence, and the results correlated to histopathologic grading in 4 groups: non/mild dysplasia (I), moderate dysplasia (II), severe dysplasia/cancer in situ (III), and carcinoma. RESULTS: At 337-nm excitation, there were differences in the fluorescence ratio I(431)/I(390) between groups I/III and carcinoma. Following 405-nm excitation, I(500 nm) group I differed significantly from group III and cancer. The sensitivity for the fluorescence method was 89%, and the specificity was 100%. CONCLUSIONS: There are differences in the in vivo tissue fluorescence between tissue with different gradings of dysplasia and carcinoma.