HER-2阴性乳腺癌中VEGF、COX-2的表达及相关性研究

目的:研究血管内皮生长因子（VEGF）、环氧化酶-2（COX-2）在91例HER-2阴性乳腺癌组织中的表达及相互关系,分析其与临床病理特征及预后的关系。方法:采用免疫组化SABC法,检测91例HER-2阴性乳腺癌组织中VEGF、COX-2蛋白的表达,并与临床病理特征进行相关性分析。结果:HER-2阴性乳腺癌组织中VEGF阳性表达率为94.5%,其中47.2%为高表达（+++）,VEGF的表达与肿瘤大小、淋巴结转移相关（P<0.05）。HER-2阴性乳腺癌组织中COX-2阳性表达率为86.8%,其中34.0%为高表达（+++）,COX-2的表达与患者年龄、组织学分级、肿瘤大小、淋巴结转移及TNM分期无关（P>0.05）。VEGF与COX-2的表达呈正相关（r=0.1798,P=0.018）,VEGF/COX-2均高表达的患者淋巴结转移率高。结论:VEGF、COX-2在HER-2阴性乳腺癌组织中均高表达且两者呈正相关,联合检测VEGF、COX-2的表达对HER-2阴性乳腺癌预后判断可能具有重要价值。     

乳腺癌中血管内皮生长因子和环氧合酶-2蛋白表达与临床因素的关系

 【摘要】　目的　探讨乳腺癌组织中血管内皮生长因子（VEGF）和环氧合酶-2（COX-2）蛋白表达及其与临床的相关性。方法　应用免疫组织化学EliVision法检测60例原发性乳腺浸润性导管癌组织中VEGF和COX-2蛋白表达,分析其表达与年龄、肿瘤大小、TNM分期、肿瘤病理组织学分级和腋窝淋巴结转移等临床病理因素和预后的关系。结果　乳腺癌组织中VEGF的表达与肿瘤大小、TNM分期、病理学分级和腋窝淋巴结转移密切相关（P＜0.05）,而与年龄无关。乳腺癌组织中COX-2表达与TNM分期、病理学分级和腋窝淋巴结转移密切相关,而与年龄和肿瘤大小无关。VEGF与COX-2两者表达呈正相关（r＝0.2615,P＜0.05）。在死亡组中,VEGF和COX-2蛋白表达均明显高于生存组（P＜0.05）。结论　乳腺癌中VEGF和COX-2蛋白表达上调,与乳腺癌的发生、发展、转移及浸润密切相关。VEGF与COX-2表达在乳腺癌中呈正相关,联合检测有助于筛选出具有高复发及转移危险的乳腺癌患者,判断其预后,从而指导临床治疗。     

乳腺浸润性导管癌血管内皮生长因子和环氧化酶-2的表达及意义

目的:探讨血管内皮生长因子(VEGF)和环氧化酶-2(COX-2)在乳腺浸润性导管癌组织中的表达及其临床意义。方法:应用免疫组化法检测了100例乳腺浸润性导管癌和40例良性乳腺肿瘤组织中COX-2、VEGF的表达情况,并分析它们与生物学行为、预后的关系。结果:乳腺癌组COX-2和VEGF阳性率分别达54%和66%,与对照组比较差异有统计学意义(P<0·01);COX-2表达与VEGF显著相关(P<0·05)。两者均与乳腺癌预后有关。结论:COX-2、VEGF在乳腺癌组织中的表达较高,是影响乳腺癌患者预后的主要因素之一。因此,联合检测COX-2和VEGF对乳腺癌患者判断预后、指导用药具有重要意义。     

乳腺癌组织COX-2和Bc1-2蛋白表达及其临床意义

目的:探讨乳腺癌组织COX-2和Bc1-2蛋白的表达及其意义.方法:选取102例乳腺癌组织为研究对象,各对应的癌旁组织为对照组,并选取30例正常乳腺组织为正常对照组.采用免疫组化ABC法检测各样本的COX-2和Bc1-2蛋白表达,并时所得数据进行统计分析.结果:COX-2及Be1-2蛋白在乳腺癌组织中的阳性表达均明显高于癌旁组织及正常对照组织,P=0.000.Ⅲ、Ⅳ期患者以及淋巴结转移阳性组COX-2的阳性表达分别高于Ⅰ、Ⅱ期患者和淋巴结转移阴性组,P值分别为0.014和0.001;COX-2表达与患者年龄(P=0.866)、肿瘤大小(P=0.286)及组织学类型(p=0.148)均无相关性.淋巴结转移阳性组Bc1-2的阳性表达明显高于淋巴结转移阴性组,P=0.000;Bc1-2表达与患者年龄(P=0.260)、肿瘤大小(P=0.060)、组织学类型(P=0.170)及TNM分期(P=0.452)均无相关性.乳腺癌组织中OOX-2与Bc1-2表达显著正相关,r=0.659,P=0.01.结论:COX-2与Be1-2在乳腺癌组织中均高度表达且密切相关,两者可能共同促进乳腺癌的发生、发展.     

117例乳腺癌组织中COX-2和VEGF—C表达及临床意义

目的：分析117例乳腺癌患者癌组织中环氧化酶-2（COX-2）和血管内皮生长因子-C（VEGF—c）表达和两者的相关性,探讨其与临床病理特征,淋巴结转移及预后的关系。方法：收集117例乳腺癌患者的一般情况、临床病理特征和癌组织蜡块,构建乳腺癌组织芯片。应用免疫组化SP法检测COX-2和VEGF—C的表达。结果：117例乳腺癌组织中COX-2、VEGF—C表达分别为55．8％、58．1％,且二者呈正相关（r=0．356,P〈0．001）。COX-2和VEGF—C的表达均与临床分期、淋巴结转移及有否复发呈正相关,与肿块大小,PR,病理类型,组织学分级无关。COX-2的表达还与ER、Her-2表达呈正相关。结论：COX-2和VEGF—C在乳腺癌组织中均呈高表达且两者呈正相关,检测两者对评估乳腺癌患者的预后有一定的临床意义。     

环氧合酶-2和血管内皮生长因子-C在乳腺癌组织中的表达及预后生存分析

[目的]评价乳腺癌组织中环氧合酶-2(COX-2)和血管内皮生长因子-C(VEGF-C)在基因及蛋白水平表达,分析两者与乳腺癌患者预后的关系.[方法]采用免疫组化SP法和QRT-PCR法分别检测150例乳腺癌组织中COX-2和VEGF-C在mRNA和蛋白水平表达,并采用Kaplan-meier法和COX风险回归模型分析与乳腺癌预后生存的相关危险因素.[结果]乳腺癌组织中COX-2和VEGF-C在mRNA和蛋白水平率均高于乳腺良性组织(58.8％ vs 41.2％和58.9％ vs 41.1％,P＜0.01).单因素结果显示患者COX-2表达、临床分期、腋窝淋巴结转移、Her-2表达、组织学分级与患者的预后有关;COX多因素分析显示肿瘤大小和腋窝淋巴结是影响乳腺癌患者预后的因素.[结论]乳腺癌患者COX-2和VEGF-C表达上调,乳腺癌组织中肿瘤大小、腋窝淋巴结转移是乳腺癌患者预后的影响因素.     

HuR VEGF和COX-2 表达及临床病理因素与早期宫颈癌患者预后关系的分析

目的:分析和评价临床病理因素（年龄、临床分期、病理类型、组织学分级、癌灶大小、淋巴结转移）和生物学因素（HuR 、VEGF及COX-2）与早期（Ⅰ～Ⅱ期）宫颈癌手术预后的关系。方法:采用免疫组化方法检测早期宫颈癌组织中HuR 、VEGF及COX-2 蛋白的表达,将可能与预后有关的因素进行单因素分析后再进行多因素分析。结果:癌灶大小、HuR 蛋白阳性表达、COX-2 蛋白阳性表达与预后相关（P 均<0.05）;临床分期、组织学分级、有无淋巴结转移、VEGF蛋白阳性表达与预后明显相关（P均≤0.01）,不同年龄、病理类型与预后无关（P 均>0.05）。 组织学分级低者5 年累计生存率显著低于组织学分级高者,前者死亡危险度是后者的2.948 倍,是影响宫颈癌手术预后的第一位独立因素。其次为VEGF阳性表达,其相对危险度为2.801。结论:早期宫颈癌手术预后与临床分期、组织学分级、癌灶大小、有无淋巴结转移、HuR 蛋白阳性、VEGF蛋白阳性、COX-2 蛋白阳性有关,与年龄、病理类型无关。组织学分级、VEGF蛋白阳性是影响宫颈癌手术预后最显著的独立因素。      

COX-2、VEGF及MMP-9蛋白在上皮性卵巢癌组织中的表达及意义

目的 探讨环氧化酶-2(COX-2)、血管内皮生长因子(VEGF)及基质金属蛋白酶-9(MMP-9)在上皮性卵巢癌组织中的表达及意义.方法 采用免疫组化S-P法检测COX-2蛋白在65例上皮性卵巢癌、18例交界性卵巢肿瘤、18例良性上皮性卵巢肿瘤及9例正常卵巢组织中的表达;采用免疫组化S-P法检测VEGF、MMP-9蛋白在65例上皮性卵巢癌组织中的表达;分析COX-2蛋白与VEGF、MMP-9蛋白的表达是否存在相关性.结果 COX-2蛋白在上皮性卵巢癌及交界性卵巢肿瘤组织中的表达显著高于良性卵巢肿瘤及正常卵巢组织(P＜0.05).COX-2蛋白的过表达与上皮性卵巢癌组织中VEGF和MMP-9蛋白的表达均呈正相关(r=0.310、0.385,P＜0.05).结论 COX-2在上皮性卵巢癌及交界性卵巢肿瘤组织中的表达明显增强;COX-2可能参与上皮性卵巢癌的肿瘤血管生成及癌细胞侵袭的过程,在上皮性卵巢癌发生发展过程中起一定作用.     

乳腺浸润性导管癌中COX-2、MMP-9的表达及临床意义

目的:探讨COX-2和MMP-9蛋白在乳腺浸润性导管癌组织中的表达及其相关性.方法:应用免疫组织化学法检测52例乳腺癌组织COX-2和MMP-9蛋白的表达.结果:乳腺浸润性导管癌组织中COX-2阳性表达率为76.9%(40/52),MMP-9阳性表达率为82.7%(43/52),COX-2阳性表达与患者的年龄、肿瘤大小、雌孕激素受体无明显相关性(P＞0.05),而与淋巴结转移、TNM分期、组织学分级有关(P＜0.05);MMP-9阳性表达与患者的年龄、雌孕激素受体无明显相关性(P＞0.05),而与肿瘤大小、淋巴结转移、TNM分期、组织学分级有关(P＜0.05);乳腺浸润性导管癌组织中COX-2、MMP-9蛋白的表达之间存在显著正相关(r=0.448,P＜0.01).结论:乳腺浸润性导管癌组织中COX-2、MMP-9蛋白高表达,且两者具相关性.COX-2蛋白可通过诱导MMP-9蛋白的表达上调,增加乳腺癌细胞的侵袭力,促进乳腺癌浸润、转移.     

马钱子碱经皮给药对乳腺癌骨转移抑制机制的探讨

目的:探讨马钱子碱经皮给药对乳腺癌骨转移的抑制机制,为乳腺癌的治疗提供新的途径.方法:培养人乳腺癌细胞株MDA-MB-231,取对数生长期细胞制成单细胞悬液.20只雌性Balb/c-nu/nu裸鼠麻醉后,无菌条件下,局部骨内注射乳腺癌单细胞悬液0.2 mL,复制乳腺癌骨转移模型.20只荷瘤裸鼠随机分为马钱子碱高剂量组、中剂量组、低剂量组和模型组4组,分别给予20％(0.2 mg/g)、10％(0.1 mg/g)和5％(0.05 mg/g)浓度的马钱子碱膏(每日总剂量≤腹腔给药的半数致死量)和凡士林经皮给药,涂抹裸鼠的整个腹部和造模的部位,1 g/次,4次/d(每次间隔3 h),连续15 d.影像学观察骨转移情况;RT-PCR检测并比较各组肿瘤组织中,骨转移相关因子VEGF、COX-2和PTHrP的表达量.结果:胫骨的X射线表现,马钱子碱高剂量组和中剂量组的骨质破坏不明显,低剂量组和模型组的骨质破坏明显,甚至出现病理性骨折.RT-PCR结果显示,钱子碱高剂量组VEGF、COX-2和PTHrP mRNA的表达分别为25.30±0.90、20.63±0.73和25.56±0.54,马钱子碱中剂量组分别为24.10±0.73、20.49±0.76和25.74±0.48,马钱子碱低剂量组分别为25.27±0.75、21.02±0.65和25.65±0.44,模型组分别为24.09±0.74、21.14±0.66和25.75±0.39.与模型组比较,马钱子碱各剂量组VEGF、COX-2和PTHrP mRNA的表达量随着马钱子碱剂量的增加逐渐下降,差异均有统计学意义,P＜0.05.结论:马钱子碱经皮给药能抑制裸鼠乳腺癌骨转移瘤的生长,减轻骨损伤,其机制可能是通过调控VEGF、COX-2和PTHrP的表达而抑制乳腺癌骨转移瘤的生长.     

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.     

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.     

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。     

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。