BMI-1和 PADI4在食管鳞状细胞癌中的表达及其临床意义

目的：检测食管鳞状细胞癌组织及对应癌旁组织中肽酰基精氨酸脱亚胺酶4（PADI4）和B 细胞特异莫洛尼鼠白血病病毒整合位点-1（BMI-1）的表达,探讨其在食管鳞状细胞癌发生中的作用及临床意义,并探索两者的相关性。方法采用免疫组织化学、Western blotting 及实时定量 PCR 法检测86例食管鳞状细胞癌及配对癌旁组织标本中 PADI4和 BMI-1的表达,并分析其在食管鳞状细胞癌中的表达情况与各临床病理因素的关系。结果免疫组织化学结果显示食管鳞状细胞癌中 PADI4、BMI-1的阳性表达率分别为68．6％和73．3％,明显高于癌旁组织中的37．2％和30．2％（χ2＝17．011,P ＝0．000;χ2＝31．876,P ＝0．000）;Western blotting 显示食管鳞状细胞癌中 PADI4、BMI-1的表达量显著高于癌旁组织（0．919±0．098∶0．718±0．103,t ＝2．462,P ＝0．021;0．975±0．074∶0．717±0．071,t ＝2．640,P ＝0．014）;实时定量 PCR 显示食管鳞状细胞癌中 BMI-1、PADI4 mRNA 相对表达量比对应癌旁组织增高,但差异无统计学意义（0．091±0．005∶0．038±0．002,t ＝1．701,P ＝0．101;0．114±0．075∶0．048±0．003,t ＝1．499,P ＝0．146）。食管鳞状细胞癌中 PADI4表达与肿瘤的淋巴结转移（χ2＝5．771,P ＝0．016）、浸润深度（χ2＝6．672,P ＝0．010）、临床分期（χ2＝5．771,P ＝0．016）密切相关;BMI-1表达与淋巴结转移（χ2＝7．176,P ＝0．007）、分化程度（χ2＝13．787,P ＝0．001）、临床分期（χ2＝7．176,P ＝0．007）密切相关。另外,通过免疫组织化学及实时定量 PCR 检测发现 PADI4和 BMI-1在食管鳞状细胞癌中的表达呈正相关（r ＝0．214,P ＝0．047;r ＝0．534,P ＝0．005）。结论 PADI4和 BMI-1在食管鳞状细胞癌中表达较癌旁组织均明显升高且呈正相关,其有望成为食管鳞状细胞癌诊断及判断预后的新指标。     

HIF-1α和VEGF 的表达与肝细胞癌侵袭转移的关系

 目的 探讨HIF-1α、VEGF的蛋白表达与肝细胞癌血管新生及侵袭转移特性之间的关系。方法 采用免疫组化SP法检测肝细胞癌、癌旁肝组织和正常肝组织中HIF-1α、VEGF的表达，并计数MVD值。结果 HIF-1α在肝细胞癌中的阳性表达率为50．0％，显著高于癌旁（16．1％）和正常肝组织的（8．3％）（P=0．001）；VEGF在肝细胞癌中的阳性表达率为81）％，显著高于癌旁（59．4％）和正常肝组织（41．7％）（P=0．044）；肝细胞癌组织中MVD值显著高于癌旁和正常肝组织（P=0．001）。HIF-1α蛋白表达与有无门静脉或胆管癌栓及肿瘤分化程度有关（P〈0．05）；VEGF蛋白的表达与有无肝内或淋巴结转移及有无门静脉或胆管癌栓有关（P〈0．05）。HF-1α与VEGF表达有关（P=0．005）；HF-1α与VEGF共同表达阳性组的MVD值显著高于共同表达阴性组MVD值（P=0．001）。结论 HF-1α可能通过调节VEGF的表达促进肝细胞癌血管新生，从而促使肝细胞癌侵袭转移。     

胃腺癌组织中基质金属蛋白酶-13和 p73的表达及意义

目的研究 MMP-13、抑癌基因 p73在胃腺癌组织中的表达及其与临床病理参数的关系,评估其对胃腺癌转移预后的意义。方法应用免疫组织化学 SP 法检测 MMP-13、抑癌基因 p73在143例胃腺癌组织、55例癌旁正常组织中的表达情况,并分析其与临床病理参数的关系。结果胃腺癌组织中 MMP-13的表达显著高于癌旁组织（67．13％∶16．35％）,差异有统计学意义（χ2＝41．10,P ＝0．000）;p73的表达也显著高于癌旁组织（58．74％∶12．73％）,差异有统计学意义（χ2＝33．86,P ＝0．000）。胃腺癌中 MMP-13阳性表达与胃周围淋巴结转移（χ2＝11．835,P ＝0．001）、浸润深度（χ2＝5．177,P ＝0．032）、临床分期（χ2＝11．107,P ＝0．001）有关,而与患者年龄（χ2＝0．113,P ＝0．853）、肿瘤大小（χ2＝0．338,P ＝0．591）、癌细胞分化程度（χ2＝3．628,P ＝0．072）无关。胃腺癌中 p73阳性表达与胃周围淋巴结转移（χ2＝11．440,P ＝0．001）、癌细胞分化程度（χ2＝5．407,P ＝0．025）及临床分期有关（χ2＝9．497,P ＝0．003）,而与患者年龄（χ2＝1．567,P ＝0．222）、肿瘤大小（χ2＝0．841,P ＝0．392）及浸润深度（χ2＝0．554,P ＝0．498）无关,二者在胃腺癌组织中的表达呈正相关（r ＝0．684,P ＝0．000）。结论MMP-13和 p73可能共同参与胃腺癌的发生发展过程,可作为评估胃腺癌浸润和转移的重要生物学指标。     

血管内皮生长因子联合nm 23检测在非小细胞肺癌诊治中的意义

 目的　研究血管内皮生长因子（VEGF） 和nm 23在非小细胞肺癌（NSCLC）组织中的表达及相互关系,探讨其在NSCLC诊治中的临床意义。方法　采用免疫组织化学链酶素抗生物素蛋白-过氧化物酶连结（SP） 法检测60 例NSCLC及癌旁正常肺组织中VEGF 和nm 23 的表达,结合临床病理因素进行分析。结果　VEGF在NSCLC组织中的阳性表达率（63.3 %,38／60）显著高于癌旁肺组织 （16.7 %,10／60）（χ2＝27.22, P＜0. 01）。nm 23在NSCLC组织中的阳性表达率（53.3 %,32／60）则显著低于癌旁肺组织中的表达（88.3 %,53／60）（χ2＝17.79,P＜0. 01）。VEGF的阳性率与淋巴结转移及组织学分级呈正相关（χ2＝15.23、χ2＝ 7.25,P < 0.05）。nm 23 与淋巴结转移呈负相关（χ2＝16.93,P < 0.01）。VEGF阳性患者2年生存率明显低于阴性患者（χ2＝5.55,P＜0.05）,nm 23则相反（χ2＝12.86,P <0.05）。VEGF与nm 23 在NSCLC中表达无相关性（χ2＝1.83,P＞0.05）。结论　VEGF 和nm 23 可能与NSCLC的发生、发展有关,检测VEGF 和nm 23 可能有助于对NSCLC生物学行为的判断,对肺癌患者的诊治和预后评估有积极意义。     

VEGF在非小细胞肺癌中的表达及临床意义

[目的]探讨血管内皮生长因子（VEGF）在非小细胞肺癌（NSCLC）中的表达及其临床意义。[方法]应用免疫组化法检测30例肺癌组织和25例癌旁组织中VEGF表达。[结果]NSCLC组织中VEGF阳性表达率为70．00％,癌旁组织中的阳性表达率为20．00％（Х^2=11．745,P=0．001）;在腺癌、鳞癌、大细胞癌中VEGF阳性率差异无统计学意义（P〉0．05）;Ⅲ～Ⅳ期NSCLC中的VEGF阳性表达率为88．24％,高于Ⅰ～Ⅱ期的46．15％（Х^2=4．37,P=0．037）;VEGF在淋巴结转移组的阳性率为78.26％,在无淋巴结转移组中为42．86％,两组比较差异有显著性（Х^2=5．06,P=0．024）。[结论]VEGF在NSCLC组织中高表达;VEGF表达与NSCLC淋巴结转移、TNM分期呈正相关．而与NSCLC的组织学分类无关。     

CD44V6在肺鳞癌中的表达

目的 探讨CD44V6在肺鳞癌中的表达及其与肺鳞癌发生发展的相关性 。方法 应用免疫组织化学ABC法检测35例手术切除的新鲜肺鳞组织及 其癌旁正常肺组织的CD44V6蛋白,并将检测结果与患者的临床病理资料进行对照分析。结果 CD44V6在肺磷癌组织中的阳性表达率为65．7％（23／35）,而在癌旁正常肺组织中则无表达,二者差异有显著性（X^2=34．3,P＜0．01）;CD44V6在有淋巴结转移的肺鳞癌组织中的阳性表达率（84．2％,16／19）明显高于其在无淋巴结转移中的阳性表达率（43．8％,7／16）（X^2＝6．3,P＜0．01）;CD44V6阳性表达率随肺鳞癌组织分化程度的降低而或高,但无统计学意义（X^2=2．33,P＞0．05）;CD44V6在Ⅲ Ⅳ期肺鳞癌中的阳性表达率（86．7％,13／15）明显高于其在Ⅰ Ⅱ期中的阳性表达率（50％,10／20）,（X^2＝5．1,P＜0．01）;CD44V6阳性表达患者的3年生存率（30．4％,7／23）明显低于CD44V6阴性者（66．7％,8／12）（X^2＝4．2,P＜0．05）。结论 CD44V6可能与肺鳞癌的发生有关;CD44V6阳性预示肺鳞癌可能发生淋巴结转移,并对肺鳞癌的临床分期起到一定作用;CD44V6阳性还可作为评估肺鳞癌患者预后的参考指标。     

血管内皮生长因子及色素上皮衍生因子在乳腺癌中的表达及临床意义

目的：探讨血管内皮生长因子（VEGF）、色素上皮衍生因子（PEDF）在乳腺癌组织中的表达水平及其与乳腺癌病理特征的关系。方法采用Envision免疫组织化学方法对20例乳腺良性病变组织（纤维腺瘤）、85例乳腺浸润性导管癌组织中的VEGF、PEDF和CD34表达情况进行检测。 CD34表达反映微血管密度（ MVD ）。计数资料采用χ2检验, Spearman 等级相关分析方法进行相关性分析。结果 VEGF 在乳腺癌组织中的阳性表达率为71.7％（61/85）,高于在乳腺良性组织中的阳性表达率40％（8/20）,差异有统计学意义（χ2＝9.959, P＝0.002）;PEDF在乳腺癌组织中的阳性表达率为41.2％（35/85）,低于在乳腺良性组织中的阳性表达率90％（18/20）,差异有统计学意义（χ2＝19.683, P＝0.000）。在乳腺癌组织中VEGF与PEDF表达呈负相关（ r＝-0.365, P＝0.019）。乳腺癌组织中VEGF表达与肿瘤直径（χ2＝26.31,P＝0.000）、TNM分期（χ2＝5.428,P＝0.020）、淋巴结转移有关（χ2＝5.368, P＝0.021）;PEDF表达与TNM分期（χ2＝8.584, P＝0.003）、肿瘤直径（χ2＝11.079,P＝0.001）、绝经状态（χ2＝4.507,P＝0.034）、ER状态有关（χ2＝3.974,P＝0.046）。 MVD值在PEDF阴性组高于阳性组（38.67±6.52比22.56±5.16,Z＝-0.984,P＝0.000）,在VEGF阳性组则高于阴性组（38.78±6.28比25.36±5.12,Z＝-0.972,P＝0.000）。结论乳腺癌组织中存在PEDF、VEGF的表达相关性,且与MVD相关,对认识乳腺癌的生物学特性以及指导乳腺癌的诊疗具有重要意义。     

VEGF-D及其受体Flt-4在胰腺癌中的表达及意义

目的：探讨血管内皮生长因子D（vascular endothelial growth factor D，VEGF—D）及其受体Flt-4（fms—like tyrosine kinase-4）在胰腺癌中的表达及其与胰腺癌临床病理特征及预后的关系。方法：利用免疫组织化学染色法检测48例胰腺癌组织、32例癌旁胰腺组织及13例正常胰腺组织中VEGF—D及Flt-4蛋白的表达情况，结合临床病理特征及预后对其进行统计学分析。结果：VEGF-D及Flt-4在胰腺癌组织中的表达率显著低于癌旁胰腺组织中的表达率（P〈0．05）并显著高于正常胰腺组织中的表达率（P〈0．05），胰腺癌组织中有淋巴结转移的VEGF-D及Flt-4的表达率显著高于无淋巴结转移组的表达率（P〈0．05），VEGF-D阳性组和Flt-4阳性组患者的中位生存期及1、2、3年生存率均显著低于阴性组（P〈0．05）。结论：VEGF-D及Flt-4可促进胰腺癌淋巴结转移的发生，并可作为判断胰腺癌患者预后的预测因素。     

凋亡相关蛋白 Bcl-2和 Bax 在基底细胞样乳腺癌中的表达及意义

目的探讨 Bcl-2和 Bax 蛋白在基底细胞样乳腺癌（BLBC）中的表达及意义。方法免疫组织化学法检测43例 BLBC、57例非基底细胞样乳腺癌（non-BLBC）、60例正常乳腺组织中 Bcl-2和Bax 蛋白的表达,分析其与患者生理病理的关系。结果Bcl-2在 BLBC 中的表达率为69．77％,高于non-BLBC 的43．86％（χ2＝6．647,P ＝0．010）和正常乳腺组织的21．67％（χ2＝23．831,P ＝0．001）;Bax在 BLBC 中的表达率为20．93％,低于 non-BLBC 的45．61％（χ2＝6．564,P ＝0．010）和正常乳腺组织的76．67％（χ2＝31．270,P ＝0．001）。Bcl-2和 Bax 在 BLBC 中的表达水平与淋巴结转移（χ2＝6．927,P ＝0．008;χ2＝6．203,P ＝0．013）及 pTNM分期（χ2＝6．331,P ＝0．012;χ2＝5．972,P ＝0．015）相关。Bcl-2与 Bax 在 BLBC 中的表达呈负相关（r ＝－0．408,P ＜0．010）。结论Bcl-2和 Bax 分别在 BLBC 中高表达和低表达,两者可能共同作用使细胞增殖与凋亡平衡失调,从而促进了 BLBC 的发生、发展。     

膀胱癌组织Survivin和Livin表达及其临床意义的研究

目的：研究凋亡抑制蛋白Survivin和Livin在膀胱癌组织中的表达及其临床意义。方法：用荧光定量PCR技术检测40例膀胱癌组织、10例正常和癌旁组织中Survivin及Livin基因的表达,用蛋白质印迹法和免疫组化的方法验证,分析两者在膀胱癌组织表达及相关性。结果：荧光定量PCR检测结果显示,Survivin和Livin在正常和癌旁组均无表达,在肿瘤组表达分别为0．01（0．00～0．03）和0．42（0．03～2．23）,与正常组相比差异有统计学意义,P=0．000。两者表达与性别、肿瘤的单发和多发、分级和分期无关,P〉0．05。蛋白质印迹法检测结果显示,膀胱癌组织中Survivin蛋白的定量值为0．40±0．11,Livin蛋白为1．14±0．13,差异有统计学意义,P＝0．001。免疫组化结果显示,癌组织中Survivin表达率为47．5％（19／40）,Livin表达率为65．og（26／40）,差异无统计学意义,P＝0．118。在高分级、浸润性、多发、复发的膀胱癌组织中,Livin比Survivin表达更显著。结论：Livin与Survivin两者有相关性,可作为肿瘤复发有效的预测因子。Livin可能与膀胱癌的浸润性有关。     

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.     

New and emerging radiosensitizers and radioprotectors

The combination of chemotherapy and radiation has led to clinical breakthroughs in several disease sites, and current work continues to define optimum combinations of proven chemotherapy as well as more recently available, noncytotoxic agents. Administration of systemic therapies allows modulation of radiation response to improve tumor control (radiosensitization) or to prevent normal tissue toxicity (radioprotection). Substantial progress has been made in identifying the targets of standard chemotherapeutic radiation sensitizers and protectors as well as in the introduction of a new generation of molecularly targeted therapies in combination with radiation. We have reviewed the most recent, predominantly early phase clinical trials combining systemic agents with radiation. Although the proof of an improved schedule ultimately needs to come from well-run Phase III trials, the search among schedules could be shortened by the use of surrogate endpoints such as presence of active drug metabolites in the tumor. This has been accomplished only in a few cases and needs to become a more standard part of radiation sensitizer and protector trials.     

Fruit and vegetables and cancer risk

The possibility that fruit and vegetables may help to reduce the risk of cancer has been studied for over 30 years, but no protective effects have been firmly established. For cancers of the upper gastrointestinal tract, epidemiological studies have generally observed that people with a relatively high intake of fruit and vegetables have a moderately reduced risk, but these observations must be interpreted cautiously because of potential confounding by smoking and alcohol. For lung cancer, recent large prospective analyses with detailed adjustment for smoking have not shown a convincing association between fruit and vegetable intake and reduced risk. For other common cancers, including colorectal, breast and prostate cancer, epidemiological studies suggest little or no association between total fruit and vegetable consumption and risk. It is still possible that there are benefits to be identified: there could be benefits in populations with low average intakes of fruit and vegetables, such that those eating moderate amounts have a lower cancer risk than those eating very low amounts, and there could also be effects of particular nutrients in certain fruits and vegetables, as fruit and vegetables have very varied composition. Nutritional principles indicate that healthy diets should include at least moderate amounts of fruit and vegetables, but the available data suggest that general increases in fruit and vegetable intake would not have much effect on cancer rates, at least in well-nourished populations. Current advice in relation to diet and cancer should include the recommendation to consume adequate amounts of fruit and vegetables, but should put most emphasis on the well-established adverse effects of obesity and high alcohol intakes.     

Occupational and environmental radiation and cancer

Epidemiologic evidence on the relation between occupational and environmental radiation and cancer is reviewed. Studies of pioneering radiation workers, underground miners, and radium dial painters revealed excess cancer deaths and contributed to the setting of radiation protection standards and to theories of carcinogenesis. Occupational exposures today are generally much lower than in the past, thus any associated increases in cancer will be difficult to detect. Pooling investigations of these more recently exposed workers, however, has the potential to validate current estimates of risk used in radiation protection. New information on the effects of chronic radiation exposure also may come from studies in the former Soviet Union of Chernobyl clean-up workers and of workers at the Mayak nuclear facilities. Studies of environmental radiation exposures, other than radon, are largely inconclusive, due mainly to the difficulties in detecting the low risks associated with low dose exposures. Thyroid cancer, however, has been linked to environmental radiation from the Chernobyl accident and from nuclear weapons tests. Low-level radiation released during normal operations at nuclear plants has not been found to increase cancer rates in surrounding populations. Radon, a human carcinogen, is the most ubiquitous exposure to human populations; remediating high residential-radon levels is recommended, recognizing that the exposure can never be removed completely because it occurs naturally.     

VEGF及KDR在大肠腺瘤和腺癌中的表达及意义

目的：探讨VEGF和KDR在大肠腺瘤和大肠腺癌中的表达及临床病理特征的关系。方法：大肠腺瘤和大肠腺癌组织标本各100例,采用免疫组织化学染色法检测VEGF和KDR在标本中的表达情况。结果：VEGF和KDR在大肠腺癌组中的阳性表达明显高于大肠腺瘤组（P〈0.05）;在正常大肠黏膜均未见VEGF和KDR表达的阳性染色;VEGF阳性表达组中KDR的阳性表达率为70%,显著高于VEGF阴性表达组中KDR的阳性表达率16%,两组比较有统计学意义（P〈0.01）。结论：大肠腺癌组织中KDR的表达与肿瘤大小、转移情况、浸润深度密切相关;VEGF和KDR在大肠腺瘤中的表达与患者的年龄、性别及分型均无相关性,而与增生程度相关（P〈0.05）。在大肠腺癌患者中VEGF及KDR表达更高,二者具有协同效应。     

Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: A comprehensive review and meta-analysis

Vitamin D is formed mainly in the skin upon exposure to sunlight and can as well be taken orally with food or through supplements. While sun exposure is a known risk factor for skin cancer development, vitamin D exerts anti-proliferative and pro-apoptotic effects on melanocytes and keratinocytes in vitro. To clarify the role of vitamin D in skin carcinogenesis, we performed a review of the literature and meta-analysis to evaluate the association of vitamin D serum levels and dietary intake with cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) risk and melanoma prognostic factors. Twenty papers were included for an overall 1420 CM and 2317 NMSC. The summary relative risks (SRRs) from random effects models for the association of highest versus lowest vitamin D serum levels was 1.46 (95% confidence interval (CI) 0.60–3.53) and 1.64 (95% CI 1.02–2.65) for CM and NMSC, respectively. The SRR for the highest versus lowest quintile of vitamin D intake was 0.86 (95% CI 0.63–1.13) for CM and 1.03 (95% CI 0.95–1.13) for NMSC. Data were suggestive of an inverse association between vitamin D blood levels and CM thickness at diagnosis. Further research is needed to investigate the effect of vitamin D on skin cancer risk in populations with different exposure to sunlight and dietary habits, and to evaluate whether vitamin D supplementation is effective in improving CM survival.     

肾上腺素能β受体与肿瘤生长及转移

大量研究表明肿瘤细胞可表达β受体，而一些神经递质、药物和社会心理因素可能通过β受体影响肿瘤的生长和转移，β受体激动剂、β受体阻滞剂以及抑郁等社会心理因素可加强或削弱这种作用。这为表达β受体肿瘤的治疗开辟了新的道路，提供了新的治疗靶点。     

Cell and tissue interactions in carcinogenesis and metastasis and their clinical significance

This review describes a new vision for future directions in the study of metastatic cancer biology and pathology. It is based upon clinical and experimental observations on the constituent cell lineages within a neoplasm and on tumour-host interactions. The vision incorporates information from studies in population biology, developmental biology and experimental pathology as well as investigations upon human malignant disease. The assembled information reveals that invasion and metastasis are supra-cellular manifestations of "emergent behavior" among combinations of normal and malignant cell lineages in vivo. Emergent behavior is a combinatorial interactive process in which a population displays new traits which cannot be achieved by individuals acting separately and which subside when the specific population mix disaggregates. Disruption of such pathological interactions in the field of a developing primary or secondary tumour is, therefore, required to disable the malignant population and arrest progression without tissue destruction. These conclusions originate, in part, from principles which govern the sociobiology and group behavior of bees, ants, fish, birds and human societies. In all these social organisms, external factors can disrupt signaling mechanisms and induce expanding self-perpetuating rogue behavior, leading to social disintegration. These principles also apply to cellular societies composing higher animals, which likewise need intrinsic rules to maintain social order and avoid anarchy, and recognition of this is essential for advancing future research on the mechanisms involved in carcinogenesis and metastasis. Summarised evidence is presented here to support the conclusion that miscommunications between cells and tissues in the region of the developing tumour and its metastases are the main direct perpetrators of malignant disease. Genetic lesions (mutations, deletions, translocations, reduplications, etc.), commonly seen in cancers, can significantly disrupt important molecular pathways in the networks of communications needed to sustain orderly tissue/organ structure and function. However, genetic lesions can also, themselves, be induced by abnormal cell interactions initiated by extrinsic carcinogenic agents such as chemicals, viruses, hormones and radiation. The evidence shows that, irrespective of the initiating cause, it is this miscommunication in the region of a developing tumour and its metastases that is ultimately responsible for the emergence and progression of the disease. The article describes how this information collectively, provides a framework for designing specific novel therapeutic approaches targeting the cell and tissue interactions driving tumour metastasis and its manifold effects on the whole body.