人体常卵巢和卵巢恶性肿瘤雌激素及孕激素受体5年研究总结

用葡聚糖－活性炭单点饱和分析法测定２６１例正常卵巢组织，１４８例卵巢恶性肿瘤组织胞浆雌激素受体和孕激素受体。结果表明，正常卵巢组织ＥＲ和ＰＲ均值和阳性率均恶性卵巢肿瘤组织。卵巢恶性病变中，性腺间质类ＥＲ和ＰＲ含量均高于上皮性肿瘤，生殖细胞源性肿瘤和转移性癌，上皮性恶生瘤中，内膜样癌的ＥＲ和ＰＲ含量高于浆液性，粘液性及透明细胞癌，提示受体含量高者有用内分泌治疗的可能和推测有转好的预后，卵巢恶性肿瘤患     

人体正常卵巢和卵巢恶性肿瘤雌激素及孕激素受体5年研究总结

用葡聚糖—活性炭单点饱和分析法测定261例正常卵巢组织,148例卵巢恶性肿瘤组织胞浆雌激素受体和孕激素受体(ER.PR)。结果表明,正常卵巢组织ER和PR均值和阳性率均高于恶性卵巢肿瘤组织。卵巢恶性病变中,性腺间质类ER和PR含量均高于上皮性肿瘤.生殖细胞源性肿瘤和转移性癌。上皮性恶性肿瘤中,内膜样癌的ER和PR含量高于浆液性,粘液性及透明细胞癌。提示受体含量高者有用内分泌治疗的可能和推测有转好的预后。卵巢恶性肿瘤患者临床分期及月经状况与其ER阳性率有关,而与PR阳性率无关。     

卵巢上皮性肿瘤CEA、HCG及S100的免疫组织化学检测的探讨

用CEA、HCG及S-100检测卵巢粘液性肿瘤、浆液性肿瘤、卵巢子宫内膜样癌及透明细胞癌。目的是探讨CEA、HCG及S-100在卵巢上皮性肿瘤的分布及其对检测卵巢上皮性肿瘤的意义。 材料和方法 48例卵巢上皮性肿瘤(粘液性肿瘤、浆液性肿瘤、子宫内膜样癌及透明细胞癌各12例),组织作常规石蜡切片,分别作HE及PAP法免疫组化染色。     

药物诱民的小鼠肺肿瘤中雌,孕激素受体的研究

本文研究肺肿瘤组织中雌激素受体（ＥＲ）和孕激素受体（ＰＲ）的水平。小鼠注射乌拉坦和己烯雌酚诱导肺肿瘤，采用免疫组化方法测定肺肿瘤中的ＥＲ、ＰＲ。乌拉坦和己烯雌酚联合导的肺性肿瘤的ＥＲ、ＰＲ阳性率比单纯乌拉坦诱导的为高，说明已烯酚可能可提高癌组织性激素受体含量。ＥＲ阳性率与恶性肿瘤大小有关，但怀良性肿瘤大小无关；ＰＲ阳性率与良、恶性肿瘤大小均无关。恶性肿瘤的ＥＲ、ＰＲ阳性率显著高于良性肿瘤。良性肿瘤     

ER、PR及PCNA在子宫内膜增生过长和内膜腺癌中的表达

为了探讨女性激素在子宫内膜腺癌和子宫内膜增生过长发病中的作用，为临床内分泌治疗提供理论依据，作者采用免疫组织化学ＳＰ法，对手术切除和诊刮的１７例子宫内膜腺癌和４０例子宫内膜增生过长标本进行ＥＲ、ＰＲ和ＰＣＮＡ含量检测，并结合组织学类型和分化程度进行分析。结果显示内膜腺癌组织中ＥＲ、ＰＲ的含量低于增生期和增生过长内膜组织（Ｐ＜０．０５），与肿瘤的组织学类型和分化有关。ＰＣＮＡ在子宫内膜腺癌中的含量显著高于非肿瘤性内膜组织（Ｐ＜０．０１），与分化程度呈负相关。与ＥＲ、ＰＲ的含量无明显相关性。结果表明ＥＲ在子宫内膜增生过长和内膜腺癌的发病中起重要作用，ＰＣＮＡ的过度表达可能与细胞的异常生长和分化有关。     

药物诱导的小鼠肺肿瘤中雌、孕激素受体的研究

本文研究肺肿瘤组织中雌激素受体（ＥＲ）和孕激素受体（ＰＲ）的水平。小鼠注射乌拉坦和已烯雌酚诱导肺肿瘤，采用免疫组化方法测定肺肿瘤中的ＥＲ、ＰＲ。乌拉坦和已烯雌酚联合诱导的肺恶性肿瘤的ＥＲ、ＰＲ阳性率比单纯乌拉坦诱导的为高，说明已烯酚可能可提高癌组织性激素受体含量。ＥＲ阳性率与恶性肿瘤大小有关，但与良性肿瘤大小无关；ＰＲ阳性率与良、恶性肿瘤大小均无关。恶性肿瘤的ＥＲ、ＰＲ阳性率（分别为４６３％和５２５％）显著高于良性肿瘤（分别为１８８％和２０２％）。良性肿瘤ＥＲ、ＰＲ同时阳性率为１１６％，同时阴性率为７２５％；恶性肿瘤ＥＲ、ＰＲ同时阳性率为３１３％，同时阴性率为３２５％。结果提示肺肿瘤可能为性激素依赖性肿瘤，并为肺癌的临床内分泌治疗提供依据     

53BP1基因在卵巢癌中的表达及其临床意义

目的:观察53BP1在不同类型卵巢癌(浆液性癌、透明细胞癌、子宫内膜样癌和黏液性癌)中的表达,探讨53BP1在卵巢癌中表达的临床意义.方法:应用免疫组化EnVision法研究157例卵巢癌(浆液性癌61例、透明细胞癌38例、子宫内膜样癌44例、黏液性癌14例)及65例正常卵巢组织中53BP1表达.结果:157例卵巢癌中,53BP1阳性表达者64例,阳性率为40.8％,而65例正常组织中,53BP1阳性率为70.8％,53BP1在卵巢癌组织中的阳性表达明显低于正常组织(P＜0.01).53BP1在不同类型卵巢癌中的阳性表达没有明显差异(P＞0.05).53BP1在卵巢Ⅱ型癌中的阳性表达高于Ⅰ型癌,但差异无统计学意义(P=0.058).53BP1在卵巢癌Ⅲ、Ⅳ期的阳性表达虽低于Ⅰ、Ⅱ期,但无统计学差异(P＞0.05).结论:53BP1失表达可能参与了卵巢癌的发生.     

卵巢透明细胞癌46例临床特征分析

目的:探讨卵巢透明细胞癌(OCCC)的临床特点和预后。方法:回顾性分析天津医科大学附属肿瘤医院1995年至2005年收治的46例卵巢透明细胞癌,对其临床症状、合并子宫内膜异位症、血CA125水平、5年生存率,对化疗的反应、预后等做分析,并与同期43例卵巢浆液性腺癌(0SCC)进行比较。结果:早期卵巢透明细胞癌患者占73.91%,明显多于浆液性乳头状囊腺癌(30.23%),(P=0.000);I期~II期5年生存率(36.84%)明显低于浆液性腺癌(73.33%),而复发率(40.9%)高于浆液性腺癌(21.43%),差异有统计学意义(P=0.002)。透明细胞癌紫杉醇联合铂类/传统铂类为主的化疗治疗有效率分别为33.33%/26.32%,差异无统计学意义(P=0.10)。与浆液性腺癌相比较,透明细胞癌常合并卵巢子宫内膜异位症(22.64%);传统意义上的满意减瘤术预后差,5年生存率分别为52.94%/36.36%,差异具有统计学意义(P=0.02)。结论:卵巢透明细胞癌以早期患者多见,易复发,对化疗不敏感,预后差;紫杉醇联合铂类化疗有效率与传统铂类化疗相比较无差异;最大限度地切除肿瘤可能会改善其预后。     

乳腺癌核仁组成区与雌激素及孕激素受体的关系

本文采用银胶染色法，雌二醇及孕酮的酶联亲和组化方法，检查了６０例乳腺癌的ＡｇＮＯＲｓ、ＥＲ和ＰＲ。６０例中女性５９例，男性１例。单纯癌２８例，髓样癌１０例，浸润性导管癌１８例，导管癌２例，粘液腺癌２例。经方差分析ＥＲ（＋）与ＥＲ（－）者间，ＰＲ（＋）与ＰＲ（－）者间、ＥＲ（＋）ＰＲ（－）与ＥＲ（－）ＰＲ（－）者间的ＡｇＮＯＲｓ数差异有显著性，Ｐ＜０．０１。以上结果表明ＡｇＮＯＲｓ数是反映细胞增生的指标，并且ＡｇＮＯＲｓ的数量与ＥＲ（＋）、ＰＲ（十）及ＥＲ（＋）ＰＲ（＋）呈负相关性，ＡｇＮＯＲｓ亦可作为乳腺癌预后的估计指标。     

MMP-14在卵巢透明细胞癌中的表达及意义

目的:检测膜型-1基质金属蛋白酶(MMP-14)在卵巢透明细胞癌和卵巢浆液性肿瘤中的表达并探讨其临床意义.方法:采用免疫组化的方法检测35例卵巢透明细胞癌、39例卵巢浆液性癌、22例卵巢交界性浆液性肿瘤和24例卵巢浆液性囊腺瘤标本中MMP-14蛋白的表达,探讨其与卵巢透明细胞癌和浆液性肿瘤临床病理因素的关系.结果:MMP-14阳性染色定位于肿瘤细胞;其中透明细胞癌阳性率为94.3％,浆液性癌阳性率为43.5％,二者相比差异显著(P＜0.01).交界性浆液性肿瘤阳性率为45.5％,浆液性囊腺瘤阳性率为8.3％,和浆液性癌相比,差异显著(P＜0.01).MMP-14蛋白的表达与透明细胞癌、浆液性癌的临床分期、淋巴结转移和Ki-67的表达无相关性(P＞0.05).结论:卵巢透明细胞癌中MMP-14蛋白的高表达反应肿瘤有更高的恶性生物学行为并有可能成为卵巢透明细胞癌不良预后的一个指标.     

Comparison of cytosol estrogen and progestin receptor status in malignant and benign tumors and tumor-like lesions of human ovary

Some human ovarian malignancies respond favorably to hormone therapy. In order to obtain more information about the endocrine properties of these malignancies, we measured estrogen (ER) and progestin (PR) receptors in 21 malignant ovarian tumors, and compared the findings with those in 29 benign tumors and 28 tumor-like ovarian lesions. There were marked differences in steroid receptor distributions between the three groups. Only 38% of the malignant tumors simultaneously contained measurable amounts of both receptors, whereas the corresponding figure was 76% for the benign tumors. Malignant tumors were more often (29%) receptor-negative than the benign ones (7%). The major difference in the tumor-like lesions was the high frequency (43%) of samples containing PR only, as compared with the two other groups. The respective concentrations (fmol/mg cytosol protein, mean ± SEM) of ER and PR were 114 ± 42 and 148 ± 76 (malignant tumors), 71 ± 34 and 132 ± 32 (benign tumors) and 19 ± 16 and 251 ± 88 (tumor-like lesions). Of the malignant tumors, endometrioid carcinoma was characterized by a relatively high mean PR content (330 ± 262), whereas in undifferentiated carcinoma a high ER content (149 ± 97) was associated with a low PR concentration (26 ± 15). Steroid receptor content was very similar in benign epithelial tumors with different histological properties. The two main groups of tumor-like lesions, endometriosis and luteal cysts, typically contained little or no ER and a relatively high amount of PR. Hormone dependency of malignant and benign ovarian tumors and tumor-like lesions does not seem similar. These data support the notion that receptor determinations from malignant ovarian tumors could aid in selection of patients for endocrine therapy in a manner similar to that already established for certain other hormone-dependent cancers.     

卵巢子宫内膜异位症合并卵巢子宫内膜样肿瘤临床病理分析及文献复习

目的:探讨子宫内膜异位症与卵巢子宫内膜样肿瘤之间的内在联系及子宫内膜异位症在卵巢肿瘤的发生、发展中的作用。方法:对2例子宫内膜异位症合并子宫内膜样肿瘤的临床资料进行临床病理分析及免疫组化染色,并复习相关文献。结果:显微镜下2例均为子宫内膜异位症合并子宫内膜样腺癌,免疫组化染色检查子宫内膜样腺体ER、PR均阳性。结论:卵巢子宫内膜异位症虽然是良性,但具有交界性、恶性潜能,约有30%的子宫内膜异位症恶变患者有子宫内膜异位症病史。不典型子宫内膜异位症是子宫内膜异位症恶变的癌前期病变,是类似于由良性至恶性上皮渐进性移行的过渡形态。子宫内膜异位症与卵巢肿瘤发病有一定的关系,取材时应多注意,尽量减少漏诊的可能。     

卵巢恶性肿瘤雌激素受体及孕激素受体的研究

应用酶联雌二醇（Ｅ２－ＨＲＰ）和酶联孕酮（Ｐｇ－ＨＲＰ）亲和组化法检测卵巢恶性肿瘤雌激素受体和孕激素受体４５例，结果ＥＲ阳性３５例，ＰｇＲ阳性３３例，其阳性检出率依次为７７％和７３％，不同类型肿瘤的受体水平有差异，上皮性癌肿的阳性检出率较转移癌高。检测结果显示：肿瘤分化越好，受体水平也越高，早期癌比晚期癌的ＥＲ，ＰｇＲ受体水平高，受体阳性者术后加用他莫西芬联合化疗治疗，其生存时间较阴性者长，复发亦     

活化白细胞黏附分子在卵巢浆液性肿瘤中的表达及其意义

 目的　研究活化白细胞黏附分子（ALCAM或CD166）在卵巢浆液性肿瘤中的表达及其意义。方法　采用免疫组织化学EnVision二步法和图像分析技术检测56例卵巢恶性浆液性肿瘤、30例卵巢交界性浆液性肿瘤和10例卵巢良性浆液性肿瘤中CD166的表达情况,分析CD166表达与卵巢浆液性腺癌临床病理学指标的关系,以及与雌激素受体（ER）、孕激素受体（PR）表达的相关性。结果　在卵巢浆液性恶性肿瘤、交界性肿瘤和良性肿瘤组织中CD166表达的阳性率分别为87.5 %（49／56）、56.7 %（17／30）和10.0 %（1／10）,三者之间比较差异均有统计学意义（χ2＝7.463、31.054、10.563,均P＜0.01）;CD166过表达与卵巢浆液性恶性肿瘤临床分期、病理学级别和淋巴结转移呈正相关（χ2＝41.205、Z＝-4.663、Z＝-2.981,均P＜0.01）;CD166在卵巢浆液性恶性肿瘤中的表达与ER、PR阳性表达呈负相关（χ2＝23.36、21.441,均P＜0.05）。结论　CD166在卵巢浆液性肿瘤中的表达水平明显上调,CD166可能在卵巢浆液性肿瘤的发生、发展中起重要作用。     

Common epithelial ovarian tumors. Immunohistochemical intermediate filament profiles

The authors studied 79 common epithelial ovarian tumors in order to ascertain the intermediate filament profiles in formalin-fixed and methacarn-fixed, paraffin-embedded surgical pathology materials. Ultra-structural correlations were attempted with several tumors. All categories of common benign and malignant epithelial tumors were examined. Antibodies used in the study included antikeratins (AE1/AE3, 35BH11, 34BE12), carcinoembryonic antigen (CEA), and vimentin. All ovarian epithelial tumors expressed keratin in uniform fashion, except high molecular weight keratin (34BE12) which was focal. Vimentin was coexpressed with cytokeratins in 42% of serous carcinomas, 71% of endometrioid carcinomas, and 7% of clear cell carcinomas. Vimentin decoration in serous carcinoma was very focal, whereas endometrioid decoration tended to involve larger areas, similar to uterine-based endometrial adenocarcinoma. Mucinous, Brenner, and solid (not otherwise specified) ovarian tumors were positive only for cytokeratin. Carcinoembryonic antigen luminal staining was present in 52% of serous carcinomas and 87% of mucinous carcinomas. Whereas there are distinct differences in intermediate filament expression among ovarian carcinomas, these differences do not allow for specific categorization of ovarian neoplasms because there is some overlap of intermediate filament expression. In order to differentiate ovarian carcinoma from other carcinomas and mesothelioma, other methods of study would be necessary in addition to intermediate filament profiles, such as CEA immunohistochemistry, mucin histochemistry, and ultrastructural study.     

Survival of patients with ovarian cancer. Apart from stage and grade, tumor progesterone receptor content is a prognostic indicator

Estrogen (ER), progesterone (PR), and androgen receptors (AR) were determined by saturation analysis in 100 cases of primary ovarian cancer and correlated with patient survival. The mean follow-up period was 5.4 years (range, 4 to 6.5 years). Positivity for PR was associated with a significantly better survival rate (P less than 0.05). A similar observation was made for AR (P less than 0.05). Tumor ER content did not correlate with survival. Ten patients with tumors that had negative results for both PR and AR all died of the disease. In 91 cases of serous, endometrioid, and mucinous carcinomas, grade, stage, and tumor PR content, but not AR content, were identified as independent prognostic factors with the use of the Cox proportional hazards model. The relative risk of patients with PR-negative tumors was 2.3 times higher than that of patients with tumors containing high (greater than or equal to 30 fmol/mg) PR levels.     

子宫内膜样腺癌组织中内分泌细胞及其雌、孕激素受体的研究

目的　探讨子宫内膜样腺癌组织中内分泌细胞与雌、孕激素受体的关系。方法　采用免疫组化S -P法 ,检测 5 0例子宫内膜样腺癌组织中嗜铬素A(CgA )、雌激素受体 (ER )及孕激素受体 (PR )的表达情况 ,并对CgA阳性的子宫内膜样腺癌组织分别进行CgA /ER及CgA/PR双重免疫组化染色。 结果　子宫内膜样腺癌组织中CgA阳性率为 44 .0 % (2 2 /5 0 )。ER阳性率为2 8.0 % (14 /5 0 ) ,PR阳性率为 5 0 .0 % (2 5 /5 0 )。子宫内膜样腺癌CgA阳性组与阴性组之间ER表达率无显著性差异 (P >0 .0 5 ) ,但PR表达率有显著性差异 (P <0 .0 5 )。 2 2例CgA阳性子宫内膜癌细胞中CgA /ER同时表达率为 10 .1% (2 2 1/2 2 0 8个细胞 ) ,CgA/PR同时表达率为 2 0 .1% (4 90 /2 44 0个细胞 )。结论　子宫内膜癌组织出现较多的内分泌细胞及ER、PR的缺失是肿瘤异质性的表现。内分泌细胞不仅影响肿瘤细胞的生长 ,而且可能与子宫内膜癌对激素治疗的抗性或激素治疗后的复发有关     

子宫内膜和卵巢部位双原发癌中端粒长度检测及同源性研究

目的：探讨宫腔子宫内膜样腺癌和卵巢子宫内膜样腺癌（双原发癌）两部位癌组织是否有同源性。方法：收集青岛大学医学院附属医院妇科2005-01-01-2013-01-01收治的16例子宫内膜和卵巢双原发癌患者的癌组织切除标本,采用荧光定量PCR法分别检测同一患者子宫内膜部位癌组织和卵巢部位癌组织中端粒DNA的相对表达量,并采用免疫组化PV-6000二步法分别检测免疫表型雌激素受体（estrogen receptor,ER）和孕激素受体（progesterone receptor,PR）的表达。结果：16例患者子宫内膜部位癌组织端粒相对长度（3.601±1.497）与卵巢部位癌组织端粒相对长度（3.71±1.556）相近,差异无统计学意义,t=1.423,P=0.175。子宫内膜和卵巢两部位癌组织ER蛋白表达相同10例（62.5%）,其中ER蛋白均阳性表达9例（56.25%）,均阴性表达1例（6.25%）;表达不同6例（37.5%）,差异无统计学意义,P=0.06;PR蛋白表达相同9例（56.25%）,其中PR蛋白均阳性表达8例（50.00%）,均阴性表达1例（6.25%）;表达不同7例（43.75%）,差异无统计学意义,P=0.09。结论：宫腔子宫内膜和卵巢两部位癌组织的子宫内膜样腺癌中,两部位癌组织的端粒长度相近,ER和PR在两部位癌组织中的表达也相似。由此推断两部位癌组织可能存在同源性,需进一步研究证实。     

Histochemical and Immunohistochemical Study of α-SMA,Collagen, and PCNA in Epithelial Ovarian Neoplasm

Background: Alpha-smooth muscle actin (α-SMA) is an isoform of actin, positive in myofibroblasts and is an epithelial to mesenchymal transition (EMT) marker. EMT is a process by which tumor cells develop to be more hostile and able to metastasize. Progression of tumor cells is always followed by cell composition and extracellular matrix component alteration. Increased α-SMA expression and collagen alteration may predict the progressivity of ovarian neoplasms. Objective: The aim of this research was to analyse the characteristic of α-SMA and collagen in tumor cells and stroma of ovarian neoplasms. In this study, PCNA (proliferating cell nuclear antigen) expression was also investigated. Methods: Thirty samples were collected including serous, mucinous, endometrioid, and clear cell subtypes. The expression of α-SMA and PCNA were calculated in cells and stroma of ovarian tumors. Collagen was detected using Sirius Red staining and presented as area fraction. Results: The overexpressions of α-SMA in tumor cells were only detected in serous and clear cell ovarian carcinoma. The histoscore of α-SMA was higher in malignant than in benign or borderline ovarian epithelial neoplasms (105.3±129.9 vs. 17.3±17.1, P=0.011; mean±SD). Oppositely, stromal α-SMA and collagen area fractions were higher in benign than in malignant tumors (27.2±6.6 vs 20.5±8.4, P=0.028; 31.0±5.6 vs. 23.7±6.4, P=0.04). The percentages of epithelial and stromal PCNA expressions were not significantly different between benign and malignant tumors. Conclusion: Tumor cells of serous and clear cell ovarian carcinoma exhibit mesenchymal characteristic as shown by α-SMA positive expression. This expression might indicate that these subtypes were more aggressive. This research showed that collagen and α-SMA area fractions in stroma were higher in benign than in malignant neoplasms.