端粒酶活性及c-myc、p16表达与胃黏膜癌变的相关性研究

目的　研究端粒酶活性及c myc、p16在胃黏膜癌变过程中的作用。 方法　应用PCR -ELISA法检测 171例胃癌及相关组织中端粒酶活性 ;免疫组织化学法检测c myc、p16蛋白表达状况。并分析它们之间的相关性。 结果　胃癌组织端粒酶活性和c myc蛋白的表达率均最高 ,p16蛋白表达率最低 ;慢性浅表性胃炎组织 p16蛋白表达率最高。慢性萎缩性胃炎伴中、重度肠化组织中 ,端粒酶阳性和阴性组c myc和 p16蛋白表达率相互比较均有显著性差异 (P <0 .0 5 ) ;胃癌组织中 ,端粒酶阳性和阴性组c myc蛋白表达率有非常显著性差异 (P <0 .0 1) ;p16的表达率无显著性差异 (P >0 .0 5 )。 结论　在慢性萎缩性胃炎伴中、重度肠化组织中端粒酶活性和c myc的高表达及 p16的失活具有协同性 ,c myc的激活 ,p16的失活可能是端粒酶活化的 1个必要条件。     

小鼠胃癌Cyclin G1和其它相关基因表达及凋亡研究

目的:探讨胃癌中Cyclin G1、Cyclin D、p21、p16、p53、bcl-2等基因的表达水平、细胞周期变化和凋亡情况.方法:建立胃癌模型;免疫组化法检测小鼠胃癌中Cyclin G1、Cyclin D、p21、p16、p53、bcl-2等基因蛋白表达,RT-PCR技术检测Cyclin G1mRNA的表达;流式细胞术检测小鼠胃癌细胞的凋亡率和细胞周期.结果:阳性组的CvclinG1、Cyclin D表达明显高于正常组和化疗组(P＜0.05),p16则相反;各组p21、bcl-2的表达无明显差异;阳性组p53的表达为阴性,而化疗组与正常组表达无明显差异(P＞0.05);阳性组中Cvclin G1mRNA的表达水平明显高于正常组和化疗组(P＜0.05);化疗组和阳性组的细胞凋亡率均较正常组增高(P＜0.05),且化疗组的凋亡率比阳性组明显增高(P＜0.01).结论:CyclinG1、Cyclin D高表达、p16低表达可能与胃癌的发生、发展有关.     

陕北胃癌高危人群胃粘膜组织中突变型p53蛋白的表达与Hp感染的关系

目的：对胃癌高危人群胃粘膜组织中的突变型p53蛋白及Hp进行检测,探讨突变型p53蛋白与Hp感染在胃癌中的关系。方法：利用免疫组化法（S-P）检测178例胃癌高危人群胃粘膜活检标本中突变型p53蛋白的表达情况,并用HE染色和特殊染色检测Hp感染情况。结果：178例胃粘膜组织中,突变型p53蛋白在102例慢性浅表性胃炎（CSG）中的阳性表达率为4.90%,在76例慢性萎缩性胃炎（CAG）中的阳性表达率为25.00%,在伴有肠上皮化生（IM）的60例中的阳性率为40.00%,在伴有异型增生（DYS）的9例中阳性表达率为55.55%,随着病变的加重阳性表达率有增高趋势（P〈0.005）。Hp在CSG中的感染率为40.19%,在CAG中的感染率为65.78%,在伴IM中的感染率为66.67%,在伴DYS中的感染率为77.78%,随着病变的进展Hp的感染率有逐渐升高的趋势,（P〈0.005）。91例Hp阳性组中突变型p53蛋白的阳性表达率为20.87%,87例Hp阴性组中突变型p53蛋白的阳性表达率为5.74%,二者有显著性差异（P〈0.005）。结论：p53基因的突变和Hp感染是陕北胃癌高发的重要因素,可能有协同致癌作用。     

陕北胃癌高危人群胃粘膜组织中突变型p53蛋白的表达与Hp感染的关系

目的:对胃癌高危人群胃粘膜组织中的突变型p53蛋白及Hp进行检测,探讨突变型p53蛋白与Hp感染在胃癌中的关系。方法:利用免疫组化法(S-P)检测178例胃癌高危人群胃粘膜活检标本中突变型p53蛋白的表达情况,并用HE染色和特殊染色检测Hp感染情况。结果:178例胃粘膜组织中,突变型p53蛋白在102例慢性浅表性胃炎(CSG)中的阳性表达率为4.90%,在76例慢性萎缩性胃炎(CAG)中的阳性表达率为25.00%,在伴有肠上皮化生(IM)的60例中的阳性率为40.00%,在伴有异型增生(DYS)的9例中阳性表达率为55.55%,随着病变的加重阳性表达率有增高趋势(P<0.005)。Hp在CSG中的感染率为40.19%,在CAG中的感染率为65.78%,在伴IM中的感染率为66.67%,在伴DYS中的感染率为77.78%,随着病变的进展Hp的感染率有逐渐升高的趋势,(P<0.005)。91例Hp阳性组中突变型p53蛋白的阳性表达率为20.87%,87例Hp阴性组中突变型p53蛋白的阳性表达率为5.74%,二者有显著性差异(P<0.005)。结论:p53基因的突变和Hp感染是陕北胃癌高发的重要因素,可能有协同致癌作用。     

Cyclin D1和p27kip1在胃黏膜癌变过程中的表达

目的:探讨Cyclin D1和p27kip1蛋白在胃黏膜癌变过程中的表达及相互关系。方法:采用免疫组化SP法分别检测慢性浅表性胃炎(chron-ic superficial gastritis,CSG)、慢性萎缩性胃炎(chronic atrophic gastritis,CAG)、肠化生(intesti-nalm etaplasia,IM)、不典型增生(dysplasia,DYS)和胃癌(gastric carcinoma,GCA)组织中Cyclin D1和p27kip1的表达变化。结果:Cyclin D1的过表达随病变发展表达率逐渐增高,CAG组与CSG组比较,差异无统计学意义,P>0.05;IM、DYS、GCA组与CSG组比较,差异均有统计学意义,P均<0.05。p27kip1在上述黏膜中的表达呈递减趋势,CSG中最高,GCA组最低,CAG组和CSG组比较,差异无统计学意义,P>0.05;IM、DYS、GCA组与CSG组比较,差异均有统计学意义,P<0.05。Cyclin D1和p27kip1的表达呈负相关,γ=-0.53,P=0.000。结论:胃黏膜癌变过程中的Cyclin D1阳性表达呈递增趋势,p27kip1表达呈递减趋势;Cyclin D1和p27kip1表达变化发生在胃黏膜癌变早期,两者在胃癌黏膜癌变过程中的表达呈负相关提示两者可能存在相互抑制机制。     

热休克蛋白27和三叶因子Ⅱ在胃癌中的表达及与幽门螺杆菌感染关系的研究

背景与目的： 探讨热休克蛋白27(heat shock protein27, HSP27)、三叶因子Ⅱ(trefoil factors2, TFF2)在胃癌和癌前病变组织中的表达及其与幽门螺杆菌(helicobacter pylori, Hp)感染的关系。 材料与方法： 选取经病理证实的慢性浅表性胃炎、胃溃疡、慢性萎缩性胃炎和胃癌4种不同胃黏膜病变的标本共140例,用免疫组化法检测标本中HSP27和TFF2的表达及幽门螺杆菌的感染情况,分析HSP27和TFF2的表达与幽门螺杆菌感染的关系。 结果： 除TFF2在胃癌组织中表达降低外,在慢性浅表性胃炎、胃溃疡、慢性萎缩性胃炎和胃癌中,HSP27、TFF2的表达率和Hp的感染率依次呈逐渐增加的趋势。Hp感染组HSP27的表达率高于阴性组,HSP27的阳性表达率与Hp感染率之间呈正相关(r=0.235, P<0.05),Hp感染组TFF2的表达率低于阴性组,TFF2的阳性表达率与Hp感染率之间呈负相关(r=－0.259, P<0.05)。 结论： HSP27、TFF2表达和Hp感染与胃癌的发生密切相关,检测这些指标可为胃癌诊断、预后判断和指导治疗提供依据。     

不同阶段胃癌患者临床及胃镜下变化及其与HP感染的相关性

目的 观察慢性浅表性胃炎、慢性萎缩性胃炎、胃癌患者临床及内镜下变化,检测其HP感染程度,分析它们之间的相关性.方法 选取慢性浅表性胃炎、慢性萎缩性胃炎、胃癌患者,观察其临床及内镜下变化,检测其HP感染程度,分析它们之间的相关性.结果 胃癌患者Hp感染率占70％,慢性萎缩性胃炎Hp感染率占50％,慢性浅表性胃炎患者Hp感染率占35％,组间比较差异有统计学意义(P＜0.05);胃癌患者出现腹胀、腹痛、恶心、呕吐、出血、体重下降等临床表现的发生率均高于慢性萎缩性胃炎、慢性浅表性胃炎患者,差异有统计学意义(P＜0.05).腹胀者的Hp感染率(72.7％)最高,体重下降者Hp感染率(42.1％)最低,差异有统计学意义(P＜0.05).胃癌患者溃疡、肿块、出血的发生率高于慢性萎缩性胃炎、慢性浅表性胃炎患者,差异有统计学意义(P＜0.05);在Hp感染率上,有溃疡表现者Hp感染最高占60％,差异有统计学意义(P＜0.05).结论 对临床上表现为腹胀、体重减轻等消化道症状的患者应进行胃镜检查,观察是否存在溃疡等表现,并及时仔细筛查是否存在Hp感染.     

环氧合酶-2在胃癌与癌前病变和其他胃黏膜组织中表达的研究

目的:研究胃癌与癌前病变和其他胃黏膜组织中环氧合酶-2(COX-2)的表达情况,探讨COX-2蛋白作为肿瘤分子标记物对胃癌和癌前病变进行辅助诊断的意义.方法:收集胃镜活检的正常胃黏膜、慢性浅表性胃炎、慢性萎缩性胃炎、胃黏膜肠化生、胃黏膜不典型性增生和胃癌组织,用免疫组织化学染色法检测COX-2蛋白在各种组织中的阳性表达情况.以正常胃黏膜组织和正常兔血清作阴性对照.结果:COX-2蛋白在胃癌前病变和和胃癌组织中的表达阳性率为48%-84%.胃癌和胃黏膜不典型性增生标本中COX-2蛋白表达阳性率显著高于正常胃黏膜、慢性浅表性胃炎、慢性萎缩性胃炎和胃黏膜肠上皮化生标本(P<0.05).而胃癌组织COX-2蛋白表达的阳性率与胃黏膜不典型性增生组之间无显著性差异(P>0.05).此外,慢性萎缩性胃炎和胃黏膜肠化生标本与正常胃黏膜和慢性浅表性胃炎标本之间COX-2蛋白表达阳性率亦有显著性差异(P<0.05);所有病变组的COX-2蛋白表达阳性率均比正常胃黏膜组显著性地升高 (P<0.05).结论:胃癌与癌前病变组织中COX-2蛋白的表达显著升高,COX-2蛋白可作为肿瘤标记物对胃癌和胃癌前病变进行辅助诊断.     

胃癌组织NGX6和Cyclin D1表达及其生物学意义的探讨

目的:探讨胃癌组织中NGX6和Cyclin D1的表达及其生物学意义.方法:采用免疫组化SP法检测89例胃癌组织和53例正常胃黏膜组织中NGX6和Cyclin D1蛋白的表达情况.结果:NGX6蛋白在胃癌组织中的阳性表达率为51.69％,胃癌组织中阳性表达率明显高于正常胃黏膜组织的83.02％,P＜0.05;而Cyclin D1蛋白在胃癌组织中的阳性表达率为74.16％,胃癌组织中阳性表达率显著高于正常胃黏膜组织的0,P＜0.05;免疫组织化学结果显示,胃癌组织中NGX6和Cyclin D1蛋白的阳性表达呈负相关,两者均与胃癌的临床分期、浸润深度及淋巴结转移有关(P＜0.05),而与组织学分级无关.结论:NGX6和Cyclin D1蛋白表达异常可能共同参与了胃癌的发生、发展、侵袭和转移;联合检测2种蛋白对于评价胃癌的恶性程度、判断其转移潜能和预后可能具有重要的临床意义.     

胃癌及癌前病变细胞凋亡与Caspase-9,Bax表达的关系

目的:探讨细胞凋亡基因Caspase-9和Bax在胃癌前病变和胃癌发展中的作用.方法:应用免疫组化S-P法检测 Caspase-9和Bax在57例胃癌及48例非癌胃黏膜组织的表达,用原位末端标记法(TUNEL法)检测相应胃组织细胞凋亡.结果:Caspase-9蛋白在非癌胃黏膜组(慢性浅表性胃炎、慢性萎缩性胃炎、肠上皮化生、不典型增生)阳性表达率分别为 100.00%、86.67%、50.00%、42.85%,呈逐渐下降趋势.慢性浅表性胃炎组中Caspase-9蛋白阳性表达率与肠上皮化生、不典型性增生有显著性差异(P＜0.05),肠上皮化生组Caspase-9蛋白阳性表达率高于不典型增生组,但无统计学差异(P＞0.05).Bax蛋白在48例非癌胃组织中的阳性表达率分别为:慢性浅表性胃炎100.00%、慢性萎缩性胃炎80.00%、肠上皮化生56.25%、不典型增生57.14%,呈逐渐下降趋势,其中慢性浅表性胃炎组Bax蛋白阳性表达率与肠上皮化生、不典型增生有显著性差异(P＜0.05).慢性浅表性胃炎、慢性萎缩性胃炎 、肠上皮化生、不典型增生、胃癌组织中,AI值( 细胞凋亡指数)分别为(14.72±2.68)%、(10.02±2.34)%、(7.55±2.80)%、(6.09±2.35)%、(3.26±1.23)%,呈逐渐下降趋势,有显著性差异(P＜0.05).结论:Caspase-9和Bax可能参与胃癌癌前病变的形成,促进胃癌的发生.     

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.     

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。     

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.     

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).     

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 less than 0.05). Similarly, relatives of decreased myeloma patients are less satisfied with the information given to them than relatives of deceased leukemia patients (P less than 0.001). The information has improved with time, however, since the patients were more satisfied in 1986 than in 1980 (P less than 0.001) and relatives of myeloma patients still alive were more satisfied than relatives of patients who had died earlier (P less than 0.001). The opinions of patients were similar to those of their relatives. However, the relatives of leukemia patients were even more satisfied with the contact with the medical staff than the patients themselves (P less than 0.05). As many as 10-30% of the relatives never gave up hope for their relative's survival. Only two out of 27 deaths were considered not dignified. The lung carcinoma patients reported a less good quality of life (P less than 0.001), and less satisfaction with the information given (P less than 0.01), than the hematological patients from the same year. Similarly, their attitude to the medical care improved less (P less than 0.01), and they were less content with the general care than the leukemia group (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)