细胞周期蛋白依赖性激酶12、聚腺苷二磷酸核糖聚合酶1在胃癌组织中的表达及临床意义

目的 探究细胞周期蛋白依赖性激酶12(CDK12)、聚腺苷二磷酸核糖聚合酶1(PARP1)在胃癌组织中的表达及临床意义.方法 收集76例胃癌患者的胃癌组织标本及相应癌旁正常胃黏膜组织标本(距离肿瘤组织﹥5 cm).采用免疫组化法检测CDK12蛋白、PARP1蛋白在胃癌组织及癌旁正常胃黏膜组织中的表达.利用Ualcan和GEPIA数据库对胃癌组织及癌旁正常胃黏膜组织中CDK12、PARP1 mRNA表达差异进行比较,并分析胃癌组织中CDK12、PARP1 mRNA表达相关性;采用Cox回归分析对胃癌患者预后影响因素进行分析.结果 Ualcan和GEPIA数据库显示,胃癌组织中CDK12、PARP1 mRNA表达水平均明显高于癌旁正常胃黏膜组织(P﹤0.05).CDK12 mRNA和PARP1 mRNA表达呈正相关(P﹤0.05).胃癌组织中CDK12、PARP1阳性表达率均明显高于癌旁正常胃黏膜组织,差异均有统计学意义(P﹤0.01).不同TNM分期、分化程度、淋巴结转移情况的胃癌患者的胃癌组织中CDK12和PARP1蛋白表达情况比较,差异均有统计学意义(P﹤0.05).CDK12、PARP1蛋白阳性表达组胃癌患者5年生存率均明显低于阴性表达组,差异均有统计学意义(P﹤0.01).CDK12蛋白阳性表达、PARP1蛋白阳性表达、TNM分期Ⅲ～Ⅳ期、分化程度低、淋巴结转移是影响胃癌患者预后的独立危险因素(P﹤0.01).结论 胃癌组织中CDK12、PARP1蛋白呈高表达,二者表达水平与TNM分期、分化程度、淋巴结转移有关,可能作为提示胃癌患者预后不良的潜在生物标志物.     

YAP、VGLL4蛋白在胃癌组织中的表达及对侵袭和转移的影响

目的:探讨YAP、VGLL4蛋白在胃癌组织中的表达对侵袭和转移的影响。方法:采用免疫组织化学SP法及Western blot法检测胃癌组织及癌旁组织中YAP、VGLL4蛋白的表达情况,分析其表达与胃癌临床病理参数的关系,从而判断其对侵袭和转移的影响。结果:YAP、VGLL4的阳性表达主要位于细胞核,少数在胞浆表达。YAP在胃癌组织中较癌旁组织表达增加,且与患者年龄、肿瘤分化、浸润深度、淋巴结转移和TNM分期呈正相关。VGLL4蛋白在胃癌组织中较癌旁组织表达减少,且与浸润深度、淋巴结转移和TNM分期呈负相关。结论:YAP蛋白在胃癌组织中表达升高,与肿瘤发展和恶性程度呈正相关,肿瘤容易发生侵袭和转移,VGLL4在胃癌组织中呈明显下降趋势,且与肿瘤发展和恶性程度呈负相关。     

survivin与c-MYC在胃癌组织中的表达及意义

目的 探讨胃癌组织中survivin和c-MYC的表达及意义.方法 采用免疫组化法检测24例胃癌组织及其癌旁正常组织中survivin和c-MYC的阳性表达情况,分析其与临床特征的关系.结果 胃癌组织中survivin和c-MYC的阳性表达率明显高于癌旁正常组织(P﹤0.01).低分化癌组织中survivin的阳性表达明显高于高、中分化癌(P﹤0.01),Ⅲ～Ⅳ期癌组织中survivin的阳性表达高于Ⅰ～Ⅱ期(P﹤0.05),有淋巴结转移的癌组织中sur-vivin的阳性表达高于无淋巴结转移者(P﹤0.05).低分化癌组织中c-MYC的阳性表达明显高于高、中分化癌,Ⅲ～Ⅳ期癌组织中c-MYC的阳性表达明显高于Ⅰ～Ⅱ期,有淋巴结转移的癌组织中c-MYC的阳性表达明显高于无淋巴结转移者,差异均有统计学意义(P﹤0.01).胃癌组织中survivin与c-MYC、分化程度、TNM分期呈正相关(r=0.856、0.973、0.630,P﹤0.01),与淋巴结转移亦呈正相关(r=0.472,P﹤0.05);胃癌组织中c-MYC与分化程度、TNM分期、淋巴结转移呈正相关(r=0.714、0.734、0.590,P﹤0.01).结论 在胃癌组织中survivin和c-MYC表达较高,对胃癌的发生、发展起到促进作用,可成为胃癌诊断的判断指标.     

胃癌原发灶和淋巴结转移灶HER2表达的临床意义

目的 观察HER2在胃癌原发灶和淋巴结转移灶中的表达及其临床意义.方法 选取胃癌患者140例,其中淋巴结转移94例.采集胃癌患者的原发灶、淋巴结转移灶及癌旁组织,采用免疫组织化学法(Elivision)方法检测3种组织中HER2蛋白表达情况.结果 140例胃癌原发灶组织中HER2蛋白阳性表达与胃癌TNM分期、浸润深度及淋巴结转移有关(P<0.05),而与患者性别、年龄和分化程度无关(P>0.05),癌旁组织中HER2表达与性别、年龄、分化程度、TNM分期、浸润深度及淋巴结转移均无关(P>0.05);HER2蛋白在胃癌原发灶、淋巴结转移灶中表达水平均高于癌旁组织,差异有统计学意义,而94例淋巴结转移灶和对应的胃癌原发灶中HER2表达的差异无统计学意义;94例有淋巴结转移的患者淋巴结转移灶与原发灶HER2表达一致率为89.4%,两类标本HER2表达状态具有一致性(Z=6.386,P<0.001).结论 胃癌HER2蛋白的阳性表达与胃癌TNM分期、浸润深度及淋巴结转移有关,提示HER2的表达与胃癌的浸润转移有关;胃癌原发灶和淋巴结转移灶HER2的表达具有较好的一致性,患者在不能获取原发病灶的情况下,检测转移灶中HER-2可能为靶向治疗的选择提供依据,为晚期胃癌患者带来希望.     

STAT3和p38MAPK在胃癌中的表达及临床意义

[目的]探讨STAT3和p38MAPK在胃癌中的表达及临床意义.[方法]采用免疫组化法检测80例胃癌组织及40例癌旁组织中STAT3和p38MAPK的表达.[结果]80例胃癌组织中STAT3的阳性表达率为72.5％,明显高于癌旁组织的17.5％ (P＜0.001); STAT3的表达与胃癌患者性别、年龄、浸润深度无关(P＜0.05),而与分化程度、淋巴结转移、TNM分期、远处转移有关(P＜0.001).80例胃癌组织中p38MAPK的阳性表达率为71.3％,明显高于癌旁组织的12.5％(P＜0.05);p38MAPK的表达与胃癌患者性别、年龄、淋巴结转移无关(P＞0.05),而与分化程度、浸润深度、TNM分期、远处转移有关(P＜0.001).胃癌中STAT3和p38MAPK的表达呈正相关(r=0.6986,P＜0.01).[结论]胃癌中STAT3和p38MAPK均过表达,可能与胃癌的发生发展有关.     

p-MTOR在结肠癌中的表达及与患者病理学特征的关系

目的 探讨结肠癌组织中磷酸化雷帕霉素靶蛋白(p-MTOR)表达的变化及其对患者预后的影响.方法 选取结肠癌组织标本110例及其对应的癌旁组织110例,采用免疫组化染色法检测两组标本中的p-MTOR蛋白表达水平,分析p-MTOR蛋白表达与患者临床病理特征及远期预后的关系.结果 结肠癌组织中p-MTOR蛋白阳性表达率为54.55%,明显高于癌旁组织的10.00%,差异有统计学意义(P﹤0.01);不同TNM分期、浸润深度及是否有淋巴结转移患者结肠癌组织中p-MTOR蛋白阳性表达率比较,差异有统计学意义(P﹤0.01);结肠癌组织中p-MTOR蛋白阳性表达患者的3年生存率(28.33%)明显低于p-MTOR蛋白阴性表达患者(55.00%),差异有统计学意义(χ2=8.364,P=0.004);TNM分期增高、发生淋巴结转移、浸润肌层、p-MTOR蛋白阳性表达是结肠癌患者不良预后的独立危险因素(P﹤0.05).结论 结肠癌组织中p-MTOR蛋白的表达水平上调,并且与患者的TNM分期、淋巴结转移及浸润深度有关,是患者不良预后的独立危险因素.     

钙蛋白酶小亚基1与核因子κB在乳腺癌中的表达及与患者临床特征的关系

目的 探讨钙蛋白酶小亚基1(CAPN4)与核因子κB(NF-κB)在乳腺癌中的表达及与患者临床特征的关系.方法 取98例乳腺癌患者的乳腺癌组织和相应的癌旁组织,免疫组化法检测CAPN4、NF-κB蛋白的表达情况,分析其与乳腺癌患者临床特征的关系.采用Spearman法分析CAPN4和NF-κB蛋白表达的相关性.随访1年,比较不同CAPN4、NF-κB蛋白表达情况乳腺癌患者同侧乳腺癌复发率和术后肿瘤细胞转移率.结果 乳腺癌组织中CAPN4、NF-κB蛋白的高表达率均明显高于癌旁组织(P﹤0.01).TNM分期为Ⅲ～Ⅳ期、中低分化程度、雌激素受体表达阳性、有淋巴结转移乳腺癌患者乳腺癌组织中CAPN4、NF-κB蛋白高表达率均高于TNM分期为Ⅰ～Ⅱ期、高分化程度、雌激素受体表达阴性、无淋巴结转移的乳腺癌患者,差异均有统计学意义(P﹤0.05).Spearman相关分析结果显示,CAPN4蛋白的表达与NF-κB蛋白的表达呈正相关(P﹤0.05).术后随访1年,CAPN4高表达患者同侧乳腺癌复发率为17.31%,高于CAPN4低表达患者的4.35%(P﹤0.05),术后肿瘤细胞转移率为19.23%,高于CAPN4低表达患者的4.35%(P﹤0.05);NF-κB高表达患者同侧乳腺癌复发率为18.18%,高于NF-κB低表达患者的2.33%(P﹤0.05),术后肿瘤细胞转移率为18.18%,高于NF-κB低表达患者的4.65% (P﹤0.05).结论 CAPN4和NF-κB蛋白在乳腺癌患者乳腺癌组织中均呈高表达,与TNM分期、分化程度、雌激素受体表达情况和淋巴结转移情况密切相关,二者可能协同促进了乳腺癌的发生发展.     

成纤维细胞生长因子受体1和血管内皮生长因子在肺鳞癌中的表达及与预后的关系

目的 观察成纤维细胞生长因子受体1(FGFR1)和血管内皮生长因子(VEGF)在肺鳞癌中的表达,并分析其与预后的相关性.方法 收集肺鳞癌组织标本135例和癌旁组织标本125例.采用免疫组织化学染色法检测不同肺组织中FGFR1和VEGF的表达水平,分析两者表达与临床病理参数的关系.肺鳞癌患者预后的影响因素采用Cox多因素分析.结果 肺鳞癌组织标本中FGFR1和VEGF的阳性表达率和表达水平均高于癌旁组织(P﹤0.05);在肺鳞癌组织中,FGFR1阳性表达与肿瘤分化程度、淋巴结转移、远处器官转移及TNM分期有关(P﹤0.05),VEGF阳性表达与肿瘤分化程度、淋巴结转移及TNM分期有关(P﹤0.05);Cox多因素分析结果显示,肿瘤分化程度、淋巴结转移、TNM分期、FGFR1及VEGF均为肺鳞癌预后的独立因素(P﹤0.05).结论 肺鳞癌患者的FGFR1和VEGF表达水平升高,并在肿瘤分化、淋巴结转移、TNM分期及预后中发挥重要作用.     

斯钙素2、转移抑制基因23-H1在宫颈癌组织中的表达及临床意义

目的 探讨宫颈癌组织中糖蛋白激素蛋白斯钙素2(STC2)、转移抑制基因23-H1(NM23-H1)的表达情况及其临床意义.方法 收集90例宫颈癌患者(宫颈癌组)的病变组织,再收集30例健康女性(正常组)的宫颈组织,采用免疫组织化学法检测组织中STC2、NM23-H1表达情况,并分析其与宫颈癌患者临床特征的关系.结果 宫颈癌组组织中STC2阳性表达率明显高于正常组,NM23-H1阳性表达率明显低于正常组,差异均有统计学意义(P﹤0.01).Spearman相关性分析显示,STC2阳性表达与宫颈癌的发生呈正相关(r=0.358,P﹤0.01),NM23-H1阳性表达与宫颈癌的发生呈负相关(r=-0.361,P﹤0.01).不同浸润深度、分化程度、TNM分期及淋巴结转移情况的宫颈癌患者的宫颈癌组织中STC2阳性表达情况比较,差异均有统计学意义(P﹤0.05);不同淋巴结转移情况的宫颈癌患者的宫颈癌组织中NM23-H1阳性表达情况比较,差异有统计学意义(P﹤0.05).Logistic回归分析结果显示,浸润深度﹥1/2肌层、低～未分化、TNM分期为Ⅲ+Ⅳ期、淋巴结转移均是STC2阳性表达的独立危险因素(P﹤0.05),淋巴结转移是NM23-H1阴性表达的独立危险因素(P﹤0.05).结论 宫颈癌组织中STC2、NM23-H1表达存在明显异常,并与宫颈癌的发生、发展密切相关,浸润深度﹥1/2肌层、低～未分化、TNM分期为Ⅲ+Ⅳ期、淋巴结转移是影响STC2阳性表达的独立危险因素,淋巴结转移则是影响NM23-H1阴性表达的独立危险因素.     

表皮生长因子受体、自噬相关蛋白5、p62蛋白在甲状腺乳头状癌合并颈部淋巴结转移中的表达及临床意义

目的分析表皮生长因子受体(EGFR)、自噬相关蛋白5(ATG5)、p62在甲状腺乳头状癌(PTC)合并颈部淋巴结转移患者中的表达及意义。方法取80例PTC患者的PTC组织及相应的癌旁正常组织,同时取其中合并颈部淋巴结转移的45例患者的转移淋巴结组织标本。免疫组化法检测PTC组织、转移淋巴结组织和癌旁正常组织中EGFR、ATG5、p62蛋白的表达情况,及其与PTC患者临床特征及生存情况的关系。结果PTC组织和转移淋巴结组织中EGFR、p62蛋白的阳性表达率均高于癌旁正常组织,ATG5蛋白的阳性表达率低于癌旁正常组织,差异均有统计学意义(P﹤0.05)。不同TNM分期和淋巴结转移情况PTC患者PTC组织中ATG5蛋白阳性表达率比较,差异均有统计学意义(P﹤0.05);不同分化程度、TNM分期和淋巴结转移情况PTC患者PTC组织中p62蛋白阳性表达率比较,差异均有统计学意义(P﹤0.05)。Spearman相关分析结果显示,PTC组织和转移淋巴结组织中,ATG5的表达与p62呈负相关(P﹤0.01)。对80例PTC患者进行为期3年的随访,病死22例,3年生存率为72.50%(58/80)。p62阳性表达PTC患者的3年生存率为65.52%,低于阴性表达患者的90.91%,差异有统计学意义(P﹤0.05)。Cox风险比例回归模型结果显示,TNM分期、淋巴结转移、EGFR阳性表达、p62阳性表达为PTC患者预后的独立危险因素(P﹤0.05),ATG5阳性表达为PTC患者预后的独立保护因素(P﹤0.05)。结论PTC组织及淋巴结转移组织中EGFR、p62的阳性表达率较高,ATG5的阳性表达率较低,此外,ATG5及p62与PTC生物学行为有关,可能成为PTC诊断的潜在指标。     

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).     

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。