大肠癌中EGFR、c-erbB-2及VEGF的表达与临床病理特征的关系

目的研究EGFR、c-erbB-2和VEGF在大肠癌中的表达及其与临床病理特征的关系。方法应用免疫组化Envision方法检测61例大肠癌组织中EGFR、c-erbB-2及VEGF的表达水平。以多重线性回归分析上述基因表达水平与临床病理特征的关系。结果61例大肠癌中EGFR、c-erbB-2和VEGF的阳性表达率分别为49．2%（30／60）、73．8％（45／61）和70．5％（43／61）,多因素分析显示它们分别与肿瘤大小,淋巴结、肝脏转移及Dukes分期相关,而与病人的性别和年龄无关。结论EGFR、c-erbB-2及VEGF可作为临床判定大肠癌恶性程度及评估预后的指标,对指导术后化疗或靶向治疗具有一定的意义。     

Syk、c-erbB-2和EGFR在贲门腺癌中的表达及其临床意义

目的：检测贲门腺癌（ gastric cardiac adenocarcinoma, GCA）中抑癌基因脾酪氨酸激酶（spleen tyrosine kinase, Syk）及原癌基因c-erbB-2、表皮生长因子受体（epidermal growth factor receptor, EGFR）的表达情况,探讨其相互关系及其与贲门腺癌发生、发展的关系。方法：收集河北医科大学第四医院胸外科2006年10月至2007年2月手术切除贲门腺癌标本91例,患者术前未经任何抗癌治疗。应用免疫组化SP法检测贲门腺癌组织及相应切缘外正常黏膜组织中Syk、c-erbB-2、EGFR的表达情况,进行相关性比较。结果：Syk在贲门腺癌组织的阳性表达率为24.18%,明显低于相应切缘外正常组织（60.44%,P<001)。c-erbB-2、EGFR在贲门腺癌组织的阳性表达率分别为56.04%和58.24%,明显高于其在相应切缘外正常组织中的阳性表达率（20.88%,21.98%;均P<0.01）。Syk及c-erbB-2表达均与肿瘤组织的病理分级、淋巴结转移及TNM分期有明显的相关性（P<0.05或P<0.01)。EGFR表达仅与淋巴结转移相关(P<0.01)。Syk与c-erbB-2和EGFR表达均有相关性(P<0.05),而Syk和EGFR表达两者无明显相关性(P>0.05)。结论: Syk、c-erbB-2、EGFR基因在贲门腺癌中均异常表达,可能与贲门腺癌的发生有关;3种蛋白的联合检测对贲门腺癌的预后评估有一定的指导意义。     

食管癌组织中VEGF-C的表达与淋巴结转移的关系*

目的:观察食管癌组织中VEGF-C 的表达水平,探讨其与食管癌淋巴结转移的关系。方法:收集河南省肿瘤医院2000年1 月至2009年6 月间手术治疗的食管癌病例组织蜡块中资料齐全的检测样本,并摘录相应病历中的诊断信息,应用免疫组织化学SP法检测食管癌组织中VEGF-C 的表达水平,观察分析其与淋巴结转移的关系。结果:122 例食管癌组织中VEGF-C 的阳性表达率为61.48%（75/122）,其中鳞癌阳性表达率46.81%（22/47）,腺癌VEGF-C 阳性表达率为63.41%（26/41）,小细胞癌阳性表达率为79.41%（27/34）,三者存在显著统计学差异（χ2=8.95,P<0.01）。 有淋巴结转移的阳性表达率为74.29%（52/70）,无淋巴结转移的阳性表达率为44.23%（23/52）,二者差异有统计学意义（χ2=11.38,P=0.000 7）;Ⅲ期食管癌VEGF-C 阳性表达率为76.00%（38/50）,明显高于Ⅰ、Ⅱ期食管癌VEGF-C 的阳性表达率51.39%（37/72）。 VEGF-C 的表达与年龄、性别、浸润深度无明显相关性。多因素调整后食管癌组织中VEGF-C 阳性表达者发生淋巴结转移的比值比为2.87,95% 可信区间为1.28～6.44（χ2=6.57,P=0.010 4）。鳞癌、腺癌、小细胞癌发生淋巴结转移的比值比为1.66,95%可信区间为0.98～2.83（χ2=3.53,P=0.06）。浸润至外膜的食管癌和浸润至肌层以内的食管癌发生淋巴结转移的比值比为2.21,95% 可信区间为0.96～5.10（χ2=345,P=0.06）。 结论:VEGF-C阳性表达的食管癌患者发生淋巴结转移的风险高于VEGF-C 阴性表达者,VEGF-C 的检测可作为判断食管癌淋巴结转移的辅助指标。      

Dukes＇A、B期结直肠癌c-erbB-2,EGFR和TGF-α表达与复发转移的关系

背景与目的：尽管病理分期是结直肠癌患者主要的预后指标，但目前的分期系统不足以预测Dukes＇ A、B期患者术后复发风险及指导辅助治疗。分子预后标志物有可能补充分期的不足，且能为基于肿瘤个体生物学特征的治疗决策提供依据。本研究旨在探讨Dukes＇ A、B期结直肠癌中c-erbB-2、表皮生长因子受体（epithelial growth factor receptor，EGFR）、转化生长因子α（transforming growth factor-α，TGF-α）表达与术后复发转移的关系。方法：收集中山大学肿瘤防治中心1989年～1999年间88例行根治性手术的结直肠腺癌病例，Dukes＇A期26例，Dukes＇B期62例，复发转移组和非复发转移组各44例。至少随访5年或随访至复发。应用免疫组化方法检测原发瘤组织中c-erbB-2、EGFR、TGF-α蛋白表达。结果：复发组c-erbB-2、EGFR、TGF-α过表达率分别为43.2%（19/44）、63.6%（28/44）、65.9%（29/44），非复发组阳性率分别为25.0%（11/44）、27.3%（12/44）、43.2%（19/44）。x2检验提示复发组EGFR、TGF-α过表达率明显高于非复发组，但两组c-erbB-2过表达率无差异。复发组EGFR和TGF-α共同过表达率36.4%（16/44）显著高于非复发组11.4%（5/44）（x2=7.568，P=0.006）。多因素分析显示EGFR表达与术后复发转移有关。结论：EGFR表达可能与Dukes＇A、B期结直肠癌术后复发转移有关。     

同期腋窝转移淋巴结受体检测在激素受体阴性乳腺癌中的临床意义

  目的   探讨同期腋淋巴结转移病灶雌激素受体（estrogen receptor,ER）和孕激素受体（progesterone receptor,PR）补测在激素受体阴性浸润性乳腺癌中的临床意义。   方法   观察2012年7月至2013年1月,重庆医科大学附属第一医院内分泌乳腺外科门诊随访及住院患者中补测激素受体阴性乳腺癌同期腋淋巴结转移病灶ER和PR的表达情况,所有标本（包括原发癌病灶及同期腋淋巴结转移病灶）的免疫组织化学检测均由重庆医科大学病理检测中心进行,根据检测报告,原发病灶阴性而腋淋巴结转移病灶ER和/或PR阳性者补加内分泌治疗。   结果   56例激素受体阴性乳腺癌中,同期腋淋巴结转移病灶ER阳性8例（14.3%）,PR阳性2例（3.6 %）,ER和PR均阳性3例（5.4%）,共13例（23.3%）因补查腋淋巴结转移病灶ER和/或PR变阳性而在随访中加用内分泌治疗。肿瘤原发病灶与腋转移淋巴结ER和PR均阴性43例（76.7%）,即肿瘤原发癌病灶与腋转移淋巴结ER和PR均为阴性表达的总符合率为76.7%,不一致率为23.3%。   结论   受体阴性浸润性乳腺癌原发病灶与腋淋巴结转移病灶ER和PR表达具有一定的不一致性,对原发癌病灶激素受体阴性乳腺癌患者应检查其同期腋淋巴结转移病灶受体的表达,可能筛查出原发病灶受体阴性而复发转移病灶受体阳性患者,及时加用内分泌治疗,提高该类患者的疗效,亦可解释部分激素受体阴性而内分泌治疗也有一定疗效的原因。      

c-erbB-2基因在食管癌组织中的表达及其临床意义

目的研究原癌基因c-erbB-2产物在食管癌中心组织、移行区组织及正常食管组织中的表达,探讨c-erbB-2原癌基因与食管癌发生与发展的关系。方法应用免疫组织化学SABC的方法,检测了75例食管癌组织标本,每例食管癌组织标本又分成中心组织、移行区和64例正常黏膜组织。结果 c-erbB-2基因在食管癌中心组织中阳性率高达82.7%（62/75）,而在癌旁食管组织中的阳性表达率为56.0%（42/75）,在正常食管组织中为阴性表达（0/64）,其差异有统计学意义（P〈0.01）。在食管癌中心组织中,c-erbB-2的表达与肿瘤的恶性程度及淋巴结和远处转移呈正相关（P〈0.05）,c-erbB-2表达在肿瘤部位、性别、年龄等临床病理指标间的差异无统计学意义（P〉0.0 5）。结论 c-erbB-2基因的活化与食管癌的发生和发展密切相关     

乳腺癌原发灶与腋淋巴结转移灶ER和PR及c-erbB-2表达的对照研究

目的:研究雌激素受体(ER)、孕激素受体(PR)和c-erbB-2在乳腺癌原发灶和同期腋淋巴结转移灶之间的表达差异。方法:免疫组织化学方法检测60例初治单侧乳腺癌同期腋窝淋巴结转移手术治疗患者ER、PR和c-erbB-2在原发灶及腋淋巴结转移灶的表达差异。结果:ER在乳腺癌原发灶中的阳性率为56.7%(34/60),腋淋巴结转移灶中为48.3%(29/60);PR在乳腺癌原发灶中的阳性率为55.0%(33/60),腋淋巴结转移灶为48.3%(29/60);c-erbB-2在乳腺癌原发灶中的阳性率为26.7%(16/60),腋淋巴结转移灶为28.3%(17/60);ER、PR和c-erbB-2的阳性率在两者之间的差异均无统计学意义。ER在原发灶和腋窝淋巴结转移灶之间总的变化率为21.7%(13/60),PR为16.7%(10/60),c-erbB-2为15.0%(9/60)。结论:ER、PR和c-erbB-2的表达在乳腺癌原发灶和腋窝淋巴结转移灶之间存在不一致现象,但无统计学意义。判断乳腺癌的预后要综合考虑其原发灶和转移灶的生物学特性。     

食管癌细胞c-erbB-2与P-gp表达相关性研究

目的探讨食管癌细胞c-erbB-2与多药耐药性相关性及其临床意义。方法用免疫组化方法检测癌细胞c-erbB-2和用流式细胞术检测了46例食管癌手术标本中癌细胞P-糖蛋白(P-gp)表达水平,并进行相关性分析。结果食管癌中c-erbB-2表达阳性12/46例(26.1%),其中4例低度表达,8例中-高度表达;P-gp表达阳性28/46例(60.9%),其中6例低度表达,13例中度表达,9例高度表达。食管癌淋巴结转移情况与c-erbB-2和P-gp表达比较发现,在c-erbB-2阳性时淋巴结有转移(31.09±5.33)与无转移(8.04±3.03)组的P-gp表达比较差异有显著性(P相似文献   

阴阳因子-1表达与乳腺癌复发转移相关性的研究

目的:探讨正常乳腺组织、乳腺癌原发病灶及乳腺癌复发转移灶中阴阳因子-1(YY1)的表达及其临床意义。方法:采用免疫组织化学SP法检测56例乳腺癌原发病灶及其对应的复发后二次手术的乳腺癌转移灶,以及20例正常乳腺组织中YY1的表达情况,并分析其与ER、PR、c-erbB-2、Ki-67和p53等多个乳腺癌相关因子及临床病理参数的关系。结果:乳腺癌复发转移灶中,YY1的阳性表达率为78.6%(44/56),显著高于乳腺癌原发病灶的51.8%(29/56)及正常乳腺组织的25.0%(5/20),差异有统计学意义,P<0.05。YY1的表达与乳腺癌组织学分级、TNM分期、腋窝淋巴结转移及复发部位相关(P<0.05),而与患者的年龄、肿瘤大小无关,P>0.05;YY1的表达与ER表达呈负相关(P<0.05),与c-erbB-2和Ki-67表达呈正相关(P<0.05),而与PR和p53表达无明显的相关性,P>0.05。结论:YY1的高表达预示着肿瘤具有较高的侵袭性和转移性,YY1有望成为乳腺癌治疗的新靶点。     

胃癌组织EGFR和VEGF的表达及其意义

目的探讨胃癌组织EGFR和VEGF的表达及其与临床病理特征的关系。方法应用免疫组化方法检测正常胃黏膜和胃癌切除标本EGFR和VEGF的表达,并与临床病理参数进行比较分析。结果胃癌组织EGFR和VEGF阳性表达率分别为64.7%和58.8%;正常胃黏膜组织EGFR和VEGF阳性表达率分别为0%和10.0%,差异有统计学意义（P=0.000）;EGFR阳性表达与肿瘤分化程度、浸润深度、淋巴结转移、远处转移及临床TNM分期呈显著相关,VEGF阳性表达与肿瘤分化程度、浸润深度、淋巴结转移、远处转移、脉管内癌栓和临床TNM分期呈显著相关（P〈0.01和P〈0.05）。EGFR表达阳性者有69.7%同时伴有VEGF表达阳性,EGFR和VEGF双阳性表达者的根治切除率仅为30.4%,明显低于阴性表达者（P=0.000）。结论胃癌组织EGFR和VEGF表达上调与肿瘤分化程度、浸润深度、淋巴结转移、远处转移、脉管内癌栓和TNM分期有关,EGFR促进肿瘤血管生长可能通过上调VEGF表达,胃癌组织EGFR和VEGF表达可能成为从同期别病例中甄别靶向治疗获益病例的主要预后指标。     

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。     

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.     

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.     

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。     

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.