p16、p53、Ki-67蛋白在宫颈癌组织中表达情况及病理特点分析

目的探讨p16、p53、Ki-67蛋白在宫颈癌组织中的表达状况及其病理特点,分析总结其临床诊断意义。方法选取2015年1月-2018年12月兰溪市人民医院接诊的100例宫颈癌患者为研究对象,包括鳞状细胞癌64例,高级别鳞状上皮内病变24例,腺癌9例,腺鳞癌2例,腺样基底癌1例。所有患者均采用免疫组织化学染色法检测其p16、p53、Ki-67蛋白表达情况,并分析其临床病理特点。结果 100例宫颈癌患者中,p16蛋白的阳性表达率为52. 00%,p53蛋白的阳性表达率为45. 00%,Ki-67蛋白的阳性表达率为74. 00%,差异有统计学意义(P0. 05)。宫颈癌组织中p16、p53、Ki-67蛋白的阳性表达与患者年龄、淋巴结是否转移无关(P0. 05),与患者临床分期、病理分级有关(P0. 05);宫颈癌组织p16、p53蛋白表达与Ki-67蛋白表达有关(P0. 05)。结论宫颈癌组织中p16、p53、Ki-67蛋白的阳性表达与患者临床分期、病理分级有关,通过检测患者p16、p53、Ki-67蛋白表达状况,可有效诊断宫颈癌组织病变进展,提高临床诊断价值,对宫颈癌患者起到良好预后作用。     

哈密地区维吾尔族与汉族妇女乳腺癌组织中CerbB-2、Ki-67、p53的表达及临床意义

目的探究哈密地区维吾尔族与汉族患乳腺癌女性的癌组织中CerbB-2、Ki-67、p53的意义和表达的状况。方法选取哈密地区中心医院2011年1月~2015年10月的汉族乳腺癌患者100例,维吾尔族乳腺癌患者80例入选为研究对象。以免疫组织化学SP法联合检测哈密地区维吾尔族与汉族妇女乳腺癌组织中CerbB-2、Ki-67、p53的表达,探讨不同民族间其表达差异以及年龄、肿块大小、淋巴结转移情况与其表达的关系。评价其可否作为判断乳腺癌预后的指标。结果 CerbB-2在维吾尔族妇女乳腺癌组织中的表达阳性率明显高于汉族妇女,差异有统计学意义(χ~2=5.040,P0.05)。Ki-67、p53在维吾尔族与汉族妇女乳腺癌组织中的表达阳性率差异无统计学意义(χ~2=1.067、1.001,均P0.05)。维吾尔族与汉族妇女乳腺癌组织中CerbB-2、Ki-67、p53的表达与淋巴结转移状况、病理类型、肿块大小均呈正相关(均P0.05)。结论 CerbB-2在维吾尔族与汉族患乳腺癌女性的癌组织中的表达具备民族的区别,Ki-67及p53不具备民族的区别。CerbB-2、Ki-67、p53能够作为判断维吾尔族与汉族妇女乳腺癌预后的指标。     

p53蛋白在宫颈上皮内瘤变和宫颈癌中的表达

目的 探讨p53蛋白在子宫颈上皮内瘤变和宫颈癌中的表达及淋巴转移的关系.方法 采用免疫组化SP法分别对34例子宫颈上皮内瘤变、40例宫颈癌、10例正常宫颈组织进行p53蛋白表达状况的检测.结果 p53蛋白在正常宫颈组织、子宫颈上皮内瘤变、宫颈癌中的阳性表达率差异有显著性(P＜0.0005).在子宫颈上皮内瘤变I中,p53蛋白低表达,与正常宫颈组织的阳性表达率差异无显著性(P=0.481＞0.01),与宫颈癌的阳性表达率差异有显著性(P＜0.005);在子宫颈上皮内瘤变II中,p53蛋白的表达率明显增高,与正常宫颈组织的阳性表达率差异有显著性(P=0.002＜0.005),与宫颈癌的阳性表达率差异无显著性(P＞0.01).p53蛋白的表达在淋巴转移组与非淋巴转移组差异无显著性(P=0.565＞0.01),既p53蛋白的表达与宫颈癌的淋巴转移无关.结论 p53的过表达与宫颈癌的发生发展有关,可作为宫颈癌早期诊断和子宫颈上皮内瘤变治疗指导及预后判断的一项有效指标.     

p53、Ki-67在三阴性乳腺癌中的表达及临床意义

目的探讨p53蛋白、Ki-67在三阴性乳腺癌中的表达及临床意义。方法采用免疫组化sP法检测134例TNBC组织中p53、Ki-67的表达,分析其与TNBC临床病理特征及预后的关系,并以非三阴性乳腺癌（N-TNBC）组织134例作为对照。结果TNl3C组织中p53、Ki-67阳性表达率分别为66．0％、89．6％,均明显高于N-TNBC的37．3％、79．9％（p均〈0．05）。p53、Ki-67阳性表达率与TNBC大小、组织学分级、TNM分期、脉管内癌栓、淋巴结转移有关（P均〈0．05）,与患者年龄及绝经状态无关（p〉0．05）。结论TNBC组织中p53、Ki-67表达均上调,可作为判断TNBC预后的重要指标。     

子宫内膜癌中ER、PR、Ki-67和p53的表达及临床意义

目的 探讨子宫内膜癌中雌激素受体(ER)、孕激素受体(PR)、Ki-67和p53的表达及其临床意义.方法 应用免疫组织化学SP法检测20例正常子宫内膜、20例子宫内膜非典型增生及66例子宫内膜癌的ER、PR、Ki-67和p53的表达,分析其表达及与临床分期、组织学分级、肿瘤肌层浸润和淋巴结转的相关性.结果 p53和Ki-67表达阳性率在正常内膜、子宫内膜非典型增生到内膜癌的表达逐渐升高(χ2值分别为16.23、16.23;7.10、5.01,均P<0.05),而ER、PR表达相反,但差异亦均有统计学意义(χ2值分别为18.76、9.69;16.23、10.40,均P<0.05).p53随组织学分级、肌层浸润、淋巴结转移的增高而升高,差异均有统计学意义(均P<0.01),与临床分期无关(P>0.05);Ki-67与淋巴结转移有关(P<0.01),与临床分期、组织学分级及肌层浸润无关(均P>0.05).结论 ER、PR、p53和Ki-67与子宫内膜癌的发生、发展、转移及预后相关.     

胃癌中p53和Survivin的表达及其临床意义

摘 要：目的 研究p53和Survivin基因蛋白在胃癌中的表达,了解其临床意义.方法 用免疫组织化学SP法检测106例胃癌组织的p53和Survivin基因蛋白的表达水平,并选择同一时间段30例胃黏膜异型增生病例和30例正常胃黏膜病例进行对照研究,对患者随访5年.结果 p53蛋白的阳性率,胃癌中为86.8%,胃黏膜异型增生为30.0%,正常胃黏膜呈阴性表达 p53蛋白表达与组织类型无关.Survivin阳性率,胃癌中82.1%,胃黏膜异型增生为26.7%,呈弱表达 正常胃黏膜为1.3%,呈弱表达,Survivin蛋白表达与组织类型无关.淋巴结转移组的p53蛋白及Survivin蛋白均相应高于无淋巴结转移组 随访结果提示,随着p53蛋白和Survivin蛋白阳性率的增高,胃癌患者的生存期缩短.结论 p53和Survivin基因蛋白在胃癌中高表达,此两种蛋白高表达,癌细胞易转移,患者预后差,生存期短.     

α-SMA和TGF-β在胃癌及癌前病变组织中的表达及与Ki-67的相关性

目的探讨α-平滑肌肌动蛋白(α-SMA)和转化生长因子-β(TGF-β)在胃癌及癌前病变组织中的表达及与Ki-67的相关性。方法选取2018年3月至2019年5月在本院确诊的胃癌患者156例和癌前病变患者86例。胃镜检查时采集胃黏膜组织标本,Western blot检测α-SMA、TGF-β及Ki-67蛋白表达,免疫组化染色观察α-SMA、TGF-β及Ki-67阳性细胞分布情况。结果胃癌组患者胃黏膜组织标本中α-SMA JGF-β及Ki-67蛋白相对表达量明显髙于癌前病变组,差异均有统计学意义(均P<0.01)。胃癌患者胃黏膜组织中α-SMA、TGF-β及Ki-67阳性细胞率均处于较高水平,其中强阳性分布率最高,分别为42.31%,38.46%、42.95%。不同TNM分期、浸润深度及淋巴结转移的胃癌患者中α-SMA、TGF-β及Ki-67蛋白表达水平之间比较差异均有统计学意义(均P<0.05)。胃癌组织中α-SMA和TGF-β表达与Ki-67呈正相关(均P<0.01)。癌前病变组织中α-SMA和TGF-β表达与Ki-67呈正相关(均P<0.05).结论在胃癌发生发展过程中α-SMA和TGF-β表达与Ki-67均呈正相关,其可作为判断病情及评估预后的标志物。     

胃癌组织中Ki67、EGFR、p53阳性表达情况及其临床意义分析

目的探讨胃癌组织中Ki67、表皮生长因子受体(EGFR)、p53阳性表达情况及其临床意义。方法选取2017年9月至2019年8月在我院行手术治疗的胃癌患者90例,对其胃癌组织及癌旁组织的石蜡切片进行Ki67、EGFR、p53免疫组化染色,比较胃癌组织及癌旁组织中Ki67、EGFR、p53阳性表达率,并分析胃癌组织中Ki67、EGFR、p53阳性表达与胃癌临床病理特征的关系。结果胃癌组织中Ki67、EGFR、p53阳性表达率均高于癌旁组织(P<0.05)。在Ki67、EGFR、p53阳性表达率方面,胃癌Ⅲ~Ⅳ期高于Ⅰ~Ⅱ期,高中分化高于低分化,肌层及浆膜层浸润高于黏膜及黏膜下层浸润,淋巴结转移高于无淋巴结转移(P<0.05);但在肿瘤位置、肿瘤直径及病理组织类型方面,胃癌组织中Ki67、EGFR、p53阳性表达率比较无统计学差异(P>0.05)。结论Ki67、EGFR、p53阳性表达与胃癌发生、进展关系密切,可将其作为判断胃癌恶性程度与发展的有效指标。     

p53基因在胃癌、胃炎和正常组织中的表达

目的从基因角度探讨胃癌、胃炎的发病机理的差别.方法用免疫组化Sp法检测35例进展期胃癌、8例早期胃癌、17例萎缩性胃炎、15例浅表性胃炎及14例正常组织标本中抑癌基因p53蛋白的表达.结果p53基因的表达在进展期胃癌标本中最高,其次是早期胃癌和萎缩性胃炎,而浅表性胃炎和正常组织标本中,p53均无表达.高分化腺癌中p53的表达要低于低分化腺癌和中分化腺癌,有统计学差异(P＝0.02和P＝0.02),p53基因表达在有淋巴结转移组和无淋巴结转移组之间无统计学差异(P＝0.57).结论p53基因异常与胃粘膜细胞癌变过程密切相关,可用于高危个体筛查或癌前病变危险的预测,从而在基因水平对胃癌的早期诊断及治疗提供帮助.     

胃癌和大肠癌转移淋巴结多癌基因过度表达的研究

目的 探讨胃癌，大肠癌中多种癌基因表达与淋巴结转移的相关性及一致性。方法 应用SP免疫组织化学染色法分别检测胃癌与大肠癌原发性和转移淋巴结中p53,p170,C-erbB-2,EGFR,Bcl-2,Nm23,PCNA,Ki-67多基因的表达。结果 EGFR基因的过度表达对胃癌淋巴结转移有显著意义（P〈0.01），Nm23基因的过度表达对大肠癌淋巴结转移有显著意义（P〈0.01），不同基因的过度表达对胃癌，大肠癌的淋巴结转移有影响，相互之间并无一致性，任意二项或多项基因过度表达均与淋巴结转移率无相关性。结论 同一基因过度表达对胃癌，大肠癌的淋巴的结转移的预示作用无一致性，不同基因的过度表达对同一癌肿的淋巴结转移的预示作用无一致性，任意二项或多项基因过度表达均与淋巴结转移率无相关性。     

肿瘤干细胞在卵巢癌治疗中的进展

卵巢恶性肿瘤是死亡率最高的妇科恶性肿瘤。尽管标准化的治疗方法（包括理想的肿瘤细胞减灭术和以铂类／紫杉醇为基础的化疗方案）使得70％的患者得到一定程度的临床缓解,但绝大多数患者仍然会在2年内复发并出现耐药。肿瘤干细胞理论认为,肿瘤组织中有小部分细胞群体具有极强的增殖能力,它们具有类似正常干细胞的生物学特性,能通过自我更新和分化来高频度地启动肿瘤的发生发展,它们是导致肿瘤发生、发展、转移和耐药的主要细胞,是肿瘤复发的根源。该文将概述近几年卵巢癌干细胞的各项研究,包括卵巢癌干细胞的分离及其耐药机制、各种治疗方法等。     

Progress in the prevention of cancer

Most cancers appear to arise through the action of environmental factors, especially those to which we are exposed as a result of our diet, occupation, or lifestyle. Only a few factors, including radiation, tobacco, and certain chemicals, have been identified precisely. To the extent that causal factors can be identified and controlled, the cancers they would otherwise induce may be considered preventable. Epidemiological studies of cancer incidence in human populations have suggested that up to 90% of all cancers are attributable to environmental causes. The results of these studies are supported by research on the mechanisms of carcinogenesis in laboratory animals and cellular model systems. The observations in both the human and animal studies strongly suggest that there is no “safe” level of any carcinogen. The strategy for prevention calls for a multipronged approach, including epidemiological studies to identify high-risk populations and risk factors, bioassays to detect carcinogens in the environment, research on the causes and mechanisms of carcinogenesis, and education of health professionals, the public, and lawmakers so that policies can be instituted to minimize the risks. In addition, efforts should be made to identify disorders that increase susceptibility to cancer.     

Nutrition and cancer The role of nutrition in the causation of cancer

A link between diet and cancer of a number of varied sites has been observed. The link is probably best documented in colorectal cancer; a plausible mechanism has been proposed and has been tested. A group of hormone-related cancers have been correlated with dietary fat. A group of tobacco-related cancers have also been related to dietary fat, presumably by a different mechanism. Some cancers have been related to alcohol consumption whilst others have been associated with malnutrition in general. This is not, therefore, a homogeneous picture but shows a varied role of diet in disease. It will have been noted that most of these dietary related cancers are diseases of affluence and are associated with ‘overnutrition’. The same diet, however, is associated with low infant mortality and appears to be protective against the more severe effect of virus infections. It may be, therefore, that we should not be hasty in modifying our diet and should first ensure that the benefits that accrue from our current diet are not lost in the change.     

卵巢癌风险模型在卵巢癌诊断中的应用价值研究

目的分析基于血清中人附睾上皮分泌蛋白4(HE4)及CA125抗原表达水平所构建的卵巢癌风险模型(ROMA)在卵巢癌诊断中的价值。方法选取2015年1—12月收治的30名卵巢癌患者作为癌症组,选择同期收治的30例卵巢良性肿瘤患者作为良性组,同期在本院接受健康体检的30名健康者为对照组。对比三组受检者血清中HE4与CA125的表达水平,并根据检测结果计算ROMA值,分析HE4、CA125及ROMA对于卵巢癌诊断的价值。计量资料三组比较采取单因素方差分析,两两比较采用LSD-t检验,P0.05为差异有统计学意义。结果三组受检者血清HE4、CA125及ROMA比较差异有统计学意义(均P0.05);癌症组HE4、CA125水平及ROMA高于对照组与良性组(均P0.05),良性组HE4、ROMA与对照组比较差异无统计学意义(均P0.05),良性组CA125高于对照组(P0.05)。在卵巢癌的诊断方面,ROMA灵敏度与阴性预测值最高,HE4特异度与阳性预测值及诊断符合率最高。ROC曲线图分析HE4曲线下面积最大(0.867)。结论血清HE4与CA125抗原表达水平构建的ROMA有利于卵巢癌的早期诊断。     

Geographic variation in cancer incidence in the USSR: estimating the proportion of avoidable cancer.

BACKGROUND. The Soviet Union offers a unique frame in which to study geographic variation in cancer incidence because of its uniform registration system of all newly diagnosed cancer cases throughout its 15 republics and 162 oblasts (administrative units). Variation in cancer rates is stronger when examined by oblasts than it is when examined by republics. In 1986, the age-standardized all-site cancer incidence rate for both sexes, in the Soviet republic having the highest overall rate (Russian Soviet Federative Socialist Republic for males, Lithuania for females) was about twice that of the Soviet republic with the lowest all-site cancer rate (Georgia). Within Soviet oblasts (data are from 1979), the ratio of the highest to the lowest rates was about 4 for all sites, 144 for male oesophageal cancer, and 303 for female oesophageal cancer. The excess incidence in the entire USSR compared with the republic having the lowest all-site incidence rate was 59% for males and 49% for females. CONCLUSION. Although the observed differences between republics or between oblasts are partially due to uneven quality of data recording or to statistical variability related to population sizes, there is a strong geographic variation of cancer incidence rates in the USSR that suggests a potentially important role of environmental factors in cancer etiology.     

Perceived colorectal cancer candidacy and the role of candidacy in colorectal cancer screening

Screening is a well-established tool to advance earlier cancer diagnosis. We used Davison’s concept of ‘candidacy’ to explore how individuals draw on collectively constructed images of ‘typical’ colorectal cancer (CRC) sufferers, or ‘candidates’, in order to evaluate their own risk and to ascertain the impact of candidacy on screening participation in CRC. We interviewed 61 individuals who were invited to participate in the Scottish Bowel Screening Programme. Of these, 37 were screeners (17 men and 20 women) and 24 non-screeners (13 men and 11 women). To analyse these data we used a coding frame that drew on: symptoms, risk factors, and retrospective and prospective candidacy. Few participants could identify a definite bowel cancer candidate and notions of candidacy were largely predicated on luck in the sense that anyone could be a candidate for CRC and there was little evidence to support a linear relationship between feelings of risk and screening decisions. Often participants described screening as part of a wider portfolio of being healthy and referred to feeling obliged to look after themselves. Our study suggests that rather than candidates for bowel cancer, screeners viewed themselves as candidates for screening by which screening decisions pointed towards the acceptance and normalisation of the rhetoric of personal responsibility for health. These findings have related theoretical and practical implications; the moral structure that underpins the new public health can be witnessed practically in the narratives by which those who see themselves as candidates for screening embrace wider positive health practices.