济南市济阳县15~40岁人群乙型肝炎血清流行病学调查

目的了解济阳县乙型肝炎（乙肝）病毒（HBV）感染标志的分布情况。方法2003年11月在济南市济阳县开展了15～40岁人群HBV感染标志分布的横断面调查，共采集合格外周静脉血1994人份。乙肝病毒表面抗原（HBsAg）、乙肝病毒表面抗体（抗-HBs）、乙肝病毒核心抗体（抗-HBc）均用固相放射免疫（SPRIA）法检测。结果15～40岁人群HBsAg、抗-HBs、抗-HBc和HBV感染率分别为6．52％、24．77％、30．99％和43．63％。HBsAg感染率随年龄的增长而升高，HBsAg感染率在男女之间的差异无统计学意义。结论济阳县15～40岁人群HBsAg的阳性率仍处于较高水平，提示我们未来应加强儿童乙肝疫苗计划免疫的同时，加强高危人群和成人的预防接种工作。     

乙型肝炎患者外膜大蛋白与HBV DNA复制的相关性分析及临床意义

目的:探讨血清乙型肝炎病毒外膜大蛋白(HBV-LP)检测对于判定乙型肝炎病毒(HBV)复制的相关性及其临床意义。方法:分别采用ELISA法、时间分辨免疫荧光分析法和实时荧光定量PCR法检测376份乙型肝炎患者血清中HBV-LP、Pre-S1蛋白、HBV-M和HBV DNA,并进行相关性分析。结果:376份乙型肝炎患者血清中HBV-LP水平与HBV DNA拷贝数变化相一致,两者呈正相关(r=0.938,P<0.01);在不同模式的HBeAg血清中HBV-LP与HBV DNA的阳性率差异无统计学意义(P均>0.05);HBV DNA阳性血清中HBV-LP阳性率(92.8%)明显高于Pre-S1蛋白和HBeAg的阳性率(75.1%和41.0%),差异有统计学意义(P均<0.05)。结论:血清HBV-LP水平能反映HBV感染者体内HBV复制程度,其灵敏度高于Pre-S1蛋白和HBeAg,是对HBV M检测的补充,可作为判断HBV复制新的血清学指标。     

MIB-1 and involucrin expression in laryngeal squamous carcinoma: the relationship to host and tumour factors and survival

MIB-1 is an antibody which attaches to the Ki67 antigen expressed by proliferating cells. MIB-1 immunoreactivity may be used to quantify the proliferative component of a tumour. Involucrin is a protein expressed by mature keratinocytes and may be used as a marker of differentiation. The present paper studies the expression of these two markers in a group of patients with squamous carcinoma of the larynx. Tumour cell kinetics were studied in 49 patients with squamous cell carcinoma of the larynx using antibodies to `Ki67' and involucrin. The median potential follow-up for the group was 8.1 years with a minimum follow-up of 5 years. The median MIB-1 index was 32%. The median involucrin index was 56%. Fifteen patients had no or only slight involucrin staining whereas 34 stained intensely for this protein. Involucrin expression was found to be associated with histological grade with those patients expressing involucrin tending to have well differentiated tumours and those not expressing this parameter tending to have poorly differentiated tumours ( P = 0.045). There were no other associations between host and tumour factors and the various biological parameters. Survival analysis demonstrated that patients with an involucrin count above the median value had a better 5-year survival than those below the median (89% and 56% respectively) ( P < 0.05). In addition, patients with no (or poor) involucrin expression had an increased risk of developing a recurrence at the primary site ( P < 0.05). Involucrin appears to be a promising marker of tumour differentiation and survival in squamous carcinoma of the larynx.     

听神经瘤误诊分析

对经耳鼻咽喉科首诊，最终由神经外科手术全切或部分切除的经病理证实的７２例听神经瘤进行早期误诊分析，误诊时间平均５．５年，误诊病种为神经性耳聋、突发性耳聋、神经性耳鸣、颈椎病、鼻咽癌等。文中重点讨论了误诊原因。     

BCG vaccination in India and tuberculosis in children: Newer facets

With the extended programme of immunisation and since 1985 the universal programme of immunisation and the coverage status of BCG vaccination in India has been very good, although it is still unsatisfactory in the eastern states. It is emphasized that BCG vaccination cannot prevent natural tuberculous infection of the lungs and its local complications, although it reduces the haematogenous complications of primary infection. However, this is not true for malnourished children who, inspite of BCG vaccination, develop serious, and often fatal types of tuberculosis such as miliary, meningitic and disseminated tuberculosis. The tuberculin anergy in malnourished children, is mainly responsible for high morbidity and mortality. BCG vaccinated, well-nourished children manifest modified patterns of tuberculous disease, following infection. The most important manifestation is the increased incidence of intrathoracic tuberculosis, specially enlargement of the various groups of mediastinal nodes and their local complications. Localisation of the disease by T cell immunity, due to BCG vaccination is responsible for this and the much lower incidence of haemotological complications such as neurotuberculosis and disseminated disease. In these children, the clinical picture of neurotuberculosis is also modified, with a tendency for more localised involvement of the brain and meninges. Similarly, vaccinated children may present with hepatomegaly, splenomegaly or isolated organ disease. It is important to relearn the new patterns of tuberculosis disease seen in vaccinated, non-malnourished children, and to a lesser extent in children with grade 1 to 2 protein energy malnutrition (PEM). With these limitations of BCG vaccination, other strategies like chemoprophylaxis need multicentric trials in high risk children, in different parts of the country.     

The utility of tumour markers in assessing the response to chemotherapy in advanced bladder cancer

In patients with advanced bladder cancer receiving chemotherapy, early assessment of response can avoid unnecessary toxicity. The aim of this study was to assess the role of tumour markers in monitoring response. Serum levels of one or more of markers beta human chorionic gonadotrophin (betahCG), carcinoembryomic antigen (CEA), CA125 and CA19.9 were measured in 74 patients with advanced bladder cancer receiving chemotherapy from 1992 to 1997. Forty-three of 74 (58%) of patients had at least one raised marker (1.5 times upper limit of normal range). This was more common in patients with extra-pelvic disease than in those with disease confined to the pelvis (P = 0.002). Thirty-eight of 78 (49%) assessable patients had a radiological response. Neither clinical response (P = 0.81) nor survival (P = 0.16) differed between marker-negative and marker-positive patients. Clinical response was strongly related to marker response in the 35 comparable patients (P = 0.0001). No patient had a clinical response without response of at least one marker. Ninety per cent of patients who achieved a marker response had done so by 8 weeks. Monitoring of tumour markers in patients with advanced bladder cancer can help predict the response to chemotherapy.     

HERG potassium channels are more frequently expressed in human endometrial cancer as compared to non-cancerous endometrium

HERG K(+)channels, besides contributing to regulate cardiac and neuronal excitability, are preferentially expressed in tumour cell lines of different histogenesis, where their role in the development and maintenance of the neoplastic phenotype is under study. We show here that both herg gene and HERG protein are expressed with high frequency in primary human endometrial cancers, as compared to normal and hyperplastic endometrium. RT-PCR and immunohistochemistry, using specific anti-HERG antibodies developed in our laboratory, were applied to tissue specimens obtained from 18 endometrial cancers and 11 non-cancerous endometrial tissues. herg RNA and HERG protein are expressed in 67% and 82%, respectively, of cancerous, while in only 18% of non-cancerous tissues. In particular, no expression was found in endometrial hyperplasia. Moreover, electrophysiological experiments confirmed the presence of functioning HERG channels on the plasma membrane of tumour cells. On the whole, these data are the first demonstration of the presence of HERG channels in primary human neoplasias, and could candidate HERG as a potential tool capable of marking cancerous versus hyperplastic endometrial growth.     

Diagnostic and prognostic values of plasma levels of fibrinolytic markers in ovarian cancer

OBJECTIVE: The aim of this study was to find out whether any of the fibrinolytic parameters could be used as tumor markers in predicting the prognosis of ovarian cancers. MATERIALS AND METHODS: In the present study, we determined the plasma concentrations of tissue-type plasminogen activator (tPA), urokinase-type plasminogen activator (uPA), plasminogen activator inhibitor-1 (PAI-1), PAI-2, and uPA receptor (uPAR) in 25 patients with ovarian cancer, 16 patients with benign gynecologic tumor or inflammation, and 36 healthy controls in order to find out whether the plasma levels of these markers could be used to evaluate the prognostic value in patients with gynecologic cancers. We also determined two tissue concentrations of malignant tumor (one was at the tumor site itself and the other at the cut-end tissue of the tumor, which was expected to be free of tumor) in order to see the correlation between plasma and tissue concentrations. RESULTS: Plasma PAI-1 was significantly higher in patients with malignancy than in the healthy controls (P = 0.0001). There was no significant correlation between plasma and tissue concentrations, either tumor tissue or cut-end tissue, of the same parameters. Tissue concentrations of uPA, PAI-1, and PAI-2 were significantly higher and tPA significantly lower in the malignant tumor tissue than in the cut-end tissue in the patients with ovarian cancer (P = 0.014, 0.03, 0.002, and 0.01, respectively). Plasma PAI-1 was significantly higher in patients in the late stage of ovarian cancer than in the early stages and in the controls. CONCLUSION: From our study, we concluded that plasma levels of PAI-1 were correlated with the presence of malignant ovarian cancer and higher stage of disease.