喉癌细胞中S100A8新的相互作用蛋白质的鉴定

目的探索S100A8相互作用蛋白在喉癌发生、发展中的可能机制。方法应用抗S100A8抗体通过免疫沉淀的方法从喉癌细胞系Hep-2中分离与S100A8相互作用的蛋白质。用基质辅助激光解析电离飞行时间质谱仪分析目的蛋白条带。根据这些目的蛋白条带的肽指纹谱,用Mascot软件预测其相应的蛋白质。用P-Match软件预测这些蛋白质的NF-kappa B结合位点。用免疫共沉淀方法证实其中一个蛋白质与S100A8相互结合的能力。结果获得了4种与S100A8相互作用的新的蛋白质,它们分别是假想蛋白质LOC80154（hypothetical protein LOC80154）、MHCclass Ⅰ HLA-B、T-box1异构体C相似蛋白质（similar to T-box1 isoformC）和肌纤维膜相关蛋白1（sarcolemmal associated protein 1）。这4种蛋白质均具有NF-kappa B的结合位点,其中MHCclass Ⅰ HLA-B是NF-kappa B通路中的一个成员,我们首次证实该蛋白质具有结合S100A8的能力。结论本研究获得的S100A8新的伴侣可能是NF-kappa B通路的成员。MHCclass Ⅰ HLA-B与S100A8的结合提示S100A8可能作为新成员与包括HLA-B在内的其他蛋白质在NF-kappa B通路中发挥作用。这些发现为进一步研究S100A8在喉癌发生中的分子机制提供了新线索。     

外阴部、阴囊疣状黄瘤临床病理特点及文献复习

目的 探讨外阴部、阴囊疣状黄瘤（verruciform xanthoma,VX）的临床病理学特征、诊断、鉴别诊断及发病机制。方法 对1例阴囊VX、2例外阴VX进行光镜、免疫组化、特殊染色、HPV原位杂交观察并结合文献分析。结果 VX表皮疣状增生,棘层增厚,钉突延长位于真皮同一水平;表面过度角化伴角化不全,内有中性粒细胞浸润;真皮乳头层内上皮钉突间见黄色瘤样细胞（泡沫细胞）浸润。免疫组化标记黄色瘤样细胞CD68、α1-AT、Mac387阳性,CK（AE1/AE3）弱阳性,S-100、Ki-67、HPV阴性。PAS阳性。原位杂交HPV6/11呈阴性。结论 外阴部、阴囊VX与发生于口腔黏膜的VX临床病理学特征相似,黄色瘤样细胞来源于单核/巨噬细胞。     

Criteria for grading in the Ljubljana classification of epithelial hyperplastic laryngeal lesions. A study by members of the Working Group on Epithelial Hyperplastic Laryngeal Lesions of the European Society of Pathology

AIMS: To validate histological criteria for the grading of epithelial hyperplastic laryngeal lesions (EHHL) (dysplastic laryngeal lesions), we used a system that had been devised and tested in Ljubljana, Slovenia over many years and was felt to be more appropriate to laryngeal pathology than is the commonly-used model of intraepithelial neoplasia in the cervix. METHODS AND RESULTS: Vocal cord biopsies of 45 patients with a broad spectrum of EHLL were reviewed. Detailed histological criteria were formulated for each of the four grades of EHLL in the Ljubljana classification, comprising simple hyperplasia (benign spinous layer augmentation), abnormal hyperplasia (benign basal and parabasal layer augmentation), atypical hyperplasia (risky for malignancy) and carcinoma in situ (actually malignant, but without invasion). CONCLUSIONS: Using these criteria a high degree of concordance of histological diagnoses of grading levels for the Ljubljana classification was achieved between the pathologists of the Working Group. The system was found to be more precise for routine diagnostic work than the others in vogue. The different grades of the Ljubljana classification correspond to significantly different levels yielded in each grade by the semiobjective methods of quantitative morphometry and immunohistochemistry.     

Primary polypeptide hormones and mucin-producing malignant carcinoid of the larynx

A case of primary malignant laryngeal carcinoid with dual endocrine and mucous differentiation i s reported. Histologically the tumor showed a characteristic organoid pattern and exhibited Alcian-blue, periodic acidschiff, and Grimelius silver positivity. By the immunoperoxidase technique cal citoni n, ACTH, and or-hCG subunit were demonstrated in the tumor cells. ELectron microscopy revealed two different types of endocrinelike cells: mucous cells and occasional cells containing both endocrinelike granules and mucin droplets. Diagnostic morphologic criteria of this rare tumor entity are discussed and reference t o biologic behavior and possible h istogenesis is made.     

长托宁用于喉罩全麻术前用药的临床观察

目的研究选择性M受体拮抗剂长托宁用于喉罩全麻术前用药的临床效果。方法选取ASAⅠ～Ⅱ级行择期腹腔镜下胆囊切除术患者90例，随机分为3组（每组30例）：对照组（A组），术前不应用任何抗胆能药；阿托品组（B组）和长托宁组（C组），麻醉诱导前30min肌肉注射阿托品或长托宁0．01mg／kg，麻醉诱导后置入标准型喉罩后接麻醉机行机械通气；分别记录气管插管后5min（T1）、气管插管后30min（T2）、气管拨管前（T3）气道内分泌物量以及心率变化。结果在T1、T2、T3三个时点，B组和C组患者的气道分泌物明显少于A组（P〈0．05）；B组在T1时间点的心率明显高于A组与C组（P〈0．05）。结论长托宁用于喉罩全麻术前用药临床效果较好。     

Central atypical papillomas of the breast: a clinicopathological study of 119 cases

The clinicopathological features of central intraductal papillomas of the breast presenting with florid usual ductal hyperplasia or atypical ductal hyperplasia (ADH) were analyzed in a retrospective series of 119 patients, whose lesions were sent to the Armed Forces Institute of Pathology from 1976 to 1990. After histological review considering predefined morphological and quantitative criteria, the 119 central papillomas were classified into 22 papillomas with florid usual ductal hyperplasia (18%), 40 papillomas with focal atypia (34%), 24 atypical papillomas (20%) and 33 carcinomas arising in a papilloma (28%). After a median period of follow-up of 110 months, 16 recurrences (5 papillomas, 2 carcinomas arising in a papilloma, 4 ductal carcinomas in situ, 5 invasive carcinomas) occurred. No statistically significant difference was observed in relation to recurrence for the various categories of papillomas. The presence of epithelial hyperplasia, ADH or lobular neoplasia in the surrounding breast as well as infarction of the papilloma were significant predictive factors of recurrence (P=0.02 and P=0.005, respectively, log-rank test). The main reason for the observed low rate of significant recurrences in this series was that epithelial atypia (whether comprising 20% or 60% of the papillary lesion) was, in most of the cases, localized in a confined lesion that was completely excised.     

声带鳞状细胞癌早期改变的病理学观察

目的探讨声带鳞状细胞癌早期病理学的特点，提高病理诊断水平。方法总结89例声带鳞状细胞癌早期改变病例的病理资料，对其石蜡切片进行HE染色、PAS染色及p53、Ki-67免疫组化染色；以59例声带角化症（分为单纯增生组40例和异型增生组19例）和30例声带浸润癌（浸润深度〉3mm的癌）作为对照。结果在HE染色下，声带鳞状细胞癌的早期改变可区分为两种类型：Ⅰ型为上皮全层癌变型，占67．4％（60／89）；Ⅱ型为上皮基底层及副基底层癌变型，占32．6％（29／89），又可分为Ⅱa和Ⅱb两个亚型。HE染色显示有可疑微小浸润者52例，PAS染色示其中的43例（83％）的可疑病灶周边基膜样物质消失，有微浸润，Ⅰ型微浸润的比例较Ⅱ型明显偏低（P=0．007）。HE染色下3例（3．4％，3／89）认为无微浸润者经深切证实有浸润，并经PAS染色确认。Ⅰ型和Ⅱ型的p53表达率差异无显著性（P=0．445），而Ki-67阳性率Ⅰ型高于Ⅱ型（P=0．048）。癌早期改变组的p53阳性率高于声带角化症伴单纯增生组（P=0．008），而与声带角化症异型增生组和声带进展癌组之间的差异无统计学意义（P=0．240，P=0．268）。癌早期改变组的Ki-67阳性率明显低于浸润癌组（P=0．000），并明显高于角化症伴单纯增生组（P=0．001），但与角化症伴异型增生组之间差异无显著性（P=0．248）。结论声带鳞状细胞癌早期改变可区分为Ⅰ型和Ⅱ型，Ⅱ型癌变可在不累及上皮全层的情况下，由上皮的基底层和（或）副基底层细胞直接向固有膜内增生及癌变，此型占全部病例的近1／3，早期浸润是Ⅱ型诊断的可靠依据；Ⅱ型的存在提示声带鳞状细胞癌的早期发生和演进可能存在不同的机制；PAS染色和p53、Ki-67免疫组化染色有助于声带鳞状细胞癌Ⅱ型早期的诊断。     

XRCC1、hOGG1基因多态性与喉癌遗传易感性的关系

目的 探讨X线修复交叉互补组1基因(X-ray repair cross complementing group 1,XRCC1)、8-羟基鸟嘌呤修复酶基因(human 8-oxoguanine glycosylase I,hOGG1)多态性与喉癌遗传易感性的关系.方法 采用病例-对照设计,应用聚合酶链反应-限制性片段长度多态性分析法检测了72例经病理确诊的喉癌患者和随机抽样的72例无肿瘤、无遗传病对照者XRCC1-Arg399Gln、hOGG1-Ser326Cys多态性.结果 病例组XRCC1第399位密码子杂合型(Arg/Gln)及突变型(Gln/Gln)和hOGG1第326位密码子杂合型(Ser/Cys)及突变型(Cys/Cys)分布频率均高于对照组(P＜0.05),与携带XRCC1-399野生型(Arg/Arg)、hOGG1-326野生型(Ser/Ser)个体相比,携带该基因型的个体喉癌的发病风险分别升高了3.37和2.54倍.交互作用分析显示,吸烟组与不吸烟组相比,携带XRCC1、hOGG1各基因型的个体的喉癌发病风险差异未发现存在统计学意义(xH12=0.15,xH22=0.28,P＞0.05).结论 XRCC1-399位点Arg→Gln和hOGG1-326位点Ser→Cys的氨基酸替换可能导致喉癌的发病风险增加,XRCC1-Arg399Gln、hOGG1-Ser326Cys多态性可能与喉癌的遗传易感性有关.     

Absence of the left inferior thyroid artery: clinical implications

Dissection of an adult male cadaver revealed an absence of the left inferior thyroid artery; its usual area of distribution to the thyroid gland was supplied by the right inferior thyroid artery. Absence of the left inferior thyroid artery occurs in 1-6% of cases. The inferior thyroid artery arises commonly from the thyrocervical trunk, passes posterior to the carotid sheath and supplies the inferior pole of the corresponding lobe of the thyroid gland; its branches can course anterior or posterior to or between branches of the recurrent laryngeal nerve. During thyroid surgery it is imperative to identify the relationship of the inferior thyroid artery to the recurrent laryngeal nerve or to establish its absence because injury to the nerve can be a major complication; awareness of significant variations of the surgical anatomy of the thyroid gland is vital for preserving the integrity of important structures.     

Ventilatory and upper-airway resistance responses to upper-airway cooling and CO2 in anaesthetised rats

The effects of upper airway (UA) cool air and CO₂ on breathing and on laryngeal and supraglottic resistances were studied in anaesthetised rats breathing spontaneously through a tracheostomy. Warm, humidified air containing 0, 5 and 9–10% CO₂ and cool, room-humidity air were delivered at constant flow to either the isolated larynx to exit through a pharyngotomy or to the supraglottic UA to exit through the mouth and/or nose (nose open or sealed). Spontaneous tracheal airflow and UA airflows, temperatures and pressures were recorded. CO₂ had no effect on breathing but caused a slight increase in laryngeal resistance which was abolished by cutting the superior laryngeal nerves (SLN). Cool air caused a decrease in respiratory frequency and/or peak inspiratory flow when applied to the isolated larynx or to the supraglottic airway with the nose closed. These effects were abolished by SLN section. With the nose open, the ventilatory inhibition was not abolished by SLN section. Cool air also caused substantial decreases in laryngeal and supraglottic resistances which were attenuated by SLN section and which persisted following recurrent laryngeal nerve section. In conclusion, whilst UA cooling inhibits breathing and decreases UA resistances, UA CO₂ has minimal effects.