C-erbB-2基因在青老年乳腺癌中的表达及其意义

探讨c erbB 2基因在青老年乳腺癌中表达的差异及其意义。应用免疫组织化学SABC法检测 63例青年乳腺癌组织和 60例老年乳腺癌组织c erbB 2蛋白表达 ,分析两组间的差异及其与腋窝淋巴结转移、肿瘤临床分期的关系。c erbB 2基因青老年乳腺癌中阳性表达分别为 61.90 % ( 3 9/63 )和 43 .3 3 % ( 2 6/60 ) ,差异有显著性 (P <0 .0 5 )。在青老年乳腺癌组织中 ,腋窝淋巴结转移组c erbB 2阳性表达率 (青年组 71.0 5 % ,老年组 61.16% )明显高于腋窝淋巴结阴性组 ( 4 3 .48% ,3 2 .3 5 % ;P <0 .0 5 )。 0～Ⅱ期乳腺癌c erbB 2阳性表达率 (青年组 5 2 .2 7% ,老年组 3 4.15 % )明显低于Ⅲ～Ⅳ期 ( 84.2 1% ,5 7.89% ;P <0 .0 5 )。在青年乳腺癌组织中c erbB 2阳性表达率高 ,是青年乳腺癌生物学行为特征之一 ,亦是影响青年乳腺癌预后的重要因素。青老年乳腺癌中c erbB 2表达与病期及腋窝淋巴结转移有关。     

乳腺癌组织中paxillin和c-erbB-2的表达及临床意义

目的：研究paxillin蛋白和c—erbB-2蛋白在乳腺癌组织中的表达，探讨其与乳腺癌患者临床病理因素的关系，以评价乳腺癌的预后。方法：采用免疫组织化学SP法检测53例原发性乳腺癌、10例乳腺纤维腺瘤及10例距癌灶边缘〉5cm病理组织学检查正常的乳腺组织中paxillin和c—erbB－2蛋白的表达情况。结果：与正常乳腺组织和乳腺纤维腺瘤相比，乳腺癌中paxillin表达显著刚氏（P=0．003），而c—erbB－2表达显著增高（P〈0．001）。paxillin的表达与患者的年龄、绝经状况、肿瘤细胞的ER和PR表达及肿瘤大小无关，而与病理学分期、组织学分级和淋巴结转移有关；c—erbB－2表达与患者的年龄、绝经状况、肿瘤大小、PR表达和病理学分期无关，而与ER表达、组织学分级和淋巴结转移有关。paxillin和c—erbB－2的表达无相关性。结论：paxillin和c—erbB－2与乳腺癌细胞的恶性转化、侵袭转移有关，检测paxillin和c—erbB－2蛋白表达情况有助于准确评价乳腺癌患者的预后。     

胆囊癌组织中c-erbB-2,nm23H_1癌基因产物的表达及意义

目的　探讨癌基因c erbB 2和肿瘤转移抑制基因nm2 3H1的产物在胆囊癌组织中的表达与其生物学意义。方法　采用免疫组织化学方法检测胆囊癌标本中c erbB 2和nm2 3H1蛋白的表达 ,分析其与临床病理间关系。结果　c erbB 2和nm2 3H1蛋白的阳性表达率分别为 43 75 % (2 8/ 6 4)和 5 4 6 9% (35 / 6 4)。Ⅳ期胆囊癌中c erbB 2蛋白阳性率 (80 % )明显高于其他期胆囊癌 (P <0 0 1) ,c erbB 2阳性组平均生存期差于阴性组 (P <0 0 5 )。而nm2 3H1蛋白的表达与肿瘤的分化、分期和预后无关。结论　在胆囊癌中 ,c erbB 2和nm2 3H1参与肿瘤发生发展过程 ,c erbB 2的表达与肿瘤的转移和预后有着密切关系。     

c-erbB-2和cox-2在乳腺癌中的表达及其意义

应用免疫组化技术 ,检测人乳腺良恶性疾病组织中c erbB 2和cox 2蛋白的表达 ,分析其与淋巴结转移、激素受体状态的关系。 40例乳腺癌组织中c erbB 2表达阳性率为 3 5 .0 %,淋巴结阳性及激素受体阴性者表达率显著高于无淋巴结转移及受体阳性者 (均P <0 .0 5 ) ;cox 2表达阳性率为 47.5 %,激素受体阴性者表达率显著高于受体阳性者 (P <0 .0 5 ) ,但与淋巴结转移无关 (P >0 .0 5 )。 10例良性乳腺疾病及 2例正常乳腺组织中无c erbB 2表达 ,仅有 1例乳腺囊肿病cox 2表达阳性 ,c erbB 2与cox 2的表达存在显著的相关性 (P <0 .0 5 )。提示c erbB 2和cox 2与乳腺癌的发生、转移及预后均有密切关系 ,同时进行两者的免疫组化检测对评估乳腺癌的预后及选择靶向治疗对象可能有意义。     

原发性乳腺癌PCNA、P53表达及临床意义

目的　探讨增殖细胞核抗原 (PCNA)、P5 3表达与原发性乳腺癌临床病理学参数和预后的关系。方法　运用免疫组织化学方法对 48例原发性乳腺癌组织切片中PCNA、P5 3的表达进行检测。结果　PCNA表达和原发灶大小、腋淋巴结转移、TNM分期、组织学分级相关 (P <0 .0 5 )。P5 3表达和腋淋巴结转移、TNM分期、病理学类型和组织学分级相关 (P <0 .0 5 )。PCNA高表达者P5 3阳性率高 ,差别显著 (P <0 .0 5 )。在单因素分析中 ,PCNA、P5 3、腋淋巴结、原发灶大小、TNM分期对预后的判断有统计学意义 (P <0 .0 5 )。COX比例风险回归模型的分析表明 ,腋淋巴结和PCNA是影响乳腺癌预后的独立因素 (P <0 .0 5 )。结论　PCNA和P5 3免疫组化染色可以作为判断乳腺癌患者预后的有价值的指标。     

乳腺癌c-erbB-2的表达及其与肿瘤血管生成的关系

摘要：为探讨乳腺癌c erbB 2与腋窝淋巴结转移和肿瘤血管生成的关系，笔者应用SABC免疫组化法检测70例乳腺癌组织中c erbB 2基因表达和VEGF，FLK 1，bFGF，FLG阳性系数值及MVC值。结果示腋窝淋巴结转移组c erbB 2阳性率明显高于腋窝淋巴结未转移组（P＜0.01）。VEGF，FLK 1，bFGF，FLG和MVC值在c erbB 2阳性和阴性组间有差异（P＜0.05或P＜0.01）。提示乳腺癌c erbB 2表达与腋窝淋巴结转移和肿瘤血管生成有关。     

OPN在乳腺癌淋巴结转移中的作用

目的:探讨骨桥蛋白（OPN）在乳腺癌中的表达及其与腋窝淋巴结转移之间的关系。方法:采用免疫组织化学方法检测 66例乳腺癌、28例乳腺良性肿瘤、37例癌旁乳腺组织和29组腋窝转移淋巴结中OPN的表达，分析OPN表达与腋窝淋巴结转移及其他临床病理特征的关系。结果:乳腺癌组织中OPN的表达水平（4.83）明显高于癌旁乳腺组织（1.86）和乳腺良性肿瘤（2.18)（P＜0.01)；乳腺癌淋巴结转移阳性组与阴性组之间、乳腺癌原发病灶与相应的腋窝转移淋巴结之间OPN表达差异有统计学意义（P=0.048,0.03）。乳腺癌c erbB 2阳性表达组OPN表达水平（5.22）高于c erbB 2阴性组（4.00），但差异无统计学意义（P=0.056）。乳腺癌OPN表达与患者年龄、肿瘤大小、转移淋巴结数量、组织学类型、肿瘤分级以及TNM分期无关（P＞0.05），而与淋巴结转移有关（P=0.048）。结论:OPN在乳腺癌组织中高表达，且与乳腺癌腋窝淋巴结转移密切相关。     

乳腺癌中HER2基质金属蛋白酶-2和9的表达及其相互关系

目的　研究乳腺癌中HER2基因、基质金属蛋白酶 (MMP) 2、基质金属蛋白酶(MMP) 9的表达情况、与临床病理指标之间的关系以及它们之间的相互关系。方法　采用免疫组织化学的方法对 114例乳腺癌组织标本中HER2、MMP 2、MMP 9的表达情况进行检测。结果　乳腺癌组织中HER2、MMP 2、MMP 9的表达阳性率分别是 46.49%、78.95 %、68.42 %。HER2表达与淋巴结转移相关。原发肿瘤 >2cm或有淋巴结转移的患者中 ,其MMP 2、MMP 9表达明显高于原发肿瘤≤ 2cm或无淋巴结转移的患者 (P <0 .0 5 ) ,且MMP 2表达与临床分期相关 (P <0 .0 5 )。HER2表达与MMP 2、MMP 9表达相关 (P <0 .0 5 )。结论　HER2、MMP 2、MMP 9的阳性表达提示乳腺癌有较强的浸润转移能力 ,这 3种蛋白的表达在乳腺癌浸润转移过程中可能起协同作用。     

膀胱癌组织中nm23蛋白和p53蛋白的表达及其意义

目的　探讨肿瘤抑制基因nm2 3、p5 3蛋白在膀胱癌组织中的异常表达及其与肿瘤病理分级、浸润程度和淋巴结转移等肿瘤的病理特征的关系。方法　应用免疫组织化学ABC方法检测 4 0例膀胱癌组织标本中nm2 3、p5 3蛋白的表达水平。 结果　膀胱癌组织中nm2 3和 p5 3蛋白表达的阳性率分别为 5 0 .0 %和 4 7.3%。nm2 3蛋白表达与病理分级和浸润程度呈正相关 ,而与膀胱癌的淋巴结转移呈负相关 (P <0 .0 5 )。p5 3蛋白表达与膀胱癌的浸润程度和分化程度呈正相关 ,而与肿瘤的淋巴结转移无关(P >0 .0 5 )。结论　nm2 3、p5 3蛋白的表达在膀胱癌的浸润转移中起重要作用 ,p5 3表达与膀胱癌组织浸润、分化程度有关 ,膀胱癌的淋巴结转移可能与多基因异常改变有关。     

176例Ⅱ、Ⅲ期乳腺癌腋淋巴结转移临床病理相关因素分析

目的探讨乳腺癌腋淋巴结转移的临床病理相关因素,为乳腺癌患者病情判断、选择合理手术方式及术后辅助治疗方案提供依据。方法回顾性分析经手术治疗的176例Ⅱ、Ⅲ期乳腺癌患者与腋淋巴结转移相关临床病理资料。结果影响Ⅱ、Ⅲ期乳腺癌腋淋巴结转移及转移数目的重要因素有乳腺癌的病理类型、分期、肿瘤大小、部位以及ER/PR和HER2表达状况。结论乳腺癌腋窝淋巴结转移受多种因素影响。     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.