鳞状细胞癌抗原与肝细胞癌的关系

鳞状细胞癌抗原(SCC-Ag)是一种肿瘤相关蛋白,SCC-Ag可能通过抑制肿瘤细胞凋亡和免疫细胞向肿瘤位置迁移参与恶性生物学过程。在肝细胞癌(HCC)组织,SCC-Ag的表达水平明显高于肝硬化组织和正常肝组织,HCC患者血清SCC-Ag水平亦明显高于肝硬化患者及正常人,SCC-Ag有可能成为新的肝细胞癌标志物。     

鳞状细胞癌抗原与原发性肝癌相关性研究进展

<正>原发性肝癌(hepatocellular carcinoma,HCC)是世界上最常见的恶性肿瘤之一[1]。目前HCC的临床诊断主要依赖于影像学证据、血清学指标及肝组织的病理学和细胞学检查。其中影像学方法无法准确判断占位的良、恶性,而肝脏穿刺病理学检查是有创检查,一般医院尚难开展,甲胎蛋白(α-fetoprotein,AFP)是目前常用的HCC标记物,但其敏感性及特异性均不高。近年来,鳞状细胞癌抗原(squa-     

血清鳞状细胞癌抗原和组织蛋白酶-D检测在宫颈鳞癌诊治中的应用价值

目的探讨血清鳞状细胞癌抗原(SCCAg)和组织蛋白酶(Cath)-D水平检测对宫颈鳞癌的临床应用价值。方法采用酶联免疫吸附实验(ELISA)检测血清中SCCAg和Cath-D的水平。分为宫颈鳞癌组35例;宫颈上皮内瘤变组(CIN组)25例;慢性宫颈炎组25例。宫颈鳞癌组在术前、术后分别检测血清SCCAg和Cath-D浓度,分析其对宫颈鳞癌预后的情况。CIN、慢性宫颈炎组仅检测术前血清SCCAg和Cath-D水平,分析血清SCCAg和Cath-D水平与宫颈鳞癌临床病理特征、手术疗效的关系。结果宫颈鳞癌组术前血清SCCAg和Cath-D水平明显高于CIN、慢性宫颈炎组(P=0.001,0.000),两组之间无统计学差异(P=0.432、0.321)。宫颈鳞癌组术后1年内未复发患者动态检测SCCAg和Cath-D水平呈进行性下降(P=0.02,0.04)。宫颈鳞癌组术前血清SCCAg和Cath-D水平与临床分期、肿瘤体积、分化程度、间质浸润、盆腔淋巴结转移等有关(P0.05);计算血清SCCAg和Cath-D诊断宫颈鳞癌及预测盆腔淋巴转移的临界值分别为0.95、3.21和17.33、20.25ng/L,ROC曲线下面积分别为0.91、0.78和0.95、0.90;同时对SCCAg和Cath-D进行相关性分析,二者在宫颈鳞癌组织中表达呈显著正相关。结论血清SCCAg和Cath-D检测对宫颈鳞癌具有很高的诊断价值,联合检测对宫颈鳞癌术后疗效、预后判断及预测盆腔淋巴结转移等方面具有更高参考价值。     

宫颈癌患者治疗前检测外周血细胞角蛋白19 mRNA和鳞状细胞癌抗原的临床意义

目的通过检测宫颈癌患者治疗前外周血中细胞角蛋白(CK)19 mRNA和鳞状细胞癌抗原(SCC-Ag)的表达,探讨其对宫颈癌的诊断意义及与临床病理的相关性。方法对100例宫颈癌患者行治疗前外周血CK19 mRNA及SCC-Ag检测,以40例健康妇女为对照,分析其作为诊断参考的特异性和敏感性,并对两者与宫颈癌临床病理特征的相关性进行分析。结果 CK19 mRNA、SCC-Ag检测诊断宫颈癌的特异性均为97.5%。CK19 mRNA、SCC-Ag水平升高用于治疗前诊断的敏感性分别为39%和57%,两者差异显著(P<0.05)。CK19 mRNA表达升高与深肌层浸润(P=0.031)、盆腔淋巴结转移(P=0.027)相关。SCC-Ag水平升高与病理类型(P=0.005)、肿瘤大小(P=0.002)、深肌层浸润(P=0.001)、盆腔淋巴结转移(P=0.012)显著相关。结论外周血CK19 mRNA和SCC-Ag均是宫颈癌微转移有价值的肿瘤标志物;就宫颈鳞癌患者而言,SCC-Ag仍然是目前首选的肿瘤标志物。     

宫颈鳞状细胞癌组织中PTEN、PCNA的表达及意义

目的检测酪氨酸磷酸酶蛋白（PTEN）、增殖细胞核抗原（PCNA）的表达并探讨其意义。方法采用免疫组化S-P法检测70例宫颈鳞状细胞癌组织中PTEN、PENA表达水平,并以11例正常宫颈组织为对照。结果与正常宫颈组织相比,宫颈鳞状细胞癌PTEN的阳性表达率明显降低,而PCNA阳性表达率明显增高（P均〈0.05）。PTEN的表达与PCNA的表达呈负相关（r=-0.574,P〈0.01）。PTEN、PCNA阳性表达率与宫颈鳞癌组织学分级、临床分期和淋巴结转移有相关性（P均〈0.05）。结论PCNA的异常高表达与PTEN的异常低表达参与了宫颈癌的发生、发展过程。联合检测PTEN、PCNA蛋白对宫颈鳞癌临床诊断、确定治疗方案及预后评估有一定意义。     

食管鳞状细胞癌类器官的应用

类器官(organoid)作为一种新型的研究模型能够稳定保持肿瘤多细胞团的异质性特征,高度还原原位肿瘤组织的生理结构和功能。既能适用于高通量的临床药物筛选,提供个性化治疗的策略;又能构建病理模型,作为研究肿瘤发生、多个阶段发展和转移机制的有力工具。目前,食管、胃、肠、肝、胰、前列腺和乳腺等结构的类器官和相应的肿瘤类器官已有报道,开拓了体外培养的新平台。肿瘤类器官模型具有易操作、成本相对低廉且可以与其他先进技术相结合应用等明显优势,有望在相关领域广泛应用。本文对食管鳞状细胞癌类器官的培养技术及应用现状进行了总结。     

胃原发性鳞状细胞癌和腺鳞细胞癌

对４例原发性胃鳞状细胞癌和腺鳞癌进行临床病理分析，并结合文献对其诊断、尤其组织学起源进行讨论。结果１例胃鳞状细胞癌（胃镜活检材料），另３例胃腺鳞癌有明显的鳞癌与腺癌过渡现象。４例均在诊断后７个月之内死亡。认为对胃鳞状细胞癌，应再次尽可能多取材、多制片以明确是单纯胃鳞状细胞癌或胃腺鳞癌。胃腺鳞癌起源倾向腺癌的鳞状化生，建议病理报告注明鳞癌与腺癌成分各占的比例。     

扁桃体鳞状细胞癌的治疗

目的 分析扁桃体鳞状细胞癌不同治疗方案对患者生存率的影响,以期明确影响预后的因素并指导临床治疗.方法 回顾性分析1990～2011年南京医科大学附属淮安第一医院耳鼻咽喉头颈外科和头颈放疗科治疗的经病理证实、无远处转移的扁桃体鳞癌40例患者临床资料.采用Kaplan-Meier法和Log-rank检验进行生存分析,多因素分析采用Cox回归模型.结果 40例扁桃体鳞癌患者5年生存率为41.7％,Ⅰ～Ⅱ期5年生存率为74.2％,Ⅲ期为26.1％,Ⅳ期为0％,差异有统计学意义(x2=4.258,P＜0.05).单纯放疗组、综合治疗组(手术联合放化疗组和化疗联合放疗组)5年生存率分别为32.4％和30.2％,差异无统计学意义(x2=0.409,P＞0.05).有、无淋巴转移患者5年生存率分别为62.2％和8.4％,差异有统计学意义(x2 =9.987,P＜0.05).Cox多因素分析显示TNM分期、病理分化和颈淋巴结是否转移为影响预后的独立危险因素(P＜0.05).结论 Ⅰ～Ⅱ期扁桃体鳞癌的治疗倾向于单纯放疗,Ⅲ～Ⅳ期扁桃体鳞癌的治疗模式和疗效仍需进一步研究.TNM分期、病理分化和淋巴结是否转移为影响预后的独立危险因素.     

原发性乳腺鳞状细胞癌一例

正1病例介绍患者,女,44岁,因发现左乳腺肿物2个月余,于2014-04在当地县人民医院就诊。查体:左乳局部无红肿、胀痛,无乳头溢液,无乳头或乳晕糜烂,皮肤外观无改变;在该院行左乳腺肿物切除活组织检查术。病理检查结果示(左乳腺)恶性肿瘤,鳞状细胞癌的可能性大。患者遂于2014-05入住广西壮族自治区人民医院肝胆外科。其既往体健,否认乳腺相关病史,否认肿瘤家族史。查体:左乳腺外侧见一     

原发性甲状腺鳞状细胞癌10例病理分析

目的总结原发性甲状腺鳞状细胞癌的病理学特征。方法对10例原发性甲状腺鳞状细胞癌患者的病理资料作回顾性分析。结果大体观察肿瘤组织质硬、实性、切面灰白色,无包膜,浸润性生长。光镜下观察可见甲状腺正常结构被破坏,甲状腺滤泡结构消失,癌巢由多边形瘤细胞组成,细胞质多,嗜伊红色,核大小不一,可见病理性核分裂,部分癌巢中央可见角化珠;低分化鳞状细胞癌细胞体积大,胞质淡染嗜伊红色,呈片巢状排列,可见脉管内瘤栓形成。病理检查确诊为高分化鳞状细胞癌4例,低分化鳞状细胞癌6例。6例行免疫组化染色,Tg和CK/L蛋白表达阴性,CK/H蛋白表达阳性。结论原发性甲状腺鳞状细胞癌病理表现以甲状腺细胞鳞状化生伴中度以上异型增生为主。免疫组化检查可见Tg和CK/L蛋白表达阴性,CK/H蛋白表达阳性。     

Squamous Cell Carcinoma Antigen in Lung Cancer and Nonmalignant Respiratory Diseases

Study Objectives Squamous cell carcinoma antigen (SCC) has been found in elevated amounts in patients with squamous cell lung cancer (SQLC). Elevated levels have also been found among patients with nonsquamous cell lung cancer (NSQLC) and in subjects with nonmalignant pulmonary disease (NMPD). The purpose of the current study was to evaluate SCC levels among a large number of patients with SQLC, NSQLC, and NMPD. Six hundred thirty-nine lung cancer patients, including 201 SQLC patients and 299 patients with NMPD, who were diagnosed at our hospital up to 2006 were entered. Serum SCC levels were measured with a commercially available kit. Results Elevated levels (>1.5 ng/ml) of SCC were observed in 52.7% of SQLC patients, but in only 14.2% of NSQLC patients. There was a statistically significant difference in positive rate between SQLC and NSQLC patients. None of the NSQLC patients had serum SCC levels greater than 40.0 ng/ml. Among subjects with NMPD, 28.4% had elevated levels of SCC. However, none of the NMPD patients had serum SCC levels greater than 20.0 ng/ml. Conclusions Serum levels of SCC can be elevated (<20.0 ng/ml) in some NMPD patients without coexisting SQLC. Patients with NSQLC and NMPD with elevated SCC levels greater than 40 ng/ml may have coexisting SQLC or squamous cell carcinoma in an extrapulmonary site.     

Tissue Polypeptide Specific Antigen and Squamous Cell Carcinoma Antigen for Early Prediction of Recurrence in Lung Squamous Cell Carcinoma

One of the major problems in the follow-up of patients with lung cancer is the early detection of recurrent disease. Tumor markers have been found helpful in detecting early recurrent disease. The aims of this study were to evaluate and compare the clinical usefulness of serial and simultaneous measurement of tissue polypeptide antigen (TPS) and squamous cell carcinoma (SCC) antigen for the early prediction of recurrence in patients with SCC of the lung. Sixty patients with SCC of the lung, including 25 patients with recurrence and 35 patients without recurrence after 1 year's follow-up after surgery, were enrolled in this study. The serial serum levels of TPS and SCC antigen were measured before surgery and 1 week, 1 month, 3 months, 6 months, 9 months, and 12 months after the operation for early detection of recurrence. The results revealed that (1) the mean serum values of TPS were significantly greater at all times after surgery in the 25 patients with recurrent SCC compared with the 35 patients without recurrent SCC, and (2) the mean serum values of SCC antigen were significantly greater only at 9 and 12 months after surgery in the 25 patients with recurrent SCC compared with the 35 patients without recurrent SCC. We conclude that TPS is a better marker than SCC antigen for early prediction of SCC recurrence in the lung. Accepted for publication 27 December 1999     

基于BP神经网络的食管鳞癌预后预测模型

目的基于BP神经网络建立食管鳞癌临床辅助诊断模型。方法对食管鳞癌患者的临床信息进行结构化处理,采用BP神经网络建立一种检测模型,对食管鳞癌患者的预后进行预测。结果建立了食管鳞癌患者的预后预测模型,通过测试验证了该模型的可行性。结论基于BP神经网络建立的食管鳞癌患者预后预测模型对临床治疗有参考价值。     

Self-Powered Electrical Impulse Chemotherapy for Oral Squamous Cell Carcinoma

Oral squamous cell carcinoma (OSCC) is a common oral cancer of the head and neck, which causes tremendous physical and mental pain to people. Traditional chemotherapy usually results in drug resistance and side effects, affecting the therapy process. In this study, a self-powered electrical impulse chemotherapy (EIC) method based on a portable triboelectric nanogenerator (TENG) was established for OSCC therapy. A common chemotherapeutic drug, doxorubicin (DOX), was used in the experiment. The TENG designed with zigzag structure had a small size of 6 cm × 6 cm, which could controllably generate the fixed output of 200 V, 400 V and 600 V. The electrical impulses generated by the TENG increased the cell endocytosis of DOX remarkably. Besides, a simply and ingeniously designed microneedle electrode increased the intensity of electric field (EF) between two adjacent microneedle tips compared with the most used planar interdigital electrode at the same height, which was more suitable for three-dimensional (3D) cells or tissues. Based on the TENG, microneedle electrode and DOX, the self-powered EIC system demonstrated a maximal apoptotic cell ratio of 22.47% and a minimum relative 3D multicellular tumor sphere (MCTS) volume of 160% with the drug dosage of 1 μg mL⁻¹.     

Squamous Cell Carcinoma of the Rectum 21 Years after Radiotherapy for Cervical Carcinoma

Squamous cell carcinoma (SCC) of the rectum is an extremely rare malignancy, accounting for 0.1-0.2% of rectal malignancies. It is associated with ulcerative colitis, prior radiation, schistosomiasis, ovarian cancer, endometrial cancer, human papilloma virus, colocutaneous fistulas and colonic duplication. Prior reported cases of SCC of the rectum have involved treatment with brachytherapy and external beam radiation. This case is particularly interesting because of the remote exposure of radiation (21 years previously) and the subsequent development of SCC of the rectum. Although extremely rare, SCC of the rectum can occur decades after radiation exposure.     

Prognostic Markers and Driver Genes and Options for Targeted Therapy in Human-Papillomavirus-Positive Tonsillar and Base-of-Tongue Squamous Cell Carcinoma

The incidence of Human-papillomavirus-positive (HPV⁺) tonsillar and base-of-tongue squamous cell carcinoma (TSCC and BOTSCC, respectively) is increasing epidemically, but they have better prognosis than equivalent HPV-negative (HPV⁻) cancers, with roughly 80% vs. 50% 3-year disease-free survival, respectively. The majority of HPV⁺ TSCC and BOTSCC patients therefore most likely do not require the intensified chemoradiotherapy given today to head and neck cancer patients and would with de-escalated therapy avoid several severe side effects. Moreover, for those with poor prognosis, survival has not improved, so better-tailored alternatives are urgently needed. In line with refined personalized medicine, recent studies have focused on identifying predictive markers and driver cancer genes useful for better stratifying patient treatment as well as for targeted therapy. This review presents some of these endeavors and briefly describes some recent experimental progress and some clinical trials with targeted therapy.     

瘦素及其受体在食管鳞癌中的表达意义

目的 探讨瘦素(leptin)及其受体(Ob- Ra、Ob-Rb)与食管鳞癌的关系,为食管鳞癌的发病机制研究提供一定的理论依据.方法 RT- PCR法检测20例正常食管和24例食管鳞癌组织中leptin、Ob-Ra、Ob- Rb的mRNA表达.结果 (1)20例正常食管组织中leptin、Ob- Ra、Ob-Rb的mRNA表达阳性率分别为50.0％、50.0％、40.0％;24例食管鳞癌组织中leptin、Ob- Ra、Ob-Rb的mRNA表达阳性率分别为79.2％、83.3％、83.3％.正常食管组与食管鳞癌组相比差异均有统计学意义(P＜0.05).(2)食管鳞癌组织中leptin、Ob-Ra、Ob-Rb的mRNA相对表达量亦高于正常食管组织,差异均有统计学意义(P＜0.05).结论 瘦素及其受体在食管鳞癌组织中的表达阳性率和相对表达量均高于正常食管组织,提示瘦素及其受体可能在食管鳞癌的发生发展中发挥重要作用.     

Coexistent Ampullary Squamous Cell Carcinoma with Adenocarcinoma of the Pancreatic Duct

Primary squamous cell carcinoma (SCC) of ampulla has seldom been reported. However, metastatic SCC to ampulla of Vater is well known. We report a case of primary SCC of ampulla of Vater coexistent with well-differentiated adenocarcinoma of the distal pancreatic duct. A 50-year-old female presented with evidence of obstructive jaundice. Endoscopic retrograde cholangio-pancreatography revealed bulging papilla with ulcero-infiltrative growth at the ampulla of Vater. An initial endoscopic biopsy of the ampullary mass showed a well-differentiated SCC. The patient underwent Whipple''s operation. Thorough sampling of the dilated portion of the pancreatic duct showed presence of well-differentiated adenocarcinoma of the distal pancreatic duct. Immunohistochemical study with synaptophysin and chromogranin was done with negative result, ruling out neuroendocrine differentiation. Also, a detailed clinical, endoscopic and radiological examination was carried out, that excluded the presence of primary SCC elsewhere.     

Entry of Oncolytic Herpes Simplex Virus into Human Squamous Cell Carcinoma Cells by Ultrasound

Low-intensity ultrasound is a useful method to introduce materials into cells due to the transient formation of micropores, called sonoporations, on the cell membrane. Whether oncolytic herpes simplex virus type 1 (HSV-1) can be introduced into oral squamous cell carcinoma (SCC) cells through membrane pores remains undetermined. Human SCC cell line SAS and oncolytic HSV-1 RH2, which was deficient in the γ₁34.5 gene and fusogenic, were used. Cells were exposed to ultrasound in the presence or absence of microbubbles. The increase of virus entry was estimated by plaque numbers. Viral infection was hardly established without the adsorption step, but plaque number was increased by the exposure of HSV-1-inoculated cells to ultrasound. Plaque number was also increased even if SAS cells were exposed to ultrasound and inoculated with RH2 without the adsorption step. This effect was abolished when the interval from ultrasound exposure to virus inoculation was prolonged. Scanning electron microscopy revealed depressed spots on the cell surface after exposure to ultrasound. These results suggest that oncolytic HSV-1 RH2 can be introduced into SAS cells through ultrasound-mediated pores of the cell membrane that are resealed after an interval.