hMLH1和hMSH2蛋白在肝细胞癌中的表达及意义

本研究采用免疫组织化学法 ,对ＤＮＡ错配修复 (ＭＭＲ)系统中 2个主要基因ｈＭＬＨ1和ｈＭＳＨ2在肝细胞癌 (ＨＣＣ)中的表达状况进行了检测和相关指标分析 ,以进一步了解ＭＭＲ路径在ＨＣＣ发生中的可能作用。一、对象与方法1 .研究对象 :随机选择第二军医大学东方肝胆外科医院病理科 2 0 0 0年 6月～ 7月期间连续手术切除的ＨＣＣ标本 50例 ,患者中男 40例 ,女 1 0例 ,年龄范围 35～ 76岁 ,所有患者术前均未做过放疗或化疗。于癌和癌旁肝组织交界处取材 ,1 0 %中性甲醛固定 ,常规石蜡包埋 ,4μｍ连续组织切片 ,分别行常规ＨＥ染色和ｈＭ…     

错配修复基因hMSH2、hMLH1在非霍奇金

目的 探讨错配修复基因hMSH2、hMLH1在非霍奇金淋巴瘤中的表达及意义.方法 运用免疫组化SP法检测22例B细胞性非霍奇金淋巴瘤及18例NK/T细胞性非霍奇金淋巴瘤中hMSH2、hMLH1蛋白表达情况,并探讨其与非霍奇金淋巴瘤临床病理间的关系.结果 NK/T细胞非霍奇金淋巴瘤hMSH2、hMLH1蛋白表达缺失率分别为55.56%、44.44%;B细胞非霍奇金淋巴瘤分别为31.82%、50.00%,两种肿瘤间缺失率比较均无统计学意义.hMSH2、hMLH1蛋白表达缺失与患者性别及肿瘤是否发生于淋巴结无关.结论 错配修复基因hMSH2、hMLH1在非霍奇金淋巴瘤肿瘤组织中存在蛋白表达缺失,可导致基因组不稳定,该肿瘤易感.     

错配修复基因hMSH2、hMLH1在非霍奇金淋巴瘤中的表达及意义

目的探讨错配修复基因hMSH2、hMLH1在非霍奇金淋巴瘤中的表达及意义。方法运用免疫组化SP法检测22例B细胞性非霍奇金淋巴瘤及18例NK／T细胞性非霍奇金淋巴瘤中hMSH2、hMLH1蛋白表达情况,并探讨其与非霍奇金淋巴瘤临床病理问的关系。结果NK／T细胞非霍奇金淋巴瘤hMSH2、hMLH1蛋白表达缺失率分别为55．56％、44．44％;B细胞非霍奇金淋巴瘤分别为31．82％、50．00％,两种肿瘤间缺失率比较均无统计学意义。hMSH2、hMLHl蛋白表达缺失与患者性别及肿瘤是否发生于淋巴结无关。结论错配修复基因hMSH2、hM-LH1在非霍奇金淋巴瘤肿瘤组织中存在蛋白表达缺失,可导致基因组不稳定,该肿瘤易感。     

Expression of HIF-2α／EPAS1 in hepatocellular carcinoma

AIM:To investigate the expression of hypoxia-inducible factor (HIF)-2α/endothelial PAS domain protein1 (EPAS1) in hepatocellular carcinoma (HCC).METHODS: Expression of HIF-2α/EPAS1 was investigated immunohistochemically on paraffin-embedded sections from 97 patients with HCC.To further confirm that HIF-2α/EPAS1 in HCC tissues also correlated with angiogenesis, a parallel immunohistchemistry study of vascular endothelial growth factor (VEGF) was performed on these 97 cases.RESULTS:HIF-2α/EPAS1 could be detected in 50 of 97 cases (51.6%), including 19 weakly positive (19.8%), and 31 strongly positive (31.1%), the other 47 cases were negative(48.4%). The expression of HIF-2α/EPASlwas significantly correlated with tumor size,capsule infiltration, portal vein invasion, and necrosis. A parallel immunohistochemical analysis of VEGF demonstrated its positive correlation with capsule infiltration, portal vein invasion, and HIF-α/EPAS1 overexpression, which supported the correlation of HIF-2α/EPASlup-regulation with tumor angiogenesis. No apparent correlation was observed between HIF-2α/EPAS1 and capsular formation, presence of cirrhosis, and histological grade.CONCLUSION: HIF-2α/EPAS1 is expressed in most of HCC with capsular infiltration and portal vein invasion, which indicates a possible role of HIF-2α/EPAS1 in HCC metastasis.     

76个中国人遗传性非息肉病性大肠癌家系hMLH1和hMSH2基因突变规律研究

遗传性非息肉病性结直肠癌（hereditary nonpolyposis colorectal cancer，HNPCC）是一种常染色体显性遗传疾病综合征，由错配修复（mismatch repair，MMR）基因种系突变引起，占所有结直肠癌的5％-10％。HNPCC的发病与人类错配修复基因功能异常密切相关，已定位并克隆的人MMR基因有hMLH1、hMSH2、hMSH6、hMSH3、hPMS1、hPMS2，遗传连锁分析和遗传学研究显示，约80％的HNPCC与hMLH1、hMSH2基因的种系异常相关。     

hMLH1和hMSH2蛋白表达在遗传性非息肉病性大肠癌诊断中的应用

目的　评价错配修复基因hMLH1和hMSH2蛋白表达在筛选遗传性非息肉病性大肠癌(HNPCC)中的价值。方法　收集大肠癌患者 6 6例 ,分为HNPCC患者 (A组 ,n =19)、高度可疑HNPCC患者 (B组 ,n =2 0 )、符合Bethesda指导标准的可疑HNPCC患者 (C组 ,n =14 )及散发性大肠癌患者 (D组 ,n =13)四组 ,用免疫组化方法检测各组错配修复基因hMLH1和hMSH2的蛋白表达。结果　A组hMLH1和hMSH2蛋白表达减低或缺失达 72 .8% ;B组为 6 0 .0 % ;C组为 2 8.4 % ;D组为 7.7%。hMLH1和hMSH2蛋白表达减低或缺失与HNPCC显著相关 (P =0 .0 0 0 8)。此外 ,hMLH1蛋白表达减低或缺失率显著高于hMSH2 (P <0 .0 1)。结论　hMLH1和hMSH2蛋白表达减低或缺失与HNPCC的可能性显著相关 ,免疫组化检测此二种蛋白表达能快速、有效地帮助临床医生评估患者HNPCC的可能性 ,同时提示相应错配修复基因存在突变。中国HNPCC患者中hMLH1基因发生突变的机会可能高于hMSH2基因。     

大肠腺管开口分型与hMLH1和hMSH2蛋白表达在染色放大内镜下的相关性

目的:探讨染色放大内镜下大肠病变的腺管开1:2分型与病变组织hMLH1和hMSH2蛋白表达的关系.方法:根据Kudo分型方法,染色放大内镜下大肠病变腺管开口分为I.V型;所有病灶性质由病理组织学分别确诊为非肿瘤性病变、腺瘤性病变及癌性病变:免疫组织化学方法检测活检组织hMLH1和hMSH2蛋白的表达.结果:应用染色放大...     

Usefulness of serum des-γ-carboxy prothrombin in detection of hepatocellular carcinoma

AIM: Des-gamma-carboxy prothrombin (DCP) has been reported to be more sensitive and specific in diagnosing hepatocellular carcinoma (HCC) when compared with alpha-fetoprotein (AFP). However, its ability to identify small HCC still remains unclear. Thus, we conducted a cross-sectional case control study to evaluate whether DCP is better than AFP for differentiating HCC from nonmalignant liver disease and further evaluate the usefulness of DCP in early diagnosis of small HCC. METHODS: Serum DCP and AFP levels were determined in 127 patients. Among these patients, 32 were with non-cirrhotic chronic hepatitis, 34 were with compensated cirrhosis, and 61 were with HCC. The cut-off value for the DCP and AFP were set as 40 mAU/mL and 20 ng/mL, respectively. To compare the diagnostic value of DCP and AFP in distinguishing HCC from nonmalignant chronic liver disease, receiver operating characteristic (ROC) curves were constructed for each assay. RESULTS: The accuracy, sensitivity and specificity of DCP were higher than AFP in detecting HCC (81.9%, 77% and 86.4% vs 68.5%, 59% and 77.3%, respectively). The area under the ROC (AUROC) curves revealed that DCP had a better accuracy than AFP in diagnosis of HCC (0.85 [95%CI, 0.78-0.91] vs 0.73 [95%CI, 0.65-0.81], P = 0.013). In 39 patients with solitary HCC, the positive rates of DCP were 100% in patients with tumor size larger than 3 cm, 66.7% in patients with tumor size 2-3 cm and 50% in patients with tumor size less than 2 cm. The positive rates of AFP in patients with tumor size larger than 3 cm, 2-3 cm and less than 2 cm were 55.6%, 50%, and 33.3%, respectively. The median level of DCP in HCC patients with tumor size larger than 3 cm was significantly higher than those with tumor size 2-3 cm and those with the size of less than 2 cm. CONCLUSION: Our study indicates that DCP has a better diagnostic value than AFP in differentiating HCC from nonmalignant chronic liver disease. DCP has not only a stronger correlation with HCC than AFP in tumor size but also more effectiveness than AFP in detecting small size of HCC.     

Correlation between expression of cyclooxygenase-2 and the presence of inflammatory cells in human primary hepatocellular carcinoma： Possible role in tumor promotion and angiogenesis

AIM: To investigate the association of cyclooxygenase-2 (COX-2) expression with angiogenesis and the number and type of inflammatory cells (macrophages/Kupffer cells; mast cells) within primary hepatocellular carcinoma (HCC) tissues and adjacent non-tumorous (NT) tissues. METHODS: Immunohistochemistry for COX-2, CD34, CD68 and mast cell tryptase (MCT) was performed on 14 well-characterized series of liver-cirrhosis-associated HCC patients. COX-2 expression and the number of inflammatory cells in tumor lesions and surrounding liver tissues of each specimen were compared. Moreover, COX-2, CD34 staining and the number of inflammatory cells in areas with different histological degrees within each tumor sample were comparatively analyzed. RESULTS: The percentage of COX-2 positive cells was significantly higher in NT tissues than in tumors. COX-2 expression was higher in well-differentiated HCC than in poorly-differentiated tissues. Few mast cells were observed within the tumor mass, whereas a higher number was observed in the surrounding tissue, especially in peri-portal spaces of NT tissues. Abundant macrophages/ Kupffer cells were observed in NT tissues, whereas the number of cells was significantly lower in the tumor mass. However, a higher cell number was observed in the well-differentiated tumor and progressively decreased in relation to the differentiation grade. Within the tumor, a positive correlation was found between COX-2 expression and the number of macrophages/Kupffer cells and mast cells. Moreover, there was a positive correlation between CD34 and COX-2 expression in tumor tissues. Comparison between well- and poorly-differentiated HCC showed that the number of CD34-positive cells decreased with dedifferentiation. However, COX-2 was the only independent variable showing a positive correlation with CD34 in a multivariate analysis. CONCLUSION: The presence of inflammatory cells and COX-2 expression in liver tumor suggests a possible relationship with tumor angiogenesis. COX-2 expressing cells and the number of macrophages/Kupffer cells and mast cells decrease with progression of the disease.     

hMLH1和hMSH2基因在胃癌易感人群中的突变

目的:分析中国北方地区胃癌家系人群及胃癌散发患者hMLH1和hMSH2基因的突变.方法:收集胃癌家族史的胃癌患者16例及5个家系健康人114例,无胃癌家族史的胃癌患者56例,正常人群对照100例.采取外周血,用小样本血液DNA提取试剂盒提取DNA.分别扩增hMLH1的外显子3、8、12、13和外显子16以及hMSH2的外显子5和外显子7,热变性后,用毛细管电泳进行单链构象多态性的分析,对可疑样本进行测序.结果:突变出现在hMLH1基因第8、第12和第16外显子,而外显子3和外显子13没有检测到突变,hMSH2基因的外显子5和外显子7也没有检测到突变.在有家族史的胃癌患者的16例外周血标本中,有6例出现突变,突变率37%;无胃癌家族史的56例患者,总计6例出现突变,突变率11%;胃癌家系健康人群的114例样本中,31例出现突变,突变率27%;在100例对照样本中,5例出现突变,突变率5%.第8外显子的突变点位于219位密码子的第一个碱基(ATC→GTC):第12外显子的突变点位于第384位密码子的第二个碱基(GTT→GAT);第16外显子的突变点位于第553位密码子的第二个碱基(AGT→AGG),这三个突变都是碱基置换.但有家族史的胃癌患者和胃癌家系健康成员的突变率明显高于对照组(P=0.001,0.000),无家族史的胃癌患者突变率虽然略高于对照组,但差异不显著(P=0.204).第16外显子的突变是目前尚未见报道的新的突变.结论:胃癌家系人群体细胞存在与遗传性非息肉性结肠癌(hereditary nonpolyposis colorectal cancer,HNPCC)相似的基因突变.     

X-ray repair cross-complementing group 1 polymorphisms and hepatocellular carcinoma: a meta-analysis

AIM: To perform a systematic meta-analysis to investigate the association between X-ray repair cross-complementing group 1 (XRCC1) polymorphisms and hepatocellular carcinoma (HCC) risk.METHODS: Relevant studies extracted from PubMed, Embase, Wanfang, VIP and the Chinese National Knowledge Infrastructure databases up to March 2012 were included in the study. Stata software, version 11.0, was used for the statistical analysis. The odds ratios (ORs) and 95% confidence interval (CI) of the XRCC1 polymorphisms in HCC patients were analyzed and compared with healthy controls. The meta-analysis was performed using fixed-effect or random-effect methods, depending on the absence or presence of significant heterogeneity.RESULTS: Eleven studies with 2075 HCC cases and 2604 controls met our eligibility criteria (four studies, 888 cases and 938 controls for Arg194Trp, four studies, 858 cases and 880 controls for Arg280His, and nine studies, 1845 cases and 2401 controls for Arg399Gln). The meta-analysis revealed no associations between the Arg194Trp and Arg399Gln polymorphisms of the XRCC1 gene and HCC risk under all contrast models (codominant, dominant and recessive models) in the overall analysis and sensitivity analysis (the studies with controls not in the Hardy-Weinberg equilibrium were excluded). For XRCC1 Arg280His polymorphism, the overall analysis revealed the significant association between the His/His genotype and the increased risk of HCC (His/His vs Arg/Arg model, OR: 1.96, 95% CI: 1.03-3.75, P = 0.04). However, sensitivity analysis showed an altered pattern of result and non-significant association (OR: 2.06, 95% CI: 0.67-6.25, P = 0.20). The heterogeneity hypothesis test did not reveal any heterogeneity, and Begg’s and Egger’s tests did not find any obvious publication bias.CONCLUSION: The XRCC1 Arg194Trp and Arg399Gln polymorphisms are not associated with HCC risk. More rigorous association studies are needed to verify the involvement of XRCC1 Arg280His polymorphism in HCC susceptibility.     

子宫内膜异位症组织中hMLH1、hMSH2蛋白的表达及意义

目的观察人类错配修复基因h MLH1、h MSH2蛋白在子宫内膜异位症（EMS）病灶组织中的表达变化并探讨其意义。方法选择28例EMS患者的子宫内膜异位病灶组织作为病例组,其中Ⅲ期14例、Ⅳ期14例。选择因子宫肌瘤行子宫全切术的26例患者的正常子宫内膜组织作为对照组。采用免疫组化SP法检测两组h MLH1、h MSH2蛋白的表达。比较两组h MLH1、h MSH2蛋白的阳性率,比较病例组Ⅲ、Ⅳ期患者h MLH1、h MSH2蛋白的阳性率。结果病例组、对照组h MLH1蛋白阳性率分别为71.4%（20/28）、30.8%（8/26）,病例组h MLH1蛋白阳性率高于对照组（P〈0.01）。病例组、对照组h MSH2蛋白的阳性率分别为53.6%（15/28）、57.7%（15/26）,两组h MSH2蛋白表达差异无统计学意义。病例组Ⅲ、Ⅳ期患者h MLH1、h MSH2蛋白的阳性率差异无统计学意义（P均〉0.05）。结论 EMS组织h MLH1蛋白表达增高,h MLH1蛋白表达增高可能与EMS的发病有关。     

错配修复基因 hMLH1 和hMSH2 在胃癌组织中的表达及意义

目的探讨错配修复基因hMLH1 和hMSH2 在胃癌发生中的作用.方法采用免疫组化SP法,检测散发性胃癌、癌旁黏膜和胃炎黏膜组织中hMLH1 和 hMSH2基因的表达情况.结果 hMSH2在胃癌组织中的阳性表达率(67.1%)显著高于癌旁黏膜(41.4%)和胃炎黏膜组织(41.2%)(P<0.05),而后两者无显著差异(P>0.05).hMSH2在低分化腺癌中的阳性率(80.6% )显著高于高中分化腺癌(57.7%)和黏液癌(53.8%)(P<0.05),而后两者无显著差异(P>0.05).hMLH1在胃炎黏膜组织的阳性表达率(38.2%)显著低于胃癌(77.1%)和癌旁黏膜组织(74.3%)(P<0.05),后两者无显著差异(P>0.05). hMLH1在黏液癌中的阳性率(38.5%)显著低于高中分化腺癌(80.8%)和低分化腺癌(90.3%)(P<0.05),后两者无显著差异(P>0.05).结论 hMSH2高表达可能是胃癌发生的标志之一;hMSH2表达与肿瘤分化程度及患者预后有关;hMLH1有可能作为胃癌预警组织学标记物.     

错配修复基因hMLH1和hMSH2在胃癌组织中的表达及意义

目的:探讨错配修复基因hMLH1和hMSH2在胃癌发生中的作用.方法:收集青岛大学医学院附属医院普外科手术切除的胃癌组织40例, 经病理诊断腺癌33例, 黏液腺癌7例, 患者术前均未接受放化疗和免疫治疗, 每例均取相应癌旁组织. 胃镜活检20例慢性胃炎黏膜组织(慢性浅表性胃炎10例, 慢性萎缩性胃炎10例). 采用Western blot法检测hMLH1和hMSH2蛋白在胃癌组织、癌旁组织及胃炎组织中的表达.结果:胃癌组织中hMSH2蛋白的表达显著高于癌旁组织和胃炎组织(0.28±0.10 vs 0.23±0.07, 0.11±0.10, 均P <0.01); hMLH1蛋白在胃炎组织和癌旁组织中的表达显著高于胃癌组织(0.28±0.07, 0.26±0.06 vs 0.22±0.06, 均P <0.01); hMLH1和hMSH2在胃癌中的表达与年龄、性别、肿瘤部位、肿瘤大小、浸润深度、组织学类型、分化程度、淋巴结转移、远处转移等无关, 差异均无显著性.结论:hMSH2高表达可能是胃癌发生的标志之一, 而hMLH1则可能是胃癌预警组织的一种标志物.     

食管鳞状细胞癌及不典型增生组织中 hMLH1基因蛋白表达的研究

目的 探讨在食管鳞状细胞癌及不典型增生组织中hMLH1基因的蛋白表达情况及其与食管鳞状细胞癌发生发展的关系。方法 40例食管鳞状细胞癌，相应40例正常组织及26例不典型增生组织，采用免疫组织化学方法，检测了hMLHI蛋白的表达情况。结果 在正常组织、小典跫增生组织、肿瘤组织中的阳性率分别为90％、57．6％和45％，不典型增生组织及肿瘤组织均低于正常组织（P〈0．05）。肿瘤组织中hMLH1蛋白表达阳性者年龄较阴性者大（P〈0．05）。结论 错配修复缺陷早期参与了食管鳞状细胞癌的发生过程；hMLH1蛋白可能抑制和延缓食管鳞状细胞癌的发生和浸润。     

PITX1和Pan-ras在肝癌细胞中的表达及意义

目的研究抑癌基因PITX1和其下游癌基因Pan-ras在正常胚肝细胞株L02，肝癌细胞株HepG2和SMMC-7721中的表达，探讨其在肝癌发生发展中的作用和关系。方法应用SABC免疫组织化学染色技术和westem blot蛋白质印迹以及半定量RT-PCR检测L02、HepG2和SMMC-7721细胞株中PITX1和Pan-ras基因的表达情况，并分析其意义。结果PITX1在肝癌细胞（HepG2、SMMC-7721）中表达比正常肝细胞L02显著降低，Pan-ras在肝癌细胞（HepG2、SMMC-7721）中的表达与正常肝细胞L02相比显著升高。结论PITX1在肝癌细胞中的低表达，以及Pan-ras的高表达，可能导致肝癌无限增殖，构成了肝癌细胞信号传导网络中的重要一环。     

DNA损伤修复基因hOGG1的遗传多态与乙肝相关性HCC的风险

目的:探讨DNA损伤修复基因hOGGI的遗传多态Ser326Cys与肝细胞癌(HCC)易感性的关系．方法:应用基因测序分型方法,分析96例HCC患者和96例健康对照hOGG1的遗传多态及与HBV感染的交互作用．结果:HCC病例组的Cys／Cys,Cys／Ser和Ser／Ser基因型分别为20．9％,44．2％和34．9％．Ser／Cys杂合子个体的OR值为1．5,Cys／Cys纯合子个体的OR值为1．9,明显高于Ser/Ser个体,表现出剂量效应．HBV感染者发生HCC的相对风险度是非HBV感染者的9倍(OR=9．2;95％CI 0．99-5．9)．对于HCC,hOGG1-Ser326Cys变异或HBV感染单一因素的OR值分别为5．5 (95％CI 0．7-240．1)和10．9(95％CI1．6-453．3),但携带变异基因者如果感染HB V,OR值则高达27．8(95％CI4．7-970．2)．结论:DNA修复基因hOGG1的Cys等位基因可能增加HCC的遗传易感性,他与HBV协同在乙肝相关性HCC的发生中起着重要作用．     

Prognostic significance of HIF-2α/EPAS1 expression in hepatocellular carcinoma

AIM: To evaluate the prognostic significance of HIF-2α/EPAS1 expression in hepatocellular carcinoma(NCC).METHODS: Surgical specimens from 315 patients with HCC as well as 196 adjacent noncancerous lesions and 22 cases of normal liver tissue were investigated by immunohistochemistry (IHC) for HIF-2α/EPAS1 using a standard detection system. Correlations with clinicopathological factors, VEGF, microvessel density(MVD), and prognosis were analyzed.RESULTS: Immunoreactivity of HIF-2α/EPAS1 was positive in 69.5% of HCC, 55.6% of adjacent noncancerous tissue, and 0% of normal liver tissue. And it was significantly correlated with tumor grade, venous invasion, intrahepatic metastasis, necrosis, and capsule infiltration. Correlation analysis of HIF-2α/EPAS1 with angiogenic factor VEGF (P＜0.001), and MVD (P =0.016) was also noted. HIF-2α/EPAS1 protein was less frequently expressed in low MVD cases, whereas a high rate of expression was noted in cases with both medium and high MVD (P=0.042). By Kaplan-Meier analysis,strong HIF-2α/EPAS1 staining (＞ 50% of tumor cells) in HCC correlated with a shortened survival in patients (Cox's regression, P＜0.001, r= 3.699).CONCLUSION: We conclude that HIF-2α/EPAS1 expression may play an important role in tumor progression and prognosis of HCC. Assessment of HIF-2α/EPAS1 expression in HCC may be used as a diagnostic tool and possibly a target in the treatment of HCC.