p53蛋白表达与HPV16感染相关新疆维吾尔族妇女宫颈癌的关系

目的 探讨p53蛋白表达在HPV16型感染相关的新疆维吾尔族妇女宫颈癌发生发展中的作用。方法 采用半巢式PCR和免疫组化技术检测79例新疆维吾尔族妇女宫颈癌组织中HPV16 DNA和p53蛋白表达情况，探讨其与宫颈癌发生的相关性。结果 在宫颈癌组织中，HPV16检出率为81．0％（64／79），高于对照组7．5％（3／40），二者存在显著性差异（x^2=58．328，P=0．000）。宫颈癌组中p53蛋白阳性率为68.4％（54／79），明显高于正常宫颈组织12．5％（5／40），二者在统计学上有显著性差异（x^2=33．140，P=0．000）。结论 高危型HPV E6介导的p53蛋白降解失活是宫颈癌发生的重要机制之一，但在部分HPV感染的宫颈癌组织中p53蛋白表达蓄积的现象提示宫颈癌的发生还涉及到其它多基因和多步骤的致癌机制。     

HPV感染与非小细胞肺癌的相关性

背景与目的：人乳头瘤病毒（HPV）是宫颈癌的主要病因，但近来发现在非小细胞肺癌（NSCLC）中能检测到HPV，两者间的关系已经引起了人们的重视。本研究探讨人乳头瘤病毒（HPV）16、18型感染与非小细胞肺癌（NSCLC）是否存在相关性及其意义。方法：应用PCR、免疫组化和TUNEL分别检测76例NSCLC及13例肺良性病变中HPV16、18型DNA及其原癌蛋白E6 E7、端粒酶hTERT、P53、MDM2、桩蛋白（paxillin）和细胞凋亡的表达。结果：NSCLC中HPV16、18型总阳性率为40．8％（31／76），而肺良性病变组阳性率为7．7％（1／13），差异有显著性（P〈0．05）。NSCLC中HPV阳性组与阴性组之间细胞凋亡、P53、MDM2、paxillin的表达均有显著性差异（P〈0．05），而端粒酶hTERT无显著性差异。HPV感染与组织学类型及淋巴结转移无关，而与组织分化程度有显著性差异（P〈0．05）。结论：HPV16、18型感染在NSCLC发生中可能有病因学意义，其致癌机制可能与细胞凋亡、P53、MDM2及paxillin表达变化有关。     

鼻咽癌p53 p21 WAF1和MDM2蛋白异常表达的临床意义

目的：探讨p53、p21^WAF1、MDM2蛋白在原发鼻咽癌（NPC）异常表达的临床意义。方法：采用LSAB法检测69例原发NPC组织中p53、p21^WAF1和MDM2蛋白的表达状况。结果：1）p53、p21^WAF1和MDM2蛋白在原发NPC组织的阳性表达率分别为79．7％、84．1％、和82．6％；高表达率分别为50．7％、46．4％和31．9％。2）p53蛋白的高表达率随TNM分期的升高而增多，P＝0．042。3）p53或MDM2蛋白高表达者的复发间期显著短于相应蛋白低表达／阴性者，分别P＝0．038和P＝0．002。4）p53和MDM2蛋白同时高表达者、MDM2蛋白高表达同时p21^WAF1蛋白低表达／阴性者的复发间期明显短于对照组，分别P＜0．001；p21^WAF1蛋白高表达同时p53蛋白低表达／阴性者、p53和MDM2蛋白同时低表达／阴性者的复发间期显著长于对照组，分别P＝0．002和P＝0．014。5）p53和MDM2蛋白高表达同时p21^WAF1蛋白低表达／阴性者的复发间期明显短于对照组，P＜0．001；p53和MDM2蛋白低表达阴性同时p21^WAF1蛋白高表达者的复发间期明显长于对照组，P＝0．002。结论：p53或MDM2蛋白高表达提示有促进NPC复发的作用，p21^WAF1蛋白高表达提示有抑制NPC复发的作用。单独检测p53或MDM2蛋白在原发NPC组织的表达情况可以和为预测NPC复发倾向和临床预后的参考指标；如同时检测p53、MDM2和p21^WAF1蛋白的两项或三项指标，预测意义更理想。     

MDM2和p53在反应性及肿瘤性星形胶质细胞中的表达

目的：检测MDM2和p53蛋白在星形胶质细胞反应性增生与星形胶质细胞瘤中的表达，探讨二者在胶质瘤形成和发展中的作用及其相关性。方法：应用组织芯片和免疫组化染色技术检测正常脑组织、星形胶质细胞反应性增生、低级别（Ⅰ-Ⅱ级）和高级别（Ⅲ-Ⅳ级）星形胶质细胞瘤中MDM2和p53蛋白的表达情况。结果：正常脑组织中MDM2和p53蛋白均呈阴性表达；反应性增生组、低级别肿瘤组及高级别肿瘤组中MDM2蛋白的阳性率分别为32.7％（16／49）、59．2％（29／49）、80．0％（40／50）；p53蛋白的阳性率分别为27．3％（12／49）、57．1％（28／49）、82．0％（41／50）。二者阳性表达率均随着病变恶性程度的增加而升高，MDM2和p53在各实验组间的比较差异均有统计学意义（P〈0．05）；且MDM2和p53表达密切相关（P〈0．05）。结论：MDM2和p53在星形胶质细胞反应性增生及星形胶质细胞瘤中均呈不同程度的过度表达，且随着病变恶性程度的增加表达水平增高，MDM2扩增和p53突变是胶质瘤发生的早期事件，二者的联合检测可能会对星形胶质细胞反应性增生与低级别胶质细胞瘤的鉴别诊断以及星形胶质细胞瘤的早期诊断提供一定的依据。     

脑胶质瘤中p14ARF、MDM2及p53的表达及其意义

目的：探讨p14^ARF、MDM2和p53蛋白在脑胶质瘤组织中的表达及p14^ARF-MDM2-p53通路在胶质瘤进展中的意义。方法：应用免疫组化SP法检测25例Ⅱ级和23例Ⅳ级胶质瘤组织中-p14^ARF、MDM2和-p53蛋白的表达，并分析其与胶质瘤组织学分级之间的关系。结果：Ⅱ级和Ⅳ级胶质瘤中，MDM2蛋白的阳性表达率分别为24．00％（6／25）及56．52％（13／23）（P=0．021），p53蛋白的阳性表达率分别为28．00％（7／25）及60．87％（14／23）（P=0．022），二者阳性表达率均随胶质瘤恶性程度的增加而升高，Spearman等级相关分析显示，MDM2、p53的表达与胶质瘤分级呈正相关；p14^ARF的阳性表达率分别为76．00％（19／25）及34．78％（8／23）（P=0．004），其阳性表达率随胶质瘤恶性程度的增加而降低，Spearman等级相关分析显示，p14^ARF的表达与胶质瘤分级呈负相关（P〈0．05）。结论：脑胶质瘤组织中，MDM2和p53均呈不同程度的过度表达，且随恶性程度的增加表达水平增高；而p14^ARF随恶性程度的增加而表达水平降低。MDM2扩增、p53突变及p14^ARF蛋白低表达均与胶质瘤的进展有关。     

食管鳞癌中HPV—16／18感染与c—erbB—2、p53和Rb表达及其意义

目的：探讨食管鳞癌组织中人乳头瘤病毒HPV－16／18感染与c-erbB-2，p53和Rb表达及其意义。方法：采用聚合酶链反应（PCR）法检测90例活检存档的食管鳞癌蜡块中HPV－16／18的感染情况。从中随机选择20例，采用免疫组化法检测单独的HPV－16感染及c-erbB-2，p53和Rb表达。结果：PCR检测食管癌组织HPV－16／18的感染率为31．1％（28／90）；免疫组化法检测食管癌组织中单独的HPV－16的感染率为55％（11／20）。食管癌组织表达c-erbB-2，Rb和p53和Rb的阳性率分别为75％（15／20），65％（13／20）和80％（16／20）。HPV－16感染与c-erbB-2，Rb和p53表达之间未见相关性。HPV－16感染以及c-erbB-2，p53和Rb表达与淋巴结转移之间差异无显著性（P＞0．05）。p53表达与食管癌组织学分级之间差异有显著性（P＜0．05），而PV－16感染以及Rb和c-erbB-2表达与食管癌组织学分级之间差异无显著性（P＞0．05）。结论：食管癌组织中HPV－16／18感染与c-erbB-2，p53和Rb表达之间的关系是复杂的，尚有待于进一步研究。     

p53Arg72Pro多态性与HPV相关宫颈癌发生机制

[目的]探讨p53Arg72Pro多态性与HPV相关宫颈癌发生机制的关系。[方法]采用PCR技术检测210例宫颈癌和95例正常宫颈组织的HPV16DNA．采用免疫组化方法及TUNEL检测p53Arg72Pro三种基因型中p53、p21、Bax、Ki-67蛋白（P1）表达以及细胞凋亡（AI）。[结果]宫颈癌HPV16阳性率为70．5％,与正常宫颈组织（7．4％）相比差异具有统计学意义（P〈0．05）。HPV16阳性的宫颈癌中：①p53蛋白阴性和弱阳性表达率（73．6％）高于强阳性率（26．4％）,其中p53Arg的阴性表达率（39．2％）高于p53Pro（16．7％）,差异有统计学意义（P〈0．05）;②p21蛋白阴性和弱阳性组中,p53Pro型中PI高于p53Arg型,差异有统计学意义（P〈0．05）;④Bax蛋白阴性和弱阳性组中,p53Pro型中AI低于p53Arg型,差异有统计学意义（P〈0．05）。[结论]p53蛋白可被HPV16E6蛋白降解,其中p53Arg蛋白更易被降解;p53Arg和p53Pro蛋白被降解后,两者抑制细胞增殖能力的降低和诱导细胞凋亡能力的降低程度不同．其中p53Pro蛋白转录激活p21和Bax基因的功能及细胞周期阻滞作用的降低更明显。     

宫颈腺癌HPV16／18感染与ki67、p53蛋白表达的关系

目的研究人宫颈腺癌组织中ki67、p53蛋白表达,分析HPV16／18感染与ki67、p53蛋白表达的关系。方法采用组织微阵列技术结合原位杂交和免疫组化（二步法）检测24例慢性宫颈炎和86例宫颈腺癌HPV16／18-E6DNA和ki67、p53蛋白表达情况。结果HPV16／18-E6DNA与ki67、p53蛋白表达在宫颈腺癌组织中的阳性率分别为65．1％、51．2％、45．3％,均显著高于慢性宫颈炎组织8．3％、0．0％、0．0％（P〈0．01）。HPV16／18感染与宫颈腺癌的病理分级和组织学类型无关,但与ki67表达呈正相关（P〈0．05）,与p53表达呈负相关（P〈0．05）。ki67、p53蛋白表达与宫颈腺癌的病理分级有关,G2、G3组阳性表达率均明显高于G1组（P〈0．05）。ki67、p53蛋白表达与宫颈腺癌组织学类型无相关性。结论宫颈腺癌的发生发展与HPV16／18感染及ki67、p53蛋白表达异常相关。     

MDM2与p21、p53在胃癌、食管癌中表达的相关性研究

目的 探讨MDM2基因蛋白与p21、p53蛋白在胃癌、食管癌中表达的相关 性。方法 对41例胃癌、45例食管癌标本,进行石蜡工片和S－P组织化学染色。结果 MDM2、p21和p53在胃癌、食管癌中的表达率分别为67．44％（58／86）、61．63％（53／86）和30．23％（26／86）。MDM2与p21蛋白表达呈正相关、与p53蛋白表达呈负相关（rs＝－0．4932）。结论 MDM2和p53蛋白在消化道癌瘤的发生、发展过程中具有互相排斥和调节作用,而MDM2和p21是的相互作用不明显。     

高危人乳头状瘤病毒和p53、p21WAF1、MDM2在子宫颈鳞癌中的表达

 目的 探讨子宫颈浸润性鳞状细胞癌（ISCC）中人乳头状瘤病毒（HPV）16／18、31／33 感染及p53、p21WAF1、双微体2（MDM2）蛋白的表达，研究其相关性及在ISCC发生、发展中的作用。方法 利用组织芯片、原位杂交和免疫组织化学法检测106例ISCC、10例子宫颈上皮内瘤变（CIN）、10例正常子宫颈鳞状上皮（NCE）中HPV16／18、31／33和p53、p21WAF1、MDM2的表达。应用SPSS12.5统计软件分析结果。结果 HPV16／18、p53、p21WAF1、MDM2在ISCC中的表达明显高于CIN和NCE组，差异有统计学意义；HPV31／33表达与淋巴结转移呈正相关（P＜0.05）；p53蛋白与组织学分级、淋巴结转移呈正相关；p21WAF1阳性表达率与子宫颈管壁浸润深度呈正相关；MDM2蛋白与临床各参数均无相关性（P＞0.05）。结论 高危HPV和突变型p53在ISCC的发生、发展中起重要作用，p53的下游基因MDM2作为癌基因在进展中起作用，而p21WAF1基因可能不是单纯作为抑癌基因在起作用。     

New and emerging radiosensitizers and radioprotectors

The combination of chemotherapy and radiation has led to clinical breakthroughs in several disease sites, and current work continues to define optimum combinations of proven chemotherapy as well as more recently available, noncytotoxic agents. Administration of systemic therapies allows modulation of radiation response to improve tumor control (radiosensitization) or to prevent normal tissue toxicity (radioprotection). Substantial progress has been made in identifying the targets of standard chemotherapeutic radiation sensitizers and protectors as well as in the introduction of a new generation of molecularly targeted therapies in combination with radiation. We have reviewed the most recent, predominantly early phase clinical trials combining systemic agents with radiation. Although the proof of an improved schedule ultimately needs to come from well-run Phase III trials, the search among schedules could be shortened by the use of surrogate endpoints such as presence of active drug metabolites in the tumor. This has been accomplished only in a few cases and needs to become a more standard part of radiation sensitizer and protector trials.     

Religiosity and Physical and Emotional Functioning Among African American and White Colorectal and Lung Cancer Patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

Fruit and vegetables and cancer risk

The possibility that fruit and vegetables may help to reduce the risk of cancer has been studied for over 30 years, but no protective effects have been firmly established. For cancers of the upper gastrointestinal tract, epidemiological studies have generally observed that people with a relatively high intake of fruit and vegetables have a moderately reduced risk, but these observations must be interpreted cautiously because of potential confounding by smoking and alcohol. For lung cancer, recent large prospective analyses with detailed adjustment for smoking have not shown a convincing association between fruit and vegetable intake and reduced risk. For other common cancers, including colorectal, breast and prostate cancer, epidemiological studies suggest little or no association between total fruit and vegetable consumption and risk. It is still possible that there are benefits to be identified: there could be benefits in populations with low average intakes of fruit and vegetables, such that those eating moderate amounts have a lower cancer risk than those eating very low amounts, and there could also be effects of particular nutrients in certain fruits and vegetables, as fruit and vegetables have very varied composition. Nutritional principles indicate that healthy diets should include at least moderate amounts of fruit and vegetables, but the available data suggest that general increases in fruit and vegetable intake would not have much effect on cancer rates, at least in well-nourished populations. Current advice in relation to diet and cancer should include the recommendation to consume adequate amounts of fruit and vegetables, but should put most emphasis on the well-established adverse effects of obesity and high alcohol intakes.     

VEGF及KDR在大肠腺瘤和腺癌中的表达及意义

目的：探讨VEGF和KDR在大肠腺瘤和大肠腺癌中的表达及临床病理特征的关系。方法：大肠腺瘤和大肠腺癌组织标本各100例,采用免疫组织化学染色法检测VEGF和KDR在标本中的表达情况。结果：VEGF和KDR在大肠腺癌组中的阳性表达明显高于大肠腺瘤组（P〈0.05）;在正常大肠黏膜均未见VEGF和KDR表达的阳性染色;VEGF阳性表达组中KDR的阳性表达率为70%,显著高于VEGF阴性表达组中KDR的阳性表达率16%,两组比较有统计学意义（P〈0.01）。结论：大肠腺癌组织中KDR的表达与肿瘤大小、转移情况、浸润深度密切相关;VEGF和KDR在大肠腺瘤中的表达与患者的年龄、性别及分型均无相关性,而与增生程度相关（P〈0.05）。在大肠腺癌患者中VEGF及KDR表达更高,二者具有协同效应。     

肾上腺素能β受体与肿瘤生长及转移

大量研究表明肿瘤细胞可表达β受体，而一些神经递质、药物和社会心理因素可能通过β受体影响肿瘤的生长和转移，β受体激动剂、β受体阻滞剂以及抑郁等社会心理因素可加强或削弱这种作用。这为表达β受体肿瘤的治疗开辟了新的道路，提供了新的治疗靶点。     

Occupational and environmental radiation and cancer

Epidemiologic evidence on the relation between occupational and environmental radiation and cancer is reviewed. Studies of pioneering radiation workers, underground miners, and radium dial painters revealed excess cancer deaths and contributed to the setting of radiation protection standards and to theories of carcinogenesis. Occupational exposures today are generally much lower than in the past, thus any associated increases in cancer will be difficult to detect. Pooling investigations of these more recently exposed workers, however, has the potential to validate current estimates of risk used in radiation protection. New information on the effects of chronic radiation exposure also may come from studies in the former Soviet Union of Chernobyl clean-up workers and of workers at the Mayak nuclear facilities. Studies of environmental radiation exposures, other than radon, are largely inconclusive, due mainly to the difficulties in detecting the low risks associated with low dose exposures. Thyroid cancer, however, has been linked to environmental radiation from the Chernobyl accident and from nuclear weapons tests. Low-level radiation released during normal operations at nuclear plants has not been found to increase cancer rates in surrounding populations. Radon, a human carcinogen, is the most ubiquitous exposure to human populations; remediating high residential-radon levels is recommended, recognizing that the exposure can never be removed completely because it occurs naturally.     

Cell and tissue interactions in carcinogenesis and metastasis and their clinical significance

This review describes a new vision for future directions in the study of metastatic cancer biology and pathology. It is based upon clinical and experimental observations on the constituent cell lineages within a neoplasm and on tumour-host interactions. The vision incorporates information from studies in population biology, developmental biology and experimental pathology as well as investigations upon human malignant disease. The assembled information reveals that invasion and metastasis are supra-cellular manifestations of "emergent behavior" among combinations of normal and malignant cell lineages in vivo. Emergent behavior is a combinatorial interactive process in which a population displays new traits which cannot be achieved by individuals acting separately and which subside when the specific population mix disaggregates. Disruption of such pathological interactions in the field of a developing primary or secondary tumour is, therefore, required to disable the malignant population and arrest progression without tissue destruction. These conclusions originate, in part, from principles which govern the sociobiology and group behavior of bees, ants, fish, birds and human societies. In all these social organisms, external factors can disrupt signaling mechanisms and induce expanding self-perpetuating rogue behavior, leading to social disintegration. These principles also apply to cellular societies composing higher animals, which likewise need intrinsic rules to maintain social order and avoid anarchy, and recognition of this is essential for advancing future research on the mechanisms involved in carcinogenesis and metastasis. Summarised evidence is presented here to support the conclusion that miscommunications between cells and tissues in the region of the developing tumour and its metastases are the main direct perpetrators of malignant disease. Genetic lesions (mutations, deletions, translocations, reduplications, etc.), commonly seen in cancers, can significantly disrupt important molecular pathways in the networks of communications needed to sustain orderly tissue/organ structure and function. However, genetic lesions can also, themselves, be induced by abnormal cell interactions initiated by extrinsic carcinogenic agents such as chemicals, viruses, hormones and radiation. The evidence shows that, irrespective of the initiating cause, it is this miscommunication in the region of a developing tumour and its metastases that is ultimately responsible for the emergence and progression of the disease. The article describes how this information collectively, provides a framework for designing specific novel therapeutic approaches targeting the cell and tissue interactions driving tumour metastasis and its manifold effects on the whole body.     

Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: A comprehensive review and meta-analysis

Vitamin D is formed mainly in the skin upon exposure to sunlight and can as well be taken orally with food or through supplements. While sun exposure is a known risk factor for skin cancer development, vitamin D exerts anti-proliferative and pro-apoptotic effects on melanocytes and keratinocytes in vitro. To clarify the role of vitamin D in skin carcinogenesis, we performed a review of the literature and meta-analysis to evaluate the association of vitamin D serum levels and dietary intake with cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) risk and melanoma prognostic factors. Twenty papers were included for an overall 1420 CM and 2317 NMSC. The summary relative risks (SRRs) from random effects models for the association of highest versus lowest vitamin D serum levels was 1.46 (95% confidence interval (CI) 0.60–3.53) and 1.64 (95% CI 1.02–2.65) for CM and NMSC, respectively. The SRR for the highest versus lowest quintile of vitamin D intake was 0.86 (95% CI 0.63–1.13) for CM and 1.03 (95% CI 0.95–1.13) for NMSC. Data were suggestive of an inverse association between vitamin D blood levels and CM thickness at diagnosis. Further research is needed to investigate the effect of vitamin D on skin cancer risk in populations with different exposure to sunlight and dietary habits, and to evaluate whether vitamin D supplementation is effective in improving CM survival.