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1.
为探讨妊高征胎盘床血管和胎盘绒毛的组织结构特点及其与妊高征发病机制的关系。本文应用图像分析系统对29例重度妊高征(妊高征组)和29例正常妊娠(正常组)的子宫胎盘床血管和胎盘绒毛进行了形态计量学检测。结果显示∶1妊高征组胎盘的重量、大小均显著低于正常组(P<005)。2妊高征组胎盘绒毛具有合体细胞结节、细胞滋养细胞、绒毛基底膜增厚和纤维素样坏死的绒毛数显著高于正常组(P<005),而具有血管合体细胞膜的绒毛数显著低于正常组(P<005)。3妊高征组胎盘的游离绒毛直径、周长和面积均比正常组显著减小(P<005)。4妊高征组子宫胎盘床螺旋动脉妊娠生理性改变缺乏,管壁增生肥厚、纤维素样坏死和动脉粥样硬化的发生率显著高于正常组(均P<005)。提示妊高征子宫胎盘床血管病变在妊高征发病中可能起重要作用,而胎盘绒毛的组织形态学变化是胎盘缺血、缺氧的结果  相似文献   

2.
本文应用图像分析技术对过期妊娠20例(过期组)、延期妊娠15例(延期组)和正常足月妊娠29例(正常组)的胎盘绒毛和胎盘床螺旋小动脉进行形态计量学检测。结果:(1)过期组胎盘绒毛具有合体细胞结节、细胞滋养细胞增生、绒毛基底膜增厚和纤维素样坏死的绒毛数高于正常组(均P<005),血管合体细胞膜形成的绒毛数低于正常组(P<005);延期组与对照组和过期组间均无显著区别。(2)过期组胎盘绒毛直经、周长和面积参数均小于正常组(均P<001);延期组仅周长和面积参数小于正常组(P<005)。(3)过期、延期组胎盘床螺旋小动脉管壁增厚者高于正常组(P<005),而妊娠生理性改变、管壁纤维素样坏死以及急性动脉粥样化病变与对照组无明显区别。(4)过期、延期组羊水过少和羊水粪染的发生率高于正常组(均P<005),而新生儿低评分者发生率较高,但与正常组无明显区别。提示:过期和延期妊娠的子宫胎盘床血管和胎盘绒毛的形态学病变是导致胎盘功能逐渐低下以及胎儿预后不良的主要原因,尤其过期妊娠者更著  相似文献   

3.
米非司酮对人中期妊娠胎盘的影响   总被引:1,自引:0,他引:1  
目的:探讨米非司酮对中期妊娠胎盘绒毛的影响程度,借此评价该药用于足月妊娠引产的安全性。方法:利用体视学原理,对8例胎龄17~19孕周妇女服用150mg米非司酮后行水囊引产的胎盘绒毛合体滋养细胞线粒体体视学参数、滋养细胞基底膜和毛细血管屏障厚度进行测算,并与8例胎龄17~19孕周水囊引产的胎盘组织对照。结果:米非司酮组合体滋养细胞线粒体的体积密度与对照组间无差异,而其表面积密度、比表面、数密度显著降低,平均体积则明显增大;其次米非司酮组滋养细胞基底膜与对照组相比明显增厚,绒毛间质毛细血管内皮细胞变薄。结论:米非司酮对中期妊娠胎盘组织具较强损伤作用。故在米非司酮用于足月妊娠引产的安全性未充分证实前,不宜将其用于足月妊娠引产中。  相似文献   

4.
目的:建立正常妊娠和妊高征胎盘血管的三维铸型模型,探讨正常妊娠和妊高征胎盘血管的三维分布结构特征和临床价值。方法:采用改良的血管铸型方法,通过胎盘脐动、静脉灌注血管铸型材料,铸建20例正常胎盘,48例异常胎盘血管模型。结果:①人胎盘血管三维结构模型中,正常胎盘血管分支分为5-7级,胎盘动静脉系统容积为152.5mL±45.3mL,末梢动静脉分支数比值为1:2;②重度妊高征胎盘血管系统容积为102.8mL±36.1mL(P<0.01),末稍动静脉分支数比值2:3或1:1(P<0.05);③特殊胎盘的血管结构均有特殊性。结论:建立胎盘血管三维铸型,有利于直观了解正常和异常胎盘血管系统的结构,它不仅可作为教研模型,而且对深入探讨胎盘功能也有一定价值。  相似文献   

5.
目的探讨妊娠期肝内胆汁淤积症(Intrahepatic Cholestasis of Pregnancy,ICP)围生儿出生即刻脐动脉血血气分析值和胎盘绒毛间隙及合体结节面积的变化及其相关性。方法选择ICP晚期妊娠60例,正常晚期妊娠25例,测定围生儿出生即刻脐动脉血血气分析值(PH值、血氧分压PO2及二氧化碳分压PCO2),运用体视学方法测量胎盘绒毛间隙及合体结节的面密度;分析血气分析值与胎盘结构之间的相关性。结果ICP患者胎盘绒毛间隙面密度减小,合体结节面密度增大,围生儿出生即刻脐动脉血pH值、PO2均显著降低,PCO2升高。胎儿脐动脉血pH值、PO2与胎盘绒毛间隙面密度呈正相关,与合体结节面密度呈负相关;PCO2值与绒毛间隙面密度呈负相关,而与合体结节面密度呈正相关。结论ICP患者胎盘血液灌流量减少,绒毛有效交换面积减小,易出现胎儿宫内缺氧。  相似文献   

6.
对32例ICP及12例正常胎盘组织进行了组织形态计量学测定,并分析了组织计量学参数与实验室淤胆指标(血甘胆酸、GPT、T-BI、D-BI)、胎儿预后(羊水粪染、胎儿宫内窘迫)的关系.测定表明ICP组胎盘的实质体积百分比、绒毛间腔容积百分比小于对照组,合体结节占绒毛结构容积百分比大于对照组,其中以重症组差异为显著.相关回归分析表明合体结节占绒毛结构容积百分比、绒毛组织容积百分比、绒毛间腔容积百分比与血甘胆酸相关性显著(r=0.521,p<0.01;r=0.401,p<0.05;r=0.328,p<0.05);绒毛间腔容积百分比与羊水粪染程度、胎儿宫内窘迫相关性显著(r=-0.355,p<0.05;r=-0.346,p<0.05);血甘胆酸与羊水粪染程度相关性显著(r=0.402,p<0.05).结论ICP时最主要的胎盘组织形态学异常是绒毛间腔狭窄及合体结节增多,绒毛间腔狭窄可能是绒毛间质水肿所致,血中甘胆酸水平升高对绒毛组织有直接的不良作用,绒毛间腔狭窄可能是导致ICP胎儿宫内缺氧的原因之一.  相似文献   

7.
目的 探讨螺旋CT动脉三期扫描联合CT血管造影(CT angiography,CTA)技术对小肝癌(small hepatic carcinoma,SHCC)的诊断效果.方法 选取占位性肝脏病变的44例患者作为研究对象,所有对象均给予螺旋CT常规扫描(对照组),螺旋CT动脉三期扫描联合CTA诊断(观察组),对比分析2组诊断结果 .结果 观察组动脉早期实质样强化6例,血管样强化7例;动脉中期实质样强化8例,血管样强化15例;动脉晚期实质样强化24例,血管样强化4例.观察组动脉早期无强化12例,轻度强化9例,中度强化5例,重度强化2例;动脉中期无强化2例,轻度强化10例,中度强化6例,重度强化10例;动脉晚期无强化0例,轻度强化2例,中度强化7例,重度强化19例.观察组灵敏度92.86%,特异度93.75%,漏诊率7.14%,准确度93.18%,阳性预测值96.30%,阴性预测值88.24%.观察组的诊断准确度为93.18%,明显高于对照组的86.36%,差异有统计学意义(P<0.05).结论 螺旋CT动脉三期扫描联合CTA诊断技术对小肝癌患者的诊断准确率高,漏诊率低,值得临床推广.  相似文献   

8.
抑癌基因p16在胃癌及胃癌前病变组织中的表达   总被引:1,自引:0,他引:1  
米建强  沈铭昌 《肿瘤》2003,23(1):53-54
目的探讨p16基因表达与胃癌发生及胃癌生物学行为的关系。方法应用抗p16蛋白单克隆抗体,采用免疫组化ABE方法对10例正常胃粘膜、16例胃粘膜轻度异型增生、12例中度异型增生、14例重度异型增生、16例早期胃癌及52例进展期胃癌进行了标记分析。结果正常胃粘膜全部表达p16蛋白,随着胃粘膜病变的进展,p16蛋白的阳性率逐渐下降。轻、中、重度异型增生阳性率分别为87.5%、75%、50%,早期胃癌及进展期胃癌的阳性率分别为43.8%和38.5%。p16蛋白在轻度异型增生中的阳性率分别与重度异型增生、早期胃癌及进展期胃癌相比,差异均有显著性(P<0.05);中度异型增生的阳性率显著高于进展期胃癌(P<0.05);而淋巴结转移组的阳性率明显低于淋巴结未转移组(22.2%vs 51.2%,P<0.05)。结论胃粘膜的癌变过程与抑癌基因p16表达缺失密切相关,p16蛋白可作为判断胃癌生物学行为的一个有用指标。  相似文献   

9.
目的:探讨基质金属蛋白酶-2(m atrix m etalloprote inase,MMP-2)在妊娠滋养细胞疾病中的表达。方法:应用免疫组化SP法检测正常早孕妇女胎盘绒毛10例、葡萄胎20例、侵蚀性葡萄胎32例及绒毛膜癌16例组织中MMP-2的表达情况。结果:MMP-2主要表达于合体滋养细胞、绒毛外滋养细胞。正常早孕绒毛组织、妊娠滋养细胞疾病组织中,MMP-2均有阳性表达,早孕绒毛与早孕期葡萄胎间有显著差异(P<0.05),与葡萄胎病理分型、胎次无相关性,早孕期葡萄胎MMP-2阳性表达率显著高于晚孕期葡萄胎(P<0.05)。正常绒毛组MMP-2阳性表达率与葡萄胎组、侵蚀性葡萄胎组和绒毛膜癌组相比有显著性差异(P<0.05)且有逐渐上升趋势,但其余各组间无统计学意义。MMP-2表达与侵蚀性葡萄胎、绒毛膜癌临床分期无相关性。侵蚀性葡萄胎组中未化疗者MMP-2阳性表达率显著高于化疗者(P<0.05);绒毛膜癌组中未化疗组MMP-2阳性表达率高于化疗组,但无统计学意义。结论:MMP-2与滋养细胞的浸润活性呈正相关,与孕周呈负相关,可能与正常滋养细胞浸润行为的时空阶段性和限制性有关。随着妊娠滋养细胞疾病恶性程度升高MMP-2逐渐呈强表达,化疗后其阳性表达明显下降,提示MMP-2可能作为临床早期诊断妊娠滋养细胞疾病、判断治疗疗效及预后的重要指标之一。  相似文献   

10.
目的 评价重组人血小板生成素(rhTPO)治疗肺癌患者化疗后血小板减少的临床疗效和安全性.方法 51例肺癌患者在化疗后出现不同程度的血小板减少,根据其血小板下降程度分为轻度、中度、重度组,均给予rhTPO治疗,同时监测血常规、肝肾功能、凝血功能.结果 51例肺癌患者血小板轻度、中度、重度抑制者分别有24、15和12例,rhTPO持续用药时间分别为(5.3±2.8)、(6.3±3.2)和(5.6±2.8)d,3组间差异无统计学意义(P=0.595).血小板开始恢复时间和血小板减少持续时间,轻度组明显低于中度组与重度组(均P<0.01);rhTPO治疗后,3组患者血小板恢复最高值和血小板提高最大值差异无统计学意义(均P>0.05);3组外源性血小板输注情况比较,差异有统计学意义(P<0.01),随着血小板减少程度的加重,外源性血小板输注比例增加.结论 rhTPO可用于治疗肺癌患者化疗后出现的Ⅲ、Ⅳ度血小板减少,不良反应轻微.  相似文献   

11.
IntroductionPulmonary emphysema is a frequent comorbidity in lung cancer, but its role in tumor prognosis remains obscure. Our aim was to evaluate the impact of the regional emphysema score (RES) on a patient’s overall survival, quality of life (QOL), and recovery of pulmonary function in stage I to II lung cancer.MethodsBetween 1997 and 2009, a total of 1073 patients were identified and divided into two surgical groups—cancer in the emphysematous (group 1 [n = 565]) and nonemphysematous (group 2 [n = 435]) regions—and one nonsurgical group (group 3 [n = 73]). RES was derived from the emphysematous region and categorized as mild (≤5%), moderate (6%–24%), or severe (25%–60%).ResultsIn group 1, patients with a moderate or severe RES experienced slight decreases in postoperative forced expiratory volume in 1 second, but increases in the ratio of forced expiratory volume in 1 second to forced vital capacity compared with those with a mild RES (p < 0.01); however, this correlation was not observed in group 2. Posttreatment QOL was lower in patients with higher RESs in all groups, mainly owing to dyspnea (p < 0.05). Cox regression analysis revealed that patients with a higher RES had significantly poorer survival in both surgical groups, with adjusted hazard ratios of 1.41 and 1.43 for a moderate RES and 1.63 and 2.04 for a severe RES, respectively; however, this association was insignificant in the nonsurgical group (adjusted hazard ratio of 0.99 for a moderate or severe RES).ConclusionsIn surgically treated patients with cancer in the emphysematous region, RES is associated with postoperative changes in lung function. RES is also predictive of posttreatment QOL related to dyspnea in early-stage lung cancer. In both surgical groups, RES is an independent predictor of survival.  相似文献   

12.
应用图像分析仪, 对56 例胎儿宫内缺氧胎盘及8 例正常胎盘中的气体交换结构—血管合胞体细胞膜(VSM) 进行了形态计量测试, 并对其中8 例缺氧胎盘及4 例正常胎盘的超微结构作了观测。结果显示: 缺氧组VSM 表面积密度较正常组显著减少; VSM 表面积在绒毛表面积中所占比例减少; VSM 滋养层下基底膜增厚; VSM 厚度增加( P< 0-01) , 并且宫内缺氧并发胎儿受损病例的VSM 总表面积明显低于生长正常胎儿。上述结果证实, VSM 的表面积减少、滋养层下基底膜增厚及VSM 厚度增加, 是宫内缺氧, 影响胎儿生长发育的病理形态学基础  相似文献   

13.
赵莉莉  庞有成  张鑫磊  陶陵 《癌症进展》2017,15(11):1308-1311,1344
目的 探讨绒毛蛋白(Villin)和血管内皮生长因子(VEGF)在结直肠腺癌组织中的表达及临床病理意义.方法 采用免疫组化方法检测40例结直肠腺癌、10例结直肠腺癌切缘黏膜、10例结直肠腺瘤(轻-中度不典型增生5例,重度不典型增生5例)组织中Villin和VEGF的表达情况,并对二者表达的相关性及与各临床病理特征的关系进行统计学分析.结果 Villin在结直肠腺癌切缘黏膜、结直肠腺瘤(轻-中度不典型增生、重度不典型增生)及结直肠腺癌中的阳性表达率分别为90.0%、70.0%(80.0%、60.0%)及50.0%,呈递减趋势,3组比较,差异有统计学意义(P=0.029);切缘黏膜的Villin阳性表达率高于结直肠腺癌,差异有统计学意义(P﹤0.05);Villin的表达与结直肠腺癌的病理分级、淋巴结是否发生转移以及临床病理分期相关(P﹤0.05).VEGF在切缘黏膜、结直肠腺瘤(轻-中度不典型增生、重度不典型增生)及结直肠腺癌中的阳性表达率分别为30.0%、50.0%(40.0%、60.0%)及72.5%,呈递增趋势,3组比较,差异有统计学意义(P=0.024);切缘黏膜的VEGF阳性表达率低于结直肠腺癌,差异有统计学意义(P﹤0.05);VEGF的表达与结直肠腺癌的病理分级及肌层浸润深度相关(P﹤0.05).结直肠腺癌组织中Villin和VEGF的表达不存在相关性(P﹥0.05).结论 Villin和VEGF在结直肠黏膜恶性转变中发挥一定作用,可能参与结直肠腺癌的浸润和转移.在结直肠腺癌中同时检测Villin和VEGF的表达情况,可能对判断结直肠腺癌的发生、发展及恶变程度具有一定价值,并可能有助于预测其生物学行为.  相似文献   

14.
15.
Objective: To detect the changes of p16 and FHIT and investigate their relationship in esophageal squamous cell carcinoma development by measuring their expression levels in normal squamous epithelium tissue, mild, moderate, severe dysplasia lesions, carcinoma in situ and invasive squamous cell carcinomas. Methods: Expressions of p16 protein and FHIT protein were detected and analyzed in 17 cases of normal squamous epithelium, 16 cases of mild dysplasia, 16 cases of moderate dysplasia, 17 cases of severe dysplasia, 10 cases of carcinoma in situ, and 18 cases of esophageal squamous cell carcinoma by immunohistochemical method. Results: With increasing histopathologic grades, the expressions of pl6 and FHIT became gradually lower. There was no remarkable difference of p16 and FHIT expressions between the normal and mild dysplasia group (P〉0.05), but the differences between the normal and other groups were all significant (P〈0.05). There was no remarkable difference among the squamous cell carcinoma group, the moderate and severe dysplasia groups, and the carcinoma in situ group (P〉0.05), but significant differences existed in the expressions of p16 and FHIT proteins between the squamous cell carcinoma and the normal groups, and between the squamous cell carcinoma and the mild dysplasia groups (P〈0.05). There was an association of descending trend between p16 and FHIT protein expressions. Conclusion: Reduced expressions of pl6 and/or FHIT proteins possible play an important role in the early occurrence of esophageal cancer. There was a positive correlation between the expressions of p16 and FHIT proteins.  相似文献   

16.
Using the PAP technique, the location of two new membrane-associated placental tissue proteins, MP1 and PP4 was studied in the placenta, its membranes, decidua and umbilical cord of human and cynomolgus monkeys. The results were the same throughout pregnancy. MP1 was located in the syncytiotrophoblast and trophoblastic cells of the reflected chorion. Other placental tissue components (cytotrophoblast, amnion, decidua, and umbilical cord) were negative. At present, MP1 appears to be specific for trophoblast. PP4 was located in the syncytiotrophoblast. Furthermore clear positive staining for PP4 was found in the villous cytotrophoblast, reflected and basal chorion, amnion, umbilical cord and decidua. In addition, PP4 was positive in some granulocyte-like blood cells in the intervillous space. Immunocytochemically, the most positive staining for both proteins was observed in the membrane of villous syncytiotrophoblastic cells. The findings in the placenta of cynomolgus monkeys were similar to those in women. The monkey could, thus, serve as a model for the investigation of these new membrane-associated placental tissue proteins.  相似文献   

17.
Complete hydatidiform mole (CHM), a condition related to abnormal gestation, occurs predominantly in the young reproductive age group and has a high prevalence rate in the Trivandrum region, occurring in 1.2% of deliveries. Transforming growth factor alpha (TGF-alpha) is an important growth regulatory molecule, the location and function of which at the human fetomaternal interface in CHM remains to be determined. The present study examined the presence of TGF-alpha in the normal and complete molar placenta and decidua throughout gestation. A total of 149 complete molar placental tissue samples and 96 normal placental tissue samples were evaluated for TGF-alpha expression by immunohistochemistry and 50 each of CHM and normal placental tissue for TGF-alpha concentration by radioimmunoassay. The peptide was localized immunocytochemically with a monoclonal anti-TGF-alpha antibody on paraffin-embedded tissue using the avidin-biotin complex peroxidase technique with aminoethyl carbazole as the chromogen. In molar placenta, villous trophoblast cells (syncytiotrophoblasts and cytotrophoblasts) showed intense cytoplasmic staining at all gestational ages compared to normal placenta of the same gestational age. The tissue concentration of TGF-alpha was highly overexpressed in the molar placenta (10-1000 fold) compared to that in the normal placenta. The results indicate that TGF-alpha is present in trophoblasts throughout human gestation and may provide additional growth advantage to maintenance of the hyperproliferative condition in trophoblastic tumors.  相似文献   

18.
目的 探讨中重度负性情绪倾向(焦虑、抑郁)发生率指标在乳腺癌患者中应用的效果。方法 将基于德尔菲法构建的“中重度负性情绪倾向(焦虑、抑郁)发生率”设为乳腺科护理质量指标,进行心理护理质量控制与评价。将2019年7月至12月江苏省肿瘤医院收治的90例乳腺癌患者设为观察组,构建并实施乳腺科标准化心理护理活动;另以同年1月至6月收治的给予乳腺癌常规心理护理的90例患者为对照组。于两组患者术前及出院时用广泛性焦虑量表(GAD-7)评价患者焦虑程度(界定GAD-7≥10分为中重度焦虑),健康问卷抑郁症状群量表(PHQ-9)评价患者抑郁程度(界定PHQ-9≥10分为中重度抑郁),获得中重度负性情绪倾向发生率,并以心理弹性量表(CD-RISC)评价患者心理弹性水平。结果 观察组术前中重度负性情绪倾向发生率为35.6%,心理弹性(56.61±10.76)分;出院时中重度负性情绪倾向发生率10.0%,心理弹性(67.43±12.53)分。对照组术前中重度负性情绪倾向发生率38.89%,心理弹性(57.18±11.88)分;出院时中重度负性情绪倾向发生率23.33%,心理弹性(53.98±10.46)分,差异均有统计学意义(均P<0.05)。结论 中重度负性情绪倾向(焦虑、抑郁)发生率护理质量指标的应用,有助提高乳腺癌患者负性情绪的改善,提高患者心理弹性水平,同时为乳腺科护理质控及评价提供了规范指引。  相似文献   

19.
目的探讨连续性护理支持对于乳腺癌根治术患者的影响。方法将2011年12月至2012年12月间收治的102例乳腺癌根治术者患者随机分为实验组和对照组,每组51例。实验组者患采取连续性护理支持,对照组患者采取常规护理方法进行护理。实验期结束后,比较两组患者的护理效果。结果实验组患者的轻度焦虑由22例上升为34例,中度焦虑由16例下降为12例,重度焦虑由13例下降为5例。对照组患者轻度焦虑由21例上升为27例,中度焦虑由27例下降为15例,重度焦虑由13例下降为9例。两组间差异有统计学意义(P〈0.05)。结论相对于常规护理措施,连续性护理支持能够更加有效地促进乳腺癌根治术患者的术后恢复,改善患者的术后生活质量。  相似文献   

20.
目的:探讨肺部肿瘤合并轻度肺心病的临床诊断及治疗方法。方法:选择80例肺部肿瘤合并轻度肺心病患者,对所有患者进行多层螺旋CT灌注成像扫描,分析其临床数据。并观察同期60例正常人的右心室血流变化。将80例患者分为实验组和对照组,实验组患者行高射频(RFA)和放化疗综合治疗,对照组患者则单纯性放化疗治疗,所有患者均给予多巴酚丁胺和低分子肝素治疗,比较两组受试者3年的生存状况以及术后的并发症发生状况。结果:恶性肿瘤与良性肿瘤在局部血流量(BF)与对比剂平均通过时间(MTT)数据间无差异性(P>0.05),局部血容量(BV)与表面通透性(PS)差异有统计学意义(P<0.05)。以BV≤4ml/100g为诊断良性肿瘤的标准,诊断准确率为92.5%,误诊率为7.5%;以PS≥9ml/100g为诊断恶性肿瘤的标准,诊断正确率为90.0%,误诊率为10.0%。80例肺部肿瘤合并轻度肺心病患者肺动脉血流加速度(ACC)、最大肺动脉血流速度值(Vm)和右心室射血力(F)较正常对照组受试者差异有统计学意义(P<0.05)。实验组患者生存3年生存率高于对照组(P<0.05)。结论:CT 灌注成像可提高肺部肿瘤的诊断准确率。合并轻度肺心病的患者肺动脉ACC、Vm和F值较正常人存在差异性。行RFA和放化疗综合治疗,能够显著提高患者的3年生存率,降低死亡率和复发率。  相似文献   

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