血浆溶血磷脂酸及CA125水平与子宫内膜癌临床病理特征的关系

目的:探讨血浆溶血磷脂酸（LPA）及CA125在子宫内膜癌的表达及与临床病理特征之间的关系。方法:利用化学比色法检测65例子宫内膜癌患者和40例子宫内膜非典型增生患者及40例健康献血员（对照组）血浆溶血磷脂酸含量,同时采用电化学发光法检测血浆CA125含量并作对比分析。结果:子宫内膜癌组患者血浆LPA水平为（5.87±2.02）μmol/L,明显高于对照组（2.31±0.45）μmol/L（P<0.01）,子宫内膜非典型增生组与对照组比较,差异无统计学意义（P>0.05）。LPA和CA125对子宫内膜癌诊断的灵敏度分别为69.2%、63.1%,特异度为60.0%、53.8%;LPA对子宫内膜癌早期（0+Ⅰ期）诊断的阳性率明显高于晚期（Ⅱ～Ⅳ期）（P<0.05）。与肿瘤大小无明显的相关性（P>0.05）。其阳性率随病理分级逐渐降低并有显著性差异（P均＜0.05）,且随肿瘤浸润肌层深度及淋巴结转移程度增加亦逐渐降低（P均＜0.05）。而CA125阳性率随着病理分级逐渐升高,并有显著性差异（P均＜0.01）,在深肌层浸润及子宫外转移病例中明显升高（P均＜0.01）。结论:血浆LPA检测对子宫内膜癌的早期诊断及鉴别诊断具有一定的临床应用价值,明显优于CA125,LPA可作为判断子宫内膜癌预后的重要指标。     

血浆溶血磷脂酸检测在妇科恶性肿瘤诊断中的应用研究

目的探讨血浆溶血磷脂酸(LPA)检测在妇科恶性肿瘤特别是卵巢癌诊断中的临床意义。方法检测191例妇科恶性肿瘤和40例妇科良性疾病患者及40例健康献血员血浆溶血磷脂酸含量,同时测定卵巢癌患者血浆CA125含量,并作对比分析。结果卵巢癌组、宫颈癌组及子宫内膜癌组患者血浆LPA水平分别为(5.98±2.49)、(4.81±2.12)和(4.56±2.16)μmol/L与正常对照组的(2.31±0.45)μmol/L比较,有显著性差异(P均<0.01),三者阳性率分别为86.3%、62.5%及65.0%;乳腺癌组、白血病组及妇科良性疾病组与正常对照组比较,有显著性差异(P>0.05);血浆LPA和CA125对卵巢癌诊断的敏感性和特异性分别为86.3%、75.0%和92.3%、73.1%。结论血浆LPA检测对妇科恶性肿瘤特别是对卵巢癌的诊断及鉴别诊断可能具有潜在的临床应用价值。     

卵巢恶性上皮性肿瘤血浆溶血磷脂酸与CA125诊断价值的对比观察

目的:探讨卵巢恶性上皮性肿瘤患者血浆溶血磷脂酸(1ysophosphatidic acid,LPA)水平变化及其潜在的临床应用价值.方法:对28例卵巢恶性上皮性肿瘤、20例卵巢良性肿瘤、20例卵巢巧克力囊肿及20名正常妇女分别测定血浆LPA和血清CA125水平.结果:卵巢恶性上皮性肿瘤、卵巢良性肿瘤、卵巢巧克力囊肿及正常妇女组血浆LPA分别为(5.25±1.57)、(1.74±0.71)、(2.99±1.28)和(1.85±0.35)μmol/L.卵巢恶性肿瘤组血浆LPA水平高于卵巢良性肿瘤组、卵巢巧克力囊肿组及正常妇女组,P均<0.05.血浆LPA诊断卵巢恶性上皮性肿瘤的敏感性89.29%(25/28),特异性85%(51/60);而CA125诊断的敏感性为75%(21/28),特异性为76.67%(46/60),LPA诊断的敏感性及特异性均优于CA125,P均<0.05.LPA诊断早期卵巢恶性上皮性肿瘤的敏感性80%(8/10),而CA125诊断的敏感性为50%(5/10),LPA的敏感性高于CA125,差异有统计学意义,P<0.05.另外,卵巢恶性上皮性肿瘤患者术后血浆LPA为(3.10±1.30)μmol/L,明显低于术前水平,P<0.01.结论:血浆LPA有望成为一种新的检测卵巢恶性上皮性肿瘤标志及术后监测指标.应用这两种标志诊断早期卵巢恶性上皮性肿瘤,血浆LPA比血清CA125可能更具有临床价值.     

宫颈癌患者血浆溶血磷脂酸表达临床意义的探讨

目的:探讨血浆溶血磷脂酸(LPA)在宫颈癌中的表达及临床意义。方法:利用化学比色法检测135例宫颈癌和85例宫颈良性疾病患者及40位健康体检者(对照组)血浆溶血磷脂酸含量,同时采用电化学发光法检测血浆CYFRA21-1含量并作对比分析。结果:宫颈癌组患者血浆LPA水平为(5.11±1.92)μmol/L,明显高于对照组的(2.31±0.45)μmol/L,P<0.01;宫颈良性疾病组患者血浆LPA水平为(2.46±1.05)μmol/L,与对照组比较差异无统计学意义,P>0.05。血浆LPA对宫颈癌诊断的灵敏度和特异度分别为67.4%和97.5%,CYFRA21-1的灵敏度和特异度分别为41.5%和95.0%,LPA均优于CYFRA21-1。血浆LPA和CYFRA21-1在宫颈鳞状上皮癌的表达分别为71.0%和43.5%,均高于腺癌+腺角化癌的27.3%和18.2%,P值均<0.05。宫颈癌晚期(Ⅲ+Ⅳ期)CYFRA21-1阳性率53.2%,明显高于早期(Ⅰ+Ⅱ期)的14.6%;有远处转移的宫颈癌患者血浆LPA阳性率91.9%,明显高于无远处转移者的24.5%,P<0.05。结论:LPA可能与宫颈癌的浸润和转移有关;血浆LPA检测对宫颈癌的诊断及鉴别诊断具有一定的临床应用价值。     

胰腺癌患者血浆溶血磷脂酸的临床意义

目的:检测胰腺癌患者血浆溶血磷脂酸(lysphosphaticlic acid,LPA)的水平,评价LPA在胰腺癌诊治中的临床意义。方法:采用定磷法检测2006年6月至2010年10月南京第一医院收治的胰腺癌患者50例、胰腺良性疾病患者32例及健康志愿者36人的血浆LPA水平,同时测定血清CA19-9、AFP和CEA的水平;免疫组化法检测胰腺癌组织及癌旁胰腺组织LPA2受体的表达。分析血浆LPA水平与胰腺癌临床病理特征的关系。结果:胰腺癌患者血浆LPA水平明显高于胰腺良性疾病患者和健康志愿者[(4.10±2.03)vs(3.28±1.26)、(2.27±1.02)μmol/L,P<0.05],胰腺癌患者血浆LPA水平和血清CA19-9水平密切相关(r=0.9070,P<0.01)。胰腺癌组织LPA2受体表达阳性率显著高于癌旁正常胰腺组织(88%vs 4%,P<0.05)。血浆LPA水平的升高与胰腺癌浸润和淋巴结转移等相关。结论:血浆LPA检测为胰腺癌诊断和预后判断增加了一项潜在的评价指标。     

CA125联合CA199检测在妇科肿瘤诊断中的应用

目的探讨糖类抗原125(CA125)联合糖类抗原199(CA199)检测在妇科肿瘤诊断中的应用效果。方法选取2011年10月至2014年10月间收治的111例良性肿瘤妇科患者为良性肿瘤组,111例恶性肿瘤妇科患者为恶性肿瘤组,同时选取111例正常体检妇女为对照组,均行CA125、CA199检测,分析其在妇科肿瘤诊断中的诊断价值。结果良性肿瘤组患者CA125、CA199水平均明显高于对照组,差异有统计学意义(P<0.05)。恶性肿瘤组患者CA125、CA199水平均明显高于对照组和良性肿瘤组,差异有统计学意义(P<0.05)。CA125在<35 U/mol、35~70 U/mol时,恶性肿瘤组患者CA125检出率均明显低于良性肿瘤组,差异有统计学意义(P<0.05)。CA125在71~140 U/mol、141~280 U/mol、>280 U/mol时,恶性肿瘤组CA125检出率均明显高于良性肿瘤组,差异有统计学意义(P<0.05)。无论是CA125检测还是CA125+CA199联合检测,CA125>140 U/mol的敏感性均明显高于CA125≤140 U/mol,CA125>140 U/mol的特异性均明显低于CA125≤140 U/mol,差异有统计学意义(P<0.05)。CA125+CA199联合检测的敏感性高于单独CA125检测,特异性低于CA125检测,差异有统计学意义(P<0.05)。良性肿瘤组的CA125、CA125+CA199检测的ROC曲线下面积分别为0.841和0.879;恶性肿瘤组的CA125、CA125+CA199检测的ROC曲线下面积分别为0.901和0.967。结论 CA125联合CA199检测可提高CA125诊断的敏感性,具有较高的诊断价值。     

CA125、HE4、AngII联合检测诊断子宫内膜癌

目的:探讨糖链抗原125（CA125）、附睾蛋白4（HE4）和血管紧张素II（AngII）单检以及联合检测在子宫内膜癌（endometrial cancer,EC）诊断的应用价值。方法:搜集2013年1月至2014年11月在中国医科大学附属盛京医院就诊的130例EC患者作为实验组以及46例健康女性作为对照组。检测其CA125表达水平。同时应用酶联免疫试验（ELISA）技术对血清中HE4、AngII表达水平进行检测,分析三种肿瘤标记物单独检测时各自的灵敏度、特异度的优、缺势,及联合检测时灵敏度和特异度否有所提升。结果:实验组血清中CA125、HE4、AngII的表达水平分别是34.33±14.45、78.19±32.31、13.82±5.42,而对照组中其表达水平分别为13.30±9.22、45.61±15.70、7.70±3.58,EC组血清CA125、HE4、AngII明显高于对照组,分别比较,差异均有统计学意义（P<0.05）。CA125、HE4、AngII在EC的I-II期组阳性率分别为37.27%、47.27%、7.27%;III-IV期组阳性率分别为60%、70%、35%,对比三者各自的阳性率发现,在早期三者的诊断率均较晚期低;将其按年龄分为＜60岁、 ≥60岁,CA125、HE4、AngII三者在＜60岁组的阳性率分别为46.15%、32.69%、9.61%;在≥60岁组的阳性率分别为37.18%、70.78%、24.37%,对比发现,CA125在年龄方面无明显区别,而HE4、AngII在年龄方面却有显著差异;CA125、HE4、AngII三者检测的灵敏度分别为49.23%、52.31%、46.15%,三者联检的灵敏度为86.15%;CA125、HE4、AngII三者检测的特异度分别为89.30%、91.65%、85.65%,三者联检的特异度为73.60%,联合检测可以提高诊断的灵敏度,但特异度却相对降低。结论:单项肿瘤标记物在子宫内膜癌中的诊断价值具有一定的局限性,但3项联合检测可有效提高子宫内膜癌的诊断性能及早期检出率,是检测子宫内膜癌的较为理想的标志物组合。     

子宫内膜增生及癌变组织中增殖细胞核抗原与p16和p53基因表达的相关性研究

目的探讨增殖细胞核抗原(PCNA)及基因p16、p53在单纯性子宫内膜增生(ESH)、子宫内膜不典型增生(EAH)和子宫内膜癌(EC)组织中表达情况。方法应用免疫组化法分别对26例EC、28例EAH、24例ESH组织进行PCNA和p16、p53基因蛋白定位及表达程度检测,并对比其差异,分析它们之间的关系。结果PCNA在ESH、EAH和EC 3组病例中强阳性表达分别为16．7％、82．1％和96．2％,ESH与EAH、EC比较差异有统计学意义(P＜0．01),而EAH与EC比较差异无统计学意义(P＞0．05)。p16在ESH、EAH和EC 3组病例中阳性表达分别为95．8％、46．4％和50．0％,ESH与EAH、EC组比较差异有统计学意义(P＜0．05);EAH与EC组比较差异无统计学意义(P＞0．05)。p53在ESH组无阳性表达病例,EAH组阳性率25％,EC组阳性率65．4％,3组病例之间比较差异均有统计学意义(P＜0．01)。结论PCNA、p53表达在子宫内膜增殖性病变、细胞恶性转化的进程中呈递增趋势,而p16趋于递减,提示细胞的过度增殖和增殖-凋亡相关基因的表达失衡在子宫内膜恶性转化过程中起重要作用。PCNA、p16和p53的异常表达可作为子宫内膜增生性疾病不同发展阶段的诊断及预测其生物学行为的参考指标。     

卵巢上皮癌患者血浆LPA水平检测的临床意义

目的探讨溶血磷脂酸(lysophosphatidic acid,LPA)在卵巢上皮癌发生和发展中的作用及临床意义。方法用生物化学法检测24例卵巢上皮癌、18例卵巢良性上皮肿瘤患者和10例健康妇女的血浆LPA水平。结果卵巢上皮癌患者血浆LPA水平明显高于卵巢良性上皮肿瘤患者及健康妇女(P<0.001),后两者血浆LPA水平差异无统计学意义;卵巢上皮癌患者血浆LPA的水平Ⅲ~Ⅳ期高于Ⅰ~Ⅱ期,但是差异无统计学意义(P>0.05)。结论LPA在卵巢上皮癌患者中呈高表达,具有潜在的早期诊断价值。     

人附睾分泌蛋白4和CA125联合检测在子宫内膜恶性肿瘤与子宫良性肿瘤鉴别诊断中的价值

背景与目的:目前对子宫内膜癌的早期筛查及疾病监测仍缺少有效的肿瘤监测指标。本文旨在探讨肿瘤标志物CA125及人附睾分泌蛋白4(human epididymis protein 4,HE4)单项或联合检测对诊断子宫内膜癌患者的临床意义。方法:选择80例具有肿瘤标志物检测结果的子宫内膜癌患者和27例子宫良性肿瘤患者的临床资料进行回顾性分析。结果:子宫内膜癌患者血清HE4水平为(92.32±7.60)pmol/L,子宫良性肿瘤患者血清HE4水平为(58.88±3.01)pmoL/L;以上2组CAl25水平分别为(30.05±5.24)、(34.32±8.16)U/mL。子宫内膜癌患者血清HE4水平明显高于子宫良性肿瘤患者,差异有统计学意义(P<0.01),而CA125水平差异无统计学意义(P>0.05)。HE4和CA125单项检测的ROC-AUC值分别为0.731和0.503,差异有统计学意义(P<0.001)。两项指标联合检测的ROC-AUC值为0.758,与单项指标检测相比,差异有统计学意义(P<0.001)。特异度为95%的情况下,CA125单项检测的灵敏度为10%,HE4单项检测的灵敏度为32.5%,而联合检测的灵敏度为33.8%。结论:HE4是检测子宫内膜癌肿瘤较理想的标志物,其血清水平对子宫体肿瘤的良恶性辅助诊断及鉴别诊断具有一定的应用价值,联合CA125检测可以提高对子宫内膜癌的诊断率。     

Bacteria and cancer--antagonisms and benefits

There is considerable historical and recent evidence concerning the antagonisms between acute bacterial infections or their toxins and cancer and allied diseases. These data provide renewed incentives to undertake clinical programmes with mixed bacterial vaccines in many countries at the present time.     

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.     

Renal irradiation and the pharmacology and toxicity of methotrexate and cisplatinum

We used a rat model to study the effects of renal irradiation on the pharmacology of methotrexate (MTX) and cisplatinum (cis-Pt). Unanesthetized rats were given bilateral kidney irradiation (20 Gy in 9 fractions). At 9 months after irradiation, 3% of the animals had died and survivors showed moderately impaired renal function. At 15 months, 30% of the animals had died and survivors showed severely impaired renal function. Some animals were given i.v. MTX 1 week to 15 months after irradiation. In irradiated rats, the area under the MTX plasma clearance curve equaled that of controls through 6 months, and was significantly above controls from 9 months on. Other animals were given i.p. cis-Pt 1 week to 9 months after irradiation. The acute toxicity of cis-Pt was the same in control and irradiated rats when cis-Pt was given immediately before or after irradiation. Beginning 3 months after irradiation there was a progressive increase in cis-Pt toxicity and a simultaneous decrease in urinary platinum excretion. Irradiated animals that survived cis-Pt treatment showed increased radiation nephritis; the greatest effect occurred when cis-Pt was given 3 months or more after irradiation. MTX and cis-Pt clearance decreased when renal dysfunction was first observed and changes in renal function preceded changes in drug clearance and toxicity.     

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。     

Morphine and tumor growth and metastasis

Morphine is an analgesic widely used to alleviate cancer pain. In addition, the perioperative management of pain in cancer surgery patients most often includes opioids. However, there are reports that these drugs may alter cancer recurrence or metastasis. Several mechanisms have been proposed, such as the modulation of the immune response or cellular pathways that control the survival and migratory behavior of cancer cells. The published literature, however, presents some discrepancies, with reports suggesting that opioids may either promote or prevent the spread of cancer. It is of great importance to determine whether opioids, in particular the most widely used, morphine, may increase the risk of metastasis when used in cancer surgery. This review examines the available data on the effects of morphine which influence cancer metastasis or recurrence, including immunomodulation, tumor cell aggressiveness, and angiogenesis, with special emphasis on recently published clinical and laboratory based studies. We further discuss the parameters that may explain the difference between reports on the effects of morphine on cancer.     

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。