趋化因子受体CXCR7在卵巢上皮性癌中的表达及其临床意义

目的 探讨趋化因子受体CXCR7在卵巢上皮性癌(卵巢癌)组织中的表达情况及其临床意义.方法 采用免疫组化方法检测57例卵巢癌组织、15例良性卵巢肿瘤组织及15例正常卵巢生发上皮组织中CXCR7蛋白的阳性表达,并通过x2检验、Kaplan-Meier法及多因素Cox回归分析等方法探讨CXCR7蛋白的阳性表达与卵巢癌患者临床病理特征及预后的相关性.结果 卵巢癌组织中CXCR7蛋白的阳性表达率为68.42％ (39/57),良性卵巢肿瘤组织中CXCR7蛋白的阳性表达率为26.67％(4/15),正常卵巢生发上皮组织中CXCR7蛋白的阳性表达率为13.33％ (2/15),3组间差异有统计学意义(x2=19.97,P=0.000 1).CXCR7蛋白的阳性表达与患者的年龄、术前CA125水平、卵巢癌肿瘤病理类型、残余肿瘤直径、腹水的含量及肿瘤的大小无关(P＞0.05),而与患者FIGO分期、肿瘤的组织学分级、有无淋巴结转移及腹腔转移有关(P＜0.05).单因素及多因素分析发现,CXCR7蛋白表达水平、患者FIGO分期、肿瘤的组织学分级、有无淋巴结转移及腹腔转移与卵巢癌患者的总生存率和无瘤生存率存在统计学意义上的关联.Kaplan-Meier曲线显示,卵巢癌患者中CXCR7蛋白阳性患者的总生存率和无瘤生存率均较CXCR7蛋白阴性患者降低,差异有统计学意义(P＜0.05).结论 卵巢癌患者组织中CXCR7蛋白的表达升高,且与转移复发及预后存在密切联系,提示CXCR7可能是预测卵巢癌预后及治疗的一项重要指标.     

Clinics in diagnostic imaging (157). Acinar cell carcinoma (ACC) of the pancreatic tail.

A 50-year-old Chinese man presented to the clinic with left hypochondrial pain, more than 10 kg of weight loss over a 3-month period, and a firm, large, ill-defined mass in the left upper quadrant. Contrast-enhanced computed tomography of the abdomen and pelvis revealed a well-circumscribed exophytic pancreatic mass with features suggestive of acinar cell carcinoma (ACC). The patient underwent chemotherapy and radiotherapy, with no evidence of local recurrence detected at one-year follow-up. He remains under close surveillance by his oncologist. Treatment for ACC includes surgical resection with adjuvant radiotherapy. Better overall survival is seen in patients with surgically resectable ACC as compared to those with the more common ductal cell carcinoma.     

趋化因子受体7 (CXCR7)在食管鳞形细胞癌组织中的表达及其临床意义

 目的 探讨趋化因子受体7 (chemokine receptor 7,CXCR7)在食管鳞癌组织中的表达情况,分析其与患者临床病理特征及预后的关系。方法 选择2006年在复旦大学附属中山医院胸外科行胸段食管鳞癌根治术患者的手术切除标本共154例,同时选取49例正常食管鳞形上皮组织标本做对照。利用免疫组织化学染色方法检测肿瘤组织及正常食管鳞形上皮组织中CXCR7蛋白的表达情况,分析CXCR7表达水平与患者临床病理特征及预后的关系。结果 正常食管鳞形上皮组织中的CXCR7蛋白阳性表达率为6.1%(4/49),肿瘤组织中的CXCR7阳性表达率为76.0%(116/154);CXCR7表达水平与肿瘤浸润深度、淋巴结转移及pTNM分期密切相关,差异有显著统计学意义(P<0.01)。单因素分析结果显示,患者性别、年龄、肿瘤浸润深度、淋巴结转移、pTNM分期及CXCR7表达水平与患者预后密切相关,差异有统计学意义(P<0.05);多因素分析结果显示pTNM分期和CXCR7表达水平是患者独立不良预后因素。结论 CXCR7表达水平与食管鳞癌患者复发、转移及预后密切相关,推测CXCR7在食管鳞癌发生及发展过程中起非常重要的作用。     

Penile cancer: a local case series and literature review

INTRODUCTION

Penile cancer is an uncommon disease affecting only about one in 100,000 men worldwide in a year. The diagnosis of the condition is frequently delayed, and the disease and its treatment frequently result in significant morbidity in patients.

METHODS

We herein describe seven cases of penile tumours: six cases of squamous cell carcinomas and one case of B-cell lymphoma that presented to our hospital’s urology department between March 2011 and October 2012. We reviewed the literature to discuss the clinical presentation, natural history and current management of penile cancer.

RESULTS

The patients were followed up for 1–24 months. They were managed according to their disease stage and lymph node status. Four out of seven patients showed disease progression during the follow-up period.

CONCLUSION

The accurate staging of inguinal nodes in cases of low-risk disease is important to prescribe appropriate surgery for the inguinal nodes. Aggressive management of inguinal and pelvic lymph nodes remains the cornerstone in the treatment of high-risk disease cases.     

趋化因子受体CCR7在胃癌组织中的表达及意义

目的探讨趋化因子受体CCR7在胃癌组织中的表达及其临床意义。方法采用RT—PCR及Western blot法检测32例胃癌及其癌旁对照组织中CCR7的表达。结果CCR7mRNA在胃癌组织中的表达水平为癌旁对照组的1．66倍（P〈0．01），且其表达水平与肿瘤TNM分期（P〈0．05）、浸润深度（P〈0．05）及淋巴结转移有关（P〈0．05）；Western blot结果显示CCR7蛋自在胃癌组织中的表达水平为癌旁对照组的2．3倍（P〈0．01），且高表达于肿瘤分期较晚（P〈0．05）、分化较差（P〈0．05）、浸润较深（P〈0．05）、有淋巴结转移（P〈0．05）和远处转移（P〈0．05）的组织。结论趋化因子受体CCR7可能与胃癌的发生、发展、侵袭、转移有关。     

Primary sarcomatoid carcinoma of the mandibular gingiva: clinicopathological and radiological findings

Sarcomatoid carcinoma is a rare, malignant biphasic neoplasm with an epithelial and a spindle cell component. Primary sarcomatoid carcinomas arising from mandibular gingiva are known to be extremely rare, with only one case reported to date. Herein, we discuss the radiographic and computed tomographic appearances and pathological features of primary mandibular sarcomatoid carcinoma, which was confirmed by clinicopathology, in a 72-year-old man. In addition, we present a brief review of the relevant literature.     

趋化因子受体CXCR7/RDC1在乳腺癌细胞株中的表达及意义

目的:探讨趋化因子受体(Chemokine receptor CXCR7)在不同乳腺癌细胞株中的相对表达强度及意义.方法:采用RT-PCR、Western Blot等方法,检测6株乳腺癌细胞株中趋化因子受体CXCR7在mRNA水平及蛋白水平上的表达情况.结果:CXCR7在6株乳腺癌细胞中的表达水平存在显著差异,其mRNA在6种人乳腺癌细胞株中均可检出,雌激素受体(Estrogen recepter,ER)(+)细胞株在蛋白水平上的表达明显高于ER(-)细胞株(P<0.01).结论:CXCR7/RDC1与乳腺癌的发生、发展及预后有一定的相关性.     

Nephrogenic epistaxis

Metastatic renal cell carcinoma (RCC) in the nose and paranasal sinuses is very rare. We report an unusual case of metastatic RCC that presented as recurrent epistaxis ten years after curative nephrectomy. The purpose of this report is to draw the attention of clinicians to the possibility of metastatic RCC in patients with recurrent epistaxis and nasal mass. We also discuss treatment options and review the relevant literature.     

不同分子分型乳腺癌组织中趋化因子 CXCL12 及其受体 CXCR4 和 CXCR7 的表达及临床意义

目的：探讨趋化因子CXCL12及其受体CXCR4和CXCR7在不同分子分型乳腺癌组织中的表达及临床意 义。方法：应用实时定量PCR检查80例不同分子分型乳腺癌组织中的趋化因子CXCL12 mRNA及其受体CXCR4和 CXCR7 mRNA的表达,采用免疫组织化学技术检测160例不同分子分型乳腺癌细胞组织中趋化因子CXCL12蛋白及其 受体CXCR4和CXCR7蛋白的表达,并分析它们在不同分子分型乳腺癌中的表达差异。结果：CXCL12 mRNA及其受 体CXCR4和CXCR7 mRNA在Luminal A和Luminal B型中表达无差异,在HER-2过表达型和三阴性乳腺癌(triple negative breast cancer,TNBC)两个类型之间的表达也无差异,但三者在HER-2过表达型和TNBC中的表达明显高于Luminal A和 Luminal B型(均P<0.05);CXCL12蛋白、CXCR4蛋白和CXCR7蛋白在HER-2过表达型和TNBC中的阳性表达率均明显高 于Luminal A和Luminal B型(均P<0.05),但在Luminal A和Luminal B之间及HER-2过表达型和TNBC之间的表达无差异。 结 论：趋化因子CXCL12及其受体CXCR4和CXCR7在HER-2过表达型乳腺癌和TNBC组织中高表达,可能与该类型乳腺 癌预后较差有关,抑制其表达可为该类乳腺癌的治疗提供重要途径。     

CXCL12-CXCR4／CXCR7趋化轴在结直肠癌中作用的研究进展

结直肠癌（ colorectal carcinoma , CRC）是世界上发病率和死亡率最高的恶性肿瘤之一。 CRC的侵袭和转移往往是导致治疗失败和死亡的主要原因。既往认为CXCR4是CXCL12的专一受体,最近研究表明,CXCL12还存在着CXCR7这一新受体,这2个受体与CXCL12构成的趋化轴与结直肠癌细胞的增殖、迁移、黏附及肿瘤相关血管生成等密切相关,有可能成为抗肿瘤和抗转移治疗的重要新靶点。     

Post-thyroidectomy neck ultrasonography in patients with thyroid cancer and a review of the literature

The importance of routine neck ultrasonography for the detection of unsuspected local or nodal recurrence of thyroid cancer following thyroidectomy (with or without neck dissection) is well documented in many journal articles and international guidelines. Herein, we present a pictorial summary of the sonographic features of benign and malignant central neck compartment nodules and cervical lymph nodes via a series of high-quality ultra-sonographic images, with a review of the literature.     

Dural metastasis of nasopharyngeal carcinoma: rare,but worth considering

Metastasis of nasopharyngeal carcinoma (NPC) to the dura, an extremely rare condition, can be symptomatically silent and mistaken for a benign entity radiographically. Missed diagnosis can lead to serious consequences or prove immediately fatal. We report a woman with dural metastasis of NPC that mimicked a meningioma on radiography. Craniectomy with tumour resection was performed due to rapid progression from the onset of symptoms to disability. The patient was still alive two years after surgery. This case emphasises the need to keep in mind the possibility of dural metastasis of NPC in patients with abnormal imaging features. This would not only avoid wrong and optimistic diagnosis, but also allow for appropriate treatment in a timely manner. To our knowledge, this is the first report of metastasis of NPC to the dura. We provide detailed information on the neoplastic lesion, which masqueraded as a benign entity and caused potentially fatal consequences.     

Myopia in young patients with type 1 diabetes mellitus

INTRODUCTION

This study aimed to evaluate the proportion of young patients with type 1 diabetes mellitus (T1DM) who have myopia, as well as the risk factors associated with myopia in this group.

METHODS

In this cross-sectional study, patients aged < 21 years with T1DM for ≥ 1 year underwent a comprehensive eye examination. Presence of parental myopia, and average hours of near-work and outdoor activity were estimated using a questionnaire. Annualised glycosylated haemoglobin (HbA1c), defined as the mean of the last three HbA1c readings taken over the last year, was calculated. Multivariate analysis using genetic, environmental and diabetes-related factors was done to evaluate risk factors associated with myopia.

RESULTS

Of the 146 patients (mean age 12.5 ± 3.6 years) recruited, 66.4% were Chinese and 57.5% were female. Myopia (i.e. spherical equivalent [SE] of –0.50 D or worse) was present in 96 (65.8%) patients. The proportion of patients with myopia increased from 25.0% and 53.6% in those aged < 7.0 years and 7.0–9.9 years, respectively, to 59.2% and 78.4% in those aged 10.0–11.9 years and ≥ 12.0 years, respectively. Higher levels of SE were associated with lower parental myopia (p = 0.024) and higher annualised HbA1c (p = 0.011).

CONCLUSION

Compared to the background population, the proportion of myopia in young patients with T1DM was higher in those aged < 10 years but similar in the older age group. Myopia was associated with a history of parental myopia. Environmental risk factors and poor glycaemic control were not related to higher myopia risk.     

Awake tracheal intubation in a patient with a supraglottic mass with the Bonfils fibrescope after failed attempts with a flexible fibrescope

Awake intubation with a flexible fibrescope is usually done electively in patients with a known difficult airway. Herein, we describe the case of an elective awake tracheal intubation that was performed on a patient with a large, obstructive supraglottic mass. The intubation was successfully performed using the Bonfils fibrescope after several failed attempts with a flexible fibrescope. This case highlights the usefulness of the Bonfils fibrescope and the limitations of the flexible fibrescope in certain clinical situations.     

Clinical epidemiology of gastric cancer

Gastric cancer is the second leading cause of cancer-related mortality and the fourth most common cancer globally. There are, however, distinct differences in incidence rates in different geographic regions. While the incidence rate of gastric cancer has been falling, that of gastric cardia cancers is reportedly on the rise in some regions. Helicobacter pylori (H. pylori) infection is a major risk factor of non-cardia gastric cancer, and data has emerged concerning the role of H. pylori eradication for primary prevention of gastric cancer. Dietary, lifestyle and metabolic factors have also been implicated. Although addressing these other factors may contribute to health, the actual impact in terms of cancer prevention is unclear. Once irreversible histological changes have occurred, endoscopic surveillance would be necessary. A molecular classification system offers hope for molecularly tailored, personalised therapies for gastric cancer, which may improve the prognosis for patients.     

Syndecan-1 is a potential biomarker for triple-positive breast carcinomas in Asian women with correlation to survival

INTRODUCTION

While overexpression of syndecan-1 has been associated with aggressive breast cancer in the Caucasian population, the expression pattern of syndecan-1 in Asian women remains unclear. Triple-positive breast carcinoma, in particular, is a unique subtype that has not been extensively studied. We aimed to evaluate the role of syndecan-1 as a potential biomarker and prognostic factor for triple-positive breast carcinoma in Asian women.

METHODS

Using immunohistochemistry, staining scores of 61 triple-positive breast carcinoma specimens were correlated with patients’ clinicopathological variables such as age, ethnicity, tumour size, histological grade, lymph node status, lymphovascular invasion, associated ductal carcinoma in situ grade, recurrence and overall survival.

RESULTS

Syndecan-1 had intense staining scores in triple-positive invasive ductal breast carcinomas when compared to normal breast tissue. On multivariate analysis, syndecan-1 epithelial total percentage and immunoreactivity score showed statistical correlation with survival (p = 0.02).

CONCLUSION

The intense staining scores of syndecan-1 and their correlation with overall survival in patients with triple-positive breast carcinoma suggest that syndecan-1 may have a role as a biological and prognostic marker in patients with this specific subtype of breast cancer.     

Predictors of poor glycaemic control in older patients with type 2 diabetes mellitus

INTRODUCTION

We assessed the predictors of poor glycaemic control among older patients with type 2 diabetes mellitus (T2DM) in Malaysia.

METHODS

This cross-sectional study used the data of 21,336 patients aged ≥ 60 years with T2DM from the Adult Diabetes Control and Management Registry 2008–2009.

RESULTS

Predictors of poor glycaemic control were: age groups 60–69 years (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.66–2.33) and 70–79 years (OR 1.43, 95% CI 1.20–1.71); Malay (OR 1.53, 95% CI 1.41–1.66) and Indian (OR 1.32, 95% CI 1.19–1.46) ethnicities; T2DM durations of 5–10 years (OR 1.46, 95% CI 1.35–1.58) and > 10 years (OR 1.75, 95% CI 1.59–1.91); the use of oral antidiabetic agents only (OR 5.86, 95% CI 3.32–10.34), insulin only (OR 17.93, 95% CI 9.91–32.43), and oral antidiabetic agents and insulin (OR 29.42, 95% CI 16.47–52.53); and elevated blood pressure (OR 1.10, 95% CI 1.01–1.20), low-density lipoprotein cholesterol (OR 1.48, 95% CI 1.38–1.59) and triglycerides (OR 1.61, 95% CI 1.51–1.73). Hypertension (OR 0.71, 95% CI 0.64–0.80), hypertension and dyslipidaemia (OR 0.68, 95% CI 0.61–0.75), pre-obesity (OR 0.89, 95% CI 0.82–0.98) and obesity (OR 0.76, 95% CI 0.70–0.84) were less likely to be associated with poor glycaemic control.

CONCLUSION

Young-old and middle-old age groups (i.e. < 80 years), Malay and Indian ethnicities, longer T2DM duration, the use of pharmacological agents, and elevated blood pressure and lipid levels were associated with poor glycaemic control. The presence of comorbidities, pre-obesity and obesity were less likely to be associated with poor glycaemic control.     

Staging of colorectal cancer using contrast-enhanced multidetector computed tomographic colonography

INTRODUCTION

Preoperative staging is essential for the optimal treatment and surgical planning of colorectal cancers. This study was aimed to evaluate the accuracy of colorectal cancer staging done using contrast-enhanced multidetector computed tomographic colonography (CEMDCTC).

METHODS

We recruited 25 patients with 28 proven colorectal cancers. A 16-slice multidetector computed tomography scanner was used to generate two-dimensional multiplanar reformatted sagittal, coronal and oblique coronal images, and three-dimensional virtual colonography (endoluminal) images. Axial and reformatted views were analysed, and TNM staging was done. Patients underwent surgery and conventional colonoscopy, and surgical histopathological correlation was obtained.

RESULTS

The diagnostic accuracies for TNM colorectal cancer staging were 92.3% for T staging, 42.3% for N staging and 96.1% for M staging using CEMDCTC. There was excellent positive correlation for T staging between CEMDCTC and both surgery (κ-value = 0.686) and histopathology (κ-value = 0.838) (p < 0.0001), and moderate positive correlation for N staging between CEMDCTC and surgery (κ-value = 0.424; p < 0.0001). The correlation between CEMDCTC and histopathology for N staging was poor (κ-value = 0.186; p < 0.05); the negative predictive value was 100% for lymph node detection. Moderate positive correlation was seen for M staging between CEMDCTC and both surgery (κ-value = 0.462) and histopathology (κ-value = 0.649). No false negatives were identified in any of the M0 cases.

CONCLUSION

CEMDCTC correlated well with pathologic T and M stages, but poorly with pathologic N stage. It is an extremely accurate tool for T staging, but cannot reliably distinguish between malignant lymph nodes and enlarged reactive lymph nodes.     

趋化因子受体CCR7在口腔鳞癌中的表达及其临床意义

目的检测口腔鳞癌中趋化因子受体CCR7蛋白的表达情况。方法采用免疫组化技术检测64例口腔鳞癌中CCR7蛋白的表达。结果CCR7蛋白在口腔鳞癌中呈阳性表达,且CCR7蛋白的阳性表达率为65.6%(42/64),而在正常口腔黏膜无表达或较弱表达。此外,CCR7在伴有淋巴结转移病例中的表达显著高于无淋巴结转移者(P<0.0001)。同时,CCR7的表达也与肿瘤的分化程度(P<0.05)、侵袭模式(P<0.05)和TNM分期(P<0.001)密切相关。但与年龄、性别、肿瘤大小无关。结论CCR7在口腔鳞癌中高表达,其表达水平与口腔鳞癌的分化程度、临床分期、侵袭和淋巴结转移有关。     

趋化因子受体CXCR7对人乳腺癌细胞生长、凋亡及细胞周期的影响

目的 通过构建CXCR7短发夹状RNA(short hairpin RNA,shRNA)序列的真核表达载体,探讨趋化因子受体CXCR7对人乳腺癌细胞MDA-MB-435s增殖、凋亡、周期的影响.方法 针对CXCR7构建编码shRNA序列的重组表达载体;分别用RT-PCR和Western blot检测CXCR7 mRNA及蛋白表达水平;MTT法检测细胞增殖;TUNEL法检测细胞凋亡;流式细胞术检测细胞周期.结果 构建针对CXCR7短发夹状RNA序列的表达载体,经酶切及测序证实与设计完全一致;将2个CXCR7shRNA载体(CXCR7-shRNA1;CXCR7-shRNA2)转染MDA-MB-435s细胞后,CXCR7 mRNA及蛋白平均降低;抑制CXCR7的表达后,CXCR7-shRNA组细胞增殖率明显下降(P＜0.05),细胞凋亡增多(P＜0.05),细胞周期无明显改变.结论 重组表达载体CXCR7-shRNA1、CXCR7-shRNA2能有效抑制靶基因CXCR7的表达,进而可抑制人乳腺癌MDA-MB-435s细胞的增殖,促进细胞凋亡,而对细胞周期无明显影响.