老年大肠腺瘤恶变的临床病理分析

 目的 探讨老年大肠腺瘤恶变及其病理特点。方法 对185例老年大肠脉瘤患者进行分析,观察大肠腺瘤与恶变的关系。结果 老年大肠腺瘤恶变与腺瘤大小、部位、形态、数目、组织学类型及年龄等因素有关,与性别无关。结论 老年大肠腺瘤易恶变,对可疑恶变腺瘤做全瘤切除,术后密切而有规律随访。     

警惕，大肠腺瘤易恶变

大肠息肉,就是肠黏膜表面上的一个或多个隆起性的肉疙瘩,形状就像长在肠管内的蘑菇。早在1982年,我国大肠癌协作组将大肠息肉分为新生物性、错构瘤性、炎症性、化生性、其他共5类。新生物性大肠息肉即为大肠腺瘤,发病率男性高于女性,并随着年龄的增长而增加。临床上将大肠腺瘤分为单发性腺瘤和多发性腺瘤。     

大肠腺瘤恶变的主要危险因素

目的　探讨大肠腺瘤的分布、大小和形态特点及腺瘤恶变过程中的主要危险因素。方法　回顾性分析和研究 1994年 3月至 1998年 4月期间我院电子结肠镜检出的大肠腺瘤的形态学和恶变过程中的主要危险因素。结果　发现大肠腺瘤 12 0例 14 4个 ,占大肠息肉检出的 62 .18% ;恶变腺瘤以 >2 .0cm、山田Ⅱ型为主 ;腺瘤的恶变率为 16.67% ,绒毛状腺瘤恶变率最高 ,管状腺瘤恶变率次之 ;腺瘤≤ 1.0cm者恶变率 3 .85 % ,1.1～ 1.9cm者恶变率 2 1.0 5 % ,≥ 2 .0cm者恶变率 3 9.47% ;组织学证实管状腺瘤的百分率随着腺瘤的增大而减小 ,绒毛状腺瘤的百分率则随着腺瘤的增大而增加 ,2 4例恶变腺瘤中患者的年龄 5 0岁以上占 91.67% ;而 12例同时伴肠癌腺瘤中患者的年龄大于 5 0岁的占 83 .3 3 %。结论　管状腺瘤是大肠中最常发现的肿瘤性息肉 ,随着腺瘤体积增大 ,管状结构减少 ,绒毛状结构增加 ;大肠腺瘤的大小、形态、病理类型和患者的年龄 (特别是 5 0岁以上 )是大肠腺瘤恶变的主要危险因素。     

大肠息肉与息肉恶变的关系探讨

目的:了解大肠息肉与息肉恶变的关系。方法:分析纤维结肠镜检查发现的1482例大肠息肉患者的年龄、分布部位、大小、形态、数目、病理类型及恶变情况。结果:息肉恶变72例(4.9%)。以40岁以上多见;好发部位为直、乙状结肠;息肉直径>2.0 cm者更容易恶变(P<0.05);宽基、分叶、多发息肉恶变的机率高,腺瘤性息肉恶变率8.6%,其中绒毛状腺瘤是息肉恶变的高危因素,恶变率38.5%。结论:大肠息肉恶变与其发病年龄、分布部位、大小、形态、数目、病理类型相关。     

大肠息肉与息肉恶变的关系探讨

目的:了解大肠息肉与息肉恶变的关系.方法:分析纤维结肠镜检查发现的1482例大肠息肉患者的年龄、分布部位、大小、形态、数目、病理类型及恶变情况.结果:息肉恶变72例(4.9%).以40岁以上多见;好发部位为直、乙状结肠;息肉直径＞2.0cm者更容易恶变(P＜0.05);宽基、分叶、多发息肉恶变的机率高,腺瘤性息肉恶变率8.6%,其中绒毛状腺瘤是息肉恶变的高危因素,恶变率38.5%.结论:大肠息肉恶变与其发病年龄、分布部位、大小、形态、数目、病理类型相关.     

大肠腺瘤恶变指标的临床与病理分析

目的对大肠腺瘤恶变指标的诸多因素进行分析与探讨.方法收集1982年3月～1995年3月间本院纤维结肠镜检出的大肠息肉436例,进行了研究.结果单发腺瘤81.1%,多发者19.3%;腺瘤癌变10.8%,腺瘤合并癌5.2%;绒毛状腺瘤癌变27.5%,混合型腺瘤癌变16.2%,管状腺瘤癌变率7.1%;腺瘤发生部位以直肠居多,其次为乙状结肠.结论腺瘤癌变与腺瘤的组织学类型、肿物大小及发生部位有关.     

大肠腺瘤癌变的处理

报告49例大肠腺瘤与癌变的关系及大肠腺瘤癌变的处理。男性26例，女性23例，平均年龄43．7岁，其中癌变14例，癌变率为28．6％。脉瘤癌变与腺癌的大小、部位、腺癌的数目、组织学类型及病人年龄等因素有关。＜1cm腺癌未发生癌变，≤2cm的癌变率为55％，直肠及乙状结肠的腺癌易恶变。管状腺瘤、绒毛状腺癌、管状绒毛状腺癌的癌变率分别为22．7％、41．2％、20％，绒毛状腺癌最易癌变。癌变腺癌的术式选择应根据癌变浸润深度、病理组织分类、癌细胞分化程度、切缘是否有癌残留以及淋巴管和静脉是否有癌浸润等决定。     

大肠腺瘤癌变的处理

报告４９例大肠腺瘤与癌变的关系及大肠腺瘤癌变的处理。男性２６例，女性２３例，平均年龄４３．７岁，其中癌变１４例，癌变率为２８．６％。腺瘤癌变与腺瘤的大小、部位、腺瘤的数目、组织学类型及病人年龄等因素有关。〈１ｃｍ腺瘤未发生癌变，≥２ｃｍ的癌变率为５５％，直肠及乙状结肠的腺瘤易恶变。管状腺瘤、绒毛状腺瘤、管状绒毛状腺瘤的癌变率分别为２２．７％、４１．２％、２０％，绒毛状腺瘤最易癌变。癌变腺瘤的术式选     

Evaluation of HPV DNA positivity in colorectal cancer patients in Kerman,Southeast Iran

Background: The HPV virus is known to be oncogenic and associations with many cancers has been proven. Although many studies have been conducted on the possible relationship with colorectal cancer (CRC), a definitive role of the virus has yet to be identified. Method: In this cross-sectional study, the frequency of HPV positivity in CRC samples in Kerman was assessed in 84 cases with a mean age of 47.7 ± 12.5 years over two years. Qualitative real time PCR was performed using general primers for the L1 region of HPV DNA. Results: Out of 84 CRC samples, 19 (22.6%), proved positive for HPV DNA. Genotyping of positive samples showed all of these to be of high risk HPV type. Prevalence of HPV infection appears to depend geographic region, life style, diet and other factors. Conclusion: In our location frequency of CRC is low, and this limited the sample size for evaluation of HPV DNA. The most prevalent types were HPV types 51 and 56. While HPV infection may play an important role in colorectal carcinogenesis, this needs to be assessed in future studies.     

子宫颈癌患者血清HPV DNA抽提方法的比较

背景与目的：近年来不少学者在子宫颈癌患者外周血中发现游离HPVDNA，并认为其很有希望成为一种新的肿瘤标志物。但由于其含量极少，检测较为困难。为了提高检出率，本研究比较并评估了三种DNA抽提方法在子宫颈癌患者血清中提取HPV DNA的功效。方法：选取51例临床病理确诊的宫颈癌患者的血清作为样本，分别用三种方法对其进行DNA的抽提纯化：①酚／氯仿法，②UNIQ-10柱式病毒DNA抽提试剂盒（上海生工），③QIAamp MinElute病毒核酸抽提试剂盒。抽提后的标本用GP5＋／GP6＋为引物进行PCR扩增以检测HPV DNA。结果：在新鲜的和短期冻存的标本中，三种方法的阳性率分别为14．3％，5．7％，和57．1％。对于长期冻存的样本，三种方法阳性率均很低。结论：QIAamp试剂盒抽提血清HPV DNA的效果较为理想，但血清样本的保存时间不宜太久。     

Possible Epithelial Ovarian Cancer Association with HPV18 or HPV33 Infection

The present study was conducted to investigate the prevalence of HPV infection in epithelial ovarian cancer (EOC) in Hunan province. DNA samples were collected from paraffin embedded ovarian tissue from 322 patients with EOC, 99 with ovarian benign tumors and 199 normal persons. The polymerase chain reaction and direct sequencing were used to identify the HPV types in the samples. The relationship between the infection of human papillomavirus (HPV) and the epithelial ovarian carcinoma (EOC) was investigated combined with clinical data. The prevalence of HPV18 and HPV33 in EOC group and benign group was higher than in the normal group. HPV18 and HPV33 may play a role in the development of both EOC and ovarian benign tumor and may participate in the development of EOC with traditional risk factors, family history and abortion, possibly exerting synergistic effects.     

HPV16感染与新疆哈萨克族食管癌发病及临床病理学研究

背景与目的:人乳头状瘤病毒(human papilloma virus,HPV)作为食管癌发生重要的环境因素备受许多学者的关注,但其相关性未得到一致性公认,尤其对于高发的新疆哈萨克族食管癌.本研究探讨HPV16感染与新疆哈萨克族食管痛发生、发展的相关性.方法:采用半巢式聚合酶链反应(polymerase chain reaction,PCR)技术检测100例新疆哈萨克族食管癌患者癌组织和100例新疆哈萨克族正常人食管正常黏膜组织HPV16 E6的感染情况.结果:新疆哈萨克族食管癌患者HPV16 E6感染率为46%,明显高于新疆哈萨克族正常人群感染率的22%(P<0.001,OR=3.020);HPV16 E6感染与新疆哈萨克族食管癌患者的发病年龄、性别、肿瘤生长部位、淋巴转移、分化程度无明显相关性(P均>0.05).结论:HPV16 E6感染与新疆哈萨克族食管癌发病密切相关,是其发病的重要因素之一.     

Frequency of Human Papillomavirus (HPV) 16 and 18 Detection in Paraffin- Embedded Laryngeal Carcinoma Tissue

Background and Objective: Human papilloma virus (HPV) 16 and HPV18 have been detected in head and neck squamous cell carcinomas (HNSCC) and there is evidence that detection of HPVs would have better prognostic value than patients with HNSCC negative for HPVs. Thus, this study was conducted to evaluate frequency of HPV 16 and HPV 18 genotypes in patients with laryngeal carcinoma. Materials and methods: Fifty formalin-fixed, paraffin-embedded (FFPE) tissue blocks of laryngeal cancers were collected. Sections were prepared at 5 μm and DNA was extracted from each sample and subjected to the polymerase chain reaction (PCR) to detect HPV-16/18 DNA s. Results: All samples were squamous cell carcinomas (SCCs). Overall 14/50 (28%) were positive for HPVs, 8 (18%) with HPV-16 and 6 (12%) with HPV-18. Additionally, 2 (4%) mixed infections of HPV 16 and 18 genotypes were observed among these cases. Conclusions: Overall, 28% of HNSCC samples proved positive for HPV16 and HPV18 genotypes, two high-risk HPV types. It is important to further assess whether such viral infection, could be a risk factor in HNSCC progression.     

Association of colorectal adenoma with other malignancies in Swedish families

Using the Swedish Family-Cancer Database covering over 11.5 million individuals, estimated relative risks (RRs) for colorectal adenoma were using Poisson's regression. The RR of colorectal adenoma was found to be increased among first-degree relatives of patients with colorectal cancer (2.72; 95% confidence interval=2.46-3.00) and among the offspring and siblings of patients with endometrial and prostate cancers. We also found an increased risk of colorectal adenoma for the offspring of individuals with stomach cancer and leukaemia, and for siblings of those with pancreatic cancer and multiple myeloma. Our results suggest that colorectal adenoma may share a genetic aetiology with cancer even at extracolorectal sites. Increases of colorectal adenoma in families affected by prostate cancer and acute leukaemia cannot be attributed to known cancer syndromes, although the play of chance cannot be excluded.     

海南地区宫颈癌病例的HPV感染状况

 目的　分析本地区宫颈癌患者的HPV感染情况。方法　收集 10 1例治疗前病例的颈管分泌物 ,用PCR荧光定量方法进行HPV6、11、16、18的检测。结果　HPV阳性者 4 4例 ,阳性率 4 3.6 % ,在 <4 0岁、4 0～ 5 0岁、>5 0岁 3个年龄段 ,HPV阳性率分别为 5 9.5 %、35 .9%、2 5 % (P <0 .0 5 )。近 2年与 2年前病例HPV感染率分别是 5 0 %、33.3%。宫颈鳞癌的HPV阳性率明显高于腺癌、腺鳞癌 (P <0 .0 1)。结论　HPV感染是宫颈癌的重要致病因素 ;鳞癌的发生与HPV感染的关系较腺癌更密切 ;在本地区极可能存在除上述 4型以外的已定或未定亚型的感染     

A simplified and reliable HPV testing of archival Papanicolaou-stained cervical smears: application to cervical smears from cancer patients starting with cytologically normal smears

The efficacy of four methods to recover DNA from Papanicolaou (Pap)-stained archival cervical smears for optimal detection of human papillomavirus (HPV) DNA by GP5+/bioGP6+ polymerase chain reaction (PCR) was investigated. Two of the methods were based on proteinase K treatment and two based on treatment with guanidinium thiocyanate (GTC). The quality of the DNA as measured by PCR assays amplifying different sizes of the beta-globin gene appeared to be superior for the GTC-based assays. Using competitive beta-globin PCR assays, one of the GTC-based, assays, provisionally named High Pure PCR Template Preparation (HPPTP) assay, yielded by far the highest quantity of amplifiable DNA. It allowed the recovery of 2.2 x 10(5) to 3 x 10(5) genome equivalents in smears containing 5 x 10(5) to 20 x 10(5) nucleated cells, indicating a mean efficiency of 26% (range of 15-44%). In contrast, the other methods revealed markedly lower efficiencies varying from 1% to 10%. The use of the HPPTP assay as a reliable processing procedure was validated by demonstrating a complete agreement in HPV detection and 93% agreement in HPV typing between 39 archival Pap-stained and paired fresh-frozen cervical smears. This method was applied to 40 archival smears from ten cervical cancer patients (selected from a group of 200 patients) which had a history of 3-6 smears with the first smear being Pap 1 or 2 taken at least 5 years before cancer was diagnosed. The average time period between the first Pap 1/2 smear that contained the same HPV type as in the corresponding carcinoma and diagnosis of cervical cancer was 12.0 +/- 2.9 years. All subsequent smears were invariably positive for the same HPV type which was also found in the cervical cancer biopsy. In conclusion, the HPPTP assay provides a reliable and efficient means to extract DNA from Pap-stained archival cervical smears for the detection of HPV DNA by PCR and would be the method of choice for future HPV analysis of archival Pap-stained cervical smears.     

新疆哈萨克族食管鳞癌中人乳头状瘤病毒感染的检测

目的: 检测新疆哈萨克族食管鳞癌患者中人乳头状瘤病毒(HPV)DNA的总感染率,通过统计学分析,探讨HPV感染与新疆哈萨克族食管鳞癌的相关性。 方法: 采用聚合酶链反应(PCR)技术检测了318例新疆哈萨克族食管鳞癌(ESCC)石蜡包埋组织中HPVDNA的感染情况,其中117例用直接裂解法制备样本DNA,201例用酚-氯仿-异戊醇提取DNA;PCR产物双向测序,测序结果应用BLAST在线分析,统计处理采用χ²检验,分析HPV与新疆哈萨克族食管鳞癌发生的相关性。 结果: 在新疆哈萨克族食管鳞癌组织中,HPVDNA总检出率为64.5%(205/318),其中直接裂解法组HPVDNA检出率为82.9%(97/117),酚-氯仿-异戊醇提取DNA组HPVDNA检出率为53.7%(108/201),二者之间差异有统计学意义(P<0.05)。按照病理分化程度对哈萨克族ESCC样本DNA中HPV总感染率进行分析发现,高分化ESCC中HPV阳性率为63.2%,中分化ESCC中HPV阳性率为69.8%,低分化ESCC中HPV阳性率为50.0%,三者之间差异无统计学意(P>0.05)。 结论: HPVDNA感染与新疆哈萨克族食管鳞癌存在相关性,可能是新疆哈萨克族食管癌发生的重要因素之一。