结肠癌组织中Fas表达的定量分析

目的：探讨Fas在结肠癌中的表达及其与肿瘤发生、发展及肿瘤分化程度的关系。方法：用直接免疫荧光－流式细胞技术对50例结肠腺癌组织及手术切缘的正常结肠黏膜组织中Fas的表达进行定量检测，分析Fas表达与肿瘤大体类型、浸润深度、分化程度及淋巴结转移的关系。结果：Fas在结肠癌组织中的平均阳性率及平均荧光指数均低于其手术切缘的正常结肠黏膜组织，在12例伴有转移的结肠癌组织中Fas的平均阳性率及平均荧光指数均低于38例没有转移的结肠癌；9例肿瘤限于肌层以内的结肠癌组织中Fas平均阳性率及平均荧光指数均高于41例肿瘤侵及肌层以外的结肠癌病例。不同分化程度、不同大体类型的结肠癌组织中Fas的平均阳性率及平均荧光指数差异无显著性。结论：结肠腺癌组织中Fas的表达受到了抑制，Fas的表达与肿瘤的转移及浸润深度呈负相关，与肿瘤的分化程度及大体类型无关。     

Microsatellite-unstable mucinous colorectal carcinoma occurring in the elderly: comparison with medullary type poorly differentiated adenocarcinoma

Mucinous carcinoma and poorly differentiated adenocarcinoma of the large intestine have a high frequency of microsatellite instability, and their occurrence increases gradually with age. To elucidate the clinicopathological and immunohistochemical features of microsatellite-unstable mucinous carcinoma and compare the tumor with medullary type poorly differentiated adenocarcinoma, the clinicopathological status and expression of mucin core and hMLH1 proteins were studied in 15 microsatellite-unstable and 20 microsatellite-stable mucinous colorectal carcinomas occurring in elderly patients, and compared with 23 cases of medullary type poorly differentiated adenocarcinoma in which 21 cases were microsatellite-unstable. Thirteen (87%) of 15 microsatellite-unstable carcinomas exhibited absent hMLH1 expression compared with three (15%) of 20 microsatellite-stable carcinomas (P < 0.01). The proportion (87%) of positive MUC5AC expression in microsatellite-unstable mucinous carcinoma was significantly higher than that (45%) in microsatellite-stable mucinous carcinoma (P = 0.01). Compared with microsatellite-stable mucinous carcinoma, microsatellite-unstable mucinous carcinomas were significantly associated with a proximal location, intra- and peritumoral inflammatory cell infiltration, frequent MUC5AC expression, a low incidence of lymph node metastasis and absent hMLH1 protein expression, which is not different to medullary type poorly differentiated adenocarcinoma except for MUC2 expression and age-related occurrence. These results suggest that microsatellite-unstable mucinous carcinoma occurring in the elderly shares clinicopathological and molecular features with medullary type poorly differentiated adenocarcinoma and that microsatellite instability with absent hMLH1 expression plays an important role in the development of these two carcinomas.     

Mucinous carcinoma of the rectum

We have studied and compared 316 mucinous and 45 signet ring cell carcinomas of the rectum with 413 non-mucinous carcinomas. Mucinous carcinomas were subdivided according to the amount of mucus which was gauged subjectively as either more or less than 75% of the tumour volume. Five year survivals for non-mucinous, mucinous (less than 75%), mucinous (greater than 75%) and signet ring cell carcinoma were 62%, 60%, 53% and 13%. Mucinous carcinomas (less than 75%) were relatively well differentiated and showed an age distribution identical to their non-mucinous counterparts, but differed in their strong association with villous adenoma. Mucinous carcinomas (greater than 75%) were less well differentiated and, like signet ring cell carcinomas, occurred in younger patients and showed no special association with villous adenoma. Clinically important and independent predictive variables were found by the method of multivariate regression analysis to be number of lymph node metastases, extent of spread in continuity, character of invasive margin and peritumoural lymphocytic infiltration. After adjustment for these factors, typing of rectal cancer as mucinous, non-mucinous and signet ring cell gave no additional, clinically useful prognostic information.     

浸润性乳腺癌中基质金属蛋白酶-13蛋白的表达及其与其他相关因子和预后的关系

目的 探讨浸润性乳腺癌中基质金属蛋白酶(MMP)-13蛋白在肿瘤细胞和间质细胞中的表达及其与肿瘤临床病理、生物学指标以及预后的相关性.方法 采用组织芯片免疫组织化学染色sP法检测263例浸润性乳腺癌组织中MMP-13、ER、PR、HER2、MMP-2、MMP-9、基质金属蛋白酶组织抑制因子(TIMP)-1、TIMP-2蛋白的表达及表达间的相关性.结果 MMP-13在肿瘤细胞及间质纤维母细胞中均表达,肿瘤细胞中MMP-13过表达与淋巴结受累和高组织学分级相关(均P<0.01),且与HER2表达(P=0.015)和肿瘤细胞TIMP-1蛋白表达相关(P<0.01).MMP-13过表达与患者总生存期缩短相关,分层分析显示MMP-13的过表达分别与淋巴结阳性患者总生存期和HER2阳性和阴性表达状态下的患者总生存期有关.间质纤维母细胞表达MMP-13尽管与肿瘤细胞表达者有相关性,且与淋巴结状态和HER2表达也相关,但评估预后的价值较弱.经单因素分析,肿瘤直径、组织学分级、淋巴结和PR、HER2表达状态及肿瘤表达的TIMP-1和MMP-13均是有意义的预后指标;但多因素分析显示仅肿瘤直径、组织学分级、淋巴结状态、HER2表达、肿瘤中TIMP-1和MMP-13表达是独立预后因素.结论 MMP-13蛋白与浸润性乳腺癌的侵袭和转移相关,有可能作为预后不良的指标.     

Overexpression of GRP78 and GRP94 are markers for aggressive behavior and poor prognosis in gastric carcinomas

Glucose-related proteins (GRPs) are ubiquitously expressed in endoplasmic reticulum and able to assist in protein folding and assembly; consequently, they are considered as molecular chaperones. GRP78 and GRP94 expression was induced by glucose starvation and up-regulated in the malignancies. To clarify the roles of both molecules in tumorigenesis and progression of gastric carcinomas, immunohistochemistry was used on tissue microarray containing gastric carcinomas, adenomas, and nonneoplastic mucosa using the antibodies against GRP78 and GRP94, with a comparison of their expression with clinicopathological parameters of carcinomas. Gastric carcinoma cell lines (MKN28, AGS, MKN45, KATO-III, and HGC-27) were studied for both proteins by immunohistochemistry and Western blot. There was more expression of both proteins in gastric carcinoma and adenoma than in nonneoplastic mucosas (P < .05). All gastric carcinoma cell lines showed their expression at different levels. They were positively correlated with tumor size, depth of invasion, lymphatic and venous invasion, lymph node metastasis, and Union Internationale Contre le Cancer staging (P < .05), with positive relationship between both proteins (P < .05). Univariate analysis indicated the postsurgical cumulative survival rate of patients with positive GRP78 or GRP94 expression to be lower than that in those without GRP78 or GRP94 expression (P < .05), but the close link disappeared if stratified according to depth of invasion (P > .05). Multivariate analysis showed that age, depth of invasion, lymphatic invasion, lymph node metastasis, Union Internationale Contre le Cancer staging, and Lauren classification (P < .05), but not GRP78 and GRP94 expression, were independent prognostic factors for carcinomas (P > .05). Up-regulated expression of GRP78 and GRP94 was possibly involved in pathogenesis, growth, invasion, and metastasis of gastric carcinomas. They were considered objective and effective markers for the aggressive behavior and poor prognosis in gastric carcinomas.     

胃癌中SDF-1、CXCR4、MMP-2和MMP-9的表达及意义

目的研究趋化因子SDF-1及其受体CXCR4以及MMP-2和MMP-9在胃癌中的表达,探讨SDF-1对MMP-2和MMP-9表达的影响。方法应用免疫组化EnVision两步法检测109例胃癌组织中SDF-1、CXCR4、MMP-2和MMP-9的表达。结果 (1)SDF-1、CXCR4、MMP-2、MMP-9在胃癌组的表达阳性率分别为88.1%、56.9%、80.7%和83.4%,高于切缘对照组的47.8%、30.4%、43.4%和47.8%,差异有显著性(P<0.05);(2)SDF-1和CXCR4的表达在淋巴结转移组高于无转移组(P<0.05),SDF-1、MMP-9表达程度与淋巴结转移、组织学分级、浆膜侵犯、临床分期指标呈正相关(P<0.05);MMP-2、CXCR4表达程度与淋巴结转移、浆膜侵犯、临床分期呈正相关(P<0.05);(3)SDF-1与其受体CXCR4的表达及与MMP-2、MMP-9均呈正相关(P<0.05)。结论 (1)SDF-1、CXCR4、MMP-2和MMP-9的表达水平与胃癌的发生、侵袭及淋巴结转移密切相关,可作为预测胃癌淋巴结转移及预后的指标;(2)SDF-1/CXCR4轴可通过加强肿瘤细胞MMP-2和MMP-9分泌的途径促进肿瘤的浸润和转移,提示SDF-1可能是药物靶向治疗的重要靶点。     

Correlation between expression of MMP-7 in gastric submucosal invasive carcinoma and lymph node micrometastasis

To clarify the mechanism of tumor metastasis, lymph nodes micrometastasis and expression of MMP-7, which is related to lymph node metastases, were investigated in 45 submucosal, invasive gastric carcinomas. Metastases to lymph nodes were detected in 12 of 45 cases(26.7%) by HE stain. In 13 of 45 cases (28.9%), only micrometastases were detected by immunostaining with anti-cytokeratin antibody. The incidence of micrometastases was higher in poorly-differentiated carcinoma than well-differentiated carcinoma. Expression of MMP-7 was higher in metastasis positive cases than in negative cases. In poorly-differentiated cases, expression of MMP-7 was associated with micrometastasis. In conclusion, expression of MMP-7 may play an important role not only in tumor metastasis but in micrometastasis to lymph node especially in poorly-differentiated cases.     

Matrix metalloproteinase-2 expression in laryngeal preneoplastic and neoplastic lesions

Matrix metalloproteinase-2 (MMP-2), a member of gelatinases, is particularly important in the digestion of nonfibrillary and denaturated collagens; thus, it may play a role in tissue remodeling and in the invasion of malignant cells. The expression of MMP-2 has not yet been described in preneoplastic lesions of the larynx thus far. The purpose of this study was to evaluate whether the expression of MMP-2 plays a role in early laryngeal carcinogenesis. Laryngectomy specimens of 20 invasive carcinoma cases were studied. The slides with atypical hyperplasia, carcinoma in situ, and invasive carcinoma were selected from laryngectomy specimens. On these slides, 23 atypical hyperplasia and 17 carcinoma in situ areas were identified. MMP-2 expression was scored immunohistochemically on paraffin tissue sections using the avidin-biotin-peroxidase method. MMP-2 expression in all three groups was statistically different. A sequential increase in MMP-2 expression correlated significantly with the hypothesis of multistep carcinogenesis. In contrast, MMP-2 expression was not related to tumor stage, lymph node metastasis, or differentiation in squamous cell carcinomas. In conclusion, this sequential increase in MMP-2 expression points to an altered expression of MMP-2 in early neoplastic transformation in laryngeal mucosa, followed by an increasing expression during the progression of the disease.     

宫颈癌中MMP-2及TIMP-2的表达及其临床意义

目的 :通过检测基质金属蛋白酶 - 2 (MMP - 2 )及基质金属蛋白酶组织抑制物 - 2 (TIMP - 2 )在宫颈癌中的表达 ,探讨其与宫颈癌侵袭转移的关系。方法 :采用免疫组化S -P法检测 5 1例宫颈癌和 16例正常宫颈组织中MMP - 2和TIMP - 2的表达情况。结果 :MMP - 2、TIMP - 2在正常宫颈上皮组织中均无表达 ,在宫颈癌组织中的阳性表达率分别为 74 .5 % (38/ 5 1)、4 7.1% (2 4 / 5 1) ,有显著性差异 (P <0 .0 1)。MMP - 2、TIMP - 2的表达与组织学类型无关 ,但与临床分期、细胞分化程度、淋巴结转移有关。结论 :MMP - 2、TIMP - 2的表达与宫颈癌的侵袭转移有关 ,MMP - 2、TIMP - 2可作为预测宫颈癌侵袭转移潜能和临床预后的指标。     

宫颈癌COX-2、MMP-9和CD105表达与肿瘤血管生成及侵袭转移的关系

目的探讨环氧合酶-2(cyclooxygenase,COX-2)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)在宫颈癌局部肿瘤血管生成及肿瘤侵袭转移过程中的作用。方法采用免疫组化SP法检测32例正常宫颈上皮及68例宫颈癌中COX-2、MMP-9的表达。并用CD105标记新生血管内皮细胞,计算肿瘤内微血管密度(microvascular density,MVD)。结果COX-2、MMP-9在宫颈癌组织中的阳性表达率均显著高于正常宫颈上皮中的表达(P<0.01)。COX-2、MMP-9阳性组的MVD均显著高于COX-2、MMP-9阴性组(P<0.01),淋巴结转移组COX-2、MMP-9阳性率均高于无淋巴结转移组(P<0.05)。结论COX-2、MMP-9阳性表达可能在宫颈癌血管生成和侵袭转移中起重要作用,两者在宫颈癌血管生成中可能具有协同作用。检测宫颈癌中COX-2、MMP-9表达对进一步了解宫颈癌局部血管生成情况及判断预后有一定的应用价值。     

Expression of mucins (MUC1, MUC2, MUC5AC and MUC6) in mucinous carcinoma of the breast: comparison with invasive ductal carcinoma

AIMS: Mucinous carcinoma of the breast usually shows less frequent lymph node metastasis and more favourable outcome compared with invasive ductal carcinoma. The aim of this study is to compare the expression profiles of several mucins in mucinous carcinomas and invasive ductal carcinomas to gain insight into the relationship between the less aggressive biological nature of mucinous carcinoma and the role of mucins. METHODS AND RESULTS: We examined the expression profiles of MUC1 (membrane-bound mucin) of different glycoforms (from non-glycosylated form to fully glycosylated form), MUC2 (intestinal type secretory mucin), MUC5AC (gastric surface type secretory mucin) and MUC6 (gastric pyloric gland type secretory mucin) in 17 mucinous carcinomas and 46 invasive ductal carcinomas using immunohistochemistry. Various glycoforms of MUC1 were expressed frequently in both mucinous carcinomas (65-100%) and invasive ductal carcinomas (92-100%), although non-glycosylated MUC1 (MUC1/CORE) and fully glycosylated MUC1 (MUC1/HMFG-1) showed significantly lower expression rates in mucinous carcinomas compared with those in invasive ductal carcinomas. The expression rates of MUC2 (94%) and MUC6 (71%) in mucinous carcinomas were significantly higher than those of MUC2 (15%) and MUC6 (15%) in invasive ductal carcinomas. There was no significant difference in the expression rate of MUC5AC in mucinous carcinomas (12%) and that in invasive ductal carcinomas (4%). CONCLUSIONS: The expression rate of MUC1/CORE and MUC1/HMFG-1, which is related to poor prognosis in the gastric and colorectal cancers, is low in mucinous carcinomas. The high expression rate of gel-forming secretory mucins (MUC2 and MUC6) in mucinous carcinoma suggests that high production of these types of mucins may act as a barrier to cancerous extension resulting in their less aggressive biological behaviour.     

Alpha-methylacyl-CoA racemase/P504S overexpression in colorectal carcinoma is correlated with tumor differentiation.

Alpha-methylacyl-CoA racemase (AMACR)/P504S is an enzyme involved in the metabolism of branched-chain fatty acids. Little is known about correlation of AMACR expression with colorectal carcinoma (CRC) differentiation and prognosis. We investigated the expression of AMACR in 106 cases of primary CRC, and in 47 lymph nodes with metastatic CRC by immunohistochemical analysis. These cases were divided into 3 groups according to the histologic differentiation of the primary tumors. group A included 50 cases of histologically well and moderately differentiated CRCs, 20 of these with lymph node metastasis; group B included 23 cases of well and moderately differentiated CRCs, histologically similar to group A, except these tumors had small foci (less than 20%) of high-grade carcinoma, and 10 of these had lymph node metastasis; group C included 33 cases of poorly differentiated adenocarcinoma and undifferentiated carcinoma, 17 with lymph node metastasis. The results showed the overall positive rates of expression in primary and metastatic CRCs were 59.4% and 46.8%, respectively. Expression in groups A (76.0%) and B (69.6%) was much higher than that in group C (27.3%). In group B, although overexpression of AMACR in primary tumors was similar to that of group A, it was only seen in 30.0% of group B metastatic tumors, which was similar to the rate of expression in group C (23.5%). In contrast, rates of expression in group A primary and metastatic tumors were similar (80.0% and 75.0%). Positive staining for AMACR in benign epithelium adjacent to tumor was rare (<2%). No relation was found between AMACR expression and overall survival. Our findings support the view that the expression of AMACR in CRC is correlated with tumor differentiation.     

Expression of pRb,Ki67 and HER 2/neu in gastric carcinomas: Relation to different histopathological grades and stages

Gastric carcinoma is one of the aggressive malignancies with poor prognosis. The expression of pRb, Ki67, Her-2 in relation to tumor grade and stage in gastric carcinoma still needs more exploration. This study was performed aiming to study the immunohistochemical expression of altered retinoblastoma encoding protein (pRb), Ki67 and Her-2 in gastric carcinoma and to investigate their clinical and pathological significance.We studied tumor tissue specimens from 48 patients with gastric carcinoma. Paraffin sections were submitted for immunohistochemistry using pRb, Ki67 and Her-2. Statistical analysis was performed for clinical and pathological data of all studied cases.Altered pRb was expressed in 79% of the studied tumors, inversely correlated with tumor invasion and stage with no significant relation with tumor grade, age, and gender and tumor size. Ki67 LI was significantly associated with tumor grade and stage but not related to sex, age, tumor size, site, depth of invasion and lymph node metastasis. Her2 was expressed in 75% of studies tumors with significant association with tumor grade, the depth of invasion, lymph node metastasis and higher tumor stage. However, there was no significant association between Her-2 expression and gender, tumor site and size.In conclusion, altered pRb is frequently expressed in gastric carcinoma, inversely correlates with tumor invasion and tumor stage suggesting an early event in gastric carcinogenesis. Ki67 expression in gastric carcinoma is directly correlated with the tumor grade and depth of invasion. Her2 expression is significantly correlated with tumor grade, depth of invasion and stage.     

Cyclin A correlates with carcinogenesis and metastasis,and p27(kip1) correlates with lymphatic invasion,in colorectal neoplasms

Cyclin A binds to CDK2 and plays critical roles when cells proliferate; staining for Ki67 can monitor the proliferation. The cyclin A expression pattern remains unclear in colorectal carcinogenesis and remote metastasis, however, and no one has reported on the association of its expression with key clinicopathologic factors in primary cancer. p27(kip1) protein-an extremely important inhibitor of CDK2-seems unchanged as colorectal cancers metastasize to the lymph nodes, a result contrary to that seen in gastric and prostatic cancers. To clarify the role of cyclin A in multistage colorectal neoplasms, cyclin A, CDK2, and Ki67 were immunohistochemically stained in 22 normal mucosa, 9 hyperplastic polyps, 61 adenomas, 197 primary carcinomas, 21 lymph node metastases, and 10 hepatic metastases. To clarify the alteration of p27(kip1) during lymphatic invasion, p27(kip1) was also stained in 21 primary cancers and paired lymph node foci. Situated in nuclei, cyclin A expression gradually increased from mild through moderate to severe dysplasia in adenomas and from normal tissue through hyperplasia to adenoma to early carcinoma. Expression was significantly decreased in the hepatic metastases and in the primary cancers showing venous invasion, deep infiltration, lymph node metastasis, mucinous type, advanced stage, or short postoperative survival time. Elevated cyclin A not only was linked with elevated CDK2 in primary cancers, but also was associated with increased Ki67 in both adenomas and primary carcinomas. Lymph node metastases lost more p27(kip1) than primary foci and hepatic lesions. Thus, dysregulation of cyclin A and its control mechanisms may contribute to colorectal carcinogenesis; abatement of overexpression of cyclin A is associated with hepatic metastasis and cancerous invasion. Loss of p27(kip1) may promote lymph node metastasis.     

Detection of surface antigens defined by monoclonal antibodies in primary mucinous breast carcinomas

Summary Three monoclonal antibodies, 67D11, 115H10 and 115C2, raised against human milk fat globule membranes, have been applied to 207 primary mucinous breast carcinomas. The turnouts reacted positively in 18% (67D11), 54% (115H10), and 20% (115C2) of the cases. Thedetected epitopes (MAM-3a (67D11), MAM-3b (115H10), and MAM-3c (115C2)) have formerly been shown to be markers of differentiation in infiltrating ductal carcinomas. In the present group of mucinous breast carcinomas, statistically significant correlation to high risk factors, such as occurrence of primary lymph node metastases, large tumour size, and local invasion of the tumour into overlying skin or deep fascie, were found. Furthermore, the antigen expression was less marked in pure mucinous carcinomas as compared to carcinomas also presenting with non-mucinous tumour areas. Thus, especially the antigen MAM-3b, is more frequently present in mixed tumours, in large tumours, in tumours with local invasion, and in tumours with primary lymph node metastases. However, no association could be demonstrated between expression of MAM-3b and recurrence-free survival.Mucinous carcinomas of the breast apparently differ from other carcinomas not only with respect to morphology, but also in their pattern of antigenic expression in relation to other prognostic factors.     

Paradoxical expression of maspin in gastric carcinomas: correlation with carcinogenesis and progression

Maspin, a serine protease inhibitor related to the serpin family, can suppress invasion and metastasis of malignancies. To clarify the role of maspin in the genesis and progression of gastric carcinomas, its expression pattern and level were studied by immunohistochemistry on tissue microarrays containing gastric carcinoma (n = 237), normal gastric mucosa (n = 23), intestinal metaplasia (n = 38), and adenoma (n = 42); and the findings were compared with clinicopathological parameters. Furthermore, maspin expression in the gastric carcinoma cell lines (HCG-27, MKN28, and MKN45) was examined by immunohistochemistry and Western blotting. We found that cytoplasmic and nuclear maspin expression paralleled each other (P < .05) and decreased from intestinal metaplasia, adenoma, and carcinoma to normal gastric mucosa (P < .05). A significant positive association was noted with depth of invasion, lymphatic invasion, lymph node metastasis, and TNM stage (P < .05) but not with sex or Lauren's classification (P > .05). Univariate and multivariate analyses indicated that expression of maspin correlated negatively with cumulative patient survival in gastric carcinoma (P < .05) but was not an independent factor in the prognosis. The 2 independent factors, depth of invasion and lymphatic invasion, influenced the relation between nuclear maspin expression and survival, whereas only depth of invasion correlated with cytoplasmic maspin. Our study indicated that maspin expression experiences upregulation in gastric precancerous lesions and then slight downregulation with malignant transformation. High expression may paradoxically promote invasion and metastasis of gastric carcinomas and could be considered a good marker for the pathobiological behaviors of gastric carcinomas.     

Colorectal signet ring cell carcinoma: Influence of EGFR,E-cadherin and MMP-13 expression on clinicopathological features and prognosis

Signet ring cell carcinoma (SRCC) is unique rare subtype of mucin-producing colorectal adenocarcinoma characterized by presence of signet ring cells, in > 50% of the tumor tissue. This study aims to investigate expression of EGFR, E-cadherin and MMP-13 expression on clinicopathological features of signet ring cell type and its prognostic effect using manual tissue microarray technique. In this work, we studied tumor tissue specimens from 150 patients with colorectal cancer cases among which 19 cases of SRCC. High density manual tissue microarrays were constructed using modified mechanical pencil tips technique and immunohistochemistry for EGFR, E-cadherin and MMP-13 expression was done. We found that SRCC was significantly associated with younger age and more frequency of LN metastasis than all other groups. SRCC was also significantly associated with annular gross picture, more depth of invasion, advanced stage, more lymphovascular emboli, more perineural invasion and less arousal from an overlying adenoma. In conclusion, colorectal SRCC has distinctive clinicopathological and histological features with different unique mechanisms of carcinogenesis and more aggressive biologic behavior than other colorectal carcinoma subtypes. Negative/low expressions of EGFR and E-cadherin and MMP-13 were found in SRCC with no effect on the prognosis.