巢式PCR检测CK19 mRNA和LUNX mRNA诊断肺癌淋巴结微转移

目的：探讨非小细胞肺癌（non-small cell lung cancer，NSCLC）淋巴结微转移的基因诊断方法，并分析CK19 mRNA、LUNX mRNA作为肺癌微转移检测分子标记物的可行性。方法：采用巢式RT—PCR技术检测39例NSCLC患者的149枚淋巴结和20例肺良性病变患者的47枚淋巴结中的细胞角蛋白19（CK19 mRNA）、肺特异性X蛋白（LUNX mRNA）的表达。结果：39例NSCLN患者的149枚淋巴结中，46枚（30．9％）淋巴结存在CK19 mRNA阳性表达，56枚（37．6％）存在LUNX mRNA阳性表达，常规病理组织学检出20枚（13．4％）有癌转移，巢式RT—PCR方法和常规病理方法比较差异有统计学意义（P〈0．01）；20例肺良性病变患者的47枚淋巴结中CK19 mRNA和LUNX mRNA表达均为阴性，与肺癌组比较均有统计学意义（P〈0．01）。淋巴结微转移与病理类型、细胞分化程度和临床分期有密切关系（P〈0．05）。结论：CK19 mRNA、LUNX mRNA可作为检测NSCLC患者淋巴结微转移的分子标记物，联合检测可能有助于早期诊断肺癌转移，从而指导临床个体化治疗。     

肺特异性X蛋白角蛋白19及癌胚抗原基因在非小细胞肺癌淋巴结微转移中的比较

目的 探讨非小细胞肺癌(NSCLC)中肺特异性X蛋白(LUNX)mRNA、角蛋白19(CK19)mRNA和癌胚抗原(CEA)mRNA的表达及与NSCLC淋巴结转移和分期的关系.方法 采用逆转录聚合酶链反应(RT-PCR)方法,检测56例NSCLC患者的肺癌组织和103枚区域性淋巴结的LUNX mRNA、CK19 mRNA和CEA mRNA的表达情况.对所有淋巴结做常规病理切片并行HE染色,观察转移情况.结果 (1)LUNX mRNA、CK19 mRNA和CEA mRNA在肺癌患者淋巴结中的表达明显高于肺良性病变者(P＜0.05).(2)与常规病理学方法检查淋巴结相比,RT-PCR技术的敏感性显著增高(P＜0.05).(3)LUNX mRNA、CK19 mRNA在淋巴结中的阳性表达率与肺癌病理类型之间无明显相关性(P＞0.05),但CEA mRNA在肺腺癌组织中的表达明显增高(P＜0.05).(4)区域淋巴结中,LUNX mRNA表达的阳性率随TNM分期的升高而增加(P＜0.05).结论 LUNX mRNA与CK19mRNA均可作为RT-PCR检测肺癌患者区域性淋巴结微转移的分子标志物;在特异性和敏感性上,LUNX mRNA优于CK19 mRNA.采用RT-PCR方法,有利于早期诊断肺癌转移.     

肺癌患者三种微转移标志物临床意义的比较研究

目的评价肺癌患者外周血LUNX mRNA 、CK19 mRNA、CEA mRNA诊断微转移的特异性、敏感性,探索肺癌患者微转移的早期诊断.方法以肺部良性疾病30例、健康人10例的外周血为对照,以LUNX mRNA 、CK19 mRNA、CEA mRNA的表达为指标,采用逆转录聚合酶链反应(RT-PCR)检测48例肺癌患者外周血、手术切除区域44个淋巴结的微转移,并根据淋巴结病理切片、临床分期、随访过程中复发转移率评价微转移的临床意义.结果①LUNX mRNA、CK19 mRNA、CEA mRNA在肺癌组织的表达率均为100%(35/35).②48例肺癌患者外周血中LUNX mRNA阳性30例(62.5%),CK19 mRNA阳性24例(50.0%),CEA mRNA阳性32例(66.7%);44枚肺癌患者手术切除的区域淋巴结,LUNX mRNA阳性16枚(36.4%),CK19 mRNA阳性12枚(27.3%),CEA mRNA阳性18枚(40.9%).③30例肺部良性疾病患者外周血中,CK19 mRNA表达阳性2例(6.7%),LUNX mRNA或CEA mRNA表达均阴性;10例健康人外周血和11枚取自肺良性疾病患者的淋巴结,3个指标检测结果均为阴性.④44枚肺癌区域淋巴结中,普通病理组织学检出6枚(13.6%)有癌转移,阳性率明显低于RT-PCR检测结果(P<0.05).⑤3种微转移指标的阳性率均随TNM分期的增加而升高(P=0.01).⑥随访发现外周血微转移阳性患者的复发率高于阴性患者.结论 LUNX mRNA、CK19 mRNA 、CEA mRNA有可能成为监测肺癌微转移的分子标志.     

肺特异性X蛋白与细胞角蛋白19在非小细胞肺癌中的表达及意义

背景与目的: 常规细胞学诊断肺癌患者淋巴结中的癌细胞具有重要的应用价值,然而对淋巴结和癌旁组织内微转移的诊断有限.本研究探讨非小细胞肺癌(NSCLC)中肺特异性X蛋白(LUNX)mRNA和细胞角蛋白19(CK19)mRNA的表达及其在NSCLC发生、转移和预后中的意义.方法:采用实时定量反转录(real-timeRT-PCR)方法检测20例经病理诊断为非小细胞肺癌(NSCLC)组织及42枚区域性淋巴结中LUNX mRNA和CK19 mRNA的表达情况并进行定量分析.以9例肺良性病变患者标本及6枚淋巴结作为对照组.对所有淋巴结进行常规病理切片并行HE染色,观察转移情况.结果: ①癌组织中LUNX mRNA水平显著高于对照组,但与患者淋巴结转移、肿瘤大小及TNM分期无关.②癌旁组织中LUNX mRNA水平明显高于对照组,与淋巴结转移、肿瘤大小及TNM分期有关.③淋巴结组织中CK19 mRNA水平接近对照组,与淋巴结转移及TNM分期有关,但与患者肿瘤大小无关.④淋巴结组织中LUNX mRNA水平接近对照组,但与患者淋巴结转移、肿瘤大小及TNM分期无关.⑤LUNX mRNA和CK19 mRNA均与患者年龄、性别、组织学分型无关.⑥real-time RT-PCR法和常规病理方法检测肺癌淋巴结转移的差异有显著性. 结论: LUNX mRNA与CK19 mRNA均可作为real-time RT-PCR检测NSCLC患者癌旁组织、区域性淋巴结微转移的分子标志物,但前者在特异性和敏感性上优于后者.本方法的建立可能有利于提高肺癌淋巴转移的检出率,从而指导临床分期和治疗.     

检测LUNX mRNA表达诊断非小细胞肺癌微转移的可行性及其临床意义

背景与目的 微转移的检测对非小细胞肺癌的个体化治疗和指示预后具有重要意义。LUNX为近年新发现的人类肺组织特异性基因。本研究的目的是检测非小细胞肺癌（NSCLC）患者LUNX mRNA的表达情况，探讨其作为微转移检测分子标志物的可行性。方法 选择初治的NSCLC患者62例，以肺部良性疾病10例与健康人10例作为对照组，采用实时荧光定量逆转录聚合酶链反应（FQ-RT—PCR）和普通RT—PCR技术，检测肺癌、良性病变肺组织、骨髓和外周血LUNX mRNA的表达。结果肺癌和良性病变肺组织中LUNX mRNA阳性表达率均为100％。肺良性病变组骨髓及外周血标本和健康对照组外周血标本中LUNX mRNA表达皆为阴性。62例NSCLC患者骨髓LUNX mRNA阳性表达率为38．7％（24／62），外周血LUNX mRNA阳性表达率为29．0％（18／62），至少一项阳性表达者占45．2％（28／62）；骨髓LUNX mRNA阳性表达率随分期升高且有统计学意义（P=0．02），与病理类型、肿瘤分化程度无明显关系；外周血LUNX mRNA表达与病理分期、病理类型、肿瘤分化程度均无明显关系。NSCLC患者骨髓和外周血LUNX mRNA表达有相关性（P〈0．001）。结论 LUNX mRNA可作为检测NSCLC患者微转移的特异、敏感的分子标志物，可能有助于早期诊断肺癌转移，从而指导临床分期和治疗。     

肺癌淋巴结隐匿性微转移的基因诊断及其对预后的意义

背景与目的:常规病理检查漏诊的纵隔淋巴结隐匿性微小转移可能与肺癌的预后有关。本研究旨在探索肺癌纵隔淋巴结隐匿性微转移的诊断,并评价其对预后意义。方法:应用逆转录聚合酶链反应法(RT-PCR),对58例非小细胞肺癌手术后病理检查阴性的242组纵隔淋巴结(pN_0)进行研究,检测淋巴结中MUC1基因mRNA表达,诊断纵隔淋巴结隐匿性微转移。对全部病人随访3年,应用Kaplan-Meier法计算生存率,log-rank检验比较有、无淋巴结隐匿性微转移患者的生存差别。结果:16例患者的23组纵隔淋巴结中检测到MUC1基因mRNA表达,诊断为纵隔淋巴结隐匿性微转移,占全部患者的27.6％。患者的TNM分期由Ⅰ_A～Ⅱ_B期上调为Ⅲ_A期。纵隔淋巴结隐匿性微转移组3年生存率为43.7％(7/16),无转移组的3年生存率为73.8％(31/42)。两组的生存差别具有显著性(P<0.05)。结论:纵隔淋巴结中MUC1基因mRNA的表达与pN_0患者预后不良有关。提示肺癌患者纵隔淋巴结MUC1基因mRNA阳性表达,可以作为判断可能存在淋巴结隐性微转移的参考指标。     

Ⅰ期非小细胞肺癌淋巴结微转移的研究

目的 检测Ⅰ期非小细胞肺癌(NSCLC)淋巴结微转移的情况,分析影响Ⅰ期NSCLC淋巴结微转移的主要因素,了解微转移的规律.方法 采用免疫组织化学SP法对91例Ⅰ期NSCLC清扫的肺门和隆突下淋巴结进行混合性细胞角蛋白(MCK)检测,检测其微转移的表达.另收集45例肺部良性病变手术切除的肺门淋巴结45枚和Ⅱ、Ⅲ期NSCLC常规病理检查阳性的肺门淋巴结45枚进行MCK(AE1/AE3)检测,分别作为阴性和阳性对照.结果 45例肺部良性病变的肺门淋巴结45枚MCK(AE1/AE3)表达均为阴性.Ⅱ、Ⅲ期NSCLC常规病理检查阳性的肺门淋巴结45枚MCK(AE1/AE3)表达均为阳性.91例Ⅰ期NSCLC取其肺门和隆突下淋巴结各91枚进行MCK(AE1/AE3)检测,45例阳性,总的微转移率为49%(45/91).其中,肺门淋巴结39枚阳性,隆突下淋巴结11枚阳性,二者均为阳性5例.Logistic单因素分析显示:肿瘤大小、分期和分化是影响淋巴结微转移的临床因素,其相对危险度OR值分别为8.444、6.946和14.566.多因素分析显示:肿瘤T分期和分化程度是影响淋巴结微转移的主要因素,其相对危险度OR值分别为14.509和7.028.结论 Ⅰ期NSCLC淋巴结中存在微转移;ⅠB期NSCLC微转移率明显高于ⅠA期;有必要对ⅠB期NSCLC进行术后化疗;肿瘤分期和分化程度是影响淋巴结微转移的主要因素;淋巴结微转移遵循肺门到纵隔的途径;腺癌存在跳跃式微转移现象.     

非小细胞肺癌患者外周血和骨髓中LUNX基因表达的临床意义

[目的]探讨非小细胞肺癌（NSCLC）患者外周血和骨髓微转移的肺特异性X蛋白（LUNX）基因诊断的临床意义.[方法]应用荧光定量逆转录聚合酶链反应（RT-PCR）技术,对42例肺癌患者和12例肺良性病变患者的外周血和骨髓中LUNX基因mRNA表达进行检测.[结果]42例肺癌患者有14例在外周血中检测到LUNX基因mRNA的表达,阳性表达率为33.3%,有10例在骨髓中检测到LUNX基因mRNA的表达,阳性表达率为23.8%.LUNX mRNA的表达与CK-19基因mRNA的表达率无显著性差异（P＞0.05）.外周血和骨髓微转移与肺癌组织学类型、细胞分化程度及TNM分期均存在密切关系（P＜0.05）.[结论]外周血和骨髓LUNX基因mRNA的表达是检测肺癌微转移的一个有价值的指标,为制定治疗方案和评估预后提供重要参考依据.     

临床Ia期非小细胞肺癌淋巴结清扫范围的探讨

背景与目的：肺癌手术中淋巴结的处理方式在学术界一直存在争论，尤其是早期非小细胞肺癌（non-small cell lung cancer，NSCLC）患者。我们通过研究淋巴结转移规律来探讨Ia期NSCLC手术中淋巴结清扫的合理范围。方法：41例临床Ia期NSCLC患者进行肺叶切除及纵隔淋巴结系统清扫，将淋巴结行病理切片，HE染色明确是否有癌转移。研究肺门、纵隔淋巴结转移规律。结果：共清扫淋巴结295组，转移42组（占14．2％），其中肺门淋巴结转移33组。纵隔淋巴结中转移9组。纵隔淋巴结转移中第7站淋巴结出现转移4例，第5、9站淋巴结出现转移各2例，第4站淋巴结出现转移1例。上叶肿瘤转移包括5、7站淋巴结，中下叶肿瘤转移包括4、7、9站淋巴结。结论：临床Ia期非小细胞肺癌的肺门、纵隔淋巴结转移遵循区域性淋巴结引流规律，可行区域选择性淋巴结清扫，即上叶肿瘤在无肺门或隆突下淋巴结转移时可只清扫上纵隔淋巴结而无须清扫下纵隔淋巴结，中下叶肿瘤无论有无肺门或隆突下淋巴结转移都需要进行上下纵隔淋巴结清扫。     

Dermatomycosis in Goats in India

Summary: In an extensive survey involving 2176 goats 1.56% of goats manifested clinical lesions of ringworm infection. Animals below the age of 6 months were affected most (4.20%). The incidence of infection was higher during the winter months. T. verrucosum, T. mentagrophytes and M. gypseum were isolated from the skin scrapings of 12, 4, and 2 goats respectively. It is suggested that the infected animals could be a source of disease to human population in which the zoophilic dermatophyte invasion is characterized by severe inflammatory lesions of the skin. The zoonotic importance of different dermatophytes is stressed.
Zusammenfassung: In einer ausgedehnten Untersuchung an 2176 Ziegen wurden bei 1,56% klinische Zeichen einer Hautmykose festgestellt. Tiere, die jühger als 6 Monate alt waren, zeigten mit 4,20% am häfigsten Krankheitssymptome. In den Wintermonaten war die Erkrankungshäufigkeit am gröBten. T. vermcosum, T. mentagrophytes and M. gypseum wurden jeweils von 12,4 bzw. 2 Ziegen isoliert. Die inflzierten Tiere köinnen eine Infektionsquelle für die menschliche Bevölkerung darstellen und dort Mykosen mit stark entzündlichen Veränderungen auslösen. Die Bedeutung verschiedener Dermatophyten als Erreger von Zoonosen wird hervorgehoben.     

Trends in zygomycosis in children

Zygomycosis, or mucormycosis, is associated with significant morbidity and mortality in both children and adults. Studies in adults have shown an increase in the incidence of zygomycosis, particularly among haemtopoietic stem cell transplant (HSCT) recipients and patients with haematologic malignancies. There is a paucity of data on the epidemiology of zygomycosis in children. We performed a retrospective analysis to describe trends in zygomycosis between 1 January 2003 and 31 December 2010. We used the Pediatric Health Information System (PHIS) database to identify paediatric patients who were diagnosed with zygomycosis during the study period. Administrative data on diagnoses, demographics, underlying conditions and clinical experiences were collected. Summary statistics were calculated and tests for trend were conducted. We identified 156 unique patients with zygomycosis. The prevalence of zygomycosis did not significantly increase over time (P=0.284). The most common underlying condition was malignancy (58%) and over half received intensive care. Voriconazole utilisation among all hospitalised children significantly increased during the period (P=0.010). Our study demonstrates that the incidence of zygomycosis is not significantly increasing. During the time period there was a significant increase in the use of voriconazole among children.     

Increased apoptosis in cancer cells in vitro and in vivo by ceramides in transferrin-modified liposomes

Lysosomes are a promising therapeutic target for induction apoptosis in cancer cells due to lysosomal membrane permeabilization (LMP) leading to leakage of hydrolytic enzymes, especially the cathepsins, into the cytoplasm. We hypothesized that with the modification of the ceramide-loaded liposomes with transferrin (Tf), we would achieve both tumor targeting and increased delivery of lysosome-destabilizing agents, such as ceramides to lysosomes, to initiate LMP-induced apoptosis. We prepared Tf-modified (TL) and plain (PL) liposomes and loaded with short (C6)- or long (C16) N-acyl chain ceramides. Uptake, intracellular localization of liposomes, stability of the lysosomal membrane and release of cathepsin D were investigated on Hela cells by fluorescence microscopy and flow cytometry. Apoptosis was evaluated by binding of fluorescently-labeled Annexin V. Antitumor and pro-apoptotic effects of C6Cer-loaded Tf-liposomes were demonstrated in vivo in an A2780-ovarian carcinoma xenograft mouse model. TL were internalized specifically via the TfR-dependent endocytic pathway and localized within the endosome-lysosomal compartment. Ceramide-loaded Tf-liposomes significantly increased apoptosis compared with ceramide-free and ceramide-loaded non-modified liposomes. The treatment of cancer cells with TL led to increased LMP and cytoplasmic relocation of the intralysosomal cathepsin D. A strong antitumor and pro-apoptotic effect of C6Cer-loaded TL was also demonstrated in vivo in an A2780-ovarian carcinoma xenograft mouse model. The lysosomal accumulation of ceramides delivered by Tf-liposomes initiates the permeabilization of the lysosomal membranes required for the release of lysosomal cathepsins into the cytoplasm and initiation of the cancer cell apoptosis both in vitro and in vivo.     

Ringworm in animals in a farm in Assiut

Bericht über das Auftreten von Hautmykosen bei Tieren auf der Farm der Landwirtschaftlichen Fakultät der Universität Assiut. Von 70 Kälbern waren 42 pilzkrank, davon 22 durch T. mentagrophytes, 20 durch T. verrucosum. Von 180 Kühen waren 8 pilzbefalien, sämtlich durch T. mentagrophytes. Von 2 kranken Bullen wurde T. verrucosum isoliert. Auch die 3 Pferde und 2 Maultiere der Farm waren pilzinfiziert; Erreger war in diesen Fällen T. equinum. Auch ein Kalb war von T. equinum befallen. Die gleiche Pilzart wurde ferner von 3 Tierpflegern isoliert, die Pilzherde am Hals und an den Armen aufwiesen.     

Socioeconomic factors in cancer in Sweden

It is well known that certain cancers have shown clustering in socioeconomic groups, but limited data are available on recent results and time trends in such clustering. We determined standardized incidence ratios (SIR) for cancer, adjusted for age, period, region, parity and age at first childbirth among men and women in 6 socioeconomic groups based on the Swedish Family-Cancer Database. Persons had to be identified with the same socioeconomic status in the census of years 1960 and 1970, or of years 1960, 1970 and 1980; the comparison group was all people according to the same censuses. Cancers were followed from years 1970 to 1998 or from 1980 to 1998. Both increased and decreased SIRs were found, and a consistent pattern emerged, although the overall SIRs for cancer did not differ much, the lowest being for farmers (0.85) and the highest for professional men (1.07) and women (1.11). At individual sites, manual workers were at risk of tobacco-, alcohol- and occupation- and human papilloma virus-related cancers and at a decreased risk at most other cancers. Manual workers and farmers showed an excess of stomach cancer; professionals had an excess of melanoma and squamous cell skin cancer. Male and female SIRs correlated highly for manual and blue-collar workers and for professionals. The overall population-attributable fraction for selected sites was 16.7% for men and 10.9% for women and it was highest, over 50%, for lung cancer in both genders.     

Survey of changes in dietary preferences in cancer patients in China

Objective The aim of this study was to investigate the changes in dietary preferences in cancer patients in China and to determine the need for encouraging the adherence to a sensible diet among such patients.Methods A total of 468 cancer patients were interviewed using a self-designed questionnaire focusing on changes in the intake of specific foods. Data were analyzed using SPSS 16.0. Results Most patients completely avoided roosters and carp(73.1%), condiments(51.9%), and meat of aquatic species(40.4%). All other types of the specific foods were completely avoided by different subpopulations of the patients.Conclusion In addition to focusing on disease treatment, medical professionals need to help cancer patients overcome barriers associated with the customs of avoiding specific foods encompassed by the term ”fawu” and provide them with dietary guidance in order to prevent negative nutritional effects.     

Advances in cancer epidemiology in Japan

Epidemiologists in Japan have been performing calculations to estimate nationwide cancer incidence rates as well as 5‐year survival rates using population‐based cancer registry data. There have been remarkable changes in cancer incidence and/or mortality in cancers of the lung, liver and stomach, which were thought to be attributed to the changing impact of exposure to cigarette smoking, chronic hepatitis C virus infection and Helicobacter pylori infection, respectively. In systematic reviews providing evidence in risk/protective factors for cancer sites using case–control and cohort studies of the Japanese population, there were associations between cancer sites (esophagus, stomach, colo‐rectum, liver, pancreas, lung and breast) and various lifestyle factors. In the past 10 years, a hospital‐based case–control study at Aichi Cancer Center provided valuable evidence of gene‐environment interaction on the development of cancer [i.e., the effects of aldehyde dehydrogenase‐2 (ALDH2) polymorphism and heavy alcohol drinking on esophageal cancer, ALDH2 polymorphism and smoking on lung cancer, methylenetetrahydrofolate reductase polymorphism and heavy alcohol drinking on pancreatic cancer]. The database with stored DNA was also used and identified seven loci containing significant but low‐penetrance polymorphisms associated with the development of breast cancer. These findings together with established risk factors are likely to be useful to predict personalized breast cancer risk in East Asian women. In 2005, the Japan Multi‐Institution Collaborative Cohort (J‐MICC) study was launched to elucidate gene‐environment interactions as well as to confirm preclinical diagnostic biomarkers of cancer. J‐MICC, which has recruited 92,000 healthy individuals by the end of 2012, will follow the individuals until 2025.     

Foreign bodies in ENT in a teaching hospital in Eastern India

Objective

To evaluate the nature, common sites, modes of presentation of various foreign bodies (FB) in Ear, Nose and Throat (ENT).

Materials and methods

Observational retrospective study carried out at Vivekananda Institute of Medical Sciences, Ramakrishna Mission Seva Pratishthan. The study period was between Jan 2006 to Jan 2007. The information obtained from the hospital record books.

Results

Four hundred and eighty-two patients presented in the Department of Otorhinolaryngology of Vivekananda Institute of Medical Sciences, in the study period with FB in their ENT. Out of 482 pts, the commonest location of FB was to be in throat with 302 pts (62%) followed by ear with 119 pts (25%) and nose 61 pts (13%). Amongst the FB in throat the commonest was fish bone and the commonest site being tonsils. Artificial denture accounted for a significant number of 13 (4.3%). External auditory canal was the commonest site of FB lodgment in ear found in 118 patients (99.16%). Nasal FB were found in 61 patients; more common in pediatric age group (98.36%).

Conclusion

From this study we have found that FB lodgement is a very common complaint with which patients come to otolaryngologist. The commonest site of FB lodgement is in the throat. Most of the FB could be removed in emergency room (ER) with or without Local Anesthesia.     

整合素在急性白血病中的研究进展

急性白血病是一种早期造血干/祖细咆的恶性克隆性疾病.微小残留病和耐药被认为是其复发和难治的根源.近来,越来越多的证据显示白血病细胞通过与骨髓微环境中的基质细胞或细胞外基质相互作用促进其存活,并增强其对常规化疗药物的耐药.整合素是介导细胞与细胞外基质（细胞与非细胞成分）粘连的最主要黏附分子,在细胞增殖、存活等生物学过程中发挥关键作用,但作用机制尚不完全清楚.现就目前揭示的整合素及肿瘤微环境在急性白血病发生、发展中的作用进行综述.