浆液性和黏液性卵巢囊腺癌患者线粒体结构和紧密连接蛋白表达的差异比较

目的:探讨浆液性卵巢囊腺癌(SC)与黏液性卵巢囊腺癌(MC)细胞线粒体结构及紧密连接(TJ)蛋白occludin/ZO-1表达异常的差异及可能机制。方法:临床确诊30例卵巢囊腺癌患者中15例为SC(SC组),15例为MC(MC组),另选3例子宫肌瘤患者进行对照(对照组)。采用电镜观察各组线粒体超微结构;采用体视学方法分析线粒体面数密度(Nm)、体密度(Vvm)和外膜面密度(Sv);采用免疫组化方法检测各组卵巢上皮细胞occludin/ZO-1蛋白的阳性单位(PU)及其强弱程度(用积分光密度值IOD表示)。结果:电镜下,对照组线粒体及内质网均未见异常;MC组线粒体体积小、数量较多,线粒体Nm、Vvm和Sv较对照组明显降低(P0.05);SC组线粒体体积大,脊断裂显著,线粒体Nm、Vvm和Sv较MC组显著升高(P0.01)。免疫组化分析显示MC组occludin和ZO-1PU明显高于对照组(24.23±4.74Vs 21.07±5.51、37.07±3.58Vs 20.46±4.89,P均0.05),IOD明显低于对照组(72.39±9.86Vs 92.38±7.17、73.51±6.86Vs 80.34±7.04,P均0.05);SC组occludin和ZO-1PU明显低于对照组(11.50±4.15Vs 21.07±5.51、16.24±3.61Vs 20.46±4.89,P均0.05),IOD明显高于对照组(101.38±6.16Vs 92.38±7.1、92.78±3.07Vs 80.34±7.04,P均0.01)。结论:SC及MC两种卵巢囊腺癌患者线粒体结构和体视学特征明显不同,可能与TJ蛋白的occludin/ZO-1表达异常有关。     

卵巢浆液性乳头状囊腺癌伴肺软骨瘤样错构瘤1例

患者女性,49岁,因下腹胀痛10天就诊.妇科检查:外阴已婚式,阴道畅,宫颈尚光滑,宫体缺如,右侧附件区可扪及一15 cm×10 cm大小肿块.B超检查:右侧附件区囊实相间肿块待查(大小152 mm×85 mm×128 mm),内壁见乳头状突起;盆腔积液.实验室检查:血常规、尿常规、生化全套均无异常,CEA、AFP正常,CA125明显升高,为80.2 U/ml(0~35 U/ml),ESR明显升高,为62 mm/h(<20 mm/h).     

原发性乳腺黏液性囊腺癌1例

<正>患者女性,56岁。因发现右侧乳腺包块4年余入院。体检:右侧乳腺外侧9点钟方向可触及质地较硬包块,境界不甚清楚,活动度较差,无压痛,无乳头溢液,无橘皮征,双侧腋窝可扪及质软样组织。余无异常发现。乳腺超声示:右侧     

卵巢囊腺癌抑癌基因p16检测及其意义

进一步探讨新型抑癌基因Ｐ１６与人类卵巢癌发生发展的关系。方法：采用Ｓ－Ｐ免疫组化方法对母系ＨＯ－８９１０细胞系，高转移ＨＯ－８９１０ＰＭ，ＮＳＭＯ模型和转移瘤以及６９全卵巢癌腺癌手术标本石蜡组织进行Ｐ１６检测。结果。母素ＨＯ－８９１０细胞与高转移ＨＯ－８９１０ＰＭ细胞，ＮＳＭＯ模型及转移瘤均具有Ｐ１６阳性表达，表达强度均以转移细胞为弱。     

基于生物信息学分析PI3在卵巢浆液性囊腺癌中的表达及临床意义

目的 探究PI3基因在卵巢浆液性囊腺癌（OV）中的表达及临床意义。方法 利用多种生物信息学分析在线工具,基于GEO、TCGA、GTEx、GEA数据库挖掘PI3基因在OV的表达、生物学作用及临床意义。结果 PI3在OV组织的表达量高于正常卵巢组织（P<0.05）;OV患者中,PI3低表达组总生存期和无复发生存期比高表达组长（P<0.001）;在免疫细胞浸润方面,中性粒细胞水平与PI3在OV中的表达呈正相关,Th1细胞、Th2细胞、B细胞、嗜酸性粒细胞水平对OV患者生存有影响且与PI3表达高低有关;PI3参与了炎症反应、白细胞活化等生物学过程,参与了PI3K-Akt、Toll样受体等信号通路。结论 PI3基因在OV中高表达,可作为OV患者诊断、治疗的潜在靶点。     

卵巢浆液性癌中Netrin-1的表达及其临床意义

目的：探讨神经突起生长导向因子Netrin-1在卵巢浆液性癌（ ovarian serous carcinoma,OSC）中的表达及其临床病理意义。方法采用免疫组化EnVision法检测20例卵巢良性浆液性囊腺瘤、13例卵巢交界性浆液性囊腺瘤和32例OSC中Ne-trin-1蛋白的表达,分析Netrin-1蛋白表达与OSC临床病理特征的关系。结果 Netrin-1在OSC中的阳性率明显高于卵巢交界性和良性浆液性囊腺瘤（P<0.01）。OSC组织中Netrin-1表达与肿瘤分化程度及临床分期有关（P<0.05）,与患者年龄、发病部位、肿瘤大小及有无盆腔淋巴结转移无关（ P>0.05）。Kap1an-Meier生存分析显示,Netrin-1高表达患者5年生存率显著低于Netrin-1低表达患者（ P<0.05）。结论 Netrin-1在OSC组织中高表达,提示其可能与肿瘤的发生、发展有关,可作为OSC患者预后判断的辅助指标。     

浆液性与黏液性卵巢囊腺癌线粒体超微结构及体视学

目的观察黏液性卵巢囊腺癌(MC)及浆液性卵巢囊腺癌(SC)细胞线粒体超微结构及体视学特点的改变,探讨两种腺癌线粒体体视学改变的临床意义及其可能机制。方法用电镜观察超微结构,并用体视学检测线粒体的体密度(Vvm)、外膜面密度(Sv,μm-1)、表面积体积比(Rsv,μm-1)及其相互关系。结果癌变后的卵巢囊腺癌细胞线粒体明显增多,线粒体肿胀、嵴断裂明显。MC细胞Vvm和Sv分别为0.07±0.06和0.06±0.04,显著低于正常的0.14±0.07和0.09±0.05(P<0.05),但线粒体Rsv则明显升高(0.89±0.04,P<0.05)。SC细胞线粒体Vvm和Sv明显升高,分别为0.27±0.12和0.12±0.06(P<0.01),而线粒体Rsv则明显降低(0.58±0.49,P<0.05)。结论 MC与SC的线粒体体视学改变不同,前者以减少为主,而后者则以增大为主。     

卵巢黏液性囊性肿瘤伴实性附壁结节

目的：探讨卵巢黏液性囊性肿瘤伴实性附壁结节的临床病理学特点。方法：对2例卵巢黏液性囊性肿瘤进行光镜观察和免疫组化染色并复习文献。结果：1例卵巢黏液性交界性乳头状囊腺瘤伴实性附壁恶性纤维组织细胞瘤结节，结节内瘤细胞呈多形性。1例卵巢黏液性囊腺瘤伴实性附壁间变性癌结节；间变性癌结节内瘤细胞体积较大，胞质丰富，嗜酸，少数胞质透明，排列呈巢或索状；免疫表型：EMA和cytokeratin阳性。恶纤组结节中肿瘤细胞AACT和vimentin阳性。结论：免疫组化有助于卵巢黏液性囊性肿瘤伴实性附壁结节的诊断及鉴别诊断。     

卵巢浆液性囊腺癌中孕激素核受体A、B亚型的表达及临床意义

目的探讨孕激素核受体A、B亚型(PR-A、PR-B)在卵巢浆液性囊腺癌(ovarian serous cystadenocarcinoma,OSC)发生、发展中的作用。方法采用免疫组化Eli Vision法检测52例OSC、22例卵巢交界性浆液性囊腺瘤(ovarian borderline serous cystadenoma,OBSC)、22例正常输卵管伞端(umbrella of normal fallopian,UNF)中PR-A、PR-B的表达。结果 OSC、OBSC和UNF中的PR-A阳性率分别为94.5%、94.5%、68.38%,三组相比差异有显著性(P<0.05);OSC、OBSC和UNF中的PR-B阳性率分别为100%、77.27%、40.38%,三组相比差异有显著性(P<0.05);三组中PR-A/PR-B的比值,差异有显著性(P<0.05)。PR-A、PR-B表达逐渐下降,Ⅰ+Ⅱ期与Ⅲ+Ⅳ期比较、Ⅰ级与Ⅱ级比较,差异有显著性(P<0.05);PR-A/PR-B比值在Ⅰ级与Ⅱ级组相比,差异有显著性(P<0.05);PR-B表达在OSC有、无淋巴结转移组间差异有显著性(P<0.05)。PR-A、PR-B在OSC组织中表达呈正相关(P<0.05)。结论随着OSC恶性变的发生、发展PR-A、PR-B表达逐渐下调,其中PR-B下调更为明显,可能是卵巢组织恶性变的标志;PR-A/PR-B比值的增大可能预示卵巢癌分化越差;PR-B相对高表达有利于抑制OSC的淋巴结转移。     

乳腺原发性黏液性囊腺癌临床病理分析和文献复习

目的 探讨乳腺原发性黏液性囊腺癌(mucinous cystadenocarcinoma,MCA)的临床病理特征及鉴别诊断.方法 分析1例MCA的组织病理学、免疫表型资料并复习文献.结果 乳腺肿物切面呈囊实性.镜下见大小不等、分布不均的囊性区,囊壁衬覆富含黏液的肿瘤细胞,或呈单层柱状、或复层化增生或形成乳头状结构.肿瘤细胞胞质内黏液呈PAS、AB染色阳性.肿瘤细胞CK7阳性,CK20阴性,ER、PR、HER2均阴性.囊壁肿瘤细胞外侧肌上皮细胞呈p63、SMA阴性.结论 (1)MCA是主要发生于绝经后妇女的罕见肿瘤,预后较好.(2)与卵巢和(或)胰腺黏液性囊腺癌类似,诊断原发肿瘤需先排除转移可能.     

卵巢浆液性和黏液性肿瘤MUC1、MUC2的表达及其意义

目的探讨卵巢浆液性和黏液性肿瘤中黏蛋白MUC1、MUC2的表达与临床病理特征的相关性。方法免疫组化S—P法检测90例卵巢浆液性和黏液性肿瘤的黏蛋白MUC1、MUC2的表达,并对其中50例恶性病例作生存分析。结果（1）交界性与恶性卵巢肿瘤中黏蛋白MUC1的表达阳性率明显高于良性肿瘤,差异有显著性（P〈0．001）;黏蛋白MUC1与WHO病理分级、FIGO临床分期、大网膜转移显著相关（P〈0．05）。（2）黏蛋白MUC2与组织学类型、WHO病理分级相关（P〈0．05）。（3）黏蛋白MUC1与MUC2呈负相关（P〈0．05）。（4）对50例恶性浆液性和黏液性肿瘤进行的生存分析中,单因素分析显示：WHO病理分级、FIGO临床分期、大网膜转移、MUC1表达程度与预后相关（P〈0．05）,而多因素分析中只有FIGO临床分期、MUC1表达程度具有独立的预后意义（P〈0．05）,Kaplan—Meier生存曲线分析显示,Ⅲ、Ⅳ期较Ⅰ、Ⅱ期生存率差异有显著（P〈0．01）,MUC1阳性组和阴性组生存率差异有显著性（P〈0．01）。结论黏蛋白MUC1、MUC2与恶性卵巢浆液性和黏液性肿瘤的浸润、转移相关,Ⅲ、Ⅳ期肿瘤、MUC1强表达可作为恶性卵巢浆液性和黏液性肿瘤预后不良的可行性指标。     

卵巢浆液性交界性肿瘤中clusterin的表达

目的探讨凋亡抑制因子clusterin在卵巢浆液性肿瘤中发生、发展的作用及其与bcl-2、Ki-67表达的关系。方法免疫组化sP法检测clusterin、bcl-2、Ki-67在20例卵巢浆液性囊腺瘤,28例浆液性交界性肿瘤,26例浆液性囊腺癌标本中的表达。结果clusterin在囊腺瘤、交界性肿瘤、囊腺癌中的阳性率分别为40％,67．9％,96．2％。囊腺癌中的clusterin与Ki-67的表达水平均明显高于囊腺瘤（P〈0．05）和SBOT（P〈0．05）。交界性肿瘤中有腹水的患者clusterin阳性率要明显高于无腹水者（P=0．0390）,Ki-67在有腹膜种植的患者阳性率要明显高于无腹膜种植者（P=0．0473）。且两者的表达成正相关。结论clusterin基因可能通过抑制凋亡在卵巢浆液性肿瘤的发生发展中起重要作用。clusterin与Ki-67结合起来分析可能作为鉴别SBOT与浆液性癌的辅助指标。     

Incidence of P53 and K-ras alterations in ovarian mucinous and serous tumors

Clarification of the pathogenic relationships existing among ovarian cystadenomas, tumors of low malignant potential (LMP) and various adenocarcinoma types, a series of 29 mucinous and 19 serous ovarian tumors including adenomas, LMP tumors and adenocarcinomas were examined. P53 protein was detected by the streptavidin-biotin method and point mutation of K-ras codon 12 was detected by polymerase chain reaction-restriction fragment length polymorphism analysis. P53 overexpression was observed more frequently in serous adenocarcinomas (5/8, 63%) than in mucinous adenocarcinomas (2/9, 22%) and was correlated with the malignant potential of serous tumors. Furthermore, the proportion of P53-positive cells was significantly higher in serous adenocarcinomas than in mucinous adenocarcinomas. P53 overexpression may therefore be closely related to the early events of carcinogenesis in serous tumors. Although mutation of the K-ras oncogene appears to be an important event in the early tumorigenesis of mucinous tumors, mutation of the K-ras oncogene in serous tumors may be dependent on morphology. Different complex pathways of oncogene and/or tumor suppressor gene abnormalities may be involved in the development of mucinous and serous adenocarcinomas.     

Immunohistochemical study of DNA topoisomerase I, DNA topoisomerase II alpha, p53, and Ki-67 in oral preneoplastic lesions and oral squamous cell carcinomas

Human DNA topoisomerase I (topo I) is the molecular target of the camptothecin group of anticancer drugs. Laboratory studies have shown that the cellular response to topo I-targeted drugs depends on the topo I expression and DNA replication rate and the apoptotic pathway activity. In this study, we tested potential indicators of the sensitivity of topo I-targeted drugs in 36 cases of oral squamous cell carcinoma (OSCC). Formalin-fixed, paraffin-embedded tissue sections were immunostained with monoclonal antibodies against Ki-67, p53, and topo I, and with polyclonal antibodies against DNA topoisomerase II-alpha (topo II-alpha). These markers were also tested in 18 epithelial hyperplastic lesions and 18 mild dysplasias. Immunostaining was quantified by the percentage of stained nuclei in each sample (the labeling index); 200 immunoreactive epithelial nuclei were counted per case for each antibody. The results support the possibility of using topo II-alpha staining for assessing the proliferative activity. High expression of topo II-alpha and topo I in OSCCs suggests that they may serve as potential indicators of sensitivity to topo I inhibitors. However, the apoptotic pathway assessed by p53 immunostaining was found to be uninformative. Analysis of the relationship between immunohistochemical results and clinical and pathologic parameters (the T and N stages and differentiation) showed that only the differentiation parameter correlated with the topo I expression rate. Thus, significant increase in the topo I expression in the poorly differentiated OSCCs suggests their higher sensitivity to drug treatment.     

卵巢浆液性和粘液性交界瘤的临床病理分析

目的：观察卵巢交界瘤的临床病理学特点,探索肿瘤不同组织学改变的意义。方法：对45例卵巢浆液性和粘液性交界瘤进行回顾性分析,肿瘤分期按国际妇产科联合会（FIGO）标准,Ⅰ期34例,Ⅱ期4例,Ⅲ期7例。结果：45例卵巢浆液性和粘液性交界瘤占同期卵巢上皮恶性肿瘤的25．4％,浆液性同粘液性交界瘤的比为1：1．3,11例生长于卵巢表面的浆液性交界瘤中,9例出现腹膜种植,2例为浸润性种植,7例为非浸润性种植。2例浆液性交界瘤和1例粘液性交界瘤分别于术后5、4和1年复发。33例交界瘤经2－9年随访,按Kaplan-Meier法5年生存率为100％。结论：卵巢浆液性交界瘤预后较好,卵巢表面生长的浆液性交界瘤常伴有腹膜种植。     

卵巢粘液性肿瘤组织发生的初步探讨

目的：初步探讨卵巢粘液性肿瘤（ＯＭＴ）的组织发生。方法：用组织化学染色方法观察９１例ＯＭＴ上皮的粘液分泌。按粘液性质将上皮分为３型：胃型、肠型和中间型。并将肿瘤分为简单型及混合型。结果：良性５６例中,４５例为混合型,其中２２例由３种上皮成份组成,２３例含２种上皮,另有１１例为简单型。中间型、胃型及肠型３种上皮在良性肿瘤中的出现频率分别是４０／５６、３５／５６、２９／５６。２１例交界性、１４例恶性Ｏ     

卵巢癌中HE4、Smac的表达及临床意义

目的 探讨HE4、Smac在卵巢癌中的表达及临床意义.方法 应用免疫组化SP法检测44例卵巢交界性上皮肿瘤和148例卵巢癌组织中HE4、Smac的表达.结果 卵巢交界性上皮肿瘤(40.9％)与卵巢癌(81.1％)中HE4的阳性率差异有统计学意义(x2=27.07,P＜0.01),HE4随着病理分级的增加阳性率逐渐增加,呈上升趋势,且与病理分级呈正相关(rs=0.468,P=0.01).卵巢交界性上皮肿瘤(86.4％)与卵巢癌(33.1％)中Smac阳性率差异有统计学意义(x2=38.82,P＜0.01).Smac随着病理分级的增加阳性率逐渐降低,呈下降趋势,与病理分级呈负相关(rs=-0.602,P=0.01).二者在卵巢癌中表达呈负相关,二者的ROC曲线下面积均＞0.5,提示对卵巢癌的诊断有价值.结论 HE4、Smac与卵巢癌的发生、发展关系密切;HE4基因及Smac有望成为卵巢癌诊断、治疗的新靶点.     

Immunocytochemical detection of DNA topoisomerase type II in primary breast carcinomas: Correlation with clinico-pathological features

DNA topoisomerase type II (DT-II) is a major component of interphase nuclear matrix fractions, present in S-phase of the cell cycle. A series of 80 carcinomatous breast surgical samples was evaluated by immunohistochemistry, using a polyclonal antibody in a comparison with Ki-67 antiserum. A correlation with clinico-pathological data was also performed. Infiltrating ductal and lobular carcinomas constantly express DT-II with varying intensity of nuclear staining; a similar immunohistochemical pattern is observed with Ki-67. A frequent co-expression of DT-II and Ki-67 is encountered with double immunostaining; accordingly to these data, a linear relationship is evident when linear regression is employed. In addition, significant relationships between DT-II values and tumour size, histological grade and node involvement are shown, while an inverse correlation is appreciable between DT-II and oestrogen receptors and progesterone receptors. DT-II may be considered to be an additional operational marker for the proliferating fraction of cells in breast carcinomas.     

Clinicopathological significance of DEK overexpression in serous ovarian tumors

To investigate the significance of DEK protein expression in ovarian lesions, a total of 113 ovarian serous tumors, including 62 serous cystadenocarcinomas and 19 serous borderline tumors, were studied on immunohistochemistry. For comparison, 32 benign serous tumors, including 12 serous papillary cystadenomas, 10 serous cystadenomas, and 10 serous surface papillomas, were also included. DEK was positive in 93.5% of serous cystadenocarcinomas (58/62), 63.2% of serous borderline tumors (12/19), and weakly positive in 15.6% of benign serous tumors (5/32). The strong positive signal was detected only in serous adenocarcinomas (80.6%, 50/62) and borderline tumors (21.1%, 4/19), but no serous benign tumors were strongly positive (0%, 0/32). Meanwhile, the strong positivity rate of DEK protein was significantly higher in grade 2 and grade 3 than in grade 1 ovarian cancers ( P < 0.05), but there was no significant association between DEK protein expression level and International Federation of Gynecology and Obstetrics (FIGO) stage of serous ovarian adenocarcinoma ( P > 0.05). In summary, DEK plays an important role in the progression of ovarian serous cancers. The detection of DEK protein expression should be useful for the diagnosis and prognosis of ovarian serous cancers, and DEK might be a useful molecular target for ovarian cancer therapy.