上皮性卵巢肿瘤中p53、nm23和增殖细胞核抗原的免疫组化检测及意义

采用免疫组化ＬＳＡＢ法检测３５例卵巢上皮性肿瘤组织中ｐ５３、ｎｍ２３和增殖细胞核抗原（ＰＣＮＡ）的表达。结果显示：ｐ５３、ｎｍ２３和ＰＣＮＡ表达的阳性率均以卵巢囊腺癌为最高，交界性次之，良性囊腺瘤最低。各项检测结果与细胞增殖状态有关。ｐ５３和ＰＣＮＡ过量表达与肿瘤恶性程度、临床分期和生存期无关，但与肿瘤分化有关。ｎｍ２３不能单独作为判断卵巢肿瘤预后的因素。     

反流物对食管组织内细胞增殖相关基因表达的影响

用不同手术方式制作单纯胃食管反流（Ｇ组）、单纯十二指肠食管反流（Ｄ组）、十二指肠胃混合食管反流（ＤＧ组）及无反流对照组（Ｃ组）动物模型,于术后不同时期取出食管,用免疫组化法检测ｐ１６、ＰＣＮＡ、Ｃｙｃｌｉｎ Ｄ１、ＣＤＫ４等基因的表达。结果显示：Ｄ组、ＤＧ组大鼠食管组织中ＰＣＮＡ、Ｃｙｃｌｉｎ Ｄ１、ＣＤＫ４基因表达显著高于Ｇ组,并随反流时间延长而明显增强,反流组与Ｃ组相比均有显著差异;各组不同时     

宫颈癌P~(53)基因蛋白表达和细胞增殖活性的研究

目的：研究宫颈癌患者的Ｐ５３基因蛋白表达和细胞增殖活性。方法：对５６例正常宫颈粘膜、宫颈上皮内瘤变、宫颈浸润性鳞癌用免疫组化ＡＢＣ法和图像分析法检测Ｐ５３蛋白、ＰＣＮＡ和ＤＮＡ含量。结果：Ｐ５３表达阳性率、ＰＣＮＡ细胞增殖指数和ＤＮＡ含量随癌组织分级依次增高。结论：Ｐ５３含量和细胞活性增高与宫颈粘膜癌变发生及恶性程度有关；ＰＣＮＡ增殖指数、ＤＮＡ含量和多倍体细胞的出现，对早期宫颈癌的诊断有一定意义；Ｐ５３蛋白在宫颈癌发生中不是一个早期事件。     

上皮性卵巢肿瘤中p53,nm23和增殖细胞核抗原的免疫组化检测…

采用免疫组化ＬＳＡＢ法检测３５例卵巢上皮性肿瘤组织中ｐ５３、ｎｍ２３和增殖细胞核抗原（ＰＣＮＡ）的表达。结果显示：ｐ５３、ｎｍ２３和ＰＣＮＡ表达的阳性率均以卵巢囊腺癌为最高，交界性次之，良性囊腺瘤最低。各项检测结果与细胞增殖状态有关。ｐ５３和ＰＣＮＡ过量表达与肿瘤恶性程度、临床分期和生存期无关，但与肿瘤分化有关。ｎｍ２３不能单独作为判断卵巢肿瘤预后的因素。     

肺癌P53基因突变与临床关系的研究

采用ＰＣＲ－限制性片段长度多态性分析法（ＰＣＲ－ＲＦＬＰ）检测４７例人肺癌Ｐ５３基因２４９位密码子点突变。结果显示，ＮＳＣＬＣＰ５３基因２４９密码子突变率２４．２４％（８／３３），ＳＣＬＣ突变率为０（０／１４），Ｐ５３基因２４９位密码子点突变与肺癌分期、组织分化、吸烟无关（Ｐ＞０．０５），与ＮＳＣＬＣ淋巴结转移相关（Ｐ＜０．０５）提示：Ｐ５３基因２４９位密码子突变是ＮＳＣＬＣ突变热点，是评估ＮＳＣＬＣ预后因素之一。     

中国胃食管反流病研究现状

胃食管反流病 (ＧＥＲＤ)是由于胃、十二指肠内容物反流入食管引起反酸、反食、烧心等症状或组织损害 ,常合并食管炎。北京、上海两地对50 0 0例 1870岁普通人群的流行病学调查显示〔1、2〕,胃食管反流 (ＧＥＲ)症状发生率为 8.97% ,ＧＥＲＤ的患病率为 5.77% ,反流性食管炎的发生率为 1.92 %。可见 ,ＧＥＲＤ或ＧＥＲ症状并不少见。临床上 ,即便有典型的ＧＥＲ症状 ,Ｘ线、内镜检查亦可无异常发现 ;有的表现为心绞痛样胸痛或哮喘、咽喉炎等 ,可能在相当长的时间里不被认识 ,因而不能得到合理的治疗 ;部分严重者可发展成Ｂａｒｒｅｔｔ食管 …     

反流型非溃疡消化不良与反流性食管炎食管运动功能观察

反流性食管炎和非溃疡型消化不良（ＮＵＤ）是临床上极为常见的动力障碍性疾病。Ｃｏｌｉｎ－Ｊｏｎｅｓ〔１〕等根据其临床症状的不同,将后者分为五型,即反流型、溃疡型、胃排空障碍型、吞气型和混合型。其中反流型ＮＵＤ具有与反流性食管炎同样的胃食管反流症状,但内镜检查并无反流食管炎的粘膜改变。用ＳＧＹ－３型消化道多功能检测仪与健康志愿者对照观察了反流性食管炎及反流型ＮＵＤ患者的下食管括约肌压力（ＬＥＳＰ）和食管体部的运动功能,以期对这两种症状相同的疾病之间的关系,以及它们的发病机制进行初步探讨。１　材料与方…     

大肠癌增殖细胞核抗原与核仁组成区相关性的研究

应用免疫组织化学方法和胶质银染色技术同时对２０例大肠腺癌，２０例腺瘤组织中增殖细胞核抗原（ＰＣＮＡ）的表达以及核仁组成区嗜银蛋白（ＡｇＮＯＲ）颗粒计数进行了检测。结果显示：大肠癌及腺瘤中的ＰＣＮＡ阳性率分别为７５％和３５％（Ｐ＜０．０５），大肠癌细胞核内的ＡｇＮＯＲ颗粒均值（６．７１±０．５９）也明显高于腺瘤的颗粒均值（３．２５±０．２３）（Ｐ＜０．０１）。说明ＰＣＮＡ的增殖程度与ＡｇＮＯＲ计数有密切的相关性，同时反映了细胞的增殖活性。因此二者联合检测，可用作早期诊断大肠癌有价值的参考指标。     

上海地区成年人胃食管反流病流行病学调查：II.症状与胃食管…

在对上海地区成年人胃食管反流症状流行病学调查的基础上，对有烧心，反酸及反食管等胃食反流症状者，按症状轻重记分，根据总分将有症状者分为低分组（６～９分）中分组（１０～１２分）从高分组（≥１３分），并按随机原则分别抽取２０，１０及１０例，进行２４ｈ食管ｐＨ监测及胃镜检查，结果发现：各有症状组异常胃食管反流（ＡＧＥＲ）及胃食管反流病（ＧＯＲＤ）发生率均明显高于对照组（Ｐ〈０．０５）。高分组反流性食管炎（     

鼠类双微体2癌基因,P53蛋白与星形细胞瘤的预后

探讨鼠类双微体２癌基因（ＭＤＭ２）,Ｐ５３蛋白在星形细胞瘤中的表达与肿瘤病理分级和预后之间的关系。以免疫组化ＳＡＢＣ法检测３６例确诊并有随访的星形细胞瘤中ＭＤＭ２和Ｐ５３蛋白。结果表明：ＭＤＭ２及Ｐ５３蛋白阳性表达率分别为４４．４％（１６／３６例）和３８．９％（１４／３６例）,其阳性率与患者年龄,性别无关,但与肿瘤病理分级呈显著正相关（分别为Ｐ〈０．０５,Ｐ〈０．０１）,３６例星形细胞瘤中ＭＤＭ２     

Barrett carcinoma of the esophagus: clinical and radiographic analysis of 34 cases

Review of 34 cases of pathologically proved Barrett-type adenocarcinoma of the esophagus seen at the University of Michigan during 1962-1983 revealed that it constituted 5% of all carcinomas of the esophagus and 20% of all adenocarcinomas involving the esophagus during that period. Despite many similarities to conventional squamous cell carcinoma and gastric cardiac carcinoma, certain distinguishing features were identified. Radiologically, diagnosis of Barrett carcinoma should be suggested when a patient with a longstanding history of gastroesophageal reflux, chronic esophagitis, and hiatus hernia with or without features of Barrett esophagus demonstrates a long vertical segment of esophageal involvement by an infiltrating or varicoid-appearing lesion. This review analyzes the clinical and radiologic distinguishing features of Barrett carcinoma and compares those of gastric cardiac carcinoma and conventional squamous cell carcinoma of the esophagus.     

Barrett esophagus as an extension of severe esophagitis: analysis of radiologic signs in 29 cases

Twenty-nine cases of Barrett esophagus verified by endoscopy and 16 cases confirmed by histology were reviewed for pertinent radiologic signs. All patients had barium-filled and mucosal relief films, and all but five cases had double-contrast films. Common radiologic signs in descending order were thickened and irregular mucosal folds (28/29), hiatal hernia (26/29), esophageal stricture (25/29), esophageal ulcer (20/29), distal esophageal widening (19/29), granular mucosal pattern (16/24), reticular mucosal pattern (9/24), and intramural pseudodiverticula (6/29), all of which are also recognized signs of reflux esophagitis. Midesophageal stricture, esophageal ulcer, and distal esophageal widening were particularly indicative of Barrett esophagus. Since there appears to be no specific sign of Barrett esophagus, a multifaceted approach is suggested concentrating on the association of Barrett esophagus with the radiographic signs of severe reflux esophagitis.     

Adenocarcinoma of the esophagus in patients with scleroderma

Three cases of patients with esophageal involvement by scleroderma, chronic reflux esophagitis, and adenocarcinoma of the distal esophagus are presented. An underlying columnar metaplasia (Barrett esophagus) was identified in two patients and postulated in the third. It is believed that scleroderma patients with symptomatic chronic gastroesophageal reflux should be investigated for Barrett epithelium. If it is present, these patients should be followed and considered as having an increased risk for development of adenocarcinoma of the esophagus.     

Early esophageal cancer

Early esophageal cancer (EEC) accounted for only seven (4.7%) of 148 cases of esophageal cancer diagnosed at the authors' hospital between 1977 and 1984. Two patients with EEC had squamous cell carcinoma and five had adenocarcinoma arising in Barrett's mucosa. All seven patients had associated clinical findings, including low-grade gastrointestinal bleeding (three cases), odynophagia (one case), and chronic reflux symptoms due to underlying reflux esophagitis and Barrett esophagus (three cases). Since Barrett esophagus is a premalignant condition, the high proportion of adenocarcinomas in this series presumably reflects the more frequent radiologic evaluation of symptomatic patients with Barrett esophagus. On esophagography, four patients had 3-4.5-cm polypoid intraluminal masses that could not be distinguished radiographically from advanced esophageal carcinoma. In the other three patients, esophagrams revealed secondary achalasia, irregular flattening of the esophageal wall, and diffuse nodularity of the mucosa. The authors conclude that "early" esophageal cancers are not necessarily small cancers, since they may undergo considerable intraluminal or intramural growth and still be classified histologically as EEC. Radiologists should be aware of these findings, since EEC has an excellent prognosis with a 5-year survival approaching 90%.     

Pseudomembranes in reflux esophagitis

Three cases are presented in which double-contrast esophagograms revealed one or more plaquelike lesions in the distal esophagus, representing pseudomembrane formation in patients with severe reflux esophagitis. Although to our knowledge this finding has not been reported previously in the radiologic literature, pseudomembranes have been documented endoscopically in patients with reflux esophagitis and biopsy-proved Barrett esophagus. Radiologists should be aware of this finding, since these pseudomembranes may be indistinguishable radiographically from plaquelike carcinomas arising in Barrett esophagus.     

应用聚合酶链反应——单链构象多态技术检测大肠癌P53基因的研究

 为探讨P<'53>基因突变在大肠癌发生过程中的分子机制,应用聚合酶链反应一单链构象多态性(PGR-SS-CP)技术对30例大肠腺癌组织中P<'53>基因外显子5、6、7和8分别进行检测.结果发现16例(53.33%)大肠癌组织出现了反映P<'53>基因突变的异常条带.高、中、低分化腺癌中P<'53>基因突变率分别为33.33%、50%和70%.提示P<'53>基因突变与大肠癌的发生和发展有关.PCR-SSCP能在DNA片段的不同部位检测DNA多态性和点突变,且灵敏、快速.该方法对大肠癌的基因诊断具有应用价值.     

p53,p16,PCNA蛋白在食管癌中的表达及其临床意义

目的探讨p53,p16,PCNA蛋白在食管癌中的表达及临床意义。方法用免疫组织化学染色SP法对62例食管癌标本进行p53,p16,PCNA蛋白测定。结果62例食管癌中,p53,PCNA蛋白阳性表达均为71.0%(44/62),p16缺失率48.4%(30/62)。p16缺失与肿瘤浸润深度、淋巴结转移密切相关(P<0.05、P<0.01)。而p53,PCNA蛋白同时表达56.5%(35/62),亦与肿瘤浸润深度、淋巴结转移密切相关(P<0.05、P<0.01)。结论食管癌p53,PCNA蛋白同时表达及p16缺失可视为危险预后因素。     

Esophageal involvement in Zollinger-Ellison syndrome

Review of 18 patients with Zollinger-Ellison syndrome (ZES) revealed pathologic evidence of esophageal disease in six (33%). Four patients manifested varying degrees of esophagitis, ranging from mild to severe ulcerations and stricture formation. In two patients, symptomatic Barrett esophagus was detected 4 and 6 months after total gastrectomy, respectively. It is postulated that due to longstanding gastroesophageal reflux, Barrett esophagus was present in these two patients before total gastrectomy, and esophageal symptoms became only apparent after more compelling symptoms of gastric peptic ulceration were controlled by definitive surgery. Esophageal involvement occurs with greater frequency in patients with ZES; the previously held notion that esophageal disease due to gastroesophageal reflux in ZES patients is uncommon is contrary to the results of this study. It is recommended that all patients with ZES irrespective of symptom-complex should be routinely evaluated for the presence or absence of esophageal disease because of its important bearings on adequate surgical management.     

Expression of p53 protein in Barrett's adenocarcinoma and adenocarcinoma of the gastric cardia and antrum

BACKGROUND/AIM: Most studies of esophageal and gastric adenocarcinomas have shown a very high rate of p53 gene mutation and/or protein overexpression, but the influence of the tumour site upon the frequency of p53 protein expression has not been evaluated (gastroesophageal junction, Barret's esophagus, and antrum). The aim of our study was to analyze the correlation between the selected clinico-pathological parameters, and p53 protein overexpression in regards to the particular tumour location. METHODS: The material comprised 66 surgical specimens; 10 were Barrett's carcinomas, 25 adenocarcinomas of the gastric cardia (type II adenocarcinoma of the esophagogastric junction - EGJ), and 31 adenocarcinomas of the antrum. Immunostaining for p53 protein was performed on formalin-fixed, paraffin-embedded tissue sections, using the alkaline phosphatase antialkaline phosphatase (APAAP) method. The cases were considered positive for p53 if at least 5% of the tumour cells expressed this protein by immunostaining. RESULTS: There was no significant difference observed between the studied groups in regards to age, sex, Lauren's classification and tumour differentiation. There was, however, a significant difference observed in the depth of tumour invasion between Barrett's adenocarcinoma and adenocarcinoma of the cardia compared with the adenocarcinoma of the antrum. Namely, at the time of surgery, both Barrett's adenocarcinomas and adenocarcinomas of the cardia, were significantly more advanced comparing with the adenocarcinomas of the antrum. Overexpression of p53 was found in 40% (4/10) of Barrett's adenocarcinomas, 72% (18/25) of adenocarcinoma of the cardia and 65% (20/31) of adenocarcinoma of the antrum. No significant differences in p53 expression in relation to sex, type (Lauren) of tumour, depth of invasion, lymph node involvement, or tumour differentiation were observed in any of the analyzed groups of tumours. Patients with more advanced Barrett's adenocarcinoma and in the cases of lymph node invasion revealed tendency for the greater p53 positivity compared with the early forms and lymph node-negative cases; however, this difference was not significant according to the statistical analysis. With regard to adenocarcinoma of the cardia, higher rates of p53 positivity were recorded in poorly differentiated, more advanced cases with lymph node invasion. Nevertheless, none of these differences was statistically significant. On the contrary, in the patients with adenocarcinoma of the antrum, greater p53 positivity was revealed in early forms without lymph node involvement, but the observed difference was not statistically significant. CONCLUSION: No significant differences in p53 protein expression in terms of sex, type (Lauren) of tumour, depth of invasion, lymph node involvement, or tumour differentiation were observed in any of the analyzed groups of tumours (Barrett's adenocarcinoma, adenocarcinoma of the cardia and adenocarcinoma of the antrum).     

Barrett食管及相关并发症的X线探讨

目的:通过16例经内窥镜及病理证实为Barrett食管的钡餐检查表现,初步探讨Barrett食管及其并发症放射学检查的意义。方法:回顾性分析16例Barrett食管的内窥镜和气钡检查的记录及表现,着重探讨气钡检查的X线表现。结果:食管内窥镜和组织学检查全部病例均有炎症改变,其他可见胃食管反流、食管溃疡和食管腺癌。放射学钡餐检查结果:Barrett食管炎4例,Barrett食管溃疡7例,Barrett食管癌5例。结论:Barrett食管及其并发症至今无明确放射学征象,改进对“Z”线的检查技术和方法,有可能提高其发现率。钡餐发现胃食管反流、食管裂孔疝同时并发食管炎、食管溃疡及食管癌者均应考虑到本症的可能。