Role of TGF-β1 and its Receptors in Breast Carcinogenesis:Evaluation of Gene Expression Patterns and Clinical Implications

OBJECTIVE Transforming growth factor β1 (TGF-β1) is a multifunc-tional cytokine that may play an important role in tumor development and progression. METHODS We evaluated gene expression patterns of TGF-β1 and its receptors [transforming growth factor β type I receptor (TβR-Ⅰ) and transforming growth factor β type II receptor (TβR-Ⅱ)] in tumor tissue from patients with breast cancer or with benign breast diseases (BBD) and adja-cent normal tissue from the patients with breast cancer. Included in the study were 527 breast cancer patients and 213 BBD patients who participated in the Shanghai Breast Cancer Study. RESULTS The expression levels of the TGF-β1, TβR-Ⅰand TβR-Ⅱ genes in breast tissue were quantified using real-time PCR. TβR-Ⅱ expres-sion in cancer tissue was decreased by over 50% as compared to either adjacent normal tissue from the same patients or benign tumor tissue from BBD patients (p<0.001). TGF-β1 expression was lower by approximately 20% in cancer tissue compared to adjacent normal tissue (p=0.14) or to be-nign tumor tissue (p=0.002). Although TβR-Ⅰ expression was also reduced in cancer tissue compared to adjacent normal tissue, or benign tumor tissue, the magnitude of the reduction was less apparent than that for TβR-Ⅱ. Compared to patients with the lowest tertile value for TβR-Ⅱ, patients with median tertile value for TβR-Ⅱ had more favorable overall survival (HR 0.47, 95% CI 0.27-0.85) and disease-free survival (HR 0.65, 95% CI 0.39-1.06). No apparent associations, however, were observed between TGF-β1 or TβR-Ⅰ expression and overall or disease-free survival. CONCLUSION The results from this study support the hypothesis that a decreased level of TβR-Ⅱ gene expression, and thus reduced TGF-β1 sensitivity, is related to breast tumor progression.     

The Effects of Microwave Ablation and Surgical Resection on Hematogenous Dissemination of Cancer Cells in Treating Patients with Small Primary Hepatocellular Carcinoma

OBJECTIVE To conduct a comparative study of the effects of treatment using microwave ablation versus surgical resection on hematogenous dissemination of cancer cells, and on the level of immune cells of the peripheral blood in patients with small primary hepatocellular carcinoma (PHC,≤5 cm). METHODS Forty patients with small PHC (maximal diameter≤5 cm) were divided into a microwave group (19 cases) and a surgical operation group (21 cases). A real-time (RT) quantitative nested RT-PCR examination was performed for peripheral blood alpha-fetoprotein (AFP) mRNA. Studies were conducted to determine the level of CD3, CD4, CD8 and CD4/CD8 cells and for liver function at 30 min before, and 30 min,1 day and 3 days after the treatment. RESULTS Compared to the value before ablation, no obvious changes of CD3, CD4, CD8 and CD4/CD8 cells were found in patients of the microwave group within 7 days after ablation, but CD3, CD4 and CD4/CD8 cells in the operation group were lower compared to that before operation. The copy number of AFP mRNA in the peripheral blood samples of the patients of the 2 groups before operation was determined in 67.5% of the patients (27/40). There was an rise in the expression after treatment but no statistical difference was found in comparing the 2 groups. Follow-up of the patients was conducted for 1 to 16 months. For patients with continuous expression of peripheral blood AFP mRNA, the possibility of relapse and metastasis was increased. CONCLUSION Surgical resection or microwave ablation can cause more exfoliation of hepatoma carcinoma cells in the peripheral blood of patients with small PHC. The immune function of peripheral blood cells decreased in the patients after surgical resection, however, the immune function was better protected following microwave ablation. Microwave ablation causes minor reduction in liver function, and the treatment method presents a definite value for PHC therapy.     

Overexpression of Gli1 in cancer interstitial tissues predicts early relapse after radical operation of breast cancer

Objective:To investigate whether Gli1 expression is important in relapse after radical operation of breast cancer.Methods:Using immunohistochemistry,Gli1 expression was analyzed in human primary breast cancer(n=284) and paracancerous tissues(n=20),and also in local lymph nodes(n=28) and metastatic lymph nodes(n=28).Results:Initial analysis of Gli1 expression in a small cohort of 20 breast tumors and their paracancerous tissues showed a tendency towards Gli1 overexpression in breast cancer tissues(P<0.001).Further,Gli1 expression in 284 breast cancer tissue samples was analyzed and a significant correlation was found between increased expression of nuclear Gli1 and unfavorable recurrence-free survival(RFS)(P<0.05).The nuclear expression of Gli1 in metastatic lymph nodes following relapse after radical operation was much higher than that in the local lymph nodes of primary carcinoma(P<0.05).Most interestingly,the expression of Gli1 was much higher in the interstitial tissues of the relapsed group than of the non-relapsed group(P<0.001).Conclusions:Breast cancer shows a high prevalence of Gli1 expression,which is significantly correlated with aggressive features and unfavorable RFS.Nuclear Gli1 overexpression,especially in the interstitial tissues,signified early relapse after radical operation of breast cancer.     

黏蛋白-1和细胞角蛋白-20在食管癌中的表达及意义

Objective To investigate the expressions and clinical significances of MUC1-mRNA and CK20-mRNA in peripheral blood of esophageal cancer patients.Methods MUC1-mRNA and CK20-mRNA were detected in 53 patients with esophageal cancer,10 patients with esophageal benign tumor and 20 healthy volunteers by RT-PCR technique.Results The expressions of MUC1-mRNA,CK20-mRNA and combining group were 35.85 % (19/53),49.06 % (26/53) and 62.26 % (36/53) in peripheral blood of 53 esophageal cancer patients.In control group,there was no expression of MUC1-mRNA and CK20-mRNA in peripheral blood of 10 patients with benign esophageal disease and 20 healthy volunteers.The positive rate increased by combining test(x2 =11.0228,P ＜0.05).Conclusion MUC1-mRNA and CK20-mRNA might be specific and sensitive markers to detect circulating tumor cells in peripheral blood and their expressions are closely related to TNM stages of the esophageal cancer patients.The combining test might be of high value of the diagnosis of micrometastasis.     

黏蛋白-1和细胞角蛋白-20在食管癌中的表达及意义

Objective To investigate the expressions and clinical significances of MUC1-mRNA and CK20-mRNA in peripheral blood of esophageal cancer patients.Methods MUC1-mRNA and CK20-mRNA were detected in 53 patients with esophageal cancer,10 patients with esophageal benign tumor and 20 healthy volunteers by RT-PCR technique.Results The expressions of MUC1-mRNA,CK20-mRNA and combining group were 35.85 % (19/53),49.06 % (26/53) and 62.26 % (36/53) in peripheral blood of 53 esophageal cancer patients.In control group,there was no expression of MUC1-mRNA and CK20-mRNA in peripheral blood of 10 patients with benign esophageal disease and 20 healthy volunteers.The positive rate increased by combining test(x2 =11.0228,P ＜0.05).Conclusion MUC1-mRNA and CK20-mRNA might be specific and sensitive markers to detect circulating tumor cells in peripheral blood and their expressions are closely related to TNM stages of the esophageal cancer patients.The combining test might be of high value of the diagnosis of micrometastasis.     

乳腺癌特异性标志物人乳腺小黏蛋白的检测及临床意义

目的通过检测乳腺癌特异性的标志物人乳腺小黏蛋白（hSBEM）在良、恶性乳腺组织及外周血中表达，探讨其作为乳腺癌细胞血行转移标志物的可能性。方法应用巢式逆转录聚合酶链反应（nested-RT-PCR）技术，对67例乳腺癌、癌旁正常乳腺组织，16例乳腺良性肿瘤组织和患者外周血，以及20位健康志愿者外周血hSBEM的表达进行检测；同时分析胃癌、大肠癌、食管癌、肺癌和卵巢癌各5例组织中hSBEM的表达情况。结果hSBEM在乳腺癌、乳腺良性疾病及正常乳腺组织中的表达分别为92．54％（62／67）、87．50％（14／16）及88．05％（59／67），3组间差异无统计学意义（P〉0．05）；hSBEM在非乳腺癌的其他癌组织中无表达。67例乳腺癌患者外周血hSBEM检出率为50．75％（34／67），转移性及伴淋巴结转移乳腺癌患者外周血中hSBEM表达率明显高于局限性乳腺癌及无淋巴结转移者（P〈0．05）；hSBEM在健康人及乳腺良性疾病患者外周血中均无表达。hSBEM的表达与患者的年龄、原发肿瘤大小、病理类型、ER和PR的状态无关（P〉0．05）。结论hSBEM特异性表达于乳腺组织，乳腺癌患者外周血检测出hSBEM提示已有癌细胞进入血液循环，因此可作为检测乳腺癌血行微转移的标志物。     

乳腺癌患者外周血SBEM mRNA的检测及其临床意义

背景与目的乳腺癌患者的死亡原因几乎均为肿瘤远处转移。目前乳腺癌诊断尚无公认的特异性标志物,本文旨在探讨特异性的乳腺癌标志物─乳腺小粘蛋白(smallbreastepithelialmucin,SBEM)在乳腺癌外周血的表达及其意义。方法用巢式逆转录聚合酶链反应(Nested-RT-PCR)技术检测67例乳腺癌、16例乳腺良性肿瘤及20例健康志愿者外周静脉血中的SBEMmRNA的表达情况。结果SBEMmRNA在健康志愿者及乳腺良性肿瘤患者外周血中表达均为阴性;67例乳腺癌患者外周血中SBEMmRNA表达率为50.7%(34/67),在乳腺癌患者的临床分期Ⅰ、Ⅱ、Ⅲ和Ⅳ期中SBEMmRNA表达率分别为25.0%(2/8)、45.8%(11/24)、43.8%(7/16)和73.7%(14/19),在Ⅳ期乳腺癌患者外周血中SBEMmRNA的检出率明显高于其他各期(P<0.05)。SBEMmRNA的表达与患者年龄、原发癌灶大小、病理类型、ER和PR的状态无关(P>0.05)。结论SBEMmRNA特异表达于乳腺癌患者的外周血,有可能作为判断乳腺癌血道微小转移的指标之一。     

非小细胞肺癌患者外周血CD44V6 mRNA表达与微转移的相关性研究

目的 探讨CD44V6 mRNA表达与非小细胞肺癌(NSCLC)外周血微转移的关系及临床意义,及其与CK19 mRNA在外周血中联合检测的临床意义.方法 应用免疫组化SP法检测56例NSCLC癌组织中CD44V6 mRNA的表达情况,应用逆转录聚合酶链反应(RT-PCR)技术检测外周血中CD44V6 mRNA与CK19 mRNA的表达情况.采集20例肺部良性病变患者正常肺组织和外周血作对照.结果 CD44V6 mRNA在NSCLC癌组织中表达明显高于良性病变正常肺组织(P<0.001),其阳性表达率在各病理分期间、有无淋巴结转移组间的差异具有统计学意义(P<0.05),而在各病理类型间差异无统计学意义(P>0.05).NSCLC患者外周血中CD44V6 mRNA阳性表达率高于对照组(P<0.05),其阳性表达率在各病理分期间、有无淋巴结转移间的差异具有统计学意义(P<0.05).CD44V6 mRNA在NSCLC组织中表达与外周血中表达呈正相关,NSCLC外周血中CD44V6 mRNA与CK19 mRNA表达呈正相关;CD44V6 mRNA与CK19 mRNA联合检测灵敏度为75.0%,优于单基因检测(P<0.05).结论 NSCLC外周血中CD44V6 mRNA的高表达与其侵袭转移有关,CD44V6 mRNA可作为检测NSCLC外周血微转移的分子肿瘤标志物,并有望成为判定NSCLC预后的分子标志物;CD44V6 mRNA与CK19 mRNA联合检测可提高NSCLC血行微转移诊断的敏感度.     

p185,p170、Ki-67和CD44V6的表达与原发性乳腺癌预后的关系

目的 探讨p185、p170、Ki-67和CD44V6表达与原发性乳腺癌分期、淋巴结转移和预后的关系。方法 采用免疫组化S-P法对160例原发性乳腺癌组织进行p185、p170、Ki-67和CD44V6的检测。结果 随着肿瘤分期的提高,p185、p170、Ki-67和CD44V6的阳性表达均明显增加。p185、Ki-67和CD44V6表达在腋窝淋巴结转移病例明显高于无腋窝淋巴结转移病例(P<0.05或P<0.001),p170表达在转移组亦有增高趋势(X2=2.4)。4种标志物在死亡组病例的表达高于生存组(P<0.05或P<0.001)。结论p185、p170、Ki-67和CD44V6联合检测对于判断乳腺癌预后和指导治疗有实用价值。     

乳腺癌患者骨髓中人乳腺珠蛋白mRNA的检测及其临床意义

目的探讨乳腺癌患者骨髓中人乳腺珠蛋白（hMAM）mRNA的表达及其临床意义。方法应用巢式RT—PCR技术,同时检测75例乳腺癌患者、15例乳腺良性病变患者和8例健康人骨髓中hMAMmRNA的表达,分析hMAMmRNA表达与临床病理因素、Ki67、p53和血管内皮生长因子（VEGF）的关系。结果RT—PCR检测的敏感度达到10^-6。75例乳腺癌患者中,21例检测出hMAMmRNA阳性表达,阳性表达率为28．0％。hMAMmRNA阳性表达与乳腺癌腋窝淋巴结转移和PR状况有关（P〈0．05）,与年龄、肿瘤大小、临床分期和ER状况无关（P〉0．05）;与乳腺癌组织Ki67表达呈正相关（X^2=4．936,P=0．026）。乳腺良性病变患者和健康人骨髓中,未检测到hMAMmRNA表达。结论应用RT—PCR方法检测乳腺癌骨髓中hMAMmRNA的表达,敏感度高、特异性好。hMAMmRNA可作为检测乳腺癌患者骨髓中播散肿瘤细胞的分子指标之一,可为乳腺癌患者的治疗和预后判断提供帮助。     

CD44在卵巢上皮性肿瘤中的表达及其临床意义

目的研究黏附分子CD44在卵巢上皮性肿瘤中的表达及其表达与卵巢癌临床特征的关系。方法应用RT-PCR、巢式PCR、光密度扫描和免疫组化等方法,从mRNA和蛋白两个水平检测了卵巢上皮性肿瘤中CD44的表达,并分析了其与临床病理特征的关系。结果CD44标准型(CD44H)在恶性组和良性组中的蛋白表达率分别为61.5%和18.8%,差异有显著性;CD44HmRNA定量分析     

乳腺癌患者外周血中PIP mRNA检测的临床意义

目的:探讨泌乳素诱导蛋白(PIP)mRNA作为标志检测乳腺癌患者外周血中微转移的可能性。方法:用逆转录-聚合酶链反应(RT-PCR)法,检测69例乳腺癌患者外周血中PIPmRNA表达情况,另抽取28例乳腺良性疾病患者和10例健康志愿者外周血标本作为对照组。结果:69例乳腺癌患者外周血中PIPmRNA有21例表达,阳性率为30.4%,对照组中PIPmRNA表达均为阴性。两组比较差异有统计学意义,P<0.05。PIPmRNA的阳性表达与患者的淋巴结转移状况差异有统计学意义,P<0.05;而与患者的年龄、原发肿瘤大小、分期、病理类型、ER、PR等差异均无统计学意义,P>0.05。结论:PIPmRNA可能作为标志来检测乳腺患者外周血中微转移。