p21WAF1基因对人食管鳞癌细胞增殖的抑制作用

目的:探讨p21WAF1( p21)基因转染对食管鳞癌细胞系EC109细胞增殖的影响.方法:根据转染质粒的不同和是否进行质粒转染分为3组.p21转染组:用脂质体Lipofectamine2000介导将pCDNA3.1(+)- p21质粒转染入EC109细胞; 空载体转染组:同样方法将pCDNA3.1(+)-neo质粒转染入EC109细胞; 未转染组:未转染的EC109细胞.应用RTPCR、Western blot分别检测p21基因mRNA、P21蛋白变化; 流式细胞仪分析细胞周期变化,应用MTT、流式细胞仪和透射电镜检测转染外源p21基因对EC109细胞增殖和凋亡的影响.结果:p21转染细胞中p21 mRNA和P21蛋白高表达; p21转染组EC109细胞生长速度低于空载体组和未转染组; 流式细胞仪观察到P21蛋白高表达使EC109细胞发生G1/S阻滞,G1期细胞比例显著高于空载体组和未转染组(63.120%±2.893% vs 41.380%±6.536%,42.173%±5.301%,均P<0.01),S期比例显著低于空载体组和未转染组(18.923%±3.084%vs 22.573%±5.463%,26.867%±2.922%,均P<0.01),并出现亚G1峰(凋亡峰).透射电镜亦发现p21转染组发生细胞凋亡.结论:p21基因转染可以抑制人食管鳞癌细胞系EC109细胞增殖并能诱导其发生细胞凋亡.     

HnRNP A2/B1及p21WAF1蛋白在非小细胞肺癌中表达及意义

目的探讨核内不均一核糖核蛋白A2/B1（hnRNP A2/B1）和p21WAF1蛋白在人非小细胞肺癌（NSCLC）组织中的表达,并进行相关性分析。方法采用免疫组化S-P法检测53例NSCLC组织、40例癌旁组织、7例肺良性病变组织中hnRNPA2/B1和p21WAF1表达。结果 NSCLC组织中hnRNP A2/B1和p21WAF12种蛋白的阳性表达率分别为66.0%和45.2%,显著高于癌旁肺组织和肺良性病变肺组织,差异有统计学意义（P〈0.05）。它们均与分化程度、淋巴结转移有关（P〈0.05）,与组织类型、临床分期无关（P〉0.05）。两种蛋白在NSCLC表达呈显著负相关（P=0.001）。结论 hnRNP A2/B1可能通过下调p21WAF1的表达而缩短细胞周期,促进NSCLC的癌细胞增殖。     

p21WAF1基因对人胰腺癌细胞系BxPC-3增殖的抑制作用

目的: 探讨p21WAF1( p21)基因转染对人胰腺癌细胞系BxPC-3细胞增殖的影响.方法: 根据转染质粒的不同和是否进行质粒转染分为3组, p21转染组、空载体转染组和未转染组. 应用RT-PCR和Western blot方法检测转染细胞的p21基因表达变化; 流式细胞仪分析细胞周期变化, 用MTT、流式细胞仪和透射电镜检测转染外源p21基因对BxPC-3细胞增殖和凋亡的影响.结果: p21转染组细胞存在p21 mRNA高表达和P21蛋白高表达; p21转染组细胞生长速度低于对照空载体转染组和未转染组; 流式细胞仪观察到P21蛋白高表达使BxPC-3细胞发生G1/S阻滞, G1期细胞比例显著高于空载体组和未转染组(59.887%±3.700% vs 47.443%±6.354%, 49.223%±2.226%, P<0.05), S期显著低于空载体组和未转染组(21.277%±2.080%v s 35.247%±3.966%, 36.013%±1.540%,P<0.01), 并出现亚G1峰(凋亡峰). 透射电镜亦发现p21转染组发生细胞凋亡.结论: p21基因转染可以抑制人胰腺癌细胞系BxPC-3细胞增殖并能诱导其发生细胞凋亡.     

p15INK4B和p21WAF1基因联合转染对人食管鳞癌细胞系EC109的协同抑制作用

目的:探讨p15INK4B和p21WAF1基因联合转染对人食管鳞癌细胞系EC109细胞增殖和凋亡的影响.方法:脂质体介导PcDNA3.1(+)-p15和pcDNA3.1(+)-p21转染EC109细胞,稳定筛选后用RT-PCR检测转染细胞p15与p21基因mRNA表达,Western blot检测转染细胞P15和P21蛋白的表达.用MTT法和透射电镜检测p15和p21基因分别及联合转染对EC109细胞增殖与凋亡的影响,流式细胞仪检测EC109细胞周期分布与凋亡率.结果:p15和p21转染组EC109细胞生长速度低于空载体组与未转染组,联合转染组与二者单独转染组相比.亦明显抑制EC109细胞体外生长速度.p15和p21转染组EC109细胞发生G1/S阻滞,G1期细胞比例显著高于空载体组和未转染组,S期则显著降低(G1期:60.52%±3.75%,63.12%±2.89% vs 42.17%±5.30%.41.38%±6.54%;S期:22.67%±1.25%,17.96%±2.03% vs 30.96%±3.33%,36.05%±1.78%,均P<0.01),并出现凋亡峰,透射电镜亦发现p15和p21转染组发生细胞凋亡,联合转染组发生更为明显的G1/S阻滞,G1期比例显著升高、S期比例明显降低(G1期:72.83%±2.31% vs60.52%±3.75%,63.12%±2.89%:S期:13.59%±2.59% vs 22.67%±1.25%,17.96%±2.03%.均P<0.05),凋亡率明显升高(21.21%±1.78%vs 4.32±1.74%,10.83%±2.40%,均P<0.01).结论:p15和p21基因联合转染在体外可以进一步增强对人食管鳞癌EC109细胞的抑制与诱导凋亡作用.     

结直肠癌中CDX2、p21~(H-ras)、p21~(WAF1)表达的临床意义

背景:CDX2与肠源性肿瘤的发生密切相关,而p21表达减低或缺失可能是结直肠癌发生、发展中的一个普遍事件。目的:探讨结直肠癌中CDX2、p21~(H-ras)、p21~(WAF1)表达的相关性和临床病理意义。方法:收集45例临床病理资料完整的结直肠癌手术切除标本,以免疫组化方法检测癌组织和相应癌旁组织中的CDX2、p21~(H-ras)、p21~(WAF1)蛋白表达。结果:结直肠癌组织中CDX2、p21~(H-ras)、p21~(WAF1)阳性率分别为86.7%、68.9%和35.6%,相应癌旁组织中阳性率分别为100.0%、37.8%和51.1%,CDX2和p21~(H-ras)在癌组织和癌旁组织中的阳性率差异有统计学意义(P=0.026和P=0.006);半定量分析结果显示CDX2和p21~(WAF1)在癌组织和癌旁组织中的表达水平差异有统计学意义(P=0.007和P=0.005)。癌组织中CDX2与p21~(H-ras)的表达存在相关性(r_s=0.501,P=0.000)。Dukes A、B期患者癌组织p21~(WAF1)阳性率显著高于C、D期患者(P=0.016),有淋巴结转移者p21~(WAF1)阳性率显著低于无淋巴结转移者(P=0.048),CDX2、p21~(H-ras)的表达与结直肠癌各临床病理特征均无相关性。结论:CDX2、p21~(H-ras)、p21~(WAF1)表达改变可能与结直肠癌的发生、发展相关。     

KLF6、p21^WAF1/CIP1、CyclinD1在结直肠癌中的表达及意义

目的研究转录因子KLF6、p21WAF1/C IP1及Cyc linD1在结直肠癌中的表达及意义。方法应用免疫组化Envision法对58例结直肠癌组织、20例结直肠黏膜慢性炎症组织中的KLF6、p21WAF1/C IP1及Cyc linD1蛋白表达进行检测。结果结直肠癌组织KLF6、p21WAF1/C IP1及Cyc linD1蛋白表达率均与结直肠黏膜慢性炎症组织比较有统计学差异（P〈0.05）;KLF6、p21WAF1/C IP1及Cyc linD1蛋白在结直肠癌组织中的表达与其浸润深度及预后有关（P〈0.05）。结论 KLF6、p21WAF1/C IP1及Cyc linD1在结直肠癌的发生发展中可能起重要作用。     

p21~(WAF1/CIP1/SDI1)在大鼠肾脏组织的增龄性变化及意义

目的 研究p21野生型p53活化片段1/细胞周期蛋白依赖性激酶影响蛋白1/衰老细胞衍生抑制剂1(p21WAF1/CIP1/SDI1)在大鼠肾脏中随年龄增长的表达变化规律. 方法 取3月龄、12月龄及24月龄健康雄性Wistar大鼠肾组织进行衰老相关β-半乳糖苷酶(SA-β-gal)活性染色,TUNEL法检测细胞凋亡,采用逆转录多聚酶链反应(RT-PCR)和Western印迹法(Western blot assay)分别在基因及蛋白质表达水平上检测肾脏组织中p21WAF1/CIP1/SDI1的表达变化,并用免疫组化法检测p21WAF1/CIP1/SDI1在肾脏组织中的表达与定位. 结果 大鼠肾脏组织SA-β-gal活性随年龄增长逐渐增强,凋亡细胞也随年龄增长逐渐增加(P＜0.05);p21WAF1/CIP1/SDI1 mRNA表达随年龄增长逐渐增强,不同月龄比较差异有统计学意义(P＜0.05).Western印迹亦显示p21WAF1/CIP1/SDI1蛋白表达随鼠龄增加逐渐增强(P＜0.05).免疫组化结果显示,p21WAF1/CIP1/SDI1蛋白表达于大鼠肾小球足细胞,其在肾小管与间质细胞中也有表达,且随年龄增长表达增加(P＜0.05). 结论 p21WAF1/CIP1/SDI1在大鼠肾脏组织中的表达随年龄增加而增强,可作为肾脏组织中重要的衰老指标.     

P21/WAF1 is an independent survival prognostic factor for patients with hepatocellular carcinoma after resection.

BACKGROUND/AIMS: The cyclin kinase inhibitor p21/WAF1 is regulated by p53-dependent or independent pathways and inhibits the action of proliferating cell nuclear antigen (PCNA). The prognostic role of p21/WAF1 in hepatocellular carcinoma (HCC) is ambiguous. To further clarify this, we examined the expression of three genes in HCC. METHODS: A total of 122 resected HCC specimens were collected from 1987 to 1998. Expression of p21/WAF1, p53, and PCNA in HCC was analysed by immunohistochemistry. RESULTS: Immunoreactivity was detectable for p21/WAF1 in 37%, and for p53 in 41.8% of HCCs. Positive expression of both genes does not relate to each other, but both are associated with a high PCNA labelling index (LI) (P<0.05) in tumour. p53 (+) is also associated with high serum alpha-foetoprotein (alphaFP) (P<0.001), tumour dedifferentiation (P=0.001) and advanced pathologic stages (P=0.017). However, p21/WAF1 (+) did not show clinicopathologic significance. Survival analysis indicated that poor prognostic factors were p21/WAF1 (-) (P=0.024), p53 (+) (P=0.008), high PCNA (P<0.001), tumour without capsule (P=0.001), poor tumour differentiation (P=0.004), advanced pathologic stage (P<0.001), and high serum alphaFP(P<0.001). Independent factors were p21/WAF1 expression, pathologic stage, and PCNA. CONCLUSION: In HCC, increased proliferation index PCNA is significantly associated with positive p53 and p21/WAF1. But p21/WAF1 expression did not relate to p53 expression. P21/WAF1 (+) is a good event and serves as an independent survival prognostic factor for HCC, which is a novel finding apart from previous reports.     

Role of podoplanin expression in esophageal squamous cell carcinoma: a retrospective study

Lymphatic metastasis is the predominant cause of the low overall survival of patients with esophageal squamous cell carcinoma (ESCC), as there are no faithful methods available predicting early metastasis. Recent studies suggest an effect of podoplanin expression on metastatic spreading to lymph nodes. The purpose of this study was to investigate the influence of podoplanin expression on lymphatic metastasis and tumor cells, and to find the relationship between podoplanin expression and prognosis of patients with ESCC. We evaluated the level of podoplanin expression on tumor cells and the lymphatic vessel density change of tumor mass compared with normal tissue from the same patient through D2-40 immunohistochemistry staining, and analyzed associations between these two variables and various clinicopathologic parameters individually or conjunctively. There was an association between podoplanin expression and the frequency of lymph node metastases. In 45 patients (80%), podoplanin was expressed on the tumor cells. Twenty-one patients (37.5%) showed high levels of expression. The 5-year disease-free survival rate (5%) for patients with high levels of podoplanin expression was significantly lower (P < 0.001) than for patients with low and moderate expression of podoplanin (54% and 27%, respectively). We concluded that podoplanin is expressed frequently in ESCC, and that the expression of podoplanin on cancer cells, lymphatics, or both is correlated with lymphatic metastasis and clinical outcome.     

Risk factors of lymph node metastasis in T1 esophageal squamous cell carcinoma

Background and Aim: To perform endoscopic mucosal resection (EMR) for T1 esophageal cancer, it is essential to estimate the lymph node status exactly. In order to evaluate the feasibility of EMR for esophageal cancers, we evaluated the clinicopathological features of T1 esophageal squamous carcinomas with an emphasis on the risk factors and distribution patterns of lymph node metastasis. Methods: From 1994 to 2006, a total of 200 patients with T1 esophageal carcinoma were treated surgically in our institution. Among them, clinicopathological features were evaluated for 197 consecutive patients with T1 squamous cell carcinoma. Results: The frequency of lymph node involvement was 6.25% (4/64) in mucosal cancers and 29.3% (39/133) in submucosal cancers (P < 0.001). In patients with M1 (n = 32) and M2 (n = 14) cancers, no lymph node metastasis was found. In multivariate analysis, size larger than 20 mm, endoscopically non‐flat type, and endo‐lymphatic invasion were significant independent risk factors for lymph node metastasis. The differentiation of tumor cell was not a risk factor for lymph node metastasis. Conclusions: We suggest that EMR may be attempted for flat superficial squamous esophageal cancers smaller than 20 mm. After EMR, careful histological examination is mandatory.     

食管鳞癌组织中p34^cdc2的表达变化及意义

目的观察人食管鳞癌组织中细胞分裂周期蛋白p34^cdc2的表达,并探讨其临床意义。方法利用组织芯片技术结合免疫组化及蛋白免疫印迹法检测138例食管癌患者肿瘤组织和配对正常食管黏膜组织中的p34^cdc2蛋白。结果p34^cdc2在食管鳞癌组织的表达明显高于配对正常黏膜组织,P〈0.01。p34^cdc2表达与食管鳞癌临床分期、淋巴结转移有关（P均〈0.05）,与分化程度和肿瘤浸润深度等无关（P均〉0.05）。结论食管癌组织中p34^cdc2表达升高。p34^cdc2可促进食管癌的发生与发展。     

Expressions of p53, VEGF C,p21: could they be used in preoperative evaluation of lymph node metastasis of esophageal squamous cell carcinoma?

The prognosis of esophageal squamous cell carcinoma is primarily determined by staging. Although radiological methods have revealed lymph node metastasis preoperatively, these radiological findings cannot be correlated with pathological staging. The aim of this study was to compare the expressions of p53, vascular endothelial growth factor C (VEGF C) and p21 with lymph node metastasis in preoperative endoscopic biopsy and postoperative resection material. Tissue samples were taken from 40 patients who had undergone endoscopic biopsies and radical esophagectomies. The expressions of p53, VEGF C and p21 proteins in these sections were immunohistochemically examined. The expression of each antibody was characterized as a negative or positive reaction according to the pattern and intensity of semiquantitative immunostaining. The staining pattern of antibodies was divided into three groups: < 10% cancer cells were accepted to be (-), 10-50% were (+), heterogenous and > 50% were (+ +), homogenous. For each antibody, statistical correlation with conventional prognostic parameters such as localization, microscopic grade, stage, pathological lymph node metastasis and survival, were investigated. p53 expression was observed in 65.5% (19/29) of lymph node positive cases, whereas p53 was in 50% (20/40) of cases. VEGF C was in 65% (26/40) and p21 was in 15% (6/40) of cases. p53 has the specificity of 90.9% and sensitivity rate of 65.5% in detecting lymph node metastasis and positive predictive value was 95%. Expression of p53 was significantly correlated with stage and lymph node metastasis (P = 0.02 and P = 0.03, respectively). Prediction of lymph node metastasis by p53 was correlated independently and in coexpression with VEGF C (P < 0.01). There was no relation detected between p21 and other parameters. In esophageal squamous cell carcinoma (SCC), p53 and VEGF C expressions were correlated with pathologically positive lymph nodes. When preoperative staging has been insufficient in esophageal carcinoma cases, immunohistochemical analysis of p53 and VEGF C staining in tissues could be an aid to clinicians regarding lymph node metastasis.     

Clinicopathological and prognostic role of cyclin D1 in esophageal squamous cell carcinoma: a meta-analysis

Cyclin D1 is one of the most commonly over-expressed oncogenes; however, its role in esophageal squamous cell carcinoma (ESCC) remains controversial. We conducted a meta-analysis of 20 studies, comprising 2,041 patients to clarify this issue. In all studies, paraffin-embedded surgical specimens were collected and the status of cyclin D1 was determined by immunohistochemistry (IHC). The combined odds ratios (Ors) for cyclin D1 expression were 0.74 (95% confidence interval [CI]: 0.58-0.93) for well and moderately differentiated versus poorly differentiated tumors, 0.65 (95% CI: 0.45-0.94) for T1/T2 versus T3/ T4 tumors, 0.59 (95% CI: 0.39-0.90) for N0 versus N1 tumors, and 0.48 (95% CI: 0.33-0.71) for stage I/II versus stage III/IV diseases, respectively. The association between cyclin D1 expression and prognosis was examined in 10 studies, and the combined hazard ratio was 1.78 (95% CI: 1.49-2.12). Cyclin D1 expression level detected by IHC is associated with worst clinicopathological features and prognosis for ESCC.     

Pattern of lymph node metastases of esophageal squamous cell carcinoma based on the anatomical lymphatic drainage system

The recent anatomical studies of the esophagus showed that submucosal longitudinal lymphatic vessels connect to the superior mediastinal and the paracardial lymphatics and lymphatic routes to periesophageal nodes originate from the muscle layer. Using clinical data for lymph node metastasis, we verify these anatomical bases to clarify the rational areas of lymph node dissection in esophageal cancer surgery. Analysis was performed on 356 consecutive patients who underwent esophagectomy with three‐field dissection. Patients were divided into those with tumor limited within the submucosal layer and those with tumor invading or penetrating the muscle layer. Frequency of node metastasis was compared according to supraclavicular, upper mediastinum, mid‐mediastinum, lower mediastinum, perigastric and celiac areas. In patients with tumor limited to the submucosal layer, node metastasis was more frequent in the upper mediastinum and perigastric area than the mid‐ or lower mediastinum. Even in patients with tumor located in the lower esophagus, node metastasis was more frequent in the upper mediastinum than the mid‐mediastinum or lower mediastinum. In patients with tumor located in the mid‐esophagus, node metastasis was more frequent in the supraclavicular area than the mid‐mediastinum or lower mediastinum. In patients with tumor invading or penetrating the muscle layer, node metastasis in the mid‐ and lower mediastinum increased dramatically, but was still less frequent than those in the upper mediastinum or the perigastric area. Postoperative survival curves did not differ among the involved areas. The most predictive factor associated with lymph node metastasis for postoperative survival was not the area of involved nodes, but the number of involved nodes by multivariate analyses. These clinical results verify recent anatomical observations. The lack of difference in survival rates among the involved areas suggests that these areas should be staged equivalently. For adequate nodal staging, the upper mediastinum should be dissected for the lower esophageal tumor and supraclavicular areas should be dissected for the mid‐esophageal tumor even in patients with tumor limited to within the submucosal layer.     

肝胆管癌丙型肝炎病毒感染与p53和p21WAFD/CIP1异常表达的关系

为探讨丙型肝炎病毒（ＨＣＶ）感染与Ｐ５３和Ｐ２１ＴＷＡＦ－／ＣＩＰ１基因的关系。采用 化技术对２９例原发性肝胆管癌中ＨＣＶ抗原（ＮＳ５－Ａｇ）、ｐ５３和ｐ２１＾ＷＡＦＩ＝／ＣＩＰ１蛋白表达进行研究。结果：２９例胆管癌中ＮＳ５－Ａｇ、ｐ５３及Ｐ２１ＴＷＡＦＩ／ＣＩＰＩ蛋白表达进行研究。结果：２９例胆管癌中ＮＳ５－Ａｇ、Ｐ５３display structure     

曲古菌素A对食管癌EC1细胞增殖和细胞周期的影响及其分子机制

目的:探讨不同浓度曲古菌素A对食管癌细胞系EC1 细胞增殖、细胞周期的影响及其对细胞周期调控基因p21 WAF1/CIP1 表达的影响. 方法:用0.3,0.5,1.0 μmol/L 的TSA 处理EC1 细胞,MTT 检测TSA 作用24 、48 h 对EC1 细胞的抑制作用,流式细胞仪检测0.3,0.5,1.0 μmol/L 的TSA 作用24 h 后EC1 细胞周期的改变,Western blot 法检测p21 WAF1/CIP1 变化. 结果:TSA 在0.5 μmol/L 以上时对EC1 细胞有抑制作用;0.3 μmol/L TSA 处理细胞后细胞周期与对照组相比,无明显变化;0.5 μmol/L TSA 处理EC1 细胞后,G0/G1期细胞较对照组明显增加,S 期细胞较对照组明显减少(74.56% ±1.34% vs 62.12%±0.52%;14.52%±1.81% vs 27.50%±0.66%,均P <0.05);0.5,1.0 μmol/L TSA 处理细胞后p21 WAF1/CIP1 表达明显增加(均P<0.05). 结论:一定浓度的TSA 对人食管癌细胞EC 具有的增殖抑制作用,引起EC1 细胞发生G0/G1 期阻滞,其部分机制与p21 WAF1/CIP1 上调有关.     

食管鳞癌组织中STAT3蛋白的表达及临床意义

目的 探讨食管鳞癌组织和癌旁正常黏膜组织中信号转导子和转录激活子3（STAT3）的表达及与食管鳞癌发生发展的关系.方法 应用免疫组化SP法检测122例食管鳞癌及其癌旁正常黏膜组织中STAT3蛋白的表达.结果 食管鳞癌组织中STAT3蛋白表达阳性率为89.3%,明显高于癌旁正常黏膜组织的77%（P＜0.05）.Ⅰ级、Ⅱ级、Ⅲ级食管鳞癌组织中STAT3蛋白的阳性率分别为73.7%、89.5%和100%,Ⅲ级中STAT3蛋白的阳性率显著高于Ⅰ级（P＜0.05）.浸润至深层（深肌层和外膜）的食管鳞癌组织中STAT3蛋白阳性表达率为92.8%,明显高于浸润至浅层（黏膜和浅肌层）食管鳞癌组织的76%（P＜0.05）.STAT3的表达与淋巴结转移无关（P＞0.05）.结论 STAT3蛋白过度表达与食管鳞癌的发生发展及恶性演进有关,STAT3有望成为评估食管癌预后的一个新标志物.     

食管鳞癌患者根治性手术后早期死亡的危险因素分析

[目的]分析导致食管鳞癌患者手术后早期死亡的危险因素。[方法]回顾性分析确诊为食管鳞癌并行根治性手术切除的249例患者的临床资料,随访5年。采用χ2或Fisher精确概率法、t检验等分析所有可能导致患者在术后1年内死亡的因素。单因素及多因素Cox回归模型分析确定影响患者早期死亡最主要的危险因素,使用Kaplan-Meier法中的log-rank法对患者生存率进行统计学分析。[结果]249例中39例在术后1年内死亡(早期死亡组),其肿瘤的长度、浸润深度、淋巴结转移、TNM分期、淋巴结转移区域等与非早期死亡组相比差异有统计学意义(χ2=12.688、12.042、16.202、6.685、15.654,均P0.05)。行多因素分析发现发现肿瘤的长度≥4cm及淋巴结转移区域≥2个时是导致患者早期死亡最主要的危险因素(OR=2.305、4.370,95%CI:1.090~4.876、1.510~12.653,均P0.05)。根据这2个主要危险因素进行生存率分析,发现有0个、1个、2个危险因素的患者的1年生存率分别为90.5%、78.2%、46.1%。Log-rank统计学方法分析显示0个、1个、2个危险因素之间差异具有统计学意义(χ2=9.377、29.019、5.981,均P0.05)。[结论]导致食管鳞癌患者早期死亡的最主要因素是肿瘤长度及淋巴结转移,因此对于存在肿瘤的长度≥4cm及淋巴结转移区域≥2个危险因素的患者,术后有必要进行其他干预治疗如辅助放化疗等,以尽可能延长患者的生存时间。