c-erbB-2和cox-2在乳腺癌中的表达及其意义

应用免疫组化技术 ,检测人乳腺良恶性疾病组织中c erbB 2和cox 2蛋白的表达 ,分析其与淋巴结转移、激素受体状态的关系。 40例乳腺癌组织中c erbB 2表达阳性率为 3 5 .0 %,淋巴结阳性及激素受体阴性者表达率显著高于无淋巴结转移及受体阳性者 (均P <0 .0 5 ) ;cox 2表达阳性率为 47.5 %,激素受体阴性者表达率显著高于受体阳性者 (P <0 .0 5 ) ,但与淋巴结转移无关 (P >0 .0 5 )。 10例良性乳腺疾病及 2例正常乳腺组织中无c erbB 2表达 ,仅有 1例乳腺囊肿病cox 2表达阳性 ,c erbB 2与cox 2的表达存在显著的相关性 (P <0 .0 5 )。提示c erbB 2和cox 2与乳腺癌的发生、转移及预后均有密切关系 ,同时进行两者的免疫组化检测对评估乳腺癌的预后及选择靶向治疗对象可能有意义。     

乳腺癌c-erbB-2的表达及其与肿瘤血管生成的关系

摘要：为探讨乳腺癌c erbB 2与腋窝淋巴结转移和肿瘤血管生成的关系，笔者应用SABC免疫组化法检测70例乳腺癌组织中c erbB 2基因表达和VEGF，FLK 1，bFGF，FLG阳性系数值及MVC值。结果示腋窝淋巴结转移组c erbB 2阳性率明显高于腋窝淋巴结未转移组（P＜0.01）。VEGF，FLK 1，bFGF，FLG和MVC值在c erbB 2阳性和阴性组间有差异（P＜0.05或P＜0.01）。提示乳腺癌c erbB 2表达与腋窝淋巴结转移和肿瘤血管生成有关。     

尿激酶型纤溶酶原激活剂在乳腺癌及腋窝淋巴结组织中的表达及其临床意义

目的　研究尿激酶型纤溶酶原激活剂 (uPA)mRNA在乳腺癌及腋窝淋巴结组织中的表达及其在乳腺癌浸润转移中的作用。方法　应用逆转录 多聚酶链反应 (RT PCR)方法分析 2 5例临床乳癌标本及腋窝淋巴结组织中uPAmRNA水平的表达 ,并结合患者的临床生物学特征进行分析。结果　 2 5例乳腺癌组织中 ,uPAmRNA阳性表达率为 84%。癌旁组织uPAmRNA阳性表达率为 2 4% ,两者差异有显著性 (P <0 .0 5 ) ;腋窝淋巴结苏木素 伊红 (HE)染色阴性uPAmRNA检测表达阳性率为 3 3 .3 % ,淋巴结HE染色阳性uPAmRNA表达阳性率为 62 .5 %。结论　尿激酶型纤溶酶原激活剂mRNA水平在乳腺癌及腋窝淋巴结组织中明显升高 ,且与乳腺癌浸润、转移密切相关。     

原发性乳腺癌组织中c-erbB-2和nm23的表达及其意义

采用SP法检测 2 86例原发性乳腺癌c erbB 2和nm 2 3基因的表达 ,并分析其与病理类型、患者年龄、临床分期及腋淋巴结转移之间的关系。结果示c erbB 2阳性率为 3 9.5 % ,nm 2 3阳性率为 65 .7% ;c erbB 2的表达与患者的临床病理特征之间无明显相关 (P >0 .0 5 ) ;nm 2 3基因的表达与患者年龄、肿瘤病理类型无关 ,但与肿瘤临床分期、腋淋巴结转移有关 (P <0 .0 5 ) ;c erbB 2与nm 2 3两者的表达无明显相关性 (P >0 .0 5 )。提示nm 2 3基因有望作为预测原发性乳腺癌淋巴结转移和评估肿瘤临床预后的标记物     

青年乳腺癌微血管密度与其侵袭性关系

目的　探讨青年乳腺癌微血管密度与其侵袭性关系。方法　SABC免疫组化法检测 40例青年乳腺癌 (年龄≤ 3 5岁 )和 3 0例绝经期乳腺癌组织中微血管密度 (MVD )值 ,探讨其与腋窝淋巴结转移、临床病理特征之间的相互关系 ,比较两组之间的差异。结果　青年组腋窝淋巴结阳性率和MVD值 ( 70 %和 65 .2 8± 15 .0 6)均明显高于绝经组 ( 4 0 %和 5 1.91± 15 .0 6) ( P <0 .0 5和 P <0 .0 1)。MVD值与腋窝淋巴结转移和TNM临床分期有关 (P <0 .0 5和P <0 .0 1)。结论　青年乳腺癌侵袭性强与肿瘤血管生成有关。     

胆囊癌组织中c-erbB-2,nm23H_1癌基因产物的表达及意义

目的　探讨癌基因c erbB 2和肿瘤转移抑制基因nm2 3H1的产物在胆囊癌组织中的表达与其生物学意义。方法　采用免疫组织化学方法检测胆囊癌标本中c erbB 2和nm2 3H1蛋白的表达 ,分析其与临床病理间关系。结果　c erbB 2和nm2 3H1蛋白的阳性表达率分别为 43 75 % (2 8/ 6 4)和 5 4 6 9% (35 / 6 4)。Ⅳ期胆囊癌中c erbB 2蛋白阳性率 (80 % )明显高于其他期胆囊癌 (P <0 0 1) ,c erbB 2阳性组平均生存期差于阴性组 (P <0 0 5 )。而nm2 3H1蛋白的表达与肿瘤的分化、分期和预后无关。结论　在胆囊癌中 ,c erbB 2和nm2 3H1参与肿瘤发生发展过程 ,c erbB 2的表达与肿瘤的转移和预后有着密切关系。     

OPN在乳腺癌淋巴结转移中的作用

目的:探讨骨桥蛋白（OPN）在乳腺癌中的表达及其与腋窝淋巴结转移之间的关系。方法:采用免疫组织化学方法检测 66例乳腺癌、28例乳腺良性肿瘤、37例癌旁乳腺组织和29组腋窝转移淋巴结中OPN的表达，分析OPN表达与腋窝淋巴结转移及其他临床病理特征的关系。结果:乳腺癌组织中OPN的表达水平（4.83）明显高于癌旁乳腺组织（1.86）和乳腺良性肿瘤（2.18)（P＜0.01)；乳腺癌淋巴结转移阳性组与阴性组之间、乳腺癌原发病灶与相应的腋窝转移淋巴结之间OPN表达差异有统计学意义（P=0.048,0.03）。乳腺癌c erbB 2阳性表达组OPN表达水平（5.22）高于c erbB 2阴性组（4.00），但差异无统计学意义（P=0.056）。乳腺癌OPN表达与患者年龄、肿瘤大小、转移淋巴结数量、组织学类型、肿瘤分级以及TNM分期无关（P＞0.05），而与淋巴结转移有关（P=0.048）。结论:OPN在乳腺癌组织中高表达，且与乳腺癌腋窝淋巴结转移密切相关。     

乳腺癌c-erbB2过表达与生存率、内分泌治疗效果和预后的关系

目的　研究乳腺癌c erbB 2改变与生存率、内分泌治疗效果及预后的关系 ,探讨有效反映乳腺癌c erbB2变化的简单检测方法。方法　半定量PCR检测c erbB2基因扩增 ;免疫组化检测c erbB2蛋白表达。随访 5 8例患者。结果　c erbB 2蛋白过表达 (+ + )与基因扩增有显著的一致性 (P<0 .0 1) ,一致率 93 .7%。c erbB2蛋白过表达 (+ + )患者的 5年生存率 (4 4.4% )显著低于c erbB 2阳性表达 (+ ) (66.7% )和c erbB 2阴性表达患者 (78.6% ) (P <0 .0 5 )。c erbB 2蛋白过表达患者服用三苯氧胺不能显著提高 5年生存率。结论　c erbB2蛋白过表达患者 5年生存率低、预后差 ,且对内分泌治疗不敏感。免疫组化可以简单、有效地检测乳腺癌c erbB2的改变。     

诱导型一氧化氮合酶与乳腺癌增殖和转移关系的研究

笔者应用免疫组化技术研究诱导型一氧化氮合酶 (iNOS)与乳腺癌增殖指标碱性成纤维细胞生长因子 (bFGF)、细胞周期素D1(CyclinD 1)、癌蛋白 (c erbB 2 )的关系 ,及与淋巴结转移、远处转移、5年生存情况的关系。结果示乳癌细胞内iNOS的表达与CyclinD1,c erbB 2 ,bFGF相关 ,并与远处、淋巴结转移有关。iNOS阳性患者 5年内生存率较阴性者低 (P 0 .0 5 )。提示iNOS促进c erbB 2和CyclinD1基因及bFGF表达 ,进而刺激乳腺癌细胞的增殖 ,并促进淋巴结及远处转移。     

乳腺癌淋巴结转移与癌组织中白细胞介素-6受体及糖蛋白130的关系

目的　探讨乳腺癌淋巴结转移与活体癌组织中白细胞介素 6受体 (IL 6R)、糖蛋白13 0 (gp13 0 )表达的关系。 方法　应用病理学诊断的方法检查腋窝淋巴结有无癌细胞转移 ,采用逆转录 聚合酶链反应 (RT PCR)检测乳腺癌组织IL 6R、gp13 0的mRNA表达。 结果　IL 6R组中 ,有淋巴结转移的IL 6R表达率为 3 7.5 0 0 % (9/ 2 4) ,无转移的为 84.3 14 % (4 3 / 5 1) ,差异有非常显著性 (χ2 =16.82 ,P <0 .0 0 1) ;gp13 0组中 ,有腋窝淋巴结转移的癌组织中 gp13 0表达率为 2 5 .0 0 0 %(6/ 2 4) ,无转移的为 78.43 1% (4 0 / 5 1) ,差异有非常显著性 (χ2 =19.65 ,P <0 .0 0 1)。结论　乳腺癌组织中的IL 6R、gp13 0及IL 6表达与乳腺癌患者的淋巴结转移及预后有关。     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.