r-谷氨酰转肽酶作为大肠腺瘤恶变倾向标志的研究

大肠腺瘤是重要的癌前病变,确定其恶变倾向的大小对提高大肠癌防治水平甚有帮助。r一谷氨酸转肽酶(GGT)在多种肿瘤中活性升高[‘。中又通过测定大肠正常粘膜与肿瘤组织的GGT活性,藉以探讨腺瘤中GGT活性的变化特点及其作为腺瘤恶变倾向标志及协助诊断大肠癌的价值。 材料与方法 一、标本采集 125例大肠粘膜组织中,18例为大肠癌手术标本,9例大肠非腺瘤性息肉和36例大肠腺瘤均为经结肠镜     

警惕，大肠腺瘤易恶变

大肠息肉,就是肠黏膜表面上的一个或多个隆起性的肉疙瘩,形状就像长在肠管内的蘑菇。早在1982年,我国大肠癌协作组将大肠息肉分为新生物性、错构瘤性、炎症性、化生性、其他共5类。新生物性大肠息肉即为大肠腺瘤,发病率男性高于女性,并随着年龄的增长而增加。临床上将大肠腺瘤分为单发性腺瘤和多发性腺瘤。     

大肠腺瘤恶变的主要危险因素

目的　探讨大肠腺瘤的分布、大小和形态特点及腺瘤恶变过程中的主要危险因素。方法　回顾性分析和研究 1994年 3月至 1998年 4月期间我院电子结肠镜检出的大肠腺瘤的形态学和恶变过程中的主要危险因素。结果　发现大肠腺瘤 12 0例 14 4个 ,占大肠息肉检出的 62 .18% ;恶变腺瘤以 >2 .0cm、山田Ⅱ型为主 ;腺瘤的恶变率为 16.67% ,绒毛状腺瘤恶变率最高 ,管状腺瘤恶变率次之 ;腺瘤≤ 1.0cm者恶变率 3 .85 % ,1.1～ 1.9cm者恶变率 2 1.0 5 % ,≥ 2 .0cm者恶变率 3 9.47% ;组织学证实管状腺瘤的百分率随着腺瘤的增大而减小 ,绒毛状腺瘤的百分率则随着腺瘤的增大而增加 ,2 4例恶变腺瘤中患者的年龄 5 0岁以上占 91.67% ;而 12例同时伴肠癌腺瘤中患者的年龄大于 5 0岁的占 83 .3 3 %。结论　管状腺瘤是大肠中最常发现的肿瘤性息肉 ,随着腺瘤体积增大 ,管状结构减少 ,绒毛状结构增加 ;大肠腺瘤的大小、形态、病理类型和患者的年龄 (特别是 5 0岁以上 )是大肠腺瘤恶变的主要危险因素。     

老年大肠腺瘤恶变的临床病理分析

 目的 探讨老年大肠腺瘤恶变及其病理特点。方法 对185例老年大肠脉瘤患者进行分析,观察大肠腺瘤与恶变的关系。结果 老年大肠腺瘤恶变与腺瘤大小、部位、形态、数目、组织学类型及年龄等因素有关,与性别无关。结论 老年大肠腺瘤易恶变,对可疑恶变腺瘤做全瘤切除,术后密切而有规律随访。     

大肠腺瘤恶变与HPV感染的关系

目的　分析大肠癌腺瘤恶变与HPV感染的关系。方法　应用PCR技术检测 2 4例大肠腺瘤恶变、16例大肠腺及 2 5例正常粘膜的HPV感染情况。结果　腺瘤恶变、腺瘤和正常粘膜HPV感染率分别为 3 7.5 0 %、18.75 %和12 .0 0 % ,腺瘤恶变与正常粘膜及腺瘤的HPV感染率均有显著性差异 (P <0 .0 5 ) ,腺瘤与正常粘膜间HPV的感染率无显著性差异 (P >0 .0 5 )。结论　HPV感染存在于腺瘤恶变的过程之中 ,是大肠癌的发病原因之一。     

大肠腺瘤恶变指标的临床与病理分析

目的对大肠腺瘤恶变指标的诸多因素进行分析与探讨.方法收集1982年3月～1995年3月间本院纤维结肠镜检出的大肠息肉436例,进行了研究.结果单发腺瘤81.1%,多发者19.3%;腺瘤癌变10.8%,腺瘤合并癌5.2%;绒毛状腺瘤癌变27.5%,混合型腺瘤癌变16.2%,管状腺瘤癌变率7.1%;腺瘤发生部位以直肠居多,其次为乙状结肠.结论腺瘤癌变与腺瘤的组织学类型、肿物大小及发生部位有关.     

人大肠腺癌的超微结构研究

 本文报导38例大肠腺癌病人的腺癌超微结构特证,组织经病理诊断。实验结果如下:1.人大肠腺癌的上层组织,明显分亮和暗两种细胞,主要是柱状亮细胞。2.腺癌组织中杯状细胞不明显。3.腺腔由单层的亮、暗细胞组成并呈放射状排列。4.基底膜结构模糊,电子密度增高,可观察到细胞的浸润现象。5.腺体底部由几种不同形态结构的细胞组成。其中有一种细胞的胞浆中含有两种颗粒,大的直径为150-500nm,小的约30nm。小颗粒的增殖与大颗粒,线粒体的解体和核膜的扩张等有关。     

Shh在大肠腺瘤及大肠癌中的表达与意义

目的 探讨Shh(sonic hedgehog)在大肠腺瘤及大肠癌中的表达与意义.方法 应用免疫组织化学方法检测Shh蛋白在36例大肠腺瘤及41例大肠癌中的表达并评估.结果 Shh蛋白在大肠腺瘤中的阳性表达率为69.4%(25/36),阳性信号分布在肿瘤细胞胞浆内;Shh的染色评分随腺瘤组织学分级的增加而呈显著性升高(P<0.05).Shh蛋白在早期及进展期大肠癌中的阳性表达率分别为80.0%(12/15)和30.8%(8/26),阳性信号均分布在癌细胞胞浆内;从阳性表达率及染色评分两方面评价,Shh在早期大肠癌的表达均显著高于进展期癌(P<0.01和P<0.05).结论 Shh蛋白可能参与大肠腺瘤-癌的演进过程,对Shh的表达进行评估将有助于大肠癌的早期诊断.     

PCNA、p53在大肠腺瘤、腺癌中的表达及相关性研究

采用免疫组织化学方法，对150例大肠腺癌、腺癌进行PCNA及P53癌基因蛋白检测，并用14例正常大肠粘膜作对照。结果显示：PCNA的表达，在腺癌不典型增生Ⅰ级组、腺癌不典型增生Ⅱ、Ⅲ级组、腺癌癌变组及腺癌高、中、低分化各组中明显呈递增趋势。p53癌基因蛋白则在腺癌癌变组中表达最高。两者之间的相关性无统计学意义，但在腺瘤术典型增生Ⅱ、Ⅲ级组及腺癌癌变组中，两者的表达均具有显著性差异。提示PCNA及p53癌基因蛋白的检测，对大肠腺癌癌变的诊断具有重要意义。     

Increased Expression of Sucrase and Intestinal-type Alkaline Phosphatase in Human Gastric Carcinomas with Progression

The activities of sucrase, total alkaline phosphatase (total ALP) and intestinal-type alkaline phosphatase (I-ALP) were assayed in gastric carcinomas and in their surrounding mucosae from 57 patients with advanced cancers, and the localization of sucrase in 203 carcinomas, including 86 early cancers, was examined immunohistochemically using polyclonal anti-sucrase antibody. All three enzymes were active in the 57 carcinomas as well as in their surrounding mucosae, but the levels were fairly low as compared to those in normal jejunum mucosa. A considerable part of the total ALP activity in tumor specimens was assumed to be due to I-ALP itself. Increased sucrase and I-ALP were found with greater depth of invasion by undifferentiated-type carcinomas. The pattern of immunohistochemical localization of sucrase in the 203 carcinomas also clearly indicated increased expression with greater depth of invasion even in differentiated-type carcinomas.     

三种血清肿瘤标志物在胃癌诊断中的应用

目的 :探讨癌胚抗原 (CEA)和糖类相关抗原CA19 9、CA72 4三种肿瘤标志物在胃癌诊断、疗效监测评价中的应用价值 ,并将它们联合用于检测 ,以提高临床诊断胃癌的灵敏度、有效诊断率。方法 :应用放射免疫分析 (RIA)法和生物素—链霉亲和素双抗夹心法 ,测定 60例患有不同良性胃部疾病病人和 5 8例胃癌患者血清中CEA、CA19 9及CA72 4的含量 ,并对癌症患者进行术后 3个月到 1年的动态随访监测。结果 :良性疾病组CEA为11 8± 3 7μg/L ,CA19 9为 2 2 8± 9 9KU/L ,CA72 42 1 0 8KU/L。胃癌患者血清中这三种肿瘤标志物的含量明显高于良性疾病组 ,差异均具有显著性意义 (P <0 0 1)。患者术后血清中CEA、CA19 9及CA72 4水平较术前明显下降 (P <0 0 1)。将CEA、CA19 9及CA72 4三者联合检测较单测任何一项其灵敏度和有效诊断率均有提高。结论 :三种血清肿瘤标志物联合检测可提高胃癌诊断的灵敏度、特异性 ,胃癌患者血清中三种标志物含量变化对胃癌的诊断、疗效监测有重要的临床意义     

Adenoma of the Nipple: Report of a case

We report a case of an adenoma of the nipple in a 33-year-old Japanese woman who presented with a 2-year history of itching, eczema, and discharge from the left nipple. Examination revealed a firm, well defined and erosive tumor measuring 10 x 11 mm that was sore, crusted, and indurated. There was a slight serosanguineous discharge from the tumor. Cytological material from the tumor obtained from the discharge and by fine needle aspiration (FNA) and scraping showed a papillary cell cluster thought to be a benign papilloma.We performed a tumor resection with preservation of the nipple. The histological diagnosis was adenoma of the nipple. The patient was left with a cosmetically well-preserved nipple. No recurrent tumor has been observed for two years after surgery.     

Establishment and Characterization of an Epithelial Cell Line with Quasi-normal Chromosomes from a Tubular Adenoma of a Familial Polyposis Coli Patient

An epithelial cell line designated FPCK-1 has been established from a tubular adenoma developing in a male familial polyposis coli (FPC) patient. The FPCK-1 cells grow very slowly with adundant mucus production and have been maintained stably for 3 years in culture. No growth was evident either in soft agar or nude mice, FPCK-1 cells present a normal male karyotype and do not show loss of specific loci on chromosomes 5,17,18, and 22 which have been reported to be lost frequently in human colon carcinomas. The cells have neither a point mutation on codon 12 of K- ras gene nor gene amplification of myc , c-H- ras , and/or c-K- ras genes. These results thus suggest the existence of hitherto unknown causative event(s) underlying adenoma development in FPC patients. The FPCK-1 cell line should prove useful for further analytical investigation of the multiple steps involved in human colon carcinogenesis.     

Increased Hepatic Nicotinamide N-Methyltransferase Activity as a Marker of Cancer Cachexia in Mice Bearing Colon 26 Adenocarcinoma

When a cachexigenic subclone (clone 20) of murine colon 26 adenocarcinoma was transplanted into female BALB/c mice, hepatic NNMT activity continued to increase until death in proportion to progressive carcass weight loss, a marker of cancer cachexia. On the other hand, noncachexigenic subclone (clone 5)-transplanted mice showed neither increase of NNMT activity nor carcass weight loss. Among cytostatic fluorinated pyrimidines, 5'-dFUrd could inhibit the increase of NNMT activity and prevent weight loss in mice bearing clone 20. On the other hand, 2'-dFUrd did not show these effects. 5-FUra and Tegafur inhibited the increase of NNMT activity at higher concentrations. These findings suggest that the levels of hepatic NNMT activity are closely associated with the degree of weight loss, and they appear to be a useful marker of cancer cachexia.     

乳头管腺瘤

乳头管腺瘤是少见的一种乳腺良性肿瘤。该瘤有两种生长方式，命名较为混乱。临床上易与乳头派杰氏病混淆，病理组织学上常被误认为浸润性癌，尤其在冰冻切片中容易误诊。本文结合我院收治的１３例病例资料（包括４例临床隐性和２例癌变病例），提出临床上可从发病年龄、乳头糜烂范围、可及肿物部位等方面与乳头派杰氏病鉴别；在镜下要注意识别由致密的间质纤维组织挤压而形成的假性浸润，冰冻切片诊断时要注意送检标本是取自有特殊组织学结构的乳头部位。     

Stathmin is a Marker of Progression and Poor Prognosis in Esophageal Carcinoma

Stathmin, also called oncoprotein 18, is a founding member of the family of microtubule-destabilizing proteinsthat play a critical role in the regulation of mitosis. At the same time stathmin has been recognized as one ofresponsible factors in cancer cells. The aim of this study was to assess stathmin status, its correlations withclinicopathological parameters and its role as a progosnostic marker in EC patients. The protein and mRNAlevels of stathmin were examined byimmunohistochemistry (IHC) and in situ hybridization in 100EC tissuesand adjacent noncancerous tissues. mRNA and protein expression of stathmin in three EC cell lines(EC9706,ECa109, EC1 commonly used in research) were also analyzed using immunocytochemistry, western blot andin situ hybridization. The prognostic value of Stathmin expression within the tumor tissues were assessed byCox regression and Kaplan-Meier analysis. We showed that stathmin expression was significantly higher in ECtissues than in adjacent noncancerous tissues. High stathmin immunostaining score in the EC was positivelycorrelated with tumor differentiation, Tumor invasion, Lymph node metastases, and TNM stage. In addition, wedemonstrated that three EC cell lines examined, were constitutively expressing a high level of stathmin. Of those,EC-1 showed the strongest mRNA and protein expression for the stathmin analyzed. Kaplan-Meier analysisshowed that significantly longer 5-year survival rate was seen in EC patients with high Stathmin expression,compared to those with low expression of Stathmin expression. Furthermore, multivariate Cox proportionalhazard analyses revealed that Stathmin was an independent factors affecting the overall survival probability.In conclusion, our data provide a basis for the concept that stathmin might be associated with EC developmentand progression.. High levels of Stathmin expression in the tumor tissues may be a good prognostic marker forpatients with EC.     

CD26: A prognostic marker of other systemic malignancies besides colo-rectal carcinomas

I read with great interest the recent article by Cordero et al in a recent issue of your esteemed journal. Interestingly, the past few years have seen the emergence of CD26 as an important diagnostic and prognostic marker for a number of systemic malignancies besides colo-rectal carcinomas. For instance, serum CD26 levels are an important emerging marker of B-cell chronic lymphocytic leukemia (B-CLL). In fact, Molica et al have recently reported shorter time to first treatment in B-CLL which exhibit higher serum CD26 levels and simultaneously demonstrate absence of mutation in IgV (H). Similarly, CD26 serves as a marker of poor prognosis in T cell lymphomas. Simultaneously, a poor response to 2'-deoxycoformycin is seen T cell lymphomas expressing CD26. Similarly, breast carcinomas exhibit decreased CD26 mean fluorescence intensity and a decreased percentage of CD26 positive lymphocytes in comparison to benign breast tumors and healthy individuals.     

Adenoma of the nipple in an adolescent

We recently treated a 14-year-old girl with a clinically and histologically diagnosed with adenoma of the nipple. Enucleation of a mass preserving the nipple was successfully performed. Adenoma of the nipple is a rare disease which is often mistaken clinically for Paget's disease. About 200 cases of the tumors have been reported worldwide so far. The most common symptom is erosion of the nipple and nipple discharge. Our case had erosion of the nipple but no discharge. Adenoma of the nipple is a benign lesion which can be successfully treated by a simple surgery.     

PTEN基因编码产物与胃癌发生发展相关性的研究

目的 :观察抑癌基因PTEN编码蛋白在正常胃黏膜、肠上皮化生及胃癌组织中的表达 ,探讨PTEN与胃癌发生发展的关系及作用机制。方法 :采用sABC免疫组化方法检测 184例胃癌及其癌旁肠上皮化生组织中PTEN蛋白表达 ,比较其与胃癌的WHO组织学分型、Lauren分型、临床病理分期及淋巴结转移的关系 ;另对其中 6 8例胃癌同时检测血管内皮生长因子 (VEGF)并比较它与PTEN蛋白表达的关系。结果 :胃癌组织PTEN蛋白表达显著低于正常胃黏膜 (47 8%vs 10 0 % ,P <0 0 1)。弥漫型胃癌PTEN表达显著低于肠型胃癌 (41 5 %vs 5 7 8% ,P <0 0 5 ) ;弥漫型胃癌癌旁肠上皮化生组织PTEN蛋白表达显著低于肠型胃癌旁肠化组织 (5 2 5 %vs 10 0 % ,P <0 0 1) ;进展期胃癌PTEN表达显著低于早期胃癌 (40 9%vs 6 7 6 % ,P <0 0 1) ;PTEN蛋白表达降低或失活与胃癌淋巴结转移显著正相关 (转移组4 0 3%vs非转移组 6 3 3% ,P <0 0 1) ;PTEN蛋白与VEGF表达 (31/6 8,4 5 6 %vs 5 1/6 8,75 0 % )呈一定负相关。结论 :PTEN失活或蛋白表达降低与胃癌细胞分化程度、临床病理分期及转移能力密切相关。提示PTEN基因编码产物的检测可作为判定胃癌发生及侵袭转移能力的一项客观指标