聚合酶链反应和核酸杂交在检测阴茎癌人乳头状瘤病毒中的作用

人乳头状瘤病毒（ＨＰＶ）为一种潜在的癌基因，可能为多种泌尿生殖道肿瘤的致病因子。作者用高敏感的聚合酶链反应（ＰＣＲ）结合和核酸杂交方法，检测２８例阴茎癌组织中的ＨＰＶ１６，１８型病毒，结果表明：阴茎癌组织中ＨＰＶ１６的阳性检出率为５０％（１４／２８），ＨＰＶ１８的阳性检出率为１０．６％（３／２８）。提示ＨＰＶ１６感染在阴茎癌的发生过程中可能具有重要作用，并且与患者吸烟有关     

聚合酶链反应和核酸杂交检测人睾丸癌组织中人乳头状瘤病毒

应用聚合链反应＊（ＰＣＲ）结合核酸杂交方法检测２７例睾丸癌组织标本。结果发现：人乳头状瘤病毒ＨＰＶ１６阳性率为１４．８％（４／２７）。ＨＰＶ１８阳性标本未检出，结果提示：ＨＰＶ感染与睾丸癌低相关性，首次报道睾癌中存在ＨＰＶ感染。     

抑癌基因P16蛋白在人前列腺癌中的表达及意义

目的：研究前列腺癌中抑癌基因ＭＴＳ１蛋白产物Ｐ１６表达的情况及临床意义。方法：用免疫组织化学方法（ＳＰ法）检测了６４例前列腺癌和１２例正常前列腺组织中Ｐ１６蛋白的表达情况。结果：３８例前列腺癌Ｐ１６蛋白表达表达阳性（５９．４％）,其中高分化癌阳性率为９０．０％（１８／２０）,中分化癌为７２．２％（１３／１８）低分化癌为２６．９％（７／２６）,随着前列腺癌恶性程度的增加Ｐ１６蛋白表达阳性率显著降低,     

膀胱乳头状移行细胞癌中高危人乳头瘤病毒的检测

目的对高危人乳头瘤病毒（ＨＰＶ）１６、１８ＤＮＡ在膀胱癌组织中进行定位研究。方法运用地高辛标记的原位杂交技术对５２例膀胱乳头状移行细胞癌中高危ＨＰＶＤＮＡ进行检测。结果ＨＰＶＤＮＡ的阳性信号存在于肿瘤细胞核内,呈点状或点片状,其中以点状为主,约８９５％。癌旁不典型增生上皮、癌旁正常的上皮组织及Ｂｒｕｎｎ巢可同时有高危ＨＰＶ的感染,但表达呈点片状。５２例膀胱乳头状移行细胞癌中高危型ＨＰＶ１６、１８ＤＮＡ阳性１９例,阳性率为３６５％;ＰＴａＴ２期１７例,ＰＴ３Ｔ４期２例;Ｇ１,２级１４例,Ｇ３级５例。随着肿瘤分期分级的增加,ＨＰＶ１６及ＨＰＶ１８的感染率有逐渐降低的趋势,但差异无统计学意义（Ｐ＞００５）。结论病毒ＤＮＡ在膀胱癌变组织、癌旁正常及不典型增生组织中均有不同程度的表达。膀胱乳头状移行细胞癌ＨＰＶ感染率较高,浸润较浅分化较好的肿瘤更多见,提示该病毒感染可能是膀胱癌发生的早期诱因之一。     

Ⅰ型前胶原羧端肽原诊断前列腺癌骨转移的临床意义

为提供有效的前列腺癌诊断指标，采用放射免疫法检测６１例前列腺增生产下、１８例前列腺癌和２８例前列腺癌转移患血清Ⅰ型前胶原羧端肽原（ＰＩＣＰ）浓度，发现前列腺癌骨转移组血清ＰＩＣＰ（２６６．０±７６．６μｇ／Ｌ）２明显高于前列腺癌组（１３２．０±３２．８μｇ／Ｌ）和前列增生症组（１３６．０±３８．３μｈ／Ｌ）前列腺癌组ＰＩＣＰ浓度和前列腺增生症组无显性差异；ＰＩＣＰ最佳临界值为２０５μｇ／Ｌ，敏     

P53,Rb抑癌基因突变产物在前列腺癌中的表达

用Ｐ５３和Ｒｂ，通过免疫金－银染色方法，对３０例前列腺癌及２０例前列腺增生症进行检测。结果显示：前列腺癌Ｐ５３、Ｒｂｃ１５的阳性率分别为６０．０％和５０％，前列腺增生症仅有１０％和１５％，二者之间有显著性差异。前列腺正常组织阳性率Ｐ５３ 和Ｒｂ为０，与肿瘤区比较Ｐ＜０．００１；３０例前列腺癌中，有１０例Ｐ５３和Ｒｂ同为阳性，Ｐ５３在低分化和未分化癌中阳性表达明显高于高分化腺癌（Ｐ＜０．０１）。     

上海市238例前列腺癌新发病例的临床调查

为了解前列腺癌临床流行病学情况，对上海市市区前列腺癌新发病例进行全人群对照研究。２３８例前列腺癌年龄构成为：５０岁～１１例（４．６％），６０岁～６４例（２６．９％），７０岁～１１５例（４８．３％），８０岁～４５例（１８．９％），９０～９３岁３例（１．３％）。肛指检查阳性率６５．５％，合并良性前列腺增生症占５６．３％。临床分期Ｔ１１２例（５．４％），Ｔ２８８例（３９．８％），Ｔ３８４例（３８．０％），Ｔ４３７例（１６．８％）。９０例（３７．８％）确定有远处转移。２２０例（９２．４％）细胞类型为腺癌。１８４例患者病理分级１级２３例（１２．５％），２级７３例（３９．７％），３级８８例（４７．８％）。临床分期与肿瘤远处转移率有关（Ｐ＜０．００１）。平均血清ＰＳＡ为８７．３μｇ／Ｌ，与人群对照组及ＢＰＨ对照组有显著性差异（Ｐ＜０．００１）。对血清ＰＳＡ的价值，前列腺癌的治疗方法进行了初步探讨。     

前列腺癌中抗凋零基因bcl－2表达产物的分布及意义

采用免疫组化方法观察６０例前列腺良、恶性病变中ｂｃｌ－２基因产物的表达与分布。正常前列腺组织（１０例）和前列腺增生症（２０例）阳性率分别为２０．０％和５０．０％；３０例前列腺癌中，ｂｃｌ－２阳性病例达８６．６７％。结果提示，ｂｃｌ－２在前列腺癌中的表达与细胞的分化程度有关，ｂｃｌ－２的过量表达可能参与了前列腺癌的发生过程。     

小肠出血诊断分析(附30例报告)

目的 探讨小肠出血的诊断方法。方法 对３０例病理证实的小肠出血术前行小肠气钡造影，核素显像，血管造影，剖腹探查和术中肠镜检查。结果 阳性率为：气钡造影４６．２％（６／１３），核素显像８７．５％（１４／１６），血管造影６６．７％（１０／１５），定位符合率为：气钡造影６６．７％（４／６），核素显像４２．９％（６／１４），血管造影９０．０％（９／１０），出血术前检查阳性率９０．０％，（１８／２０），间歇     

膀胱砂状移行细胞癌中高危人乳头瘤病毒的检测

目的 地高危人乳头瘤病毒（ＨＰＶ）１６、１８ＤＮＡ在膀胱癌组织中进行定位研究。方法 运用地高辛标记的原位杂交技术对５２例膀胱砂状移行细胞癌中高危ＨＰＶＤＮＡ进行检测。结果 ＨＰＶＤＮＡ的阳性信号存在于肿瘤细胞核内，呈占 或点片状，其中以点状为主，经８９．５％。癌旁不典型增生上皮、癌旁正常的上皮组织及Ｂｒｕｎｎ巢可同时有高危ＨＰＶ的感染，但表达呈点片状。５２例胱乳头状移行细胞癌中高危型ＨＰＶ１６、１     

Characterization of prostate cancer, benign prostatic hyperplasia and normal prostates using transrectal 31phosphorus magnetic resonance spectroscopy: a preliminary report.

We assessed the ability of 31phosphorus (31P) transrectal magnetic resonance spectroscopy to characterize normal human prostates as well as prostates with benign and malignant neoplasms. With a transrectal probe that we devised for surface coil spectroscopy we studied 15 individuals with normal (5), benign hyperplastic (4) and malignant (6) prostates. Digital rectal examination, transrectal ultrasonography and magnetic resonance imaging were used to aid in accurate positioning of the transrectal probe against the region of interest within the prostate. The major findings of the in vivo studies were that normal prostates had phosphocreatine-to-adenosine triphosphate (ATP) ratios of 1.2 +/- 0.2, phosphomonoester-to-beta-ATP ratios of 1.1 +/- 0.1 and phosphomonoester-to-phosphocreatine ratios of 0.9 +/- 0.1. Malignant prostates had phosphocreatine-to-beta-ATP ratios that were lower (0.7 +/- 0.1) than those of normal prostates (p less than 0.02) or prostates with benign hyperplasia (1.1 +/- 0.2, p less than 0.01). Malignant prostates had phosphomonoester-to-beta-ATP ratios (1.8 +/- 0.2) that were higher than that of normal prostates (p less than 0.02). Using the phosphomonoester-to-phosphocreatine ratio, it was possible to differentiate metabolically malignant (2.7 +/- 0.3) from normal prostates (p less than 0.001), with no overlap of individual ratios. The mean phosphomonoester-to-phosphocreatine ratio (1.5 +/- 0.5) of prostates with benign hyperplasia was midway between the normal and malignant ratios, and there was overlap between individual phosphomonoester-to-phosphocreatine ratios of benign prostatic hyperplasia glands with that of normal and malignant glands. To verify the in vivo results, we performed high resolution magnetic resonance spectroscopy on perchloric acid extracts of benign prostatic hyperplasia tissue obtained at operation and on a human prostatic cancer cell line DU145. The extract results confirmed the differences in metabolite ratios observed in vivo. We conclude that transrectal 31P magnetic resonance spectroscopy can characterize metabolic differences between the normal and malignant prostate.     

Detection of human papillomavirus (HPV) DNA in human prostatic tissues by polymerase chain reaction (PCR)

Human papillomavirus (HPV) infections are strongly linked to the pathogenesis of uterine cervical neoplasms, and have been implicated in other cancers of the female genital tract. In contrast, the association of HPV with the cancers of the male urogenital tract is less evident, except in anal and penile cancers. However, recent studies reporting the prevalence of HPV infections in human prostate cancers (60–100% HPV 16 positive vs. no infection of HPV) have raised controversies regarding the prevalence of HPV in benign and neoplastic human prostate. We investigated the prevalence of HPV infections in prostatic intraepithelial neoplasia (PIN) and prostatic adenocarcinomas in 23 surgically resected prostates. Polymerase chain reaction (PCR) was used to amplify HPV 6b/11, 16 and 18 specific DNA sequences, using type specific HPV primers selected from the transforming gene E6-E7. The areas of PIN and cancer in 6 p.m H&E stained tissue sections were identified, and respective areas of PIN and cancer were isolated from the adjacent serial sections and used for DNA amplification and HPV detection (Fig. 1). Our results demonstrated the presence of HPV 16 in three carcinomas (13%), using type specific primers in PCR amplified samples. We were not able to demonstrate the presence of other HPV types (HPV 6b/11 or HPV 18) in any of the samples using specific primers. Two of these prostates showed relatively strong positive signals by dot blot analysis, when hybridized with a 32P-labeled HPV 16 type specific oligonucleotide probe. One more sample showed weak positivity, when hybridized with a 32P-labeled HPV 16 type specific oligonucleotide probe. Subsequently, we have confirmed these results by Southern hybridization of the samples transferred to nylon membrane after agarose gel electrophoresis and detected by HPV 16 type specific oligonucleotide probe, using chemiluminescent assay. We, therefore, conclude that HPV infections of the prostate in general are not as common as has been previously claimed by other investigators. © 1993 Wiley-Liss, Inc.     

High prevalence of human papillomavirus in prostate tissues.

Specific human papillomavirus (HPV) types are associated with benign and malignant lesions of the anogenital region including the prostate gland. Using polymerase chain reaction (PCR) amplification of type-specific HPV sequences, we have assessed the prevalence of HPV DNA in prostate tissue from 88 individuals. Amplified sequences specific for HPV 16 were found in 34 of 56 benign prostatic hyperplasias and in 14 of 27 prostatic carcinomas. In contrast, HPV 18 was identified in only three benign hyperplasias and one carcinoma, all of which also contained HPV 16 DNA. Four of five normal prostates obtained at autopsy had no detectable HPV infection; one contained HPV 16 sequences. No significant difference in the prevalence of HPV DNA is observed between patients with benign disease and those with evidence of malignancy when fragments of surgical material are analyzed. Surgical method (transurethral resection or suprapubic prostatectomy) had no effect on the frequency of HPV detection. The prevalence of HPV DNA in the small number of normal prostates analyzed was not significantly different from that in the surgical samples. The presence of HPV in prostate tissues suggests a possible reservoir for sexual transmission of types with oncogenic potential. A role for the virus in the etiology of prostatic neoplasia remains to be demonstrated.     

The development of human benign prostatic hyperplasia with age

In this study we report the prevalence and growth rate of human benign prostatic hyperplasia with age by combining and analyzing data from 10 independent studies containing more than 1,000 prostates. The normal prostate reaches 20 plus or minus 6 gm. in men between 21 and 30 years old, and this weight remains essentially constant with increasing age unless benign prostatic hyperplasia develops. The prevalence of pathological benign prostatic hyperplasia is only 8 per cent at the fourth decade; however, 50 per cent of the male population has pathological benign prostatic hyperplasia when they are 51 to 60 years old. The average weight of a prostate that is recognized at autopsy to contain benign prostatic hyperplasia is 33 plus or minus 16 gm. Only 4 per cent of the prostates in men more than 70 years old reach sizes greater than 100 gm. An analysis of a logistic growth curve of benign prostatic hyperplasia lesions removed at prostatectomy indicates that the growth of benign prostatic hyperplasia is initiated probably before the patient is 30 years old. The early phase of benign prostatic hyperplasia growth (men between 31 and 50 years old) is characterized by a doubling time for the tumor weight of 4.5 years. In the mid phase of benign prostatic hyperplasia growth (men between 51 and 70 years old) the doubling time is 10 years, and increases to more than 100 years in patients beyond 70 years old.     

前列腺穿刺活检组织端粒酶活性检测及其临床意义

通过检测国人前列腺穿刺活检组织端粒酶活性,探讨其在前列腺癌诊断和预后的临床意义。20例前列腺癌标本和16例癌旁组织均来自前列腺穿刺活检,14例良性前列腺增生(BPH)标本取自前列腺摘除手术,均经病理证实。采用改良的TRAP-银染方法检测端粒酶活性,并进行半定量分析。结果20份前列腺癌标本中18份测得端粒酶活性(90％)。在16例癌旁前列腺组织中,64％(7/11)的前列腺上皮肉瘤(PIN)及40％(2/5)的癌旁BPH组织有端粒酶活性表达。14例BPH标本端粒酶活性均为阴性。18例前列腺癌阳性标本的端粒酶活性强度与肿瘤分级分期及PSA水平呈正相关。前列腺穿刺活检组织端粒酶活性检测可作为前列腺癌诊断的一项敏感性指标,其在前列腺癌预后中的价值有待于进一步的研究。     

大鼠前列腺的锥虫蓝透过性实验研究

目的 :了解大鼠正常前列腺、炎症前列腺以及良性增生前列腺的锥虫蓝透过性。　方法 :取 6 0只SD雄性大鼠 ,随机分为正常组 (NP ,n =15 )、细菌性前列腺炎组 (BP ,n =15 )、良性前列腺增生组 (BPH ,n =15 )、良性增生合并细菌性前列腺炎组 (BPH BP ,n =15 ) ,各组随机抽取 5只作为不注射锥虫蓝的对照组 (NC ,n =5× 4 ) ,其余 10只分别由尾静脉注射 2ml1%锥虫蓝溶液。 2h后麻醉处死动物和分离前列腺 ,肉眼直接观察各组大鼠的前列腺被锥虫蓝染色情况 ,并用比色法检测前列腺组织的锥虫蓝浓度。　结果 :注射锥虫蓝的各组大鼠除脑组织和脊髓组织外 ,前列腺的表面及内部组织与肌肉、肝脏、肠道等组织同样被染成相似的蓝色。BP组和BPH BP组前列腺的锥虫蓝含量明显高于BPH组及NP组前列腺的锥虫蓝含量 (P <0 .0 5 )。　结论 :大鼠的正常前列腺、良性增生前列腺以及炎症前列腺都容易被具有较高分子量和离子化性质的锥虫蓝透过 ,但炎性前列腺具有更加明显增高的锥虫蓝透过性。     

Magnetic resonance imaging in the diagnosis of prostatic carcinoma and benign hyperplasia

Using a 0.5 tesla superconducting magnetic system, magnetic resonance imaging (MRI) studies were performed in 42 patients (27 prostatic carcinoma and 15 benign prostatic hyperplasia) and 2 healthy volunteers. Spin echo images were produced in the transverse, coronal and sagittal directions. T1 and T2 relaxation times were calculated from these images. The images of 2 normal prostates showed 2 separate zones: an internal zone and an external zone. The images of 8 of the 15 prostates with benign prostatic hyperplasia showed 3 zones: an internal zone, a band of low intensity and an external zone. Most of the cases of prostatic carcinoma showed extracapsular extension, so we could not detect zonal distinction of the images in 25 cases out of the 27 prostates with prostatic carcinoma. Most of the images of prostates with prostatic carcinoma showed irregular and asymmetric shape and inhomogeneous signal intensity. MRI had an accuracy of 85.7% in differentiating prostatic carcinoma from benign prostatic hyperplasia. A good correlation (r = 0.936) was observed between the weight of the whole prostate as predicted by MRI and the actual weight of the adenoma enucleated by retropubic prostatectomy. The change in volume of the prostate after hormone therapy was well evaluated by MRI. We were not able to differentiate prostatic carcinoma from benign prostatic hyperplasia on the basis of the T1 and T2 relaxation times alone. The serial measurements of the T1 and T2 relaxation times might be value in following therapeutic response of prostatic carcinoma.     

Immunohistochemical localization of a prostatic secretory protein of 94 amino acids in normal prostatic tissue, in primary prostatic tumors and in their metastases

Using the immunoperoxidase technique, we have studied in normal, hyperplastic and adenocarcinomatous prostates the tissue localization of an abundant 94 amino acid protein secreted by prostatic epithelial cells. In normal and hyperplastic prostates, strong immunoreactivity was found exclusively in glandular epithelial cells. No reaction was observed over the stroma. In well differentiated adenocarcinoma, the acinar cells were generally stained less intensely than in benign prostatic hyperplasia while in poorly differentiated tissue, strongly positive immunoperoxidase staining was found in some cancer cells scattered in the stroma. All prostatic cancer tissues examined (N = 21), with the exception of one, exhibited at least a few positive immunoreactive areas for the 94 amino acid secretory protein. In addition, immunoperoxidase staining was observed in lung and bone marrow metastases respectively in two patients with prostatic carcinoma. All other normal tissues and non-prostatic cancers studied to date were negative. These results suggest that this new marker could be a useful addition to prostatic acid phosphatase and prostate specific antigen.     

Creatine phosphokinase isoenzymes in human prostatic tissues: a comparison between benign hyperplasia and adenocarcinoma

The objective of this study was to determine the distribution of creatine phosphokinase (CPK) into its three isoenzymes, MM, MB, and BB, in human prostatic tissue, in patients with benign hyperplasia (BPH) and adenocarcinoma. Specimens were obtained from 23 patients with adenocarcinoma of the prostate and 25 patients with benign hyperplasia. We also had the opportunity to analyze the CPK content in two normal prostates, the first from a 16 1/2-year-old boy and the second from a 9 1/2-year-old child. Our results showed prostate tissue to contain almost exclusively the BB isoenzyme with traces of the MB and MM dimers in both cancer and BPH as well as the specimen of normal prostate from the 16 1/2-year-old boy. As for the 9 1/2-year-old child, we found the following distribution: 39% MM, 21% MB, and 40% BB dimer. A comparison of the CPK-BB content in benign hyperplasia and adenocarcinoma revealed no significant difference between the two groups. Furthermore, we tried to correlate prostatic tissue CPK-BB levels with another possible tumor marker of the prostate, prostatic acid phosphatase (PAP) measured in the cytosol. No correlation was found between these two markers. We also studied the relationship of CPK-BB and PAP content in prostatic tissue to nuclear and cytosolic androgen receptor content in human prostatic tissue. We found some correlation between CPK-BB and androgen cytosolic receptors as well as between PAP content and androgen cytosolic receptors in patients with benign hyperplasia. No such correlation was found in the group with adenocarcinoma. In conclusion, this study does not show that the measurement of CPK-BB in the prostatic tissue could be used as an index of tissue malignancy.     

PSA"灰区"值时前列腺癌组织中Trp-p8的表达及意义

目的 研究Trp-p8蛋白在PSA"灰区"前列腺组织中的表达规律,探讨其在前列腺癌(PCa)早期诊断中的作用.方法 通过免疫组织化学的方法研究了28例PSA"灰区"前列腺组织中Trp-p8蛋白的表达情况,其中前列腺增生症(BPH)和PCa标本各14例,采用图文数据成像分析系统判定各组织中Trp-p8蛋白的表达强度,分析其差异性.结果 BPH中Trp-p8蛋白的表达强度较弱,呈不表达或微量表达.在PCa组织中Trp-p8蛋白均呈不同程度的阳性表达,这种表达差异具有统计学意义.结论 Trp-p8在PSA"灰区"前列腺组织中的表达存在差异,在PCa组织中Trp-p8蛋白的表达强度高于BPH组织,这种差异性表达对于早期PCa诊断具有重要意义.