鼻咽癌组织中HSP70和Ki-67的表达及其对预后影响的评价

目的：探讨热休克蛋白70(heat shock protein 70，HSP70)和Ki-67在鼻咽癌组织中的表达及与预后的关系。方法：采用免疫组织化学二步法，观察50例鼻咽癌患者鼻咽部或颈淋巴结活体组织检查存档石蜡标本中HSP70和Ki-67蛋白的表达。结果：50例鼻咽癌组织中HSP70和Ki-67阳性表达率分别为36．0％(18／50)和98．0％(49／50)；HSP70在T分期中的阳性表达差异无统计学意义；HSP70( )组生存率(10．9％)与HSP70(-)组(33．8％)相比，差异有统计学意义，X^2=4．10，P=0．043；COX模型多因素分析显示，HSP70( )表达是独立的预后不良因素之一，P=0．031。在临床研究指标(T分期、N分期、生存率等)中，Ki-67的高表达( ／ )率与低表达( ／-)率比较均差异无统计学意义。结论：HSP70表达可作为评价鼻咽癌患者预后的指标。     

鼻咽癌HSP70表达与血清EB病毒IgA/VCA的关系及其临床意义

背景与目的:热休克蛋白(HSP)70在许多恶性肿瘤中均有表达,但在鼻咽癌组织中的表达与血清IgA/VCA滴度及预后的关系尚不清楚。本研究旨在检测鼻咽癌组织中HSP70的表达和含量水平,探讨HSP70表达与鼻咽癌患者血清EB病毒IgA/VCA滴度及预后的关系。方法:采用SP免疫组化法检测38例鼻咽癌组织中HSP70表达,ELISA法检测38例鼻咽癌组织中HSP70含量,免疫酶标法检测38例鼻咽癌患者血清IgA/VCA滴度。结果:HSP70在38例鼻咽癌组织中表达率为60.5%。在不同性别、年龄、T分期、N分期和临床分期鼻咽癌组织中HSP70表达率均无显著性差异(P>0.05)。HSP70表达和含量与血清EB病毒抗体IgA/VCA滴度呈正相关(P=0.001)。HSP70阳性组和阴性组患者的5年生存率分别为65.2%和80.0%,5年无瘤生存率分别为40.0%和78.6%(P=0.04)。结论:HSP70在临床Ⅱ、Ⅲ期鼻咽癌患者癌组织中的表达与患者的IgA/VCA滴度正相关,HSP70阳性患者常规治疗后预后较差。     

Smac、Bcl-2和Ki-67在胰腺癌组织中的表达及预后价值

目的:探讨胰腺癌组织中Smac、 Bcl-2和Ki-67蛋白的表达及其与患者临床病理特征和生存期的关系.方法:收集胰腺癌病例30例,随访生存期;所有标本行免疫组织化学检测Smac、Bcl-2和Ki-67的表达;标准评定采用半定量法.结果: 30例(100%)胰腺癌组织中均有Smac阳性表达,Bcl-2和Ki-67的阳性表达率分别为63.3%和96.7%;Smac表达与胰腺癌组织分化程度呈正相关(P<0.05),Ki-67表达与之呈负相关(P<0.05),而 Bcl-2表达与之无相关性(P>0.05);Smac、Bcl-2和Ki-67的表达强度与临床分期均无关.Smac表达与肿瘤是否发生血管浸润和淋巴结转移无关(P>0.05),而Bcl-2和Ki-67表达差异均有统计学意义(P均<0.05).Smac表达≤25%与表达>26% 2组比较,术后生存率的差异无统计学意义(P=0.08).Bcl-2表达≤25%与Bcl-2表达>26%2组比较,术后生存率差异有统计学意义(P=0.02),Bcl-2表达≤25%者的生存期明显长于Bcl-2表达>26%者.而Ki-67表达≤25%与表达>26% 2组比较,生存率无统计学差异(P=0.63).多因素分析结果提示,Bcl-2表达、有无淋巴结转移或血管浸润为独立预后因子.结论:Smac蛋白在胰腺癌组织中高表达,胰腺癌组织中Bcl-2蛋白表达水平可作为评价生存期预后的有价值指标.     

Ki-67表达与鼻咽癌放射敏感性的关系

目的探讨Ki-67表达与鼻咽癌放射敏感性的关系。方法应用免疫组织化学法检测159例鼻咽癌组织中Ki-67蛋白表达的情况。结果159例鼻咽癌组织中Ki-67阳性表达率为98.7%。Ki-67表达强度与鼻咽癌的临床分期、根治放疗70Gy后鼻咽部肿瘤大小和颈部淋巴结的消退情况无关(P>0.05)。结论Ki-67与鼻咽癌的放射敏感性无关。     

Ku70蛋白在鼻咽癌组织中的表达及临床意义

目的:探讨接受根治性放疗鼻咽癌(nasopharyngeal carcinoma,NPC)患者Ku70蛋白的表达与患者预后的关系。方法:符合入组条件的73例鼻咽癌放疗前活检标本,应用免疫组织化学技术检测Ku70的表达,并分析Ku70表达与NPC的分期,复发,转移,生存率之间的关系。结果:NPC原发灶中Ku70阳性表达率为98.7%。χ2分析Ku70蛋白高表达与T分期密切相关(P<0.01),与N分期和TNM分期无关。Cox分析显示Ku70蛋白与鼻咽癌的局控率、无进展生存率、总体生存率有关系,与无远处转移生存率无关。Ku70不或低表达者的局控率、无进展生存率、总体生存率均较高,反之则较低,各曲线之间差异具有统计学意义(P<0.05)。结论:Ku70的高表达能预测肿瘤复发,对判断鼻咽癌预后有重要的参考价值。     

survivin和Ki-67蛋白在喉癌患者中的表达情况及与临床特征的关系

目的探讨存活蛋白(survivin)和Ki-67在喉癌患者中的表达情况及其与临床特征的关系。方法收集喉癌组织标本120例及癌旁组织标本50例,采用免疫组织化学法检测喉癌组织和癌旁组织中survivin和Ki-67蛋白的表达情况,分析喉癌组织中survivin和Ki-67蛋白表达与临床特征的关系。结果喉癌组织中survivin和Ki-67蛋白的阳性表达率均明显高于癌旁组织(P﹤0.01)。不同年龄、性别、分化程度的喉癌患者喉癌组织中survivin和Ki-67蛋白的阳性表达率比较,差异均无统计学意义(P﹥0.05)。TNM分期为Ⅲ～Ⅳ期、有淋巴结转移的喉癌患者喉癌组织中survivin和Ki-67蛋白的阳性表达率均明显高于TNM分期为Ⅰ～Ⅱ期、无淋巴结转移的患者,差异均有统计学意义(P﹤0.01)。结论 survivin和Ki-67蛋白在喉癌组织中高表达,并且与喉癌的发生发展关系密切。     

宫颈鳞癌组织Ki-67和Survivin表达与新辅助化疗敏感相关性的探讨

目的:探讨Ki-67和Survivin在宫颈鳞癌新辅助化疗前后表达的意义。方法:在新辅助化疗前后用免疫组化方法检测32例宫颈癌组织Ki-67和Survivin的表达。结果:化疗前后Ki-67阳性表达率分别为96.9%(31/32)和84.4%(26/32),差异有统计学意义,P=0.045;化疗前后Sur-vivin阳性表达率为68.8%(22/32)和56.3%(18/32),差异无统计学意义,P=0.302。不同年龄段、临床分期和病理分级,化疗前后Ki-67和Survivin阳性表达率差异均无统计学意义,P>0.05;化疗前Ki-67(-)和( )组与( )和( )组的完全缓解率分别为11.1%(1/9)和52.2%(12/23),差异有统计学意义,P=0.033;化疗前Survivin(-)和阳性者的完全缓解率分别为70.0%(7/10)和27.3%(6/22),差异有统计学意义,P=0.023。结论:Ki-67和Survivin表达与化疗敏感性和疗效显著相关,与年龄、临床分期和分化程度无明显相关性;两者的表达和变化是否能做为预测宫颈鳞癌化疗敏感性和判断疗效的指标尚无法确定,仍需进一步研究。     

CD105、Ki67联合表达对卵巢上皮癌的临床意义及与其预后的相关性

目的探讨CD105和Ki67蛋白在卵巢上皮癌(EOC)中的联合表达及与其临床病理特征及预后的关系。方法采用免疫组化方法检测166例卵巢上皮癌患者石蜡包埋标本中CD105和Ki67蛋白表达。结果 CD105阳性表达率为75.9%(126/166),Ki67阳性表达率为66.3%(110/166),CD105、Ki67共同表达率为51.8%(86/166)。CD105和Ki-67在EOC中的表达呈正相关(γ=0.66,P=0.01),两者的表达与EOC淋巴结转移、临床分期呈正相关性,但与其组织细胞学分化程度及患者总体生存率呈负相关性。CD105和Ki67表达与患者总生存率显著相关。结论 CD105和Ki67蛋白表达参与卵巢上皮癌的发生、发展;CD105和Ki67均为ECO预后不良的指标。     

鼻咽癌组织多药耐药相关蛋白表达及其与临床分期关系的研究

目的:探讨多药耐药相关蛋白(mul-tidrugresistance-associatedprotein,MRP)在鼻咽癌中的表达及与临床分期的关系。方法:对73例鼻咽癌采用免疫组化SP法检测鼻咽癌中MRP的表达,并分析其表达与临床分期的关系。结果:鼻咽癌中有较高水平的MRP表达,阳性表达率为68·49%(50/73)。其中,MRP在Ⅰ~Ⅱ期的阳性表达率为58·33%(7/12),Ⅲ~Ⅳ期的阳性表达率为70·49%(43/61);T1~2期的阳性表达率为61·54%(24/39),T3~4期中阳性表达率为76·47%(26/34);N0~1期的阳性表达率为69·70%(23/33),N2~3期中阳性表达率为67·50%(27/40)。以上表达率经检验差异无统计学意义,P>0·05。结论:MRP基因在鼻咽癌中有较高的表达水平,但其表达与临床分期无关。     

鼻咽癌组织中P16、CD4和CD8的表达及其与预后的关系

目的 探讨鼻咽癌组织中P16、CD4和CD8的表达及其与鼻咽癌患者临床特点及预后的关系.方法 采用免疫组化法检测133例鼻咽癌组织中P16、CD4和CD8的表达情况,分析其表达与鼻咽癌临床病理特征及预后的关系.结果 133例鼻咽癌组织中,P16的阴性表达率为75.9％(101/133),阳性表达率为24.1％(32/133);CD4的阴性表达率为75.2％(100/133),阳性表达率为24.8％(33/133);CD8阴性表达率为76.7％(102/133),阳性表达率为23.3％(31/133).P16与CD4在鼻咽癌组织中的表达差异有统计学意义(P＜0.05),二者呈正相关趋势(r=0.206,P=0.094);P16、CD4和CD8在不同性别、年龄、民族、吸烟史、肿瘤家族史、临床分期患者中的表达差异均无统计学意义(P＞0.05),但P16表达在不同性别患者(P=0.069)、CD8表达在不同临床分期患者(P=0.085)中的差异均为临界值;P16、CD4、CD8阴性表达和阳性表达患者5年总生存率差异无统计学意义(P＞0.05),但CD4阳性表达与阴性表达患者5年无瘤生存率(P=0.002)及5年无局部复发生存率(P=0.024)差异均有统计学意义.结论 P16、CD4和CD8表达与鼻咽癌患者性别、临床分期有关.CD4阳性表达患者预后可能更佳,联合检测P16、CD4和CD8在鼻咽癌中的表达或可作为判定鼻咽癌患者生物学行为及预后评估的依据.     

Religiosity and Physical and Emotional Functioning Among African American and White Colorectal and Lung Cancer Patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

New and emerging radiosensitizers and radioprotectors

The combination of chemotherapy and radiation has led to clinical breakthroughs in several disease sites, and current work continues to define optimum combinations of proven chemotherapy as well as more recently available, noncytotoxic agents. Administration of systemic therapies allows modulation of radiation response to improve tumor control (radiosensitization) or to prevent normal tissue toxicity (radioprotection). Substantial progress has been made in identifying the targets of standard chemotherapeutic radiation sensitizers and protectors as well as in the introduction of a new generation of molecularly targeted therapies in combination with radiation. We have reviewed the most recent, predominantly early phase clinical trials combining systemic agents with radiation. Although the proof of an improved schedule ultimately needs to come from well-run Phase III trials, the search among schedules could be shortened by the use of surrogate endpoints such as presence of active drug metabolites in the tumor. This has been accomplished only in a few cases and needs to become a more standard part of radiation sensitizer and protector trials.     

Fruit and vegetables and cancer risk

The possibility that fruit and vegetables may help to reduce the risk of cancer has been studied for over 30 years, but no protective effects have been firmly established. For cancers of the upper gastrointestinal tract, epidemiological studies have generally observed that people with a relatively high intake of fruit and vegetables have a moderately reduced risk, but these observations must be interpreted cautiously because of potential confounding by smoking and alcohol. For lung cancer, recent large prospective analyses with detailed adjustment for smoking have not shown a convincing association between fruit and vegetable intake and reduced risk. For other common cancers, including colorectal, breast and prostate cancer, epidemiological studies suggest little or no association between total fruit and vegetable consumption and risk. It is still possible that there are benefits to be identified: there could be benefits in populations with low average intakes of fruit and vegetables, such that those eating moderate amounts have a lower cancer risk than those eating very low amounts, and there could also be effects of particular nutrients in certain fruits and vegetables, as fruit and vegetables have very varied composition. Nutritional principles indicate that healthy diets should include at least moderate amounts of fruit and vegetables, but the available data suggest that general increases in fruit and vegetable intake would not have much effect on cancer rates, at least in well-nourished populations. Current advice in relation to diet and cancer should include the recommendation to consume adequate amounts of fruit and vegetables, but should put most emphasis on the well-established adverse effects of obesity and high alcohol intakes.     

VEGF及KDR在大肠腺瘤和腺癌中的表达及意义

目的：探讨VEGF和KDR在大肠腺瘤和大肠腺癌中的表达及临床病理特征的关系。方法：大肠腺瘤和大肠腺癌组织标本各100例,采用免疫组织化学染色法检测VEGF和KDR在标本中的表达情况。结果：VEGF和KDR在大肠腺癌组中的阳性表达明显高于大肠腺瘤组（P〈0.05）;在正常大肠黏膜均未见VEGF和KDR表达的阳性染色;VEGF阳性表达组中KDR的阳性表达率为70%,显著高于VEGF阴性表达组中KDR的阳性表达率16%,两组比较有统计学意义（P〈0.01）。结论：大肠腺癌组织中KDR的表达与肿瘤大小、转移情况、浸润深度密切相关;VEGF和KDR在大肠腺瘤中的表达与患者的年龄、性别及分型均无相关性,而与增生程度相关（P〈0.05）。在大肠腺癌患者中VEGF及KDR表达更高,二者具有协同效应。     

肾上腺素能β受体与肿瘤生长及转移

大量研究表明肿瘤细胞可表达β受体，而一些神经递质、药物和社会心理因素可能通过β受体影响肿瘤的生长和转移，β受体激动剂、β受体阻滞剂以及抑郁等社会心理因素可加强或削弱这种作用。这为表达β受体肿瘤的治疗开辟了新的道路，提供了新的治疗靶点。     

Occupational and environmental radiation and cancer

Epidemiologic evidence on the relation between occupational and environmental radiation and cancer is reviewed. Studies of pioneering radiation workers, underground miners, and radium dial painters revealed excess cancer deaths and contributed to the setting of radiation protection standards and to theories of carcinogenesis. Occupational exposures today are generally much lower than in the past, thus any associated increases in cancer will be difficult to detect. Pooling investigations of these more recently exposed workers, however, has the potential to validate current estimates of risk used in radiation protection. New information on the effects of chronic radiation exposure also may come from studies in the former Soviet Union of Chernobyl clean-up workers and of workers at the Mayak nuclear facilities. Studies of environmental radiation exposures, other than radon, are largely inconclusive, due mainly to the difficulties in detecting the low risks associated with low dose exposures. Thyroid cancer, however, has been linked to environmental radiation from the Chernobyl accident and from nuclear weapons tests. Low-level radiation released during normal operations at nuclear plants has not been found to increase cancer rates in surrounding populations. Radon, a human carcinogen, is the most ubiquitous exposure to human populations; remediating high residential-radon levels is recommended, recognizing that the exposure can never be removed completely because it occurs naturally.     

Cell and tissue interactions in carcinogenesis and metastasis and their clinical significance

This review describes a new vision for future directions in the study of metastatic cancer biology and pathology. It is based upon clinical and experimental observations on the constituent cell lineages within a neoplasm and on tumour-host interactions. The vision incorporates information from studies in population biology, developmental biology and experimental pathology as well as investigations upon human malignant disease. The assembled information reveals that invasion and metastasis are supra-cellular manifestations of "emergent behavior" among combinations of normal and malignant cell lineages in vivo. Emergent behavior is a combinatorial interactive process in which a population displays new traits which cannot be achieved by individuals acting separately and which subside when the specific population mix disaggregates. Disruption of such pathological interactions in the field of a developing primary or secondary tumour is, therefore, required to disable the malignant population and arrest progression without tissue destruction. These conclusions originate, in part, from principles which govern the sociobiology and group behavior of bees, ants, fish, birds and human societies. In all these social organisms, external factors can disrupt signaling mechanisms and induce expanding self-perpetuating rogue behavior, leading to social disintegration. These principles also apply to cellular societies composing higher animals, which likewise need intrinsic rules to maintain social order and avoid anarchy, and recognition of this is essential for advancing future research on the mechanisms involved in carcinogenesis and metastasis. Summarised evidence is presented here to support the conclusion that miscommunications between cells and tissues in the region of the developing tumour and its metastases are the main direct perpetrators of malignant disease. Genetic lesions (mutations, deletions, translocations, reduplications, etc.), commonly seen in cancers, can significantly disrupt important molecular pathways in the networks of communications needed to sustain orderly tissue/organ structure and function. However, genetic lesions can also, themselves, be induced by abnormal cell interactions initiated by extrinsic carcinogenic agents such as chemicals, viruses, hormones and radiation. The evidence shows that, irrespective of the initiating cause, it is this miscommunication in the region of a developing tumour and its metastases that is ultimately responsible for the emergence and progression of the disease. The article describes how this information collectively, provides a framework for designing specific novel therapeutic approaches targeting the cell and tissue interactions driving tumour metastasis and its manifold effects on the whole body.     

Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: A comprehensive review and meta-analysis

Vitamin D is formed mainly in the skin upon exposure to sunlight and can as well be taken orally with food or through supplements. While sun exposure is a known risk factor for skin cancer development, vitamin D exerts anti-proliferative and pro-apoptotic effects on melanocytes and keratinocytes in vitro. To clarify the role of vitamin D in skin carcinogenesis, we performed a review of the literature and meta-analysis to evaluate the association of vitamin D serum levels and dietary intake with cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) risk and melanoma prognostic factors. Twenty papers were included for an overall 1420 CM and 2317 NMSC. The summary relative risks (SRRs) from random effects models for the association of highest versus lowest vitamin D serum levels was 1.46 (95% confidence interval (CI) 0.60–3.53) and 1.64 (95% CI 1.02–2.65) for CM and NMSC, respectively. The SRR for the highest versus lowest quintile of vitamin D intake was 0.86 (95% CI 0.63–1.13) for CM and 1.03 (95% CI 0.95–1.13) for NMSC. Data were suggestive of an inverse association between vitamin D blood levels and CM thickness at diagnosis. Further research is needed to investigate the effect of vitamin D on skin cancer risk in populations with different exposure to sunlight and dietary habits, and to evaluate whether vitamin D supplementation is effective in improving CM survival.