肿瘤转移抑制基因nm23在人卵巢癌中的表达及其与淋巴结转移的关系

目的研究肿瘤转移抑制基因ｎｍ２３，表达产物二磷酸核苷激酶（ＮＤＰＫ）在Ⅲ期卵巢癌中的表达及其意义。方法用微波仪ＡＢＣ免疫组织化学染色法研究了２３例Ⅲ期卵巢癌患者。结果ＮＤＰＫ／ｎｍ２３在人Ⅲ期卵巢癌中有较高的表达，阳性率为５２．１７％（１２／２３），其中无淋巴结转移的阳性率为８１．８２％（９／１１），伴有淋巴结转移的阳性率为２５％（３／１２），差异有显著性（Ｐ＝０．０２）；卵巢癌的细胞分化程度越高，ｎｍ２３的阳性检出率也越高，各级之间差异有显著性（Ｐ＜０．０５）。结论ｎｍ２３基因可能在卵巢癌转移和细胞分化过程中起调节作用，其表达程度与卵巢癌淋巴结转移呈负相关，与其分化程度呈正相关。     

Occult lymph node metastases detected by cytokeratin immunohistochemistry predict recurrence in node-negative endometrial cancer

OBJECTIVE: Even after curative resection of early endometrial cancer, some patients die as a result of recurrence. We believe that these patients likely had occult lymph node metastases at the time of diagnosis. In an attempt to identify the responsible occult metastases, the clinicopathological significance of cytokeratin expression in lymph nodes with unconfirmed metastasis was evaluated retrospectively in patients with endometrial carcinoma. METHODS: We examined 304 pelvic lymph nodes and 46 primary tumors excised from 46 patients with endometrial cancer, including 36 with Stage I disease and 10 with Stage IIIc disease. Formalin-fixed paraffin-embedded tissue sections were stained immunohistochemically using antibodies against cytokeratin, CA125, and macrophage-related antigen. Sections were also stained with hematoxylin and eosin. RESULTS: In 10 patients with Stage IIIc disease, cytokeratin expression was detected in cells other than the tumor cells in all 13 lymph nodes with metastasis and also in 20 (30.3%) of 66 lymph nodes without metastasis. Cytokeratin expression was observed in 37 (16.4%) of 225 lymph nodes with unconfirmed metastasis, which were obtained from 14 of 36 patients with Stage I disease. Five of fourteen patients with lymph nodes expressing cytokeratin had recurrent disease in the pelvic cavity, while all 22 patients with unconfirmed cytokeratin expression in their lymph nodes showed no recurrence. Cytokeratin and CA125 were detected simultaneously on macrophages in lymph nodes. Cytokeratin expression in lymph nodes was closely related to lymph-vascular space involvement of the primary tumor, but was not related to either histological grade or depth of myometrial invasion. Multivariate analysis identified cytokeratin expression as an independent risk factor for recurrence in Stage I endometrial cancer. CONCLUSIONS: The immunohistochemical expression of cytokeratin in lymph nodes with undetected metastases predicts occult metastasis to these nodes and is a risk factor for recurrence in early-stage endometrial cancer.     

卵巢浆、粘液性囊腺癌增殖细胞核抗原表达的研究

目的：研究卵巢浆、粘液性囊腺癌增殖细胞核抗原（ＰＣＮＡ）的表达及其临床病理意义。方法：应用ＰＣＮＡ的单克隆抗体ＰＣ１０，以ＡＢＣ免疫组织化学方法，对５０份卵巢浆液性囊腺癌、１８份卵巢粘液性囊腺癌和５份正常卵巢组织的石蜡标本作ＰＣＮＡ表达的检测，并根据其阳性细胞率评分。结果：卵巢浆液性囊腺癌ＰＣＮＡ阳性细胞率评分高于卵巢粘液性囊腺癌；组织学分化程度越低，ＰＣＮＡ阳性细胞率评分越高；临床分期越晚，ＰＣ－ＮＡ阳性细胞率评分越高；伴有淋巴转移者ＰＣＮＡ阳性细胞率评分高于无淋巴转移者；ＰＣＮＡ表达为强级的患者５ａ生存率明显低于ＰＣＮＡ表达为弱级者；差异均有显著性。结论：ＰＣＮＡ免疫组化检测可作为预测卵巢浆、粘液性囊腺癌淋巴转移和患者预后的重要参考指标。     

卵巢上皮性癌淋巴结转移相关差异表达蛋白内质网氨基肽酶1的表达及意义

目的 从基因转录及蛋白表达的水平检测内质网氨基肽酶1(ERAP1)在卵巢上皮性癌(卵巢癌)细胞、组织中的表达,探讨其与卵巢癌转移的关系.方法 应用实时荧光定量PCR技术、蛋白印迹法检测在卵巢癌淋巴结非定向转移细胞系(SKOV3)与淋巴结定向高转移细胞系(SKOV3-pm2、SKOV3-pm3、SKOV3-pm4)中ERAP1 mRNA和蛋白的表达情况;并应用免疫组化方法在人卵巢癌原发灶与相应的淋巴结转移灶、裸鼠卵巢癌移植瘤原发灶与相应的淋巴结转移灶中对ERAP1的蛋白表达进行验证.结果 SKOV3、SKOV3-pm2、SKOV3-pm3、SKOV3-pm4细胞中ERAP1 mRNA和蛋白的表达呈下降趋势(分别为0.118±0.012、0.031±0.003、0.028±0.003、0.016±0.005;0.91±0.33、0.09±0.03、0.10±0.04、0.05±0.04),其中,SKOV3细胞中ERAP1 mRNA和蛋白的表达显著高于SKOV3-pm2、SKOV3-pm3、SKOV3-pm4细胞,分别比较,差异均有统计学意义(P<0.05).ERAP1蛋白在人卵巢痛原发灶(184±14)和相应的淋巴结转移灶、裸鼠卵巢癌移植瘤原发灶(143±22)和相应的淋巴结转移灶(97±12)中的表达均呈下降趋势,分别比较,差异均有统计学意义(P<0.05).结论 卵巢癌中ERAP1表达的下降或缺失与淋巴结转移有关.     

Jejunal adenocarcinoma presenting as a primary ovarian carcinoma

OBJECTIVE: The aim of this case report was to evaluate the impact of immunohistochemical markers in diagnosing the primary site of adenocarcinoma in the abdominopelvic region. METHODS: Surgicopathologic data were obtained from laparotomy and necropsy. Paraffin-embedded tissue from the ovary and jejunum was stained with hematoxylin and eosin, as well as with immunohistochemical stains for cytokeratin 20 and cytokeratin 7. RESULTS: A 53-year-old African American woman underwent an emergency laparotomy due to small bowel obstruction. During the operation, in addition to a complex adnexal mass as the cause of obstruction, a small solid jejunal tumor was also identified. Pathologic evaluation of the two sites demonstrated an infiltrating moderately to poorly differentiated adenocarcinoma with mucinous features. The malignant cells from both intestinal and ovarian sites showed immunoreactivity for cytokeratin 20 and revealed negative staining for cytokeratin 7. These results confirmed the diagnosis of intestinal primary with ovarian metastasis, which was initially misdiagnosed as an ovarian primary. CONCLUSION: Given the potential difficulty in determining the primary site of these tumors, immunohistochemistry proved to be a useful tool in reaching the correct diagnosis.     

Retrograde Lymphatic Spread: A Likely Route for Metastatic Ovarian Cancers of Gastrointestinal Origin

In order to outline the pathways of gastrointestinal malignancies metastasizing to the ovaries, we reviewed 103 cases of metastatic ovarian tumors, and also performed para-aortic lymph node sampling on 11 patients at operation for metastatic ovarian tumors. Of the 103 patients, 74% (26/35) with gastric cancer and 67% (45/67) with colorectal cancer had lymph node metastasis at or before the diagnosis of ovarian tumor. Intraperitoneal metastases presented in 49 and 42% of patients with gastric and with colorectal cancers, respectively. Twenty-three percent of gastric cancer patients and 25% of colorectal cancer patients presented with both lymph node and intraperitoneal metastases. The ovary was the first or among the early metastatic organs diagnosed in 51 of the 53 patients with metachronous ovarian metastases. Only 4 patients with colorectal cancer and none with gastric cancer showed parenchymal organ metastases. These 4 patients also showed intraperitoneal lesions, and 3 of these 4 patients had node metastasis. Among the 11 patients who underwent prospective para-aortic lymph node sampling during operation for the ovarian tumors, only 1 had enlarged para-aortic nodes depicted by computed tomography, 2 had grossly enlarged (≥1.5 cm) para-aortic lymph nodes noted at surgery, and 6 of the 7 patients with gastric cancer and all 3 with colorectal cancer had metastatic nodes histologically. Among the 58 nodes taken from these patients, 67% showed metastatic foci. We concluded that lymph node metastasis is frequently seen in patients with metastatic ovarian tumors of gastrointestinal origin, and hypothesized that retrograde lymphatic spread is a likely route for the metastases.     

GPNMB在上皮性卵巢癌组织中的表达及临床意义

目的探讨非转移性黑色素瘤糖蛋白B（GPNMB）在上皮性卵巢癌组织中的表达,及其与卵巢癌临床病理学特征的关系。方法采用免疫组织化学染色和逆转录聚合酶链反应（RT-PCR）检测116例卵巢癌、42例卵巢良性肿瘤和40例正常卵巢组织中GPNMB的表达。结果免疫组织化学染色和RT-PCR结果显示卵巢癌患者GPNMB表达水平明显升高,与正常对照组、卵巢良性肿瘤组相比差异均有统计学意义（P〈0.05）。GPNMB表达水平与卵巢癌的组织学类型相关（P〈0.05）,而与年龄、病理分级、FIGO分期、大网膜转移、淋巴转移及腹水量无相关性（P〉0.05）;结论卵巢癌患者中GPNMB明显升高,并与组织学类型相关,提示可能参与了卵巢癌的发病。     

细胞角蛋白、CA125对子宫内膜癌淋巴结微转移的诊断价值

目的　研究细胞角蛋白 (cytokeratin ,CK)、CA12 5对子宫内膜癌淋巴结微转移的诊断价值 ,及其作为子宫内膜癌复发危险因素的临床意义。方法　采用免疫组化链霉菌抗生物素蛋白 过氧化物酶连接 (SP)法检测 5 0例子宫内膜癌患者的原发灶组织 5 0份和淋巴结 2 98枚中CK、CA12 5的表达情况 ,采用多元回归分析法对影响子宫内膜癌复发的危险因素进行分析。结果　 (1)CK、CA12 5在子宫内膜癌组织中的阳性表达率分别为 10 0 % (5 0 / 5 0 )和 78% (39/ 5 0 )。 (2 )HE染色检查有转移的淋巴结中 ,CK和CA12 5均呈强阳性表达的阳性表达率均为 10 0 % (16 / 16 )。HE染色检查无转移的淋巴结中 ,CK、CA12 5的阳性表达率分别为 15 % (4 3/ 2 82 )和 12 % (35 / 2 82 ) ,且均为弱阳性表达。 (3)Ⅰ、Ⅱ期子宫内膜癌患者淋巴结中 ,CK阳性与CK阴性表达者的复发率分别为 38%、0 ,两者比较 ,差异有显著性 (P <0 0 5 ) ;CA12 5阳性与CA12 5阴性表达者的复发率分别为 39%、4 % ,两者比较 ,差异也有显著性 (P <0 0 5 )。 (4 )多元回归分析结果显示 ,淋巴结中CK表达是影响Ⅰ、Ⅱ期子宫内膜癌复发的独立危险因素 ,而淋巴结中CA12 5表达和肌层浸润深度均为影响Ⅰ、Ⅱ期子宫内膜癌复发的相关因素。结论　在HE染色检查无转移的淋巴     

High cyclooxygenase-2 expression in stage IB cervical cancer with lymph node metastasis or parametrial invasion

OBJECTIVE: The enzymes cyclooxygenase (COX)-1 and -2 are necessary for the synthesis of prostaglandins. COX-2 is usually absent in normal cells and is upregulated and expressed as a product of the "immediate early" gene during inflammatory processes. In previous studies, the expression of COX-2 has been shown to be induced by proinflammatory cytokines, and suggestions have been made that overexpression of COX-2 suppresses apoptosis and is directly related to tumor growth. We have attempted to determine a relationship between tumor invasion and metastasis of uterine cervical cancer and COX and apoptosis by comparing the protein expression of apoptosis, COX-1, and COX-2 in tumor tissues. METHODS: The subjects were 36 patients who were FIGO stage IB uterine cervical cancer patients who underwent surgery at Ajou University Hospital. There were 12 cases with lymph node or parametrial involvement. All tissues were subjected to immunohistochemical staining for COX-1, -2, and TUNEL method for apoptosis detection, and the following results were obtained. RESULTS: Tumor tissues confirmed by cytokeratin were separated into tumor surface, tumor stroma, and invasion site portions, in which decreased apoptosis was observed in the invasion sites. COX-2 expression was observed in all tumor tissues and was especially strong in the tumor invasion site. Therefore, it is suggested that COX-2 expression may suppress cell apoptosis at the tumor invasion site. When COX-2 expression was investigated according to the groups with regard to the presence of lymph node or parametrial involvement, there was a statistically significant (Mann-Whitney U test) COX-2 expression difference in the tumor invasion site (P value = 0.040) and the tumor stroma (P value = 0. 028). CONCLUSIONS: In surgically treated stage IB cervical cancer patients, COX-2 was significantly expressed when lymph node or parametrial involvement was present. These results suggest that the expression of COX-2 in stage IB cervical cancer may downregulate apoptotic processes and thus enhance tumor invasion and metastasis.     

Urachal adenocarcinoma metastatic to the ovaries: case report and literature review.

We report a urachal adenocarcinoma metastatic to both ovaries in a 50-year-old Japanese woman. Pelvic examination and imaging studies revealed a large cystic tumor occupying the pelvis and another cystic tumor between the umbilicus and the urinary bladder. A laparotomy was performed. Histopathological examination revealed a urachal tumor that was a well-differentiated invasive mucinous adenocarcinoma; the overlying urothelium was intact. The right and left ovarian tumors were well-differentiated mucinous adenocarcinomas. The urachal and ovarian tumors were immunoreactive for cytokeratin 20 and carcinoembryonic antigen, but negative for cytokeratin 7. The patient is alive with lymph node and bone metastases 6 months postoperatively. This is the eighth reported case of an adenocarcinoma of the bladder with ovarian metastasis.     

髓系细胞触发受体-1在人卵巢癌组织中的表达及其与淋巴结转移的相关性研究

目的:通过检测髓系细胞触发受体-1(TREM-1)在人卵巢癌组织中的表达及其与淋巴转移的相关性,探讨其参与调控肿瘤相关性炎症的可能机制。方法:选择2010年10至2011年10月南昌大学第一附属医院收治的卵巢癌患者30例与卵巢良性肿瘤患者20例。免疫组织化学法测定TREM-1在卵巢癌和卵巢良性肿瘤组织中的表达;用CD163标记M2型肿瘤相关巨噬细胞(TAMs);用D2-40标记微淋巴管,计算微淋巴管密度(LMVD)。分析TREM-1表达与卵巢癌临床病理资料的相关性。结果:卵巢癌组织中TREM-1蛋白的阳性表达率为100%,强阳性表达率为70%(21/30),阳性率显著高于卵巢良性肿瘤的10.0%(2/20)(χ2=42.19,P=0.000)。卵巢良性肿瘤组织中TREM-1和CD163很少表达。TREM-1定位于TAMs。TREM-1表达强度与淋巴转移存在相关性(P=0.01)。Logistic回归分析示,TREM-1评分是淋巴结转移的危险因素(P=0.009)。结论:TREM-1表达于卵巢癌组织的TAMs,其调控的炎症可能在促进卵巢癌淋巴转移中起着重要作用。     

单中心559例卵巢癌患者淋巴结转移的危险因素分析与淋巴结切除术临床决策探讨#br#

【Abstract】?Objective?To review the data of patients with ovarian cancer, analyze the related factors of pelvic lymph node metastasis (PLNM) and para-aortic lymph node metastasis (PALNM), and establish a predictive model, so as to provide suggestions for clinical practice. Methods?The clinicopathological data of 559 patients with ovarian cancer treated in Chinese PLA General Hospital from January 2014 to January 2019 were retrospectively analyzed. The risk factors affecting PLNM and PALNM were analyzed by univariate and logistic regression, and the prediction model was established. Results?Among 559 ovarian cancer patients, pelvic lymph node metastasis was found in 205 cases (36.67%) and abdominal para-aortic lymph node metastasis in 117 cases (20.93%). The independent risk factors affecting PLNM were bilateral lesions (OR=2.278, 95%CI: 1.433~3.621), pelvic metastases (OR=1.801, 95%CI: 1.154~2.810), and abdominal metastases (OR=4.177, 95%CI: 2.597~6.717) and appendiceal metastasis (OR=2.332, 95%CI: 1.389~3.915); The independent risk factors affecting PALNM were appendiceal metastasis (OR=2.324, 95%CI: 1.383~3.906) and PLNM (OR=7.629, 95%CI: 4.615~12.610). Age (≥55 years) (OR=0.566, 95%CI: 0.350~0.915) was the protective factor. The ROC curve AUC of PLNM and PALNM was 0.803 (95%CI: 0.767~0.840) and 0.793 (95%CI: 0.745~0.841), respectively. Conclusion?Bilateral lesions, pelvic metastases, intraperitoneal metastases and appendiceal metastases were independent risk factors for PLNM in ovarian cancer patients. Appendiceal metastasis and PLNM were independent risk factors for PALNM, and age (≥55 years) was the protective factor.     

Occult lymph node metastases in early stage vulvar carcinoma patients

OBJECTIVE: In early stage vulvar carcinoma patients, there is at trend towards individualized treatment in order to reduce morbidity and sequela following inguinal lymph node dissection. However, recurrences in the groin are almost always fatal. In the present study, we address the occult lymph node metastases in vulvar squamous cell carcinoma patients by using serial sectioning and immunostaining of lymph nodes in a larger series of vulvar carcinoma patients and relate the findings to clinical follow-up data. METHODS: From 75 vulvar squamous cell carcinoma patients staged surgical FIGO I-III, 421 lymph nodes found negative at the hematoxylin & eosin (H&E) routine investigation were scrutinized. From formalin-fixed and paraffin-embedded tissues, sections were cut with 150 mum interval and stained with H&E and cytokeratin AE1/AE3. Two classes were used to describe the amount of tumor cells: <100 cells and >100 cells. RESULTS: Positive cytokeratin AE1/AE3 staining was found in 25/421 (6%) of the lymph nodes. Occult lymph node metastases were found in 17/75 (23%) of the patients. Correlation was found between lymph node metastasis and site of recurrence (P = 0.01). Twenty-eight percent of the patients had relapse. CONCLUSIONS: The present study underlines the importance of serial sectioning and immunostaining of lymph nodes in the search for micrometastases in vulvar carcinoma patients. However, the results of the present study do not suggest a more thorough examination of non-sentinel lymph nodes in vulvar carcinoma patients where the sentinel lymph nodes are thoroughly examined.     

Pathologic evaluation of inguinal sentinel lymph nodes in vulvar cancer patients: a comparison of immunohistochemical staining versus ultrastaging with hematoxylin and eosin staining

OBJECTIVES: To evaluate the value of immunohistochemical (IHC) staining of inguinal sentinel lymph nodes (SLN) found to be negative for metastatic disease by ultrastaging with hematoxylin and eosin (H&E) staining. METHODS: An IRB approved study identified 29 patients who had undergone an inguinal sentinel lymph node dissection for squamous cell carcinoma of the vulva. All sentinel lymph nodes found to be negative for metastatic disease based on ultrastaging with H&E staining were reevaluated with pancytokeratin antibody (AE1/AE3) immunohistochemical (IHC) staining to detect micrometastasis. RESULTS: Twenty-nine patients with squamous cell carcinoma of the vulva underwent an inguinal sentinel node dissection. Nineteen patients had inguinal dissections negative for metastatic disease, 2 patients had bilateral inguinal metastasis, and 8 patients had unilateral inguinal metastasis. A total of 42 groin dissections with SLN biopsies were performed; 12 groins were positive for metastatic disease and 30 were negative based on ultrastaging with eosin and hematoxylin staining. A total of 107 sentinel lymph nodes (2.5 SLN per groin) were obtained, of which 18 SLN contained metastatic disease identified by ultrastaging and staining with H&E. Two SLN contained micrometastasis less than 0.3mm in size and 16 SLN contained metastasis greater than 2mm in size. Eighty-nine SLN found to be negative for metastasis by ultrastaging with H&E staining were also negative for micrometastasis on evaluation with pancytokeratin antibody AE1/AE3 IHC staining. CONCLUSIONS: The addition of immunohistochemical staining to ultrastaging with H&E staining in the pathologic evaluation of inguinal sentinel lymph nodes does not increase the detection of micrometastasis in patients with primary squamous cell carcinoma of the vulva.     

Lymph node metastasis in ovarian cancer: difference between serous and non-serous primary tumors

OBJECTIVE: To investigate the lymph node sites most susceptible to involvement relative to primary tumor histology in ovarian cancer. METHODS: The locations of metastatic lymph nodes were investigated in 208 patients with primary ovarian cancer who underwent systemic lymphadenectomy covering both the pelvic and para-aortic regions. RESULTS: Lymph node metastasis was present in 12.8% (20/156) of patients with stage I (pT1M0), 48.6% (18/37) with stage II (pT2M0), and 60% (9/15) with stage III (pT3M0) disease, thus in 22.6% (47/208) of all study patients. Isolated para-aortic nodal involvement was present in 23.3% (14/60) of patients with serous tumor and 4.1% (6/148) of those with non-serous tumor (P = 0.00002). In an analysis of 35 positive nodes from 25 patients with up to 3 positive nodes, 86.4% (19/22) of metastatic lymph nodes from patients with serous tumor were found in the para-aortic region, with 14 positive nodes located above the inferior mesenteric artery (IMA) and 5 below it, whereas metastasis to para-aortic lymph nodes accounted for 53.8% (7/13) of metastatic lymph nodes from patients with non-serous tumor (P = 0.0334). CONCLUSIONS: The locations of metastatic lymph nodes in ovarian cancer depend upon the histologic type of the primary cancer. In cases of serous tumor, the para-aortic region, particularly above the IMA, is the prime site for the earliest lymph node metastasis. However, the likelihood of pelvic node involvement is almost equal to that of para-aortic node involvement in cases of non-serous tumor.     

Lymph node metastasis in stage I ovarian cancer]

One hundred and sixteen cases of stage I Ovarian cancer from nine hospitals in all the China during Sept. 1982-April 1991 were investigated for their lymph node metastasis. There were 70 epithelial tumors, 36 malignant germ cell tumors, 8 from gonadal stroma and 2 undifferentiated. In 89 patients the ovarian tumor was confined to one ovary (stage Ia); in 6 cases both ovaries were involved (stage Ib); 21 cases was documented stage Ic. Systemic lymphadenectomy covering all pelvic groups of node together with aortic lymph node accomplished in 82 cases. In the remaining 34 cases only pelvic lymph node dissection was performed. There was 10.3 percent incidence of lymphatic metastasis in this series. The most common lesion was serous cystadenocarcinoma. All patients were follow-up for at least half year. The mortality rate in patients without lymph node metastasis was 2.8%, but 8.3% for those with lymph node metastasis. The clinical significance of retroperitoneal lymphadenectomy in early ovarian cancer was discussed.     

卵巢癌组织中错配修复蛋白MLH1的表达及临床意义

目的:观察卵巢癌组织中错配修复蛋白Mut L同系物1(MLH1)表达水平,探讨其与卵巢癌患者临床病理特征的关系,并分析MLH1与细胞增殖相关核抗原Ki-67表达的相关性。方法:选择71例卵巢癌组织、28例卵巢交界性肿瘤组织及20例正常卵巢组织作为研究对象,用免疫组织化学染色评分标准评价分析MLH1缺失与卵巢癌组织学类型、淋巴结转移情况、临床分期以及与Ki-67表达的相关性。结果:在71例卵巢癌组织中MLH1缺失率为14.1%;在卵巢交界性肿瘤组织及正常卵巢组织中无MLH1缺失现象(P<0.05);随肿瘤临床分期的升高,MLH1的缺失率显著降低(P<0.05),但其与肿瘤组织学类型、淋巴结转移无明显关系。在Ki-67低表达组中MLH1缺失占28.00%,在Ki-67高表达组中占6.52%(P<0.05),MLH1缺失与Ki-67表达呈负相关(r=-0.295,P=0.013)。结论:与卵巢交界性肿瘤及正常卵巢组织相比,MLH1缺失率在卵巢癌中明显升高,且随着卵巢癌临床分期的升高而降低。同时与卵巢病理诊断指标Ki-67具有相关性。     

化疗对晚期卵巢、输卵管及腹膜浆液性癌淋巴结转移的临床疗效(附70例临床分析)

目的:探讨化疗对晚期卵巢、输卵管及腹膜浆液性癌腹膜后淋巴结转移的临床疗效。方法:将晚期卵巢、输卵管及腹膜浆液性癌70例患者,根据淋巴结切除术与化疗的先后顺序分为2组:A组21例,化疗后行淋巴结切除术。B组49例,淋巴结切除术后化疗。比较2组患者的一般情况、治疗方案及淋巴结转移情况。结果:2组患者的年龄,肿瘤分期分级,治疗前的肿瘤标记物,切除淋巴结的数量等均无显著性差异(P>0.05)。初治时A组患者盆腹腔黏连及转移重于B组;初次手术A组进行满意的肿瘤细胞减灭术的几率明显低于B组(0%vs73.47%,P<0.05)。化疗后A组患者淋巴结转移率低于B组(38.10%vs49.00%,P>0.05),腹主动脉旁淋巴结为肿瘤最常侵犯的淋巴结。A组行TC(泰素/紫杉醇+伯尔定/卡铂)或TP(泰素/紫杉醇+顺铂)方案化疗的患者淋巴转移率低于行CAP(顺铂+阿霉素+环磷酰胺)方案的患者(33.33%vs50%,P=0.045)。结论:化疗对卵巢、输卵管及腹膜浆液性癌淋巴结转移有一定的疗效。初治时不能进行淋巴结切除的患者可考虑先行化疗后再次手术切除淋巴结。     

The relation of intraabdominal findings and retroperitoneal lymph node metastasis in the epithelial ovarian cancer patients

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Expression and localization of aquaporin-5 in the epithelial ovarian tumors

OBJECTIVE: To investigate the expression and localization of aquaporin-5 (AQP5) in epithelial ovarian tumors and its clinic significance. METHODS: The expression of AQP5 protein and mRNA in 65 cases epithelial ovarian tumors and 13 cases normal tissue were measured by immunohistochemical technique, Western blotting and RT-PCR, respectively. RESULTS: AQP5 is mainly localized in the basolateral membranes of benign tumor cells, the apical and basolateral membrane of borderline cells and scattered in the membrane of malignant cells and almost no or weak staining in normal ovarian epithelium. The AQP5 expression in ovarian malignant and borderline tumors was significantly higher than that of benign tumors (P < 0.05) and normal tissue (P < 0.05). Of all the epithelial ovarian malignant tumors, the AQP5 expression in cases with ascites volume more than 1000 ml was higher than that of ascites volume less than 500 ml (P < 0.05). Increased AQP5 protein level was associated with lymph node metastasis (P < 0.05). There is a positive correlation between ascites amount and the expression of AQP5 protein and mRNA (P < 0.05), as well as lymph node metastasis and the expression of AQP5 protein and mRNA (P < 0.05). The AQP5 expression was not related with FIGO stage, grade and histological type (P > 0.05). CONCLUSION: The data suggest that overexpression of AQP5 play an important role in tumorigenesis of epithelial ovarian tumors, which may be related to the ascites formation of ovarian carcinoma.