胃癌组织中人表皮生长因子受体2和瘦素的表达及意义

目的 探讨胃癌组织中人表皮生长因子受体2(HER-2)、瘦素与瘦素受体的表达及其与临床病理特征和预后的关系,明确HER-2在胃癌原发灶与转移淋巴结的表达的一致性及胃癌组织中HER-2、瘦素和血管内皮生长因子(VEGF)表达水平的关系.方法 选取110例胃癌手术切除组织和相应转移淋巴结作为研究对象,以96例正常胃黏膜组织作为对照,应用免疫组织化学法检测HER-2、瘦素、瘦素受体b亚型(OB-Rb)和VEGF蛋白的表达水平.结果 HER-2、瘦素和OB-Rb在胃癌组织的表达阳性率分别为19.1％、49.1％和60.9％,显著高于正常胃黏膜组织(分别为8.0％、34.0％和46.0％,均P＜0.05).HER-2在胃癌原发灶与淋巴结转移灶中的表达状态差异无统计学意义(P=0.607),一致性呈中等水平(Kappa=0.581).在胃癌组织中,HER-2和瘦素的表达呈正相关(r=0.217,P=0.023),HER-2和瘦素与VEGF的表达也呈正相关(r=0.263,P=0.005;r=0.200,P=0.036).HER-2和瘦素的表达与肿瘤浸润深度、淋巴结及远处转移、TNM分期等因素有关,而OB-Rb的表达与各临床病理学因素皆无关.Cox回归多因素分析结果显示,肿瘤低分化、体积大、转移淋巴结比例高、分期晚、术后不接受化疗和HER-2高表达为胃癌患者的独立不良预后因素.结论 HER-2在胃癌原发灶与转移淋巴结中的表达状态基本一致.HER-2与瘦素在胃癌的侵袭进展、血管形成过程中可能起重要作用,HER-2高表达是胃癌患者的不良预后因素.     

胃癌组织HER-2表达与临床病理因素相关性的探讨

目的:探讨HER-2在胃癌组织中的表达及其与临床病理特征和预后的关系.方法:用免疫组化法检测126例胃癌组织和30例正常胃黏膜组织中HER-2表达,并与病理参数及预后比较分析.结果:胃癌组织HER2表达阳性率为29.4%(37/126),正常胃黏膜组织中无HER-2表达,P<0.05;HER-2表达与病变部位、分化程度、年龄、肿瘤浸润深度、有无远处转移、有无淋巴结转移及预后等密切相关,P<0.05;而与性别、是否侵犯神经及是否侵犯脉管无关,P>0.05.结论:HER2表达与胃癌的生物学行为有一定的相关性,检测胃癌组织中HER2的表达对于胃癌的治疗及预后判断有一定指导意义.     

胃癌组织中IGF-1R及HER-2的表达及意义

目的探讨胃癌组织中HER-2及IGF-1R的表达及意义。方法免疫组化法检测80例胃癌组织中IGF-1R及HER-2的表达,同时分析二者的表达与胃癌患者的l临床病理特征的关系。结果HER-2与IGF-1R在胃癌中的表达分别为23．8％、83．8％;在正常胃黏膜组织中的阳性率分别为10．0％及20．0％,差异有统计学意义（P〈0．05）;二者表达与淋巴结转移及肿瘤浸润深度相关;另外IGF-1R的表达还与肿瘤分化程度相关。HER-2与IGF-1R在胃癌组织中的蛋白表达水平呈正相关（P=0．001,r=0．362）;二者均阳性表达的胃癌患者预后较差。结论IGF-1R及HER-2蛋白在胃癌中的表达与侵袭和转移相关,对预后判断有重要价值。     

胃癌中HER-2和 GST-π的表达及意义

目的:探讨胃癌组织中人表皮生长因子受体-2（HER-2）和胎盘型谷胱甘肽-S-转移酶-π(GST-π)的表达及与临床病理特征的关系。方法:应用免疫组化Envision 二步法,检测70 例胃癌组织中HER-2和GST-π的表达情况,并结合其临床病理特点进行分析。结果:HER-2和GST-π在胃癌组织中的表达阳性率分别为 27.1%(19/70)和 58.6%(41/70)。 阳性表达与肿瘤分化程度,侵袭深度,有无淋巴结转移及TNM分期有关 (P<0.01,P<0.05),而与患者的性别及年龄、肿瘤部位和大小无关(P>0.05)。HER-2和[HK]GST-π两者之间在胃癌组织中的表达呈正相关（P<0.01)。结论: HER-2和 GST-π的表达参与胃癌的生长、侵袭和转移过程。其联合检测有助于胃癌患者靶向药物和化疗药物的选择,也为胃癌的预后判断提供客观的参考指标。     

胃癌中HER-2和GST-π的表达及意义

目的：探讨胃癌组织中人表皮生长因子受体-2（HER-2）和胎盘型谷胱甘肽-S-转移酶-π（GST-π）的表达及与临床病理特征的关系。方法：应用免疫组化Envision二步法,检测70例胃癌组织中HER-2和GST-π的表达情况,并结合其临床病理特点进行分析。结果：HER-2和GST-π在胃癌组织中的表达阳性率分别为27.1%（19/70）和58.6%（41/70）。阳性表达与肿瘤分化程度,侵袭深度,有无淋巴结转移及TNM分期有关（P〈0.01,P〈0.05）,而与患者的性别及年龄、肿瘤部位和大小无关（P〉0.05）。HER-2和GST-π两者之间在胃癌组织中的表达呈正相关（P〈0.01）。结论：HER-2和GST-π的表达参与胃癌的生长、侵袭和转移过程。其联合检测有助于胃癌患者靶向药物和化疗药物的选择,也为胃癌的预后判断提供客观的参考指标。     

胃癌HER-2表达与术后辅助化疗疗效的相关性分析

目的 通过总结胃癌术后辅助化疗病例及HER-2表达情况,探讨HER-2表达与胃癌术后辅助化疗疗效之间的相关性.方法 回顾性分析185例胃癌术后辅助化疗患者资料,总结其病理特点、HER-2表达状况及无疾病进展生存(DFS)、总生存(OS),分析HER-2与临床病理特点及DFS、OS的关系.结果 185例胃癌患者中,HER-2阴性141例,阳性44例,阳性率24％.HER-2基因的扩增与肿瘤部位、肿瘤的分化程度及远处转移部位相关,与年龄、性别、分期无关;HER-2阳性组中位DFS为9.1个月,中位OS为15.1个月,HER-2阴性组中位DFS为15.2个月,中位OS为25.5个月,HER-2阴性的患者较HER-2阳性的患者更能从术后辅助化疗中获益(P=0.046),并且生存期更长(P=0.01).结论 HER-2无扩增的患者可从术后辅助治疗中获益,DFS与OS均有延长.     

胃癌组织HER-2表达预后意义分析

目的 探讨胃癌组织HER-2表达及其与患者预后的关系.方法 选取云南省肿瘤医院2009-02-01-2011-02-01手术切除的胃癌组织及相应的癌旁组织(距癌组织＞5 cm)77例,采用免疫组化法检测77例胃癌组织及其癌旁非肿瘤胃组织中HER-2的表达,分析HER-2表达与患者临床病理因素的关系,以及与预后的关系.结果 胃癌组织中HER-2的阳性表达率为10.4％(8/77),显著高于癌旁非肿瘤组织0(0/77),x2=8.438,P=0.003.HER-2表达与患者年龄(rs =0.353,P=0.002)、肿瘤分化程度(rs=-0.324,P=0.004)、淋巴结转移(rS=0.29,P=0.008)、Lauren分型(rs=-0.394,P＜0.001)及TNM分期(rs=0.331,P=0.003)有关,而与性别(rs=0.2,P=0.860)、民族(rs=-0.906,P=0.404)、肿瘤部位(rs=-0.019,P=0.871)、大小(rs=-0.060,P=0.606)及浸润深度(rs=0.107,P=0.354)无关.COX比例风险分析显示,肿瘤分化程度(HR=1.26,P=0.034)、TNM分期(HR=2.85,P=0.006)、有无淋巴结转移(HR-6.85,P=0.021)及肿瘤发生的年龄(HR =2.35,P＜0.001)是影响预后的独立危险因素,而HER-2的表达不是影响胃癌预后的独立危险因素(HR-1.02,P-0.071).生存分析显示,HER-2蛋白阳性表达的患者生存率与阴性表达者比较,差异无统计学意义,x2 =0.114,P=0.736.结论 胃癌组织中HER-2可呈阳性表达,检测HER-2表达对胃癌的临床治疗有一定指导意义,但它尚不能作为判断胃癌预后独立的指标.     

MUC15和PI3K/Akt 表达与胃癌临床病理特征及预后的相关性研究

目的:探讨MUC15 和PI 3K/Akt的表达与胃癌临床病理特征和预后的关系。方法:采用组织芯片和免疫组织化学法检测144 例胃癌组织及对应癌旁组织中MUC15、Akt的表达。结果:MUC15在胃癌中阳性表达率为79.8% ,高于癌旁组织中的阳性表达率22.2%（P < 0.01）;Akt在胃癌中阳性表达率为80.6% ,高于癌旁组织的阳性表达率16.7%（P < 0.01）。 MUC15和Akt表达均与胃癌分化程度、浸润深度、有无淋巴结转移和TNM 分期相关（P < 0.05）;且胃癌组织中MUC15表达和Akt表达呈正相关（P = 0.001）。 单因素生存分析显示,MUC15和Akt高表达均与生存时间呈负相关（P < 0.05）。 Cox 多元回归分析提示,MUC15和Akt同时阳性的胃癌患者预后更差（HR= 3.115,P < 0.05）。 结论:MUC15可能通过PI 3K/Akt细胞信号转导通路参与胃癌的发生、发展、浸润转移,MUC15结合Akt是胃癌预后强有力的预测因子。      

胃癌中HER-2与COX-2的表达及临床意义

目的:探讨人表皮生长因子受体-2(HER-2)和环氧合酶-2(COX-2)在胃癌组织中的表达及与临床病理特征的关系。方法:应用免疫组化Envision二步法,检测70例胃癌组织和40例正常胃组织中HER-2及COX-2的表达情况,并结合其临床病理特点进行分析。结果:(1)HER-2在胃癌中的阳性率为27.1%,在正常胃组织的阳性率为5%;COX-2在胃癌中的阳性率为67.1%,正常胃组织阳性率为22.5%。两种蛋白分别在胃癌及正常组织中的表达差异具有统计学意义(P<0.05,P<0.01)。(2)HER-2及COX-2在胃癌组织中的阳性表达与肿瘤分化程度、侵袭深度、有无淋巴结转移及TNM分期有关(P<0.05),而与患者的性别及年龄、肿瘤部位和大小无关(P>0.05)。(3)HER-2与COX-2在胃癌组织中的表达呈正相关(P<0.05)。结论:HER-2及COX-2的表达参与胃癌的生长、侵袭和转移过程,在胃癌的预后中扮演了重要角色。     

胃癌HER-2表达的临床意义及血管新生相关性研究

目的 本研究通过检测人表皮生长因子受体-2(HER-2)在胃癌及癌旁组织中的表达,分析其与临床病理特征、血管生成以及术后早期复发的关系,旨在探讨胃癌中HER-2表达的临床意义,为胃癌患者术后制定有效的治疗方案提供理论和临床基础。方法 回顾性分析我科室2012年3月—2013年7月行手术切除的原发胃癌组织398例及相应的癌旁正常组织363例,应用免疫组织化学(Immunohistochemistry,IHC)结合荧光原位杂交(Fluorescence in situ hybridization,FISH)检测肿瘤组织及癌旁正常组织HER-2阳性表达率,同时分析HER-2表达与临床病理特征、血管生成以及术后早期复发的关系。结果 (1)胃癌组织中HER-2的阳性表达率为14.07%(56/398),显著高于癌旁非肿瘤组织0(0/363)(P＜0.05);(2)Lauren分型、肿瘤部位、脉管浸润情况、TNM分期、有无淋巴结转移与HER-2阳性表达相关(P＜0.05),而年龄、性别、肿瘤大小、分化程度、生长方式与HER-2表达无相关性(P＞0.05)。T分期中,T₄期的HER-2表达率高于(T₁+T₂+T₃)期,但无统计学差异(P＞0.05);(3)56例HER-2阳性表达组的微血管密度(Microvessel density,MVD)值为58.63±19.97,342例HER-2阴性表达组的MVD值为49.04±19.25,具有统计学差异,经Spearman等级相关性分析,两组间呈正相关(r=4.33,P＜0.001);(4)早期复发率方面,HER-2阳性表达组1年、1.5年复发率分别为16.00%、38.00%,高于HER-2阴性表达组的8.81%、25.53%,但无统计学差异(P＞0.05)。结论 HER-2在胃癌组织中存在着过度表达,HER-2的过度表达与胃癌患者的Lauren分型、肿瘤部位、脉管浸润情况、TNM分期、有无淋巴结转移具有相关性,而与年龄、性别、肿瘤大小、分化程度、生长方式无关;HER-2的过度表达与肿瘤新生血管生成呈正相关;HER-2的过度表达与术后的早期复发可能存在相关性,需待进一步的随访观察。     

Bacteria and cancer--antagonisms and benefits

There is considerable historical and recent evidence concerning the antagonisms between acute bacterial infections or their toxins and cancer and allied diseases. These data provide renewed incentives to undertake clinical programmes with mixed bacterial vaccines in many countries at the present time.     

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.     

Renal irradiation and the pharmacology and toxicity of methotrexate and cisplatinum

We used a rat model to study the effects of renal irradiation on the pharmacology of methotrexate (MTX) and cisplatinum (cis-Pt). Unanesthetized rats were given bilateral kidney irradiation (20 Gy in 9 fractions). At 9 months after irradiation, 3% of the animals had died and survivors showed moderately impaired renal function. At 15 months, 30% of the animals had died and survivors showed severely impaired renal function. Some animals were given i.v. MTX 1 week to 15 months after irradiation. In irradiated rats, the area under the MTX plasma clearance curve equaled that of controls through 6 months, and was significantly above controls from 9 months on. Other animals were given i.p. cis-Pt 1 week to 9 months after irradiation. The acute toxicity of cis-Pt was the same in control and irradiated rats when cis-Pt was given immediately before or after irradiation. Beginning 3 months after irradiation there was a progressive increase in cis-Pt toxicity and a simultaneous decrease in urinary platinum excretion. Irradiated animals that survived cis-Pt treatment showed increased radiation nephritis; the greatest effect occurred when cis-Pt was given 3 months or more after irradiation. MTX and cis-Pt clearance decreased when renal dysfunction was first observed and changes in renal function preceded changes in drug clearance and toxicity.     

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。     

Morphine and tumor growth and metastasis

Morphine is an analgesic widely used to alleviate cancer pain. In addition, the perioperative management of pain in cancer surgery patients most often includes opioids. However, there are reports that these drugs may alter cancer recurrence or metastasis. Several mechanisms have been proposed, such as the modulation of the immune response or cellular pathways that control the survival and migratory behavior of cancer cells. The published literature, however, presents some discrepancies, with reports suggesting that opioids may either promote or prevent the spread of cancer. It is of great importance to determine whether opioids, in particular the most widely used, morphine, may increase the risk of metastasis when used in cancer surgery. This review examines the available data on the effects of morphine which influence cancer metastasis or recurrence, including immunomodulation, tumor cell aggressiveness, and angiogenesis, with special emphasis on recently published clinical and laboratory based studies. We further discuss the parameters that may explain the difference between reports on the effects of morphine on cancer.     

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。