乳腺癌超声征象与Ki67、p53表达的相关性及临床意义

目的：探讨乳腺癌组织中Ki67、p53的表达与彩色多普勒超声征象的相关性及意义。方法：回顾性描述经手术病理证实为乳腺癌的135例患者彩色多普勒超声征象,包括肿块大小、边缘、形态,钙化分布和形态,血流显像分级,淋巴结转移及侵犯周围组织,并采用免疫组化方法检测Ki67、p53的表达情况,分析其与超声表现的相关性。结果：Ki67、p53在乳腺癌组织的阳性率分别为64.4%（87/135）,51.1%（69/135）。Ki67、p53表达与肿块大小、肿块边缘无相关性（P＞0.05）,与血流显像分级、淋巴结转移及侵犯周围组织有显著性相关（P＜0.05）。Ki67与肿块形态、钙化形态有显著相关性（P＜0.05）,与钙化分布无相关性（P＞0.05）,而p53与肿块形态、钙化形态无相关性（P＞0.05）,与钙化分布有显著性相关（P＜0.05）。Ki67与p53表达程度呈正相关（r=0.617,P＜0.05）。结论：乳腺癌超声征象与Ki67、p53表达存在相关性,在乳腺癌非手术治疗、术前及术后风险评估中具有潜在的临床应用价值。     

超声及其他多因素在乳腺癌腋窝淋巴结转移中的预测价值

目的探讨超声等多种因素在乳腺癌腋窝淋巴结转移中的预测价值。方法对288例乳腺癌患者的病史资料进行回顾性分析,利用多因素Logistic回归分析年龄、腋窝淋巴结超声评价、肿块大小、位置、周边血管侵犯、病理分级、ER、PR、Her-2及Ki-67在乳腺癌腋窝淋巴结转移中的预测价值。结果超声评分、肿块、肿瘤周边血管浸润、Ki-67、Her-2及病理分级进入Logistic回归方程,其中超声评分≥3、肿块>2cm及肿瘤周边血管浸润阳性的比数比(OR)最大,分别为26.510,24.222及15.041。Logistic模型的确诊率、敏感性及特异性分别为98.1%,90.6%和95.7%。结论腋窝淋巴结超声评价≥3、肿块大小>2cm、肿块周边血管浸润阳性、病理分级Ⅲ级、Her-2阳性及Ki-67指数>15%是腋窝淋巴结转移的独立预测因素。     

乳腺癌彩色多普勒血流分布类型与分子生物学的相关性研究

目的探讨乳腺癌彩色多普勒血流分布类型与肿瘤标记物ER、PR、C—erbB-2、VEGF、Ki-67和P^53之间的相关性研究。方法100例乳腺癌患者,分析其术前超声血流分布类型与术后肿瘤标记物（ER、PR、C—erbB-2、VEGF、Ki-67和P^53）的表达情况,并分析它们之间的相关性。结果100例乳腺癌患者,肿块共103个,其中血流周边型23个,穿入型46个,内部型30个,无血流4个。穿入型血流与VEGF和Ki-67阳性表达呈正相关（P〈0．01）,与P^53阳性表达呈正相关（P〈0．05）。结论乳腺癌彩色多普勒血流分布类型与分子生物学之间存在一定相关性,可以根据其声像图中血流分布类型对乳腺癌的生物学行为和预后进行评估。     

彩色多普勒超声在乳腺小肿块良恶性鉴别诊断中的应用价值

目的 探讨乳腺小肿块（直径〈2cm）的超声表现特征及彩色多普勒超声对其良恶性的鉴别诊断价值。方法 64例乳腺小肿块经手术病理证实,其中恶性肿块27例,良性肿块37例。分析乳腺小肿块患者的彩色多普勒超声表现特征,应用彩色多普勒血流显像（CDFI）观察其血流分布特征,频谱多普勒检测血流参数阻力指数（RI）的大小。结果 乳腺小肿块良性组和恶性组的形态、边界包膜、纵横比及内部有无微小钙化比较,差异有统计学意义（P〈0．05）。恶性肿块血流分级≥Ⅱ级,RI〉0．7,血流频谱表现为峰值前移,舒张末期无血流信号或可见反向血流;良性肿块血流分级多为0-I级,RI〈0．7,血流频谱表现为以静脉血流频谱为主。9例恶性肿块伴有同侧腋窝淋巴结肿大,2例良性肿块为反应增生肿大。结论 彩色多普勒超声对乳腺小肿块良恶性的鉴别诊断具有重要价值,结合声像图特征和CDFI表现能有效诊断。     

乳腺癌37例彩色超声显像特征与病理对照分析

目的：提高彩色超声对乳腺癌诊断及鉴别诊断。方法：对病理学确诊的37例乳腺癌患者回顾其彩色高频超声显像特点,包括形态、边界、包膜、内部回声、后方回声、腋窝淋巴结、彩色血流显像、钙化等情况。结果：37例乳腺恶性肿块在形态、边界、包膜、内部回声、后方回声、彩色血流显像、腋窝淋巴结、钙化等方面与良性肿瘤有明显差异。结论：彩色超声对乳腺癌诊断有重要意义。     

Ki-67、P53在乳腺癌腋窝淋巴结转移中的表达与意义

目的探讨Ki-67、P53在Her-2阴性乳腺癌腋窝淋巴结转移中的表达及临床意义。方法选取收治的60例Her-2阴性浸润性乳腺癌患者的临床资料,根据ER表达分为阴性组28例与阳性组32例,研究Ki-67、P53在Her-2阴性乳腺癌组织中的表达及与ER、腋窝淋巴结转移的相关性。结果 ER阳性组乳腺癌组织中Ki-67增殖指数、P53表达明显低于阴性组(P0.05),腋窝淋巴结阳性组中Ki-67增值指数、P53表达明显高于淋巴结阴性组(P0.05)。结论Ki-67增殖指数、P53表达在Her-2阴性乳腺癌组织中与ER阴性呈正相关,且Ki-67增殖指数与腋窝淋巴结转移可能性大,由此提示P53、Ki-67可是Her-2阴性乳腺癌不良预后的相关因素。     

乳腺癌超声征象与P120ctn、Ki67蛋白表达的相关研究

目的分析超声征象与乳腺癌P120ctn、Ki67蛋白表达的关系。方法回顾性分析我院103例乳腺癌患者的超声图像资料,采用免疫组织化学法检测组织中P120ctn、Ki67蛋白的表达情况,并分析乳腺癌超声征象与P120ctn、Ki67蛋白表达水平之间的关系。结果 103例患者中,肿块直径2 cm者46例,≥2 cm者57例;肿块形态呈规则36例,形态不规则67例;肿块边缘存在毛刺81例,不存在毛刺22例;微小钙化点呈簇状分布37例,呈散状分布26例,沿导管走向分布40例;血流显像分级为0~1级27例,2~3级76例;有淋巴结转移50例,无淋巴结转移53例。不同超声征象中,微小钙化点沿导管走向分布者P120ctn蛋白表达为阳性占12.50%,明显低于簇状分布和散状分布者(43.24%、38.46%);而血流显像分级为2~3级者P120ctn蛋白表达为阳性占13.16%,明显低于0~1级者(77.78%);有淋巴结转移者P120ctn蛋白表达为阳性占10.00%,明显低于无淋巴结转移者(49.06%),差异均有统计学意义(均P0.05)。肿块形态规则者Ki67蛋白表达为阳性占72.22%,明显低于不规则者(98.51%);血流显像分级为0~1级者Ki67蛋白表达为阳性占66.67%,明显低于2~3级者(97.37%);有淋巴结转移者Ki67蛋白表达为阳性占98.00%,明显高于无淋巴结转移者(81.13%),差异均有统计学意义(均P0.05)。结论乳腺癌超声征象中微小钙化、血流显像分级及淋巴结转移与P120ctn、Ki67蛋白表达密切相关,在乳腺癌术前、术后评估中具有一定的应用价值。     

高频超声及彩色多普勒对乳腺癌的诊断价值

目的评价高频超声及彩色多普勒对乳腺癌的诊断价值。方法应用高频二维超声对148例乳腺肿块患者进行检查,观察肿块的部位、大小、形态、边界、纵横比、内部回声、后方回声、有无微小钙化及腋下淋巴结肿大等;结合彩色多普勒血流显像观察乳腺肿块的特征。结果148例乳腺癌均经手术和病理证实,超声诊断提示恶性肿瘤133例,诊断符合率为90%(133/148)。结论高频二维超声结合彩色多普勒血流显像对乳腺癌具有较高的诊断价值。     

乳腺癌腋窝淋巴结转移超声表现与病理对照

目的：探讨腋窝淋巴结转移的超声表现。方法：采用二维及彩色多普勒超声对45例乳腺癌患者在术前对腋窝肿大淋巴结的形态、大小、内部回声及血流动力学指标进行观察。结果：病理证实的39例转移淋巴结形态更接近圆形，多呈融合状态。血流信号多位于周边，并随淋巴结的增大血流信号增多，多发性肿大淋巴结较单发性血流丰富。结论：转移性淋巴结在二维超声和彩色多普勒上各有其特征性表现，二者结合可提高检出乳腺癌淋巴结转移的准确性。     

超声征象与乳腺癌P120ctn、Ki67蛋白表达的关系研究

目的 分析超声征象与乳腺癌p120连环蛋白（P120ctn）、核抗原（Ki67）蛋白表达的关系。方法 回顾性分析我院103例乳腺癌患者的超声图像资料,采用免疫组织化学法检测组织中P120ctn、Ki67蛋白的表达情况,并分析超声征象与组织中P120ctn、Ki67蛋白表达水平之间的关系。结果 超声征象结果显示：103例患者中,肿块直径＜2 cm者46例,≥2 cm者57例;肿块形态呈规则36例,形态不规则67例;肿块边缘存在毛刺81例,不存在毛刺22例;微小钙化点呈簇状分布32例,呈散状分布24例,沿导管走向分布38例;血流显像分级为0～1级27例,2～3级76例;有淋巴结转移50例,无淋巴结转移53例。不同超声征象中,微小钙化点沿导管走向分布者P120ctn蛋白表达为13.16%,明显低于簇状分布和散状分布者（43.75%、41.67%）;而血流显像分级为2～3级者P120ctn蛋白表达为13.16%,明显低于0～1级者（77.78%）;有淋巴结转移者P120ctn蛋白表达为10.00%,明显低于无淋巴结转移者（49.06%）,差异均有统计学意义（均P＜0.05）。肿块形态规则者Ki67蛋白表达为72.22%,明显低于不规则者（98.51%）;血流显像分级为0～1级者Ki67蛋白表达为66.67%,明显低于2～3级者（97.37%）;有淋巴结转移者Ki67蛋白表达为98.00%,明显高于无淋巴结转移者（81.13%）,差异均有统计学意义（均P＜0.05）。结论 乳腺癌超声征象中微小钙化点、血流显像分级、淋巴结转移与P120ctn、Ki67蛋白表达存在密切相关,在乳腺癌术前、术后评估中具有一定的应用价值。     

NO and HNO donors,nitrones, and nitroxides: Past,present, and future

The biological effects attributed to nitric oxide (^?NO) and nitroxyl (HNO) have been extensively studied, propelling their array of putative clinical applications beyond cardiovascular disorders toward other age‐related diseases, like cancer and neurodegenerative diseases. In this context, the unique properties and reactivity of the N‐O bond enabled the development of several classes of compounds with potential clinical interest, among which ^?NO and HNO donors, nitrones, and nitroxides are of particular importance. Although primarily studied for their application as cardioprotective agents and/or molecular probes for radical detection, continuous efforts have unveiled a wide range of pharmacological activities and, ultimately, therapeutic applications. These efforts are of particular significance for diseases in which oxidative stress plays a key pathogenic role, as shown by a growing volume of in vitro and in vivo preclinical data. Although in its early stages, these efforts may provide valuable guidelines for the development of new and effective N‐O‐based drugs for age‐related disorders. In this report, we review recent advances in the chemistry of NO and HNO donors, nitrones, and nitroxides and discuss its pharmacological significance and potential therapeutic application.     

Lipid messenger, diacylglycerol, and its regulator, diacylglycerol kinase, in cells, organs, and animals: history and perspective

Diacylglycerol kinase (DGK) metabolizes diacylglycerol (DG), a glycerolipid containing two acyl chains, to convert phosphatidic acid. DG is produced through phosphoinositide turnover within the membrane and is well known to act as a second messenger that modulates the activity of protein kinase C in the cellular signal transduction. Recent studies have revealed that DG also activates several proteins, including Ras guanine-nucleotide releasing protein and ion channels such as transient receptor potential proteins. Therefore, DGK is thought to participate in a number of signaling cascades by modulating levels of DG. Previous studies have disclosed that DGK is composed of a family of the isozymes, which differ in the structure, enzymological property, gene expression and localization, subcellular localization, and binding molecules. The present review focuses on the stories of phosphoinositide turnover and DG, including historical views, structural features, metabolism, and relevant cellular phenomena, together with the characteristics of DGK isozymes and the pathophysiological findings on animal studies using knockout mice and models for human diseases. Now it is being revealed that the structural and functional diversity and heterogeneity of and around DGK support the proper arrangement of the complex signal transduction machinery.     

Heat, cold, noise, and vibration

Exposure to a cold environment induces a number of physiological alterations, the most serious being hypothermia. This state can occur in all individuals, but the very young and the elderly are more susceptible. Environmental and industrially generated high ambient temperature can place further stress on aged individuals and workers, resulting in a complex symptom picture. Morbidity and death may result from such exposures. Causative factors have been identified. Noise exposure induces hearing losses above those secondary to the aging process. Psychophysiological effects during noise exposure are considered to result from the sympathetic activity secondary to a general stress reaction. Vibration from the use of power tools results in Raynaud's phenomenon. However, modification of power tools has reduced the symptoms associated with vibration exposure. Termination of exposure to vibration appears eventually to reduce symptoms related to white-finger spasms. Interaction between these stressors has not been clarified because of the complex effects of each. The need for additional information about the response to these stressors is evident.