宫颈机能不全患者妊娠期血清抗心磷脂抗体及抗核抗体的阳性率及其临床意义

目的 探讨宫颈机能不全患者妊娠期血清抗心磷脂抗体(anticardiolipin antibody,ACA)和抗核抗体(antinuclear antibody,ANA)的阳性率及其临床意义.方法 2010年11月1日至2011年10月1日,纳入47例宫颈机能不全患者及100例无不良孕产史健康孕妇作为对照组,采用间接免疫荧光法检测血清ANA,采用酶联免疫吸附试验检测血清ACA.2组阳性率的比较采用卡方检验.结果 宫颈机能不全孕妇ACA阳性率为49.0％(22/47),ANA阳性率为49.0％(22/47),ACA和ANA双阳性率为25.6％(12/47),均高于正常孕妇[分别为13.0％(13/100)、15.0％(15/100)和2.0％(2/100)],差异均有统计学意义(x2=17.175、20.146和17.907,P均=0.000).结论 宫颈机能不全可能与母体自身免疫异常有关.     

BA-ELISA检测的宫颈粘液中抗精子抗体在不孕症中的作用

<正> 自从本世纪五十年代Rümke发现不孕症患者血清中存在抗精子抗体以来,抗精子抗体在不孕症中的地位已引起人们的注意。早期主要检测不孕患者血清中抗精子抗体。然而,由于整个生殖过程发生于生殖道局部,     

抗精子抗体、抗子宫内膜抗体及抗弓形虫抗体与反复自发性流产关系的研究

应用ELISA方法检测了186例自发性流产患者血清中抗精子抗体（AsAb）、抗子宫内膜抗体（EMAb）与抗弓形虫抗体（ATAb），并以56例正常育龄妇女作为对照。结果表明：反复自发性流产患者血清中AsAb、EMAb、ATAb阳性率分别为29．03％、38．71％和18．82％，而正常对照组的阳性率分别相应为1．79％、3．57％和1．79％（P＜0．01）。ATAb阳性率随流产次数的增加而增加（P＜0．05），AsAb阳性率随流产次数的增加而减少（P＜0．05）。流产时孕期＜90天者血清AsAb阳性率明显高于流产时孕期≥90天者（P＜0．05），EMAb阳性率与流产次数和流产时孕期之间无明显关系。本文结果提示：三种血清抗体ASAb、EMAb、ATAb与反复自发性流产密切相关，可能是造成自发性流产的重要因素，尤其在自发性流产的早期阶段。     

抗独特型抗体及其在卵巢癌研究中的现状

随着近年来对独特型-抗独特型免疫调节网络的深入研究,抗独特型抗体作为肿瘤免疫治疗的新途径越来越受到人们重视。本文简述近年来抗独特型抗体在肿瘤研究中的进展,重点介绍有关卵巢癌方面抗独特型抗体研究现状,为妇科肿瘤免疫学研究提供新信息。     

不孕症患者的自身免疫抗体分析

目的:探讨不孕症与患者自身免疫抗体的相关性.方法:采用酶联免疫吸附实验(EUSA)检测516例不孕症患者的血清抗精子抗体(ASAb)、抗卵巢抗体(AOAb)、抗子宫内膜抗体(EMAb)、抗绒毛膜促性腺激素抗体(hCGAb)及抗心磷脂抗体(ACAb).选择125例正常妊娠妇女作为对照组.比较不孕症组与对照组5项抗体的阳性率.结果:不孕症组ASAb,AOAb,EMAb,hCGAb和ACAb的阳性率分别为26.7%,24.8%,25.2%,21.7%和21.3%,明显高于正常对照组4.8%,2.4%,1.6%,3.2%和1.6%(P均<0.001);5种抗体联合检测阳性率为38.2%,与分别单独检测这5项抗体的阳性率相比,差异均有统计学意义(P均<0.05).结论:ASAb,AOAb,EMAb,hCGAb和ACAb与不孕症有密切相关性,是引起不孕的重要原因.检测这5项抗体可作为不孕症病因诊断的一项指标.     

不孕症患者的自身免疫抗体分析

目的：探讨不孕症与患者自身免疫抗体的相关性。方法：采用酶联免疫吸附实验（ELISA）检测516例不孕症患者的血清抗精子抗体（ASAb）、抗卵巢抗体（AOAb）、抗子宫内膜抗体（EMAb）、抗绒毛膜促性腺激素抗体（hCGAb）及抗心磷脂抗体（ACAb）。选择125例正常妊娠妇女作为对照组．比较不孕症组与对照组5项抗体的阳性率。结果：不孕症组ASAb,AOAb,EMAb,hCGAb和ACAb的阳性率分别为26．7％,24．8％,25．2％,21．7％和21．3％。明显高于正常对照组4．8％,2．4％,1．6％,3．2％和1．6％（P均〈0．001）;5种抗体联合检测阳性率为38．2％,与分别单独检测这5项抗体的阳性率相比,差异均有统计学意义（P均〈0．05）。结论：ASAb,AOAb,EMAb,hCGAb和ACAb与不孕症有密切相关性,是引起不孕的重要原因。检测这5项抗体可作为不孕症病因诊断的一项指标。     

HSG2表达精子抗原在抗精子抗体检测中的应用

ＨＳＧ２表达精子抗原在抗精子抗体检测中的应用周作民，沙家豪，胡志刚，王黎熔，林敏（南京医科大学组胚教研室，南京，２１００２９）抗精子抗体的研究对于免疫性不孕症的诊治和免应避孕疫苗的研究有着极其重要的意义。这一研究的首要前提是建立一个灵敏、准确的抗体检...     

O型血孕妇血清中抗A和抗B抗体效价的分析

产前检查孕妇血型抗体ＩｇＧ ,对预防和及时进行新生儿母儿血型不合溶血病的产时治疗有积极作用。临床以ＡＢＯ血型不合引起的新生儿溶血病 (ｈｅｍｏｌｙｔｉｃｄｉｓｅａｓｅｏｆｔｈｅｎｅｗｂｏｒｎ ,ＨＤＮ)最常见 ,且ＡＢＯ血型不合引起的ＨＤＮ患儿的母亲多数为Ｏ型血[1] 。我们测定了 6 71例Ｏ型血孕妇血清中的抗Ａ或抗Ｂ抗体效价水平 ,旨在了解Ｏ型血孕妇产生高效价抗Ａ或抗Ｂ抗体的原因 ,现报道如下。一、资料与方法1 资料来源 :1999年 1月～ 2 0 0 0年 4月期间 ,在我实验室检查的Ｏ型血孕妇 6 71例 ,配偶均为非Ｏ型血者 ,年龄2 2…     

非标准抗磷脂抗体检测对于风湿病合并不良妊娠患者的治疗意义

抗磷脂综合征(APS)的诊断普遍依据2006年版悉尼标准,非标准抗磷脂综合征(NC-APS)是近年来对于不完全满足悉尼标准但又合并APS相关不良妊娠事件提出的概念.在对这些有不良妊娠结局患者的研究中,开展非标准抗磷脂抗体(NC-aPL)的检测有助于提高NC-APS的诊断率,也使风湿病患者不良妊娠风险评估及治疗能得到更多...     

COX-2和VEGF在宫颈癌组织中的表达及其生物学意义

目的　探讨环氧化酶 2 (COX - 2 )和血管内皮生长因子 (VEGF)在宫颈癌中的表达及其与宫颈癌临床病理特征的关系。方法　采用免疫组化SP法检测COX - 2、VEGF在 6 8例宫颈癌、 14例正常宫颈组织中的表达。结果　COX - 2和VEGF蛋白在宫颈癌和正常宫颈组织中的表达差异有显著性 (P <0 0 1)。COX - 2蛋白表达与宫颈癌分化程度、组织学类型、淋巴结转移等显著相关 (P <0 0 5 ) ;VEGF蛋白表达与宫颈癌临床分期、淋巴结转移有显著相关 (P <0 0 5 )。宫颈癌中VEGF与COX - 2的表达密切相关。结论　COX - 2和VEGF 2种蛋白与宫颈癌的发生发展相关 ,并在宫颈癌的侵袭转移中起一定作用。     

高迁移率蛋白A2在不同宫颈病变中的表达及意义

目的探讨高迁移率蛋白A2(HMGA2)在不同宫颈病变组织中的表达及其临床意义,了解其与宫颈人乳头瘤病毒(HPV)感染的关系。方法免疫组织化学法检测无锡市第三人民医院2005至2007年30例正常宫颈组织、19例低级别上皮内瘤样病变宫颈组织、16例高级别上皮内瘤样病变宫颈组织、13例宫颈鳞癌组织中HMGA2蛋白的表达,原位杂交检测各组织中HPV感染的情况,分析HMGA2蛋白表达与HPV感染在宫颈病变组织中的相关性。结果正常宫颈组织、CINⅠ级、CINⅡ~Ⅲ级和宫颈浸润性鳞癌组织中,HMGA2蛋白的阳性表达率分别为26.67%、21.05%、68.75%和76.92%。CINI与正常宫颈组织阳性表达率比较,差异无统计学意义;CINⅡ~Ⅲ级、宫颈浸润性鳞癌组织与正常宫颈组织阳性表达率比较,差异有统计学意义(P=0.011,P=0.006)。宫颈高级别上皮内瘤样病变和宫颈癌组织具有较高的HPV感染率,HPV感染与否和HMGA2的表达两者之间未发现统计学相关性。结论HMGA2高表达于高级别宫颈上皮内瘤样病变组织和宫颈癌组织,这可能是宫颈病变的一个早期事件。HMGA2的表达与宫颈HPV感染两者没有相关性,HMGA2可能是...     

The prognostic significance of leukocytosis in cervical cancer

Cervical cancer is a frequent tumor with established prognostic factors such as FIGO stage and hemoglobin levels among others. Despite the fact that paraneoplastic leukocytosis is relatively common in many solid tumors, only isolated cases of cervical cancer patients presenting this abnormality have been published; hence, the clinical significance of leukocytosis is unknown in this tumor type. Retrospective review on the medical records of 294 consecutive newly diagnosed and untreated locally advanced cervical cancer patients who received radiotherapy and concurrent cisplatin was conducted. Leukocytosis was defined as a persistent white blood cell count exceeding 10,800/microL, determined at least twice before commencing chemoradiation providing that patients were free of any active acute or chronic infection or any other condition known to elevate the leukocyte count. The frequency of leukocytosis and their correlation with clinicopathologic features were investigated, as well as their impact on tumor response and survival. Leukocytosis with a median value of 13,300/microL (11,100-28,800) was observed in 35 (11.9%) patients at diagnosis. Leukocytosis was statistically associated only with advanced stages. Clinical complete response was observed in 57% versus 86% of the patients with and without leukocytosis, respectively. In the univariate analysis, leukocytosis, stage, and hemoglobin levels were significant predictors of survival; however, only leukocytosis and the hemoglobin level remained significant predictors of survival in the multivariate analysis. Leukocytosis is common in cervical cancer patients and has a negative prognostic significance.     

Indications for primary and secondary exenterations in patients with cervical cancer

OBJECTIVE: Fifty years after the introduction of exenterative surgery in gynecologic oncology, the indication for primary and secondary exenteration is controversially discussed in cervical cancer patients. In addition, the term "palliative exenteration" is not precisely defined. We evaluate the role of primary exenteration in patients with stage IVA cervical cancer and the role of secondary palliative exenteration. METHODS: The study retrospectively analyzed surgical and oncologic data of 55 patients who underwent exenterative surgery in the Department of Gynecology at the University of Jena between February 1998 and January 2004. Primary surgery was performed in 20 patients with laparoscopically confirmed stage IVA cervical cancer, while 35 patients with recurrent cervical cancer underwent secondary exenteration. Fifty-one had total, 3 posterior and 1 anterior exenteration. Survival was analyzed in relation to the patient's age, indication (primary versus secondary, curative versus palliative), previous therapy (operation, radiation, chemotherapy, radiochemotherapy), histology, resection margins, pelvic nodal involvement, time interval from primary therapy to recurrence, type of exenteration and adjuvant therapy. Early and late postoperative complications as well as perioperative mortality were reviewed. RESULTS: The overall cumulative survival of all patients after exenteration was 36.8% at 5 years with 52.5% in the primary group and 26.7% in the recurrent one (p=0.0472). Complications were noted in 56.9% of patients, most commonly fistulas or gastrointestinal complications. Operative mortality was 5.5%. Survival correlated significantly with the time interval between primary treatment and recurrence (within 1-2 years 16.8% five-year survival, 2-5 years 28%, >5 years 83.2%, p=0.0105) as well as with curative or palliative intention (2-year survival rate of 60% in patients with curative intent, 10.5% in those with palliative intent, p=0.0001) and with tumor-free resection margins (2-year survival of 10.2% for positive margins, 5-year survival of 55.2% for negatives ones, p=0.0057). The age, the type of exenteration, the histologic type and the metastatic spread to pelvic lymph nodes had no significant influence on long-term survival. CONCLUSION: In patients with histopathologically confirmed stage IVA cervical cancer primary, exenteration is a valid alternative to primary chemoradiation. In patients with persistent or recurrent tumor limited to the pelvis, secondary exenteration should be offered in the absence of other therapeutic options. Palliative and curative attempts can best be differentiated by the resection margin status.     

半乳糖凝集素-1在宫颈癌组织中的表达及其与高危型HPV感染的关系

目的探讨半乳糖凝集素-1(Galectin-1,Gal-1)在宫颈癌的发生、发展中作用及与高危型HPV的关系。方法免疫组织化学法检测柳州市人民医院2007年2月至2009年2月54例宫颈癌、35例宫颈上皮内瘤样病变(CIN)和20例宫颈正常组织中Gal-1蛋白的表达;并用HC-Ⅱ法检测高危型人乳头状瘤病毒(HR-HPV)感染情况。结果 Gal-1在正常宫颈、CINⅠ～Ⅱ、CIN Ⅲ和宫颈癌组织中的阳性表达率分别为5.0%、15.0%、53.3%、48.1%;晚期宫颈癌组织中Gal-1的表达率(83.1%)明显高于早期宫颈癌中的表达率(34.2%)。宫颈癌中Gal-1阳性表达与淋巴结转移(P<0.05)、肿瘤低分化(P<0.05)、临床分期(P<0.01)和HR-HPV的感染(P<0.05)有关,但与宫颈癌组织学类型无关。结论 Gal-1可能在宫颈癌的发生、发展中起着重要作用,HR-HPV可能通过诱导宫颈上皮高表达Gal-1而促使宫颈癌发生发展。     

年轻宫颈癌患者的病理特点和预后分析

目的比较年轻宫颈癌患者（≤35岁）和年龄大的患者（〉35岁）的病理特点和预后差异,初步探讨年轻宫颈癌患者的预后特点。方法采用回顾性分析的方法,通过小年龄≤35岁（研究组）患者与大年龄〉35岁（对照组）患者进行比较,分析年轻宫颈癌患者的预后因素和预后特点。结果 2002年1月至2004年12月间共有352例患者,其中年龄≤35岁者51例（14.5%）,〉35岁者301例（85.5%）。肿瘤期别在两组间存在差别,差异有统计学意义（P=0.001）：研究组ⅠA2期、ⅠB2期患者数多于对照组（9.8%vs0.3%,P=0.03;33.3%vs22.9%,P=0.04）;肿瘤病理学类型在两组间的差异有统计学意义,研究组中非鳞癌患者所占比例大于对照组（19.6%vs5.3%,P〈0.001）。研究组和对照组患者的平均生存时间分别为81.8个月和91.0个月,未发现两组患者的生存曲线存在统计学差异。对年龄≤35岁的患者使用Cox模型进行单因素及多因素分析,结果显示淋巴结转移（HR=20.515,P〈0.001）、间质深层浸润（HR=4.358,P〈0.001）、肿瘤分化（HR=3.688,P〈0.001）、肿瘤体积（直径是否超过4cm）（HR=3.206,P〈0.001）和分期（HR=3.020,P〈0.001）是影响预后的危险因素;多因素分析发现淋巴结转移（HR=11.858,P〈0.001）、肿瘤分化（HR=2.666,P=0.001）、肿瘤分期（HR=2.011,P〈0.001）是影响预后的高危因素。结论年龄≤35岁的宫颈癌患者更容易出现非鳞状细胞癌;未发现年轻宫颈癌患者（≤35岁）和年龄大患者（〉35岁）在预后方面存在差异;对于年轻患者淋巴结转移、肿瘤分化差、间质深层肿瘤浸润、肿瘤为巨块型（直径超过4cm）和临床分期高与预后不良有关,其中肿瘤分期、淋巴结转移和肿瘤分化是独立的预后因素。     

TRIF和MyD88指标在卵巢癌中的表达及与肿瘤血管生成的关系#br#

Objective?To explore the expression of TRIF and MyD88 markers in ovarian cancer and their relationship with tumor angiogenesis. Methods?The expressions of TRIF and MyD88 in 30 ovarian cancer tissues and normal ovarian tissues were detected; the relationship between TRIF and MyD88 and clinical case characteristics was analyzed; the correlation between TRIF and MyD88 and tumor angiogenesis was analyzed. Results?The positive expressions of TRIF, MyD88 and VEGF in ovarian cancer tissues were higher than those in normal ovarian tissues, and were correlated with FIGO staging and lymph node metastasis (P<0.05). The expression of TRIF, MyD88 and VEGF were positively correlated in ovarian cancer tissue, and mediate tumor angiogenesis. Conclusion?TRIF and MyD88 are highly expressed in ovarian cancer tissues, and together with VEGF mediate tumor angiogenesis, affecting the occurrence and development of ovarian cancer.