喉鳞状细胞癌发生过程中Bak和Bcl-xl基因蛋白的参与排除与性别和吸烟关系

目的探讨促凋亡基因Bak和凋亡抑制基因Bcl-xl在喉鳞状细胞癌中的表达,及其与喉癌发生和预后的关系.方法取哈尔滨医科大学附属二院耳鼻咽喉-头颈外科2000-07/2002-04行手术切除的45块喉原发性喉鳞癌及25块正常喉黏膜石蜡标本.检测标本组织中Bak和Bcl-xl蛋白的表达,采用免疫组织化学染色方法分析患者性别、吸烟情况、临床分期及不同肿瘤病理分级和淋巴结转移与喉癌组织中Bak和Bcl-xl蛋白表达的关系.结果①正常喉黏膜Bak阳性表达显著高于原发性喉鳞癌[92%(23/25),44%(20/45),P＜0.01].②正常喉黏膜Bcl-xl阳性表达显著低于原发性喉鳞癌[16%(4/25),53%(24/45),P＜0.01].③喉癌组织中Bak和Bcl-xl蛋白的表达与患者的性别、吸烟情况及临床分期无关(P＞0.05),而与肿瘤病理分级和淋巴结转移显著相关(P＜0.005,P＜0.01).结论Bak在喉鳞癌中表达较正常喉黏膜明显减少,其表达下调与喉癌的发生密切相关.肿瘤分化越好,Bcl-xl的表达越强.Bak和Bcl-xl蛋白的表达与肿瘤病理分级和淋巴结转移显著相关,说明Bak蛋白表达对防止癌细胞转移、扩散具有积极意义,可作为对喉鳞癌预后判断的指标.     

喉癌中survivin基因的表达及其与高危型人乳头瘤病毒感染的相关性研究

目的:探讨凋亡抑制基因survivin在喉鳞状细胞癌(LSCC)组织中的表达及其与人乳头状瘤病毒(HPV)16、18型感染之间的关系.方法:收集喉鳞状细胞癌标本46例,另收集声带息肉(VCP)组织20例,采用免疫组织化学链霉菌抗生物素蛋白-过氧化酶法检测喉癌组织和声带息肉组织中survivin和HPV16/18-E6蛋白的表达.结果:喉鳞状细胞癌中survivin表达阳性率为71.74%(33/46),显著高于声带息肉组织(X2=28.696,P＜0.01).临床分期Ⅲ+Ⅳ期survivin阳性表达率显著高于Ⅰ+Ⅱ期(X2=4.193,P＜0.05);有淋巴结转移者的survivin阳性表达率高于无淋巴结转移者(X2=6.691,P＜0.05),survivin的表达还与病理学分级有关,高分化与中分化间差异具有显著性(X2=4.290,P＜0.05).喉癌中survivin基因的表达与HPV16/18-E6基因表达呈正相关(r=0.735,P＜0.05).结论:survivin基因与喉癌的发生、发展密切相关,有望成为喉癌诊断和基因治疗的新靶点.HPV16/18是喉癌发生的重要的因素,喉癌中survivin表达与HPV16/18感染呈正相关.     

环氧合酶-2在喉鳞状细胞癌中的表达及临床意义

[目的]探讨环氧合酶-2(COX-2)蛋白在喉癌中的表达及其临床意义,同时探讨其在喉乳头状瘤和声带息肉中的表达情况.[方法]采用免疫组化SP法检测38例喉鳞癌、7例喉乳头状瘤及10例声带息肉组织中COX-2蛋白的表达水平.[结果]COX-2蛋白在喉癌中的表达水平明显高于声带息肉(P＜0.01); 喉乳头状瘤中的表达明显高于声带息肉(P＜0.01);声带息肉中几乎未见COX-2表达.在喉癌组的组织分级中,COX-2蛋白在高分化组织中的表达明显高于中度分化(P＜0.01)和低分化(P＜0.01);在中度分化组织中的表达明显高于低分化(P＜0.01);COX-2蛋白在各临床分期、T分级、N分级、肿瘤部位及年龄中差异均无显著性(P＞0.05).[结论] ①COX-2蛋白与喉鳞状细胞癌的组织学分化程度密切相关;②COX-2蛋白在小儿喉乳头状瘤复发和成人乳头状瘤发生方面可能起到一定的作用.     

Survivin和eIF4E在喉鳞癌组织中的表达及其关系

目的探讨Survivin和eIF4E在喉鳞癌组织中的表达及其相互关系。方法应用免疫组化法测定40例喉鳞癌组织标本及20例声带息肉组织中Survivin与eIF4E的表达,并进行比较。结果Survivin在喉鳞癌标本中的阳性表达率为65%,而在声带息肉组织中的阳性表达率为25%,二者比较差异有显著性（χ2=12.19,P〈0.05）。Survivin的表达与喉鳞癌临床分期、分化程度有明显的相关性（χ^2=8.993、7.238,P〈0.05）,而与淋巴结转移无相关性（χ^2=1.134,P〉0.05）。eIF4E在喉鳞癌和声带息肉组织中的阳性表达率分别为97.5%和65.0%,二者比较差异有显著性（χ^2=8.54,P〈0.05）,其与临床分期、分化程度、淋巴结转移情况无明显相关性（χ^2=0.054～2.477,P〉0.05）。Survivin和eIF4E在喉鳞癌组织中的表达无相关性（r=0.11,P〉0.05）。结论Survivin与eIF4E在喉鳞癌组织中的过度表达与喉鳞癌的发生有关,但两者在喉癌组织中表达的相关性还有待进一步研究。     

喉癌组织中CDK4基因表达及其扩增的意义

目的:探讨喉癌组织中CDK4基因表达特点及其扩增的临床意义。方法:利用免疫组化的方法对CDK4在111例喉癌组织及29例声带息肉组织中的表达进行了检测,同时利用原位杂交的方法检测了其中的62例喉癌组织中CDK4的DNA扩增。结果:CDK4蛋白在喉鳞状细胞癌组织和声带息肉组织中的阳性表达率分别为62.2%、58.6%(P>0.05)。在原发部位上CDK4基因蛋白的表达在声门癌与声门上癌之间差异有显著性(P=0.042)。CDK4蛋白表达与肿瘤分期有关(P=0.018),与临床分期及有无颈淋巴结转移无关(P>0.05)。CDK4 DNA在喉鳞状细胞癌中的扩增阳性率为30.6%,与喉癌的分型、淋巴结转移及病理分化程度无关(P>0.05),即与喉癌的生物学行为无关,与喉癌预后也无关(P>0.05)。结论:CDK4的过度表达可能在喉鳞状细胞癌的进展中发挥了重要作用,喉癌组织中CDK4基因有扩增,但仍存在有CDK4 mRNA的过表达,或者CDK4虽有DNA扩增,但mRNA表达不足或未表达而造成CDK4蛋白未测出。此外,是否在喉癌的发生发展中CDK4的异常还表现在基因突变、缺失等其他基因改变尚有待进一步实验的证实。     

神经生长因子受体TrkA在喉癌中的表达及意义

目的:探讨神经生长因子受体TrkA在人喉鳞状细胞癌(喉癌)中的表达及其临床意义.方法:应用免疫组织化学方法,检测34例喉癌组织、11例癌旁黏膜、6例喉乳头状瘤及8例正常声带黏膜组织中TrkA的表达.结果:34例喉癌组织中TrkA受体蛋白均有阳性表达,喉癌、癌旁黏膜及喉乳头状瘤中TrkA的表达均高于正常声带黏膜;喉癌伴随颈部淋巴结转移的病例组中TrkA表达的强阳性率明显高于无淋巴结转移组(P＜0.05).结论:TrkA的高表达与喉癌的恶性进展及淋巴结转移有相关性,这为临床诊断及治疗喉癌提供了新的途径.     

Caspase-3蛋白在喉鳞癌组织中表达及与喉癌细胞凋亡的对比研究

目的探讨半胱氨酸天冬氨酸蛋白酶3(Caspase-3)蛋白在喉鳞癌组织中的表达以及与喉癌细胞凋亡的对比关系。方法应用免疫组化SP法分别检测31例喉鳞癌组织和15例声带息肉组织中Caspase-3蛋白表达,用末端脱氧核苷酸转移酶介导的荧光素末端标记法(TUNEL)检测喉鳞癌细胞凋亡率,计算凋亡指数(AI)值并与Caspase-3喉癌组织中表达阳性率结果对比。结果 Caspase-3在喉鳞癌组织中的表达低于声带息肉组织(P<0.01)。Caspase-3的表达在喉癌组织分化程度、有无淋巴结转移及临床分期的差异具有统计学意义(P<0.05),在临床分型、有无吸烟、性别及年龄方面的差异无统计学意义(P>0.05)。喉癌组中凋亡的表达凋亡指数明显低于癌旁组,在统计学上有显著性差异(P<0.05)。喉鳞癌组织中Caspase-3的表达与TUNEL阳性细胞(凋亡细胞)数呈显著正相关,差异具有统计学意义(r=0.790,P<0.0)。结论 Caspase-3蛋白在喉鳞癌中低表达可促进喉鳞癌的发生、发展,其蛋白检测可作为判断喉癌分化、浸润转移及临床分期的重要指标。     

p63基因在喉鳞癌中表达的意义

目的：探讨p63基因在喉鳞癌中表达的意义。方法：采用免疫组化法检测30例喉癌组织中p63的表达,另选16例癌旁组织和〗4例声带息肉作为对照。结果：p63基因蛋白表达的阳性率在正常组织、癌旁组织及喉鳞癌组织中逐渐增高。其在喉癌中表达的阳性率在细胞不同分化程度中的差异有统计学意义,低分化鳞癌的表达强度高于高分化鳞癌;在不同年龄、性别、肿瘤原发部位、临床分期、有无颈淋巴结转移方面无显著差异。结论：（1）p63在喉鳞癌中呈过度表达,并且是喉鳞癌发生中的早期事件;（2）p63与喉鳞癌的分化程度有关;（3）p63基因的表达在喉鳞癌进展的过程中无变化。     

bcl-2、ki-67和p53在喉鳞状细胞癌中的表达及临床意义

目的探讨bcl-2、ki-67和p53在喉鳞状细胞癌中的表达及临床意义。方法利用免疫组织化学法测定20例喉鳞状细胞癌石蜡切片中和10例声带息肉中bcl-2、ki-67和p53蛋白的表达。结果bcl-2、ki-67和p53在声带息肉中的阳性率为20%、30%和10%;在喉鳞状细胞癌中的表达为50%、60%和50%。bcl-2的表达与喉癌的临床分期正相关(P0.05),与其他参数无关。ki-67的表达与各临床病理参数无关;p53的表达与声带息肉、喉癌相关(P0.05),与其他参数无关。bcl-2、ki-67和p53在喉鳞癌中的表达无相关性。结论bcl-2、ki-67和p53可作为反映喉鳞状细胞癌生物学行为的客观参考指标。     

喉癌的MRI形态学表现与其增殖细胞核抗原表达的相关性

目的探讨喉癌的MRI形态学特征与其增殖细胞核抗原表达的相关性.方法对41例喉癌患者术前行磁共振SE序列平扫,其中20例加行增强扫描.术后标本用ABC免疫组化技术进行PCNA半定量测量.结果①前组声门上型喉癌更易侵犯会厌软骨和室带(P＜0.05);后组更易侵犯杓状软骨和后联合(P＜0.05).声带和杓会厌皱襞受累提示癌组织PCNA标记指数＞75%的可能性大(P＜0.05).②声门型喉癌前联合受累组的PCNA标记指数高于未受累组(P＜0.05).③甲状软骨侵犯阳性组及颈淋巴结转移阳性的PCNA标记指数均高于阴性组(P＜0.05).结论喉癌的某些MRI形态学表现可以在一定程度上推测PCNA标记指数,了解其增殖活性.     

Tumor cell growth and cell kinetics

Cancer cells differ from normal cells in many ways, but most importantly by not responding to normal growth-control mechanisms. Whereas the growth and division of normal cells is carefully regulated to meet the needs of the body, tumor cells proliferate autonomously and continually, eventually interfering with and destroying the functions of normal tissue. Knowledge of molecular cell biology has grown exponentially over the last decade. Yet much remains to be understood before there can be a significant impact on our ability to design more effective therapeutic strategies for cancer patients, thereby decreasing mortality.     

Basal cell and squamous cell carcinoma

OBJECTIVES: To describe the clinical and histologic subtypes, pathophysiology, recognition, and treatment options for basal cell and squamous cell carcinoma, and the molecular biology of sunlight-induced carcinogenesis. DATA SOURCES: Journal and review articles, research studies, textbooks, and clinical practice. CONCLUSIONS: Basal cell and squamous cell carcinoma will occur in more than one million cases annually in the United States, and are highly curable when detected and treated early. During the last decade, significant progress has been made in elucidating the molecular basis of skin carcinogenesis and in identifying newer approaches for the management and treatment of these keratinocyte cancers. IMPLICATIONS FOR NURSING PRACTICE: Nurses can play crucial roles in decreasing the morbidity and mortality from the skin cancer epidemic by identifying and referring patients with lesions suspicious for basal cell and squamous cell carcinomas.     

Red blood cell storage and cell morphology

Aim: In this study, we performed weekly assessment of morphology‐related parameters through monitoring of CPD‐SAGM leuco‐filtered erythrocyte concentrates from blood withdrawal until the 42nd day of storage. Background: Liquid storage of red blood cells (RBCs) delivers a blood‐derived therapeutic, which is safe, available, effective and affordable for most patients who need transfusion therapy in developed countries. However, a growing body of accumulating controversial evidences, from either biochemical or retrospective clinical studies, prompted safety concerns about longer stored RBCs. Methods: Statistical image analysis through scanning electron microscope was coupled to osmotic fragility and erythrocyte sedimentation rate. Results: We could observe that by day 21 more than 50% of RBCs displayed non‐discocyte phenotypes. This observation was related to an increase in osmotic fragility, which was totally overlapped in day 0 controls and day 7 RBCs while only slightly augmented in day 14 samples. Cation dysregulation (pH internal/external alteration and potassium) might both reflect and trigger a negative feedback loop with metabolic fluxes and membrane cation pumps. Conclusion: Morphology parameters suggest that significant alterations to RBC morphology over storage duration occur soon after the 14th day of storage, as to become significant enough within the 21st day.     

Diagnosis and treatment of basal cell and squamous cell carcinomas

Rates of squamous cell and basal cell carcinomas have been increasing, possibly as a result of increased exposure to ultraviolet radiation. Primary care physicians can expect to diagnose six to seven cases of basal cell carcinoma and one to two cases of squamous cell carcinoma each year. Basal cell carcinomas may be plaque-like or nodular with a waxy, translucent appearance, often with ulceration and telangiectasia. They rarely metastasize and are treated with excision, cryotherapy, electrodesiccation and cautery, imiquimod, 5-fluorouracil, or photodynamic therapy (the latter is not approved for this purpose by the U.S. Food and Drug Administration), although surgery results in the fewest recurrences. Actinic keratoses are scaly keratotic patches that often are more easily felt than seen. They are amenable to any of the destructive techniques described above, with the exception of photodynamic therapy. Squamous cell carcinomas arise from keratotic patches and become more nodular and erythematous with growth, sometimes including keratin plugs, horns, or ulceration. Because they may metastasize, they often are treated with excisional biopsy.     

Diagnosis and treatment of Basal cell and squamous cell carcinoma

Cutaneous malignant melanoma accounts for 3 to 5 percent of all skin cancers and is responsible for approximately 75 percent of all deaths from skin cancer. Persons with an increased number of moles, dysplastic (also called atypical) nevi, or a family history of the disease are at increased risk compared with the general population. An important tool to assist in the evaluation of potential melanomas for patients and health care professionals is the ABCDE mnemonic, which takes into account asymmetry, border irregularities, color variation, diameter, and evolution. Any suspicious pigmented lesion should be biopsied. Appropriate methods of biopsy can vary, and include deep shave, punch, and excisional biopsy. Regardless of the procedure selected, it is essential that the size of the specimen be adequate to determine the histologic depth of lesion penetration, which is known as the Breslow depth. The Breslow depth is the most important prognostic parameter in evaluating the primary tumor. Because early detection and treatment can lead to identification of thinner lesions, which may increase survival, it is critical that physicians be comfortable with evaluating suspicious pigmented lesions and providing treatment or referral as necessary.     

激活诱导的细胞死亡与细胞周期的关系

机体免疫系统的平衡有赖于细胞增殖、分化和细胞死亡之间的适当关系。淋巴细胞中,激活诱导的细胞死亡(AICD)是免疫系统维持稳定的一种重要机制。细胞周期参与细胞的发育分化和死亡。因此,阐明免疫细胞发生激活诱导的细胞死亡与细胞周期的关系具有重要的意义。