Expression of connective tissue growth factor in cartilaginous tumors

BACKGROUND: Connective tissue growth factor (CTGF) predominantly is expressed in hypertrophic chondrocytes and its specific receptors are demonstrated on chondrocytic cells. Therefore, CTGF may be involved in the proliferation and/or differentiation of cartilage cells. In the current study, CTGF expression was examined both in chondrosarcoma and enchondroma to clarify the relation between the expression of CTGF and the grade of malignancy. METHODS: The expression of CTGF and proliferating cell nuclear antigen (PCNA) were analyzed immunohistochemically in 34 cartilaginous tumor specimens. Eighteen tumors were determined to be chondrosarcoma including 8 Grade 1 tumors, 6 Grade 2 tumors, and 4 Grade 3 tumors. The percentage of CTGF positive and PCNA positive cells was quantified using at least 500 cells. RESULTS: CTGF was expressed in 70.1% of enchondroma cells, 84.0% of Grade 1 chondrosarcoma cells, 53.7% of Grade 2 tumor cells, and 26.8% of Grade 3 tumor cells (rho = -0.501; P = 0.0053). In chondrosarcoma cases, CTGF expression was correlated closely with tumor grade (rho = -0.920; P = 0.0001). There was a strong correlation between PCNA expression and tumor grade (rho = 0.907; P < 0.0001) and a strong negative correlation between CTGF and PCNA expression (rho = -0.493; P = 0.0061). In chondrosarcoma cases, patients with high expression of CTGF (>/= 30%) showed higher overall survival compared with those with low expression (< 30%) (P = 0.004). CONCLUSIONS: The current study revealed a correlation between the histologic grade of chondrosarcoma and prognosis, and the concomitant association between CTGF immunostaining and tumor grade and prognosis. Therefore, immunohistochemical staining with CTGF is a useful procedure for assessing the tumor grade and clinical course in patients with chondrosarcoma.     

MDM2 and p53 expression in gliomas: a multivariate survival analysis including proliferation markers and epidermal growth factor receptor.

p53 and the murine double minute 2 (MDM2) oncoprotein expression was evaluated in paraffin-embedded tissue from 61 patients with central nervous system gliomas (53 astrocytomas and eight oligodendrogliomas) and related to proliferation-associated markers [i.e. proliferating cell nuclear antigen (PCNA), Ki-67 and nuclear organizer regions (NORs)] and epidermal growth factor receptor (EGFR). We used the monoclonal antibodies PC-10, MIB-1, DO-1, 1B1O and EGFR 113 and the colloid silver nitrate (AgNOR) technique. MDM2 and p53 were co-expressed in 28% of cases. A p53-positive/MDM2-negative phenotype was observed in 15% and a p53-negative/MDM2-positive phenotype in 20% of cases. There was a positive correlation of p53 and MDM2 expression with grade and proliferation indices. Univariate analysis in the group of diffuse astrocytomas showed that older age, high histological grade, high PCNA labelling index (LI) and high AgNOR score were associated with reduced overall survival (P < 0.05). p53 LI, Ki-67 LI, AgNOR score, tumour location and grade influenced disease-free survival (P < 0.05), whereas the only parameters affecting post-relapse survival were histological grade and Ki-67 LI (P < 0.1). Multivariate analysis revealed that age, radiotherapy, PCNA LI and p53 LI were the independent predictors of overall survival. p53 LI, Ki-67 LI, MDM2 LI, EGFR LI, grade and type of therapy were independent predictors of disease-free survival, and grade was the only independent predictor of post-relapse survival. Our results indicate that p53 LI and MDM2 LI, EGFR expression as well as proliferation markers (PCNA and Ki-67) are useful indicators of overall and disease-free survival in diffuse astrocytoma patients.     

Fibroblast growth factor receptor 3 protein expression in urothelial carcinoma of the urinary bladder, exhibiting no association with low-grade and/or non-invasive lesions

Activating mutations of fibroblast growth factor receptor 3 (FGFR3), found in autosomal dominant human skeletal dysplasia, were reported to be involved in tumorigenesis and correlate with low-grade and superficial lesions of urothelial carcinoma. FGFR3 protein expression was immunohistochemically investigated in 126 cases of urothelial carcinoma of the urinary bladder to evaluate the role of this receptor in tumor behavior. p53 expression and the proliferating activity of tumor cells, assessed by Ki-67 expression, were also analyzed in parallel. Cytoplasmic and/or membrane immunostaining for FGFR3 was observed in 62 (49.2%) cases, including 20 (15.9%) cases of intense staining and 42 (33.3%) of moderate staining. p53 expression and Ki-67 labeling index (LI) were significantly correlated with high tumor grade (p=0.0093 and <0.0001, respectively) and invasion (p=0.0041 and <0.0001, respectively). Although there were two groups of interesting cases: low-grade and non-invasive tumors negative for p53 but positive for FGFR3, and high-grade and invasive tumors positive for p53 but negative for FGFR3, no statistically significant relationship was found between FGFR3 expression and tumor grade, invasion, p53 expression or Ki-67 LI. These results suggest that FGFR3 protein expression in bladder cancer is unlikely to affect tumor behavior as a unique single factor.     

The abnormalities in the p53/p21WAF1 pathway have a significant role in the pathogenesis and progression of gastrointestinal stromal tumors

To elucidate the prognostic role and relationship of the p53/p21/PCNA pathway in gastrointestinal stromal tumors (GISTs), a total of 167 resected gastric and small intestinal CD117-positive stromal tumor specimens were collected from January 1987 to December 2000. Immunohistochemical studies were performed on the paraffin sections with antibodies of p53, p21/WAF1, proliferating cell nuclear antigen (PCNA) and Ki-67. The immunoreactivity of four markers was recorded by labeling index (LI, %) for clinicopathologic and survival correlation. The labeling index was 0-83% for p53, 0-81% for p21/WAF1, 0-33% for Ki-67 and 12-92% for PCNA. Completely negative immunostaining (LI<1%) was found in 54.5% of p53, 25.8% of p21/WAF1 and 44.3% of Ki-67. The LI of four markers strongly correlate with each other (p<0.05). Furthermore, the LI of all four markers positively correlate to microscopic tumor mitotic counts (p<0.05). Only the LI of p53 and PCNA positively correlate to tumor sizes. Tumors with non-spindle cell type (versus spindle cell) and high cellular pleomorphism (versus low) exhibited a higher p53, p21/WAF1 and PCNA LI (p<0.05). Increased NIH risk significantly correlates to increased p53, PCNA and Ki-67 (p<0.05) LI. Survival analysis indicated that a large tumor size (> or =5 cm, p=0.003), increased tumor mitosis (> or =5/50 HPF, p<0.001), high NIH risk (p<0.001), non-spindle cell type (p=0.024), high p53 LI (p<0.001), high p21/WAF1 LI (p=0.007), high Ki-67 LI (p<0.001) and high PCNA LI (p<0.001) were prognostic factors for poor disease-free survival. Independent factors are tumor size, NIH risk, p53 and p21/WAF1 LI. We demonstrated the first evidence of the linear relationship and prognostic role of the p53/p21/PCNA pathway in gastrointestinal stromal tumors. Abnormalities of the p53/p21WAF1 pathway lead to increased proliferating states, thereby triggering the progression of GISTs.     

PCNA、Ki-67在腮腺肿瘤中的表达

目的　研究增殖细胞核抗原 (PCNA )、增殖细胞核相关抗原 (Ki 67)在人体腮腺及其肿瘤中的表达 ,探讨PCNA、Ki 67与不同病理分级腮腺肿瘤间的关系 ,并预测其预后。方法　将已经病理诊断的 3 2例腮腺组织标本分成正常、良性、低度恶性及高度恶性 4个组 ,采用免疫组化法测定其细胞中PCNA及Ki 67的阳性表达率 ,并进行比较。结果　PCNA及Ki 67阳性表达率 :高度恶性组最高 ,且高于低度恶性组 ;良性组较低 ,但高于正常组 ;四组间阳性表达率有非常显著性差异 (P <0 .0 1)。结论　PCNA及Ki 67的表达与腮腺肿瘤病理分级密切相关 ,并能预测腮腺肿瘤预后     

Rb-loss is associated with high malignancy in chondrosarcoma

Loss of function of the human retinoblastoma gene (Rb) is a frequent genetic abnormality in human malignancies and causes a disturbance in the cell cycle and loss of normal proliferation and differentiation. We studied the loss of heterozygosity (LOH) of the Rb gene in 31 formalin-fixed, paraffin-embedded cartilaginous tumors using polymerase chain reaction. The tumors were subdivided into 8 cases of dedifferentiated (DD) chondrosarcoma, 17 cases of conventional chondrosarcoma (nine grade 1, seven grade 2 and one grade 3), 4 enchondromas and 2 chondroblastomas. Both components of DD chondrosarcoma, the low-grade and anaplastic components, were separated by a microdissection approach. The genetic data were correlated with the expression of the Rb protein examined by Rb immunohistochemistry. We found Rb-LOH in one grade 3 chondrosarcoma, and in the anaplastic component in 7 of 8 cases of DD chondrosarcoma (89% of all high-grade chondrosarcomas). All tumors with Rb-LOH were immunohistochemically Rb-negative. The only case of DD chondrosarcoma negative for Rb-LOH in both components of the tumor also showed weak expression of the Rb protein in the anaplastic component. All benign cartilaginous tumors, low-grade chondrosarcomas and low-grade tumor components of DD chondrosarcomas were negative regarding Rb-LOH but positive in Rb immunohistostaining. We concluded that Rb-LOH predominantly occurs in high-grade chondrosarcomas. However, it is not a marker for identifying low-grade tumors with a tendency towards progression or local recurrence.     

Biologic behavior of and p53 overexpression in multifocal renal cell carcinoma of clear cell type: an immunohistochemical study correlating grading, staging, and proliferation markers

BACKGROUND: In the treatment of small renal cell carcinoma (RCC), there is controversy between radical and nephron-sparing surgical treatment because of the risk of tumor multifocality. The biologic behavior of multifocal RCC compared with that of unifocal RCC is not well investigated, and the relevance of p53 and the proliferation markers MIB-1 and proliferating cell nuclear antigen (PCNA) to multifocal RCC is not yet established. METHODS: In this study, p53 protein overexpression was investigated immunohistochemically in 27 multifocal and 65 unifocal clear cell RCCs using a monoclonal antibody (DO-1). The nuclear expression of p53 was compared with the expression of PCNA and MIB-1 (Ki-67 antigen) and other prognostic factors, including grade and stage. RESULTS: Thirty-three RCCs (35.9%) had p53 positive nuclear staining. MIB-1 positivity was significantly higher in p53 positive tumors than in p53 negative tumors. PCNA positivity was not different in p53 positive tumors compared with p53 negative tumors. Proliferation marker expression was not associated with tumor focality. p53 overexpression was more often found in unifocal tumors than in multifocal tumors. Intracellular accumulation of the p53 protein was related to tumor grade but not to the T classification of tumor stage. In addition, lymph node involvement was significantly associated with p53 overexpression in tumors of the kidney. Focality did not influence progression free survival. CONCLUSIONS: This study demonstrated that there is no difference in the proliferative activity or biologic behavior of multifocal and unifocal tumors.     

Case of retroperitoneal dedifferentiated mixed-type liposarcoma: comparison of proliferative activity in specimens from four operations.

In a case of retroperitoneal dedifferentiated mixed-type liposarcoma, a dedifferentiated component was observed in the so-called mixed-type liposarcoma consisting of well-differentiated and myxoid components. The proliferative activity was compared among the different components of the tumor by immunohistochemical study using the proliferating cell nuclear antigen (PCNA) and MIB-1 monoclonal antibodies. The dedifferentiated component showed higher positivity than the well-differentiated and myxoid components, and tumor progression was most advanced in the dedifferentiated component. In the chronological examination of each component, the labeling indices of PCNA and MIB-1 were significantly higher at the third recurrence than in the primary lesion in all types, indicating that the proliferative activity of the tumor cells increased gradually. Considering the surgical treatment of liposarcoma, an extended resection encompassing normal adjacent tissues is required in cases containing the dedifferentiated component in comparison to the cases containing only well-differentiated or myxoid components.     

p53 expression and tumor proliferative activity in testicular germ-cell tumors

We evaluated p53 expression and tumor proliferative activity (TPA) using monoclonal antibodies to Ki-67 and proliferating cell nuclear antigen (PCNA) in 26 patients with seminomatous and nonseminomatous testicular germ-cell tumors (GCTs). Correlation between p53 expression and TPA, as well as the clinical correlation with the expression of these proteins were also assessed. There were eight cases of pure seminoma and 18 cases of nonseminomatous GCTs, collectively consisting of 45 tumors or tumor components. The nonseminomatous GCTs were mixed or pure and included choriocarcinoma (CC), embryonal carcinoma (EC), immature teratoma (IMT), mature teratoma (MT), seminoma, and yolk sac tumor (YST). The ages of the patients with seminomatous GCTs ranged from 24 to 47 years (mean, 34 years) and those for patients with nonseminomatous GCTs ranged from 17 to 43 years (mean, 29 years). Sixteen (44%) of the 36 nonseminomatous GCTs or tumor components were positive for p53 protein. Ten (91%) of eleven ECs, three (38%) of eight YSTs, two (20%) of ten MTs, and the single case of CC were positive for p53 protein. All nine seminomas and three of six IMTs were only focally positive for p53 protein. The p53 expression in ECs and YSTs was significantly higher than that in IMTs, MTs, and seminomas (P=0.0001). TPA was present in the majority of the seminomatous and nonseminomatous GCTs, and was significantly higher in ECs and YSTs than in seminomas, MTs, and IMTs (Ki-67, P=0.0001; PCNA, P=0.0006). In the majority of the cases PCNA expression was higher than Ki-67 expression (P=0.0001). The mean TPA percentage was significantly higher in the p53-positive tumors or tumor components (EC and YST) when compared with the mean TPA percentage in those neoplasms that were focally positive or negative for p53 protein (Ki-67, P=0.003; PCNA, P=0.046). p53 expression was also associated with histologically aggressive tumors (ECs and YSTs) that also exhibit high TPA. No relationship appears to exist between the three tumor markers and the clinical stage or the patients' follow-up and outcome in this small series. Further studies are necessary to elucidate the roles of p53 and proliferation markers in testicular tumorigenesis and as prognostic markers.     

垂体腺瘤p53基因Ki-67细胞增生抗原的表达及其临床意义

目的探讨垂体腺瘤p53基因和Ki-67细胞增生抗原表达的变化与肿瘤侵袭行为、肿瘤复发的相关性。方法经手术切除的垂体腺瘤标本67例,按影像学显示的肿瘤大小分为A,B两组(<2.5cm为A组,>2.5cm为B组),用免疫组化方法分别检测p35基因与Ki-67的表达,临床随访1￣3年,观察肿瘤复发情况。结果A组39例中p53阴性11例,低表达28例,Ki-67均为低表达,3年内肿瘤复发4例;B组26例(达到侵袭性标准),p53均显示高表达,Ki-67中度表达10例,高表达16例,其中11例肿瘤3年内复发,两组比较有显著差异(P<0.05)。结论垂体腺瘤的p53和Ki-67的表达与肿瘤的侵袭性呈正相关,而Ki-67的高表达还与肿瘤的复发有关。     

P21-ras、P53、Ki-67蛋白的表达与星形细胞瘤分化及预后的相关性研究

目的分析Ｐ２１－ｒａｓ、Ｐ５３、Ｋｉ－６７在星形细胞肿瘤中的表达,与肿瘤增生活性、分化和预后的关系。方法应用免疫组化ＬＳＡＢ法对６６例星形细胞瘤Ｐ２１－ｒａｓ、Ｐ５３、Ｋｉ－６７表达进行检测,对其中４７例有随访资料的肿瘤患者存活因素进行分析。结果Ｐ５３、Ｋｉ－６７的表达与肿瘤分级密切相关（Ｐ＜０．０１）。Ｐ５３、Ｋｉ－６７在肿瘤中的表达呈正相关（Ｐ＜０．０５）。Ｐ５３表达阳性,和Ｋｉ－６７表达指数高的肿瘤预后较差。Ｐ２１－ｒａｓ表达与肿瘤分化及预后未见显著差异。（Ｐ＞０．０５）。结论星形细胞瘤也存在Ｐ２１－ｒａｓ基因异常,Ｐ５３、Ｋｉ－６７能客观的反映肿瘤的增殖速度,分化和恶性程度,可以作为判断肿瘤预后的有用指标。     

去分化软骨肉瘤的诊断及治疗进展*

去分化软骨肉瘤（DDCS）约占所有软骨肉瘤的10% ,预后极差,5 年生存率不到10% 。好发于股骨、肱骨和骨盆。DDCS是软骨肉瘤中的一个独特类型。典型的特点是分化良好的软骨样成分和高度恶性的间充质细胞来源的肉瘤成分并存、毗邻。DDCS的诊断非常复杂,需要详细的影像学和病理学检查及准确的活检。DDCS去分化成分可以是骨肉瘤、恶性纤维组织细胞瘤,甚至是任何级别的未分化肉瘤成分。约1/3 的X 光片,1/3 的MR,一多半的CT扫描,DDCS表现为典型的“双态”征。最近利用微阵列- 比较基因组杂交技术,发现反复发生的5q14.2~q21.3,6q16~q25.3,9p24.2~q12和9p21.3。染色体缺失更多见于高度恶性的软骨肉瘤（3 级和DDCS）,该差异具有统计学意义。9 号染色体的缺失是DDCS最常见的染色体缺失。早期研究发现DDCS的去分化成分有p53和p53杂合性的丢失现象,进一步研究发现同时伴随Rb基因杂合性的丢失。DDCS的两种成分可出现p16INK 4,FHIT和E-cadherin（上皮型钙黏附蛋白）甲基化的异常。手术切除包括合适足够的外科切缘或根治性的切除,是目前DDCS最主要的治疗手段。化疗效果目前仍然不确定。最近针对软骨肉瘤（包括DDCS）发现了一些新的药物靶标,有些已经进入临床Ⅱ期试验阶段,其中包括Apomab、Perifosine （哌立福新）、Dasatinib（达沙替尼）和多烯紫杉醇联合吉西他滨的联合化疗。同时几个Ⅰ期药物临床试验报告针对DDCS新的有效药物,如组蛋白去乙酰酶抑制剂和血管内皮生长因子反义寡合甘酸。DDCS患者预后极差,预后主要由DDCS中的去分化成分决定。因此,早期诊断、早手术对改善患者的预后非常关键。      

星形细胞瘤中PTEN、p53及Ki-67的表达与肿瘤细胞增殖及分级的关系

 目的　探讨星形细胞瘤中PTEN、p53及Ki-67的表达水平及其与肿瘤细胞增殖及分级的关系。方法　采用免疫组织化学方法检测68例星形细胞瘤中PTEN、p53及Ki-67的表达水平。结果　星形细胞瘤中PTEN、p53及Ki-67的表达率分别是54.4 %、45.6 %及48.5 %,随着肿瘤级别增加,PTEN的表达率下降,而p53、Ki-67的表达率上升,Spearman等级相关分析显示PTEN的表达与星形细胞瘤的分级呈负相关,p53、Ki-67的表达与分级呈正相关。PTEN阳性表达的37例星形细胞瘤标本中,Ki-67的阳性率是24.3 %;而在PTEN阴性的31例标本中,Ki-67的阳性率是77.4 %,PTEN表达与Ki-67表达呈负相关。结论　PTEN的表达与星形细胞瘤的分级呈负相关,Ki-67、p53的表达与星形细胞瘤组织病理分级呈正相关。PTEN在一定程度上可以抑制肿瘤细胞的增殖。     

脑肿瘤细胞PCNA和Ki—67表达的对比观察

观察45例（4组）原发性脑肿瘤的免疫组化研究发现：增殖细胞核抗原（PCNA）和Ki67抗原（Ki－67）阳性率均为100％，两种阳性细胞密度均随肿瘤恶性程度增加而升高，并与肿瘤体积呈正相关，两种阳性细胞密度间也呈正相关，各肿瘤组PCNA阳性细胞密度均高于同组Ki－67阳性细胞密度。提示PCNA和Ki－67表达水平均能较客观地反应脑肿瘤的增殖速度和恶性程度。PCNA能用于石蜡切片是检测增殖期细胞更实用的标记物。     

Epidermal growth factor receptor (EGFR), proliferating cell nuclear antigen (PCNA) and Ki-67 antigen in laryngeal epithelial lesions.

The epidermal growth factor receptor (EGFR), proliferating cell nuclear antigen (PCNA) and Ki-67 immunostaining in paraffin sections from 154 cases of laryngeal squamous cell carcinoma, 25 specimens of normal and hyperplastic laryngeal epithelium, and 21 preneoplastic lesions was examined. The difference of EGFR expression and PCNA score between laryngeal cancer and dysplastic lesions vs normal and hyperplastic epithelium was significant. There was significant difference in Ki-67 score between malignant vs premalignant lesions and normal and hyperplastic epithelium. There was significant correlation between PCNA score and histopathological grading of the tumour. The highest PCNA expression was detected in stage G3. Our findings have shown that PCNA and Ki-67 staining can be used as a marker of cell proliferative activity in laryngeal epithelial lesions. EGFR, PCNA and Ki-67 expression correlate with severity of laryngeal lesions. PCNA immunostaining can aid in estimating the histological grade of malignant lesions.     

Dedifferentiated chondrosarcoma. An ultrastructural study

The light and electron microscopic features of a well-differentiated chondrosarcoma with dedifferentiated foci (dedifferentiated chondrosarcoma) is presented. Ultrastructurally, the cells of the dedifferentiated portion were embedded in a matrix containing numerous short bundles of collagen fibers; these cells showed dilated rough endoplasmic reticulum containing stippled material as well as poorly formed cell junctions and resembled the cells in the cartilaginous component. These findings contrast with those reported previously.     

结直肠肿瘤p~（53）蛋白表达与细胞增殖

应用免疫组织化学ＡＢＣ法检测６９例结直肠癌，１１例腺瘤，３０例癌旁粘膜及１５例正常粘膜的Ｐ￣５３蛋白表达及增殖细胞核抗原（ＰＣＮＡ），结果显示：ｐ￣５３蛋白表达的结直肠癌细胞增殖指数高，腺瘤ＰＣＮＡ阳性细胞多集中于细胞增殖区，与ｐ￣５３蛋白阳性表达区相仿；癌旁粘膜增殖指数与严ｐ￣５３表达无关。这表明：ｐ￣５３蛋白表达与结直肠肿瘤细胞增殖及腺瘤恶性转化有关。     

新辅助化疗对乳腺癌患者survivin、Ki-67、ER、C-erbB-2、p53和肿瘤组织学分级的影响及其疗效预测意义

目的探讨新辅助化疗对乳腺癌survivin、Ki-67、ER、C-erbB-2、p53和肿瘤组织学分级的影响,同时研究这些指标对新辅助化疗的疗效预测作用。方法通过免疫组织化学S-P法检测和HE染色对化疗前空芯针穿刺标本和化疗后手术切除的30例乳腺癌组织的survivin、Ki-67、ER、C-erbB-2、p53和肿瘤组织学分级的表达情况。化疗方案为CAF（CTX 600 mg/m^2,THP 50 mg/m2,5-FU500 mg/m^2）和TA（艾素75 mg/m^2,THP 30 mg/m^2）,每3周1疗程,用药2～3个疗程。化疗疗效通过采用临床体检、乳腺彩超检测及术后病理分析综合判断。结果 30例患者中70.0%（21/30）获PR,SD为30.0%（9/30）,全组无恶化病例,总有效率为70.0%（21/30）。通过对化疗前后的指标比较发现：新辅助化疗能降低Ki-67的表达（P〈0.01）和肿瘤分级（P〈0.05）。化疗前后survivin、ER、C-erbB-2和p53表达无明显变化（P〉0.05）。Ki-67高表达（≥20%）、肿瘤分级高的患者和Ki-67低表达（〈20%）、肿瘤分级较低的患者相比,化疗疗效更明显（P〈0.05）。结论新辅助化疗能显著降低乳腺癌组织Ki-67的表达和肿瘤分级,而对survivin、ER、C-erbB-2和p53表达均无显著影响,Ki-67高表达（≥20%）、肿瘤分级高的患者对化疗更敏感、短期疗效更显著。     

热化疗对恶性胸腔积液中肿瘤细胞表达Ｋｉ-６７、ＰＣＮＡ、Ｂｃｌ-２、ｐ５３的影响

目的　研究射频热疗联合胸腔灌注化疗对恶性胸腔积液中肿瘤细胞表达Ｋｉ-６７、ＰＣＮＡ、Ｂｃｌ-２和ｐ５３的影响。方法　８５例确诊为恶性胸腔积液患者随机分为热化疗组和灌注化疗组,采用中心静脉导管胸腔闭式引流,尽可能排尽胸水后,热化疗组４４例,给予顺铂胸腔灌注化疗,然后进行胸腔射频热疗;灌注化疗组４１例,仅予顺铂胸腔灌注化疗。通过免疫组化法检测治疗前和治疗１疗程后胸腔积液中肿瘤细胞Ｋｉ-６７、ＰＣＮＡ、Ｂｃｌ-２和ｐ５３的表达情况。结果　热化疗组治疗后胸腔积液中肿瘤细胞中Ｋｉ-６７和ＰＣＮＡ的表达率均较治疗前下降,两者比较均有统计学意义（Ｐ＜０.０５）;两组治疗后Ｋｉ-６７、ＰＣＮＡ、ｐ５３和Ｂｃｌ-２的表达率比较均无显著差异（Ｐ＞０.０５）。结论　射频热疗能够显著提高化疗抑制恶性胸腔积液中肿瘤细胞增殖和促进肿瘤细胞凋亡的作用。     

Ki-67、p53、CerbB-2表达与乳腺癌彩色超声征象的关系

目的 探讨肿瘤增殖抗原(Ki-67)、肿瘤抑制基因(p53)、原癌基因(CerbB-2)表达与乳腺癌彩色超声征象的临床关系.方法 选取拟行手术切除的乳腺癌患者44例作为研究对象,所有患者手术前均行彩色超声检查,于手术后对切除标本行石蜡包埋切片,然后采用免疫组化方法 对Ki-67、p53、CerbB-2表达情况进行检测,并分析3者和术前彩色超声征象的临床关系.结果 本组44例乳腺癌患者中,肿块直径≥2 cm者共有25例,19例肿块形态散在分布,16例分叶状分布,9例类圆形分布;23例有毛刺征,24例有高回声晕,27例有后方衰减,20例有微小钙化,21例有淋巴结转移,27例血流信号2~3级;Ki-67阳性表达率为61.36%,p53阳性表达率为52.27%,CerbB-2阳性表达率为47.73%;27例Ki-67阳性表达患者中,肿块形态、微小钙化、淋巴结转移以及肿块内血流信号,23例p53阳性表达患者中淋巴结转移和肿块内血流信号,21例CerbB-2阳性表达患者中微小钙化和肿块内血流信号比较,差异均有统计学意义(P<0.05).结论 Ki-67、p53、CerbB-2阳性表达和彩色超声征象均存在一定关联,可作为乳腺癌重要诊断指标.