胃癌细胞DNA含量肿瘤相关抗原及其异质性

目的探讨胃癌异质性标志物之间的关系．方法应用显微分光光度计和抗ＳＳＥＡ１，抗胃癌单抗ＭＧ７的免疫组织化学染色对３５例胃癌和１０例正常胃粘膜进行了ＤＮＡ含量和ＳＳＥＡ１，ＭＧ７抗原表达的研究．结果正常胃粘膜细胞和管状腺癌，低分化腺癌，粘液腺癌，印戒细胞癌及未分化癌的ＤＮＡ相对含量分别为１１６０±０２０７，２１７６±０７０３，２２１４±０６６３，２２０６±０６０２，１１９６±０２７９和１６６５±０４９１，其中正常胃粘膜９５８％细胞为２Ｃ细胞，而胃癌常见＞８Ｃ，＞１２Ｃ细胞，在直方图上分布弥散；同一类型的不同病例间，同一病例切片的不同部位呈明显的异质性，但印戒细胞癌的ＤＮＡ含量接近正常．大部分胃癌标本中可检出ＳＳＥＡ１和ＭＧ７Ａｇ，但分布及染色程度呈明显的不均质性．ＳＳＥＡ１，ＭＧ７Ａｇ的表达与ＤＮＡ含量无明显关系．结论ＤＮＡ含量和ＳＳＥＡ１，ＭＧ７的表达是互相独立的，均与肿瘤的行为有关．     

胃癌中癌基因ras c-myc mRNA表达的临床意义

目的探索癌基因ｒａｓ和ｃｍｙｃｍＲＮＡ在胃癌发生中单独和协同作用关系，选择胃癌的早期诊断依据．方法应用原位分子杂交（ＩＳＨ）技术，检测８８例胃癌组织中Ｈｒａｓ，Ｋｒａｓ，ＣｍｙｃｍＲＮＡ的表达，结合临床资料综合分析．结果Ｋｒａｓ，Ｈｒａｓ，ＣｍｙｃｍＲＮＡ在肿瘤区的阳性表达分别为７８４％，７０５％和５８０％，在癌旁区的阳性表达分别为２８４％，２７３％和２０５％，呈梯度下降趋势，３种癌基因的表达与胃癌的临床分型、组织学分类及有无淋巴结转移无关，ＣｍｙｃｍＲＮＡ的表达与患者生存期关系密切（Ｐ＜００５）．结论Ｋｒａｓ，Ｈｒａｓ，ＣｍｙｃｍＲＮＡ的表达可作为胃癌早期诊断的参考依据．     

心肌缺血再灌注损伤肌浆网Ca^2＋—ATPase活性变化电镜酶细胞化学观察

心肌缺血再灌注损伤肌浆网Ｃａ２＋－ＡＴＰａｓｅ活性变化电镜酶细胞化学观察（摘要）谷天祥肖德绵张显清谷春久石玉秀李厚文姜桂娥王天骄应用电镜酶细胞化学技术观测大鼠离体缺血再灌注心肌细胞肌浆网、细胞膜原位Ｃａ２＋－ＡＴＰａｓｅ活性变化，旨在探讨心肌缺血再灌...     

胃癌和癌旁组织中Fas抗原表达与细胞凋亡的关系

目的研究胃癌及癌旁组织中Ｆａｓ抗原表达与细胞凋亡的关系，探讨Ｆａｓ抗原及细胞凋亡在胃癌发病中的作用．方法采用免疫组织化学及脱氧核糖核酸末端转移酶介导的缺口末端标记（ＴＵＮＥＬ）技术对胃癌组织５０例及癌旁组织３３例中Ｆａｓ抗原表达状态及凋亡细胞进行原位观察和比较．结果胃癌组织Ｆａｓ抗原表达率为４６０％，显著低于癌旁组织的７５８％（χ２＝７２２，Ｐ＜００１）．胃癌组织凋亡细胞指数为５８％，显著低于癌旁组织的１６８％（ｔ＝８６３，Ｐ＜００１）；Ｆａｓ抗原表达阳性的胃癌和癌旁组织凋亡细胞指数显著高于Ｆａｓ抗原阴性组（ｔ＝５１６和ｔ＝３７１，Ｐ＜００１）．结论Ｆａｓ抗原对胃癌及癌旁组织中的细胞凋亡具有促进性调控作用，细胞凋亡调控异常在胃癌发病中可能起重要作用．     

肝癌凋亡相关抗原的表达与原位末端标记的关系

目的探讨Ｆａｓ等凋亡相关抗原在肝细胞癌（ＨＣＣ）的表达及其与凋亡的关系．方法剖腹ＨＣＣ３０例，标本作Ｆａｓ，Ｂａｘ，Ｉｃｅ，Ｂｃｌ２免疫组化和原位末端标记（ＩＳＥＬ）．结果ＩＳＥＬ与ＨＥ的凋亡形态及定位基本吻合，ＨＣＣ有小片及大片的凋亡；凋亡与坏死形态不同，且坏死ＩＳＥＬ阴性，可与凋亡鉴别．凋亡及健全癌细胞Ｆａｓ，Ｂａｘ阳性率均较高．癌旁及正常肝的Ｆａｓ，Ｂａｘ均较ＨＣＣ者低．Ｂｃｌ２在ＨＣＣ表达甚低．结论凋亡的ＨＣＣ组织Ｆａｓ表达高，较健全癌细胞、癌旁及正常肝组织的表达为高     

抗Fas单克隆抗体诱导人胃癌细胞系SGC-7901细胞

目的探讨抗Ｆａｓ单克隆抗体诱导胃癌细胞凋亡的规律及在胃癌治疗中的意义．方法应用细胞形态观察、琼脂糖凝胶电泳、流式细胞光度术检测抗Ｆａｓ单克隆抗体对胃癌细胞ＳＧＣ７９０１增殖周期的影响以及对细胞杀伤作用的方式,并检测了ＳＧＣ７９０１细胞表面Ｂｃｌ２的表达情况．．结果抗Ｆａｓ单克隆抗体有阻滞细胞周期、通过诱发凋亡而抑制肿瘤细胞生长的作用．经抗Ｆａｓ单克隆抗体处理后,ＳＧＣ７９０１细胞表面Ｂｃｌ２蛋白表达无明显变化．．结论抗Ｆａｓ单克隆抗体可以诱导胃癌细胞系ＳＧＣ７９０１细胞凋亡．抗Ｆａｓ单克隆抗体诱导胃癌细胞凋亡与Ｂｃｌ２表达无关     

大肠癌及癌旁内分泌细胞的表达意义

目的探讨内分泌细胞（ＥＣ）在大肠癌及癌旁的表达意义．方法应用ＬＳＡＢ免疫组化法，对１１７例大肠癌及８５例癌旁粘膜中嗜铬蛋白Ａ（ＣＧＡ）及几种激素进行检测，１３例大肠癌行电镜观察．结果ＥＣ阳性大肠癌４６例（３９３％），检测到一种以上激素６９２％（２７／３９），癌旁粘膜ＥＣ数高于正常肠粘膜．电镜观察８例有含内分泌颗粒的癌性ＥＣ．在中低分化癌中ＥＣ（＋＋）的表达（２５５％）高于高分化癌（６９％）（χ２＝７５４，Ｐ＜００５），含有ＥＣ的大肠癌淋巴结转移的发生率（６８０％）高于不含ＥＣ者（４３７％）（χ２＝６２３，Ｐ＜００５），且预后不良；５ＨＴ，βＨＣＧ，Ｇｌｕ，Ｇａｓ阳性癌分化及预后较差（Ｐ＞００５）．结论含ＥＣ的大肠癌具有更恶性的生物学行为，可能与ＥＣ中某些激素，通过旁分泌等途径促进肿瘤的生长转移有关，癌旁ＥＣ增生与周围肿瘤生长有关．     

C-myc,Bcl-2与胃癌生物学行为和细胞凋亡

目的探讨癌基因Ｂｃｌ２，Ｃｍｙｃ的表达变化与胃癌生物学行为和细胞凋亡的关系．方法采用免疫组化ＬＳＡＢ法，检测６０例原发性胃癌组织（男３８例，女２２例，年龄３７岁～７５岁）癌基因Ｂｃｌ２，Ｃｍｙｃ蛋白的表达变化；在普通光学显微镜下对受检组织的ＨＥ片进行形态学测量和凋亡细胞计数．结果受检组织６０例中，Ｃｍｙｃ阳性表达３７例（６２％），其表达与分化程度和临床分期呈显著性相关，且Ｃｍｙｃ阳性组织细胞凋亡指数（０７±０３）明显高于阴性组织（０３±０２）；所检标本中，Ｂｃｌ２阳性表达率为６８％（４１／６０），其中高分化胃癌的阳性表达率明显高于低分化胃癌（３２％ｖｓ９％）（Ｐ＜００５），阳性Ｂｃｌ２组织与阴性Ｂｃｌ２组织比较，前者凋亡指数明显低于后者（０４±０３ｖｓ０９±０５）（Ｐ＜００５）．结论Ｃｍｙｃ与Ｂｃｌ２基因的异常表达是胃癌生物学行为的重要影响因素，二者在胃癌形成过程中均起着一定的作用，并对细胞增生与凋亡有重要调节作用．     

胃癌及癌前期病变粘膜芳香基酰胺酶同工酶的表达意义

目的探讨胃癌及癌前期病变粘膜芳香基酰胺酶（ＡＡＤ）同工酶的表达规律，寻找癌前期病变及早期癌的标志物．方法采用本室建立的圆盘等电聚焦电泳（ＣＩＥＦ）分离１２２例各种胃病粘膜（胃癌４１例，浅表性胃炎４８例，萎缩性胃炎３０例，胃溃疡８例，其中伴肠化１９例，异型增生８例）中ＡＡＤ同工酶．以６０ｇ／Ｌ丙烯酰胺作支持递质，ｐＨ３５～５０和ｐＨ３５～１００两种载体两性电解质建立ｐＨ梯度，加匀浆液５０μｌ，阴极及阳极电极液分别用０２ｍｏｌ／ＬＮａＯＨ和０５ｍｏｌ／ＬＨ３ＰＯ４，恒压电泳（１０℃）１８ｈ后以亮氨酰β萘胺作为基质呈色．结果ＡＡＤ分为８条区带，从阳极到阴极依次命名为ＡＡＤⅠ～ＡＡＤⅧ，其中ＡＡＤⅣ主要见于胃癌（９０２％），不完全大肠型肠化（８６７％）和异型增生（７５０％）；而不伴有肠化或异型增生的良性胃病和正常胃中则未发现．ＡＡＤⅣ的阳性率与胃癌病理类型、细胞分化程度及临床分期无相关，且ＡＡＤⅣ等电点和胎盘型ＡＡＤ等电点相当．结论ＡＡＤⅣ是一种癌胚蛋白，即胃癌组织特异性同工酶，是癌前期病变及早期癌的标志物．     

残胃癌的研究

残胃癌的研究马利川ＳｕｂｊｅｃｔｈｅａｄｉｎｇｓＳｔｏｍａｃｈｎｅｏｐｌａｓｍｓ／ｄｉａｇｎｏｓｉｓＣａｒｃｉｎｏｍａ，ｐａｐｉｌａｒｙ／ｄｉａｇｎｏｓｉｓＡｄｅｎｏｃａｒｃｉｎｏｍａ／ｄｉａｇｎｏｓｉｓＧａｓｔｒｅｃｔｏｍｙ主题词胃肿瘤／诊断癌...     

Ultrastructural cytochemical study of enzymes expressed by signet ring cells in gastric cancer

AIM: To study the ultrastructural localization of five marker enzymes (ALPase, ACPase, G6Pase, TPPase and CCOase) in gastric cancer signet ring cells to demonstrate their biologic behaviors.METHODS: Five marker enzymes were examined in signet ring cells of seven gastric cancer patients by ultrastructural enzyme cytochemical techniques.RESULTS: The number of corresponding organelles and the activities of marker enzymes, especially ACPase and TPPase, increased, leading to stronger mucus synthesis, secretion and digestion in gastric cancer signet ring cells. There was a lack of collagenous fibers in the stroma around the cancer nests.CONCLUSION: Signet ring cell carcinoma is very invasive with metastasis rates due to the secretion of proteolytic enzymes.     

Pedunculated gastric carcinoma demonstrating a gastric foveolar phenotype

We report a case of gastric cancer complicated with very well differentiated adenocarcinoma containing signet ring cells. An endoscopic examination revealed a pedunculated polyp in the fornix of the stomach. A surgical operation was performed and the pathological findings showed very well differentiated adenocarcinoma mimicking gastric foveolae with a poorly differentiated component containing signet ring cells. This is the first case of pedunculated gastric cancer complicated with very well differentiated adenocarcinoma containing signet ring cells and also demonstrating a gastric foveolar phenotype.     

Expression of p53 in early (T1) gastric carcinoma and precancerous adjacent mucosa.

Abnormalities of the tumour suppressor gene p53 have been shown in approximately 60% of advanced gastric adenocarcinomas and it has been suggested that the immunohistochemical finding of increased p53 expression is a prognostic marker in gastric cancer. No studies of early (T1) tumours have been reported. Over expression of p53 protein in 95 early gastric carcinomas and in adjacent mucosa was investigated using immunohistochemistry with antibody CM1. Thirty five per cent of the tumours were positive. The frequency of p53 positivity in tumours of tubular histological type (46%) was significantly higher than that in signet ring tumours (10%) (p = 0.006), and neoplasms that invaded deeply into the submucosa were more frequently positive (45%) than others (30%). Five of eight (62%) T1 tumours with lymph node metastases showed immunoreactive p53. In signet ring tumours, immunopositivity correlated with the frequency of DNA aneuploidy. p53 Over expression was also found in 15% of 26 examples of high grade dysplasia in mucosa adjacent to invasive tumours. No positivity was found in intestinal metaplasia or in normal mucosa. The findings show that immunocytochemically demonstrable over expression of p53 correlates with other morphological markers of aggressiveness in T1 gastric adenocarcinoma. The increasing frequency of p53 immunoreactivity in the sequence of high grade dysplasia-->early gastric cancer-->advanced gastric cancer supports the view that abnormalities of p53 are related to tumour progression in gastric carcinogenesis.     

Small gastrointestinal stromal tumor concomitant with early gastric cancer： A case report

The term gastrointestinal stromal tumors (GISTs)is defined diagnostically as the main group of mesenchymal tumors with spindle or epithelioid cells arising from the wall of the gastrointestinal tract with immunohistochemical reactivity for CD117 antibody.Previous studies revealed that cells in GISTs express a growth factor receptor with tyrosine kinase activity (termed c-kit), which is the product of the c-kit protooncogene. The most specific and practical diagnostic criteria for GISTs are: immunohistochemically determined c-kit (CD117) expression; mitotic score; and tumor size.A small GIST concomitant with early gastric cancer is rarely encountered clinically. Herein we have reported a case of a 1.1-cm GIST detected by esophagogastroduo denoscopy concomitant with a Ⅱc type of early gastric cancer (signet ring cell type). It was detected during a routine physical health examination. To our knowledge,this is the first report of a small GIST concomitant with a signet ring cell type of early gastric cancer.     

Multiple depressed‐type colonic cancer (IIC)‐like configurations: metastases from gastric cancer

We present a rare case of multiple colonic metastases from advanced gastric cancer presenting colon depressed‐type multiple early cancer (IIc)‐like configuration. The case was a 74‐year‐old man who presented with a symptom of abdominal fullness. Colonoscopy and barium enema study revealed multiple IIc‐like lesions, which were shown histologically to be metastatic deposits of signet ring cell carcinoma. He had synchronous gastric cancer, which histologically demonstrated moderate to poorly differentiated adenocarcinoma with signet ring cell differentiation. In addition, he had concomitant multiple small bowel metastatic lesions. This appears to be the first published report of multiple IIc‐like colonic metastatic lesions from a gastric cancer.     

Minute signet ring cell carcinoma occurring in gastric hyperplastic polyp

We describe a 45-year-old woman with minute signet ring cell carcinoma occurring in a gastric hyperplastic polyp. A biopsy specimen obtained from the gastric hyperplastic polyp revealed signet ring cell carcinoma. Endoscopic mucosal resection （EMR） was performed to confirm the diagnosis. Histological examination of the EMR specimen revealed focal signet ring cell carcinoma in the hyperplastic polyp. There are few cases of gastric hyperplastic polyp associated with signet ring cell carcinoma.     

Endoscopic features of early-stage signet-ring-cell carcinoma of the stomach

AIM: To identify the features of early signet ring cell gastric carcinoma using magnification endoscopy with narrow band imaging (NBI).METHODS: A retrospective review was conducted of 12 cases of early signet ring cell gastric carcinoma who underwent treatment in a single institution between January 2009 and April 2013. All patients had magnification endoscopy with NBI and indigo carmine contrast to closely examine the mucosal architecture, including the microvasculature and arrangement of gastric pits. Histologic examination of the final endoscopic submucosal dissection or gastrectomy specimen was performed and compared with the endoscopic findings to identify patterns specific to signet ring cell carcinoma.RESULTS: Twelve patients with early signet ring cell gastric carcinoma were identified; 75% were male, and average age was 61 years. Most of the lesions were stage T1a (83%), while the remainder were T1b (17%). The mean lesion size was 1.4 cm². On standard endoscopy, all 12 patients had a pale, flat lesion without any evidence of mucosal abnormality such as ulceration, elevation, or depression. On magnification endoscopy with NBI, all of the patients had irregularities in the glands and microvasculature consistent with early gastric cancer. In addition, all 12 patients exhibited the “stretch sign”, an elongation or expansion of the architectural structure. Histologic examination of the resected specimens demonstrated an expanded and edematous mucosal layer infiltrated with tumor cells.CONCLUSION: The “stretch sign” appears to be specific for signet ring cell carcinoma and may aid in the early diagnosis and treatment of this aggressive pathology.     

Two cases of histopathologically advanced (stage IV) early gastric cancer]

Various minimally invasive surgical techniques in some cases of early gastric cancer are becoming common practice. However, there are rare cases of advanced cancer with distant metastasis although the invasion of the gastric wall is limited to the mucosa and/or submucosa (defined as early gastric cancer according to UICC-TNM classification). We report two cases of early gastric cancer with distant metastasis (stage IV). Both tumors were defined as early cancer because they were confined to the submucosa. One was a type IIa early cancer, histologically classifiable as a signet ring cell carcinoma (according to the Japanese Classification of Gastric Carcinoma and UICC-TNM classification); the other was a surface spreading type IIb + IIc, classifiable as a signet ring cell carcinoma, too. Stage IV factors were ovarian metastasis (Krukenberg tumor) in the former and N3 in the latter case.     

A Small Gastric Cancer in Association with Menetrier Disease

Abstract: We studied a 57-year-old man who was diagnosed as having giant rugae at a mass-screening for gastric cancer. He was examined endoscopically for check-up purposes. In addition to giant rugal folds which occurred throughout the entire fundus and body of the stomach, a type IIc lesion was noted in the posterior lower wall of the gastric body. A biopsy revealed signet ring cell carcinoma. A total gastrectomy was performed. A resected specimen was serially sectioned and underwent histopathological examination; hypertrophy and cystic elongation of the gastric glands indicative of so-called giant hypertrophic gastritis was seen. The histological type of the type IIc lesion was undifferentiated adenocarcinoma with the signet ring cells being confined to the mucosal layer. This patient had a rare case of Menetrier's disease complicated by intramucosal carcinoma.     

肺转移性印戒细胞癌1例并文献复习

目的研究胃印戒细胞癌肺转移的临床特点。方法介绍1例对肺转移性印戒细胞癌的病例,并进行文献复习。结果以慢性咳嗽患者影像学上支气管周围斑片状阴影及多发纵隔淋巴结肿大并伴有外周血嗜酸粒细胞的增多,应考虑消化道肿瘤的可能。结论恶性度极高的黏液细胞型胃癌,可以跳跃转移到肺及纵膈。如果慢性咳嗽的患者,外周血嗜酸粒细胞的增多时,应尽早行肿瘤标记物及内窥镜的检查,以提高肿瘤的早期诊断率。