粘蛋白7在膀胱癌尿脱落细胞中的表达及意义

目的:探讨粘蛋白7(mucin7,MUC7)在膀胱移行细胞癌(TCC)诊断中的意义。方法:采用巢式逆转录聚合酶链反应(nested RT-PCR)方法检测MUC7mRNA在TCC患者尿脱落细胞中的表达。结果:68例TCC患者中有42例尿液MUC7表达阳性,敏感性为62%;MUC7表达与临床分期有关而与病理分级无关。对照组25例中有3例在尿液中MUC7为阳性表达,特异性为88%。结论:用RT-PCR的方法检测尿脱落细胞中的MUC7,具有较高的膀胱癌诊断价值。     

骨桥蛋白在关节疾病中的表达及其意义

骨桥蛋白(osteopontin,OPN)是一种多功能的细胞外基质蛋白,因最初作为骨组织中一种非胶原基质蛋白被发现而得名[1]。OPN可以广泛参与多种生理和病理过程,包括炎症反应、免疫调节、组织修复、骨的发生发育和重建及肿瘤等[2～5]。同时,多种类型细胞如破骨细胞、软骨细胞、滑膜细胞、内皮细胞及     

钠碘转运体和甲状腺过氧化物酶mRNA在甲状腺病变中的表达及意义

目的 探讨甲状腺滤泡源性肿瘤及病变中钠碘转运体（NIS）和甲状腺过氧化物酶（TPO）mRNA的表达及意义。方法 应用逆转录-聚合酶链反应（RT-PCR）技术，对55例甲状腺肿块的NIS mRNA和TPO mRNA丰度进行了检查。结果NIS mRNA在5种不同病理类型以及4种不同状态间的表达差异无统计学意义（P〉0．05）。而TPO mRNA的比较，差异均有统计学意义（P〈0．05），良性病变组TPO mRNA表达率明显高于恶性病变组而接近于正常对照组。表达TPO mRNA病例的半定量观察结果，良、恶性病变组间TPO mRNA的光密度积分值（mRNA丰度）差异具有统计学意义（P〈0．01），良性病变组明显高于恶性病变组。结论良恶性甲状腺滤泡源性肿瘤及病变中均存在着NIS的缺陷；TPO作为甲状腺良性肿瘤和病变的标志物有一定的应用价值；临床甲状腺结节性病变如同位素扫描为冷结节，细针穿刺活检（FNAB）检查TPO阴性者应视为手术适应证。     

AURORA-A在肝恶性肿瘤中的表达及意义

目的　研究Aurora AmRNA在肝癌组织中的表达 ,探讨Aurora A基因与肝癌发生的关系。方法　采用半定量逆转录聚合酶链反应 (RT PCR)检测 30例肝癌组织及 30例正常肝组织中的Aurora AmRNA。结果　Aurora AmRNA在肝癌组织中的表达明显高于正常肝组织 (P <0 .0 5 )。结论　Aurora AmRNA在肝癌组织中的过度表达提示Aurora A基因与肝癌的发病及发展有关。     

骨桥蛋白在主动脉夹层中的上调表达及其意义

目的 应用Real time聚合酶链反应(PCR)、免疫组织化学技术观察OPN在夹层血管标本和正常对照标本中的表达是否存在差异.方法 选取急性期的主动脉夹层标本(AD)标本12例,正常胸主动脉12例.抽提标本总RNA,以GAPDH基因为参照,采用Real time PCR比较AD组和对照组OPN基因在RNA水平的差异;采用免疫组织化学方法 显示OPN蛋白在两组标本中的表达,两组各个标本在低倍视野下随机选择3个部位进行阳性细胞计数,比较两组OPN在蛋白质水平表达的差异.结果　AD组OPN基因的表达水平是正常组的5.56倍(P＜0.01),AD组OPN蛋白的表达水平是对照组的3.03倍(P＜0.01).结论　AD组标本OPN在基因和蛋白质水平均发生上调表达;OPN的上调表达可能与AD的形成密切相关.

Abstract：

Objective To identify the differential expression of osteopontin (OPN) between the aorta specimens from the aortic dissection (AD) and the normal controls. Methods Twelve descending aorta specimens from patients with acute Stanford B dissection were taken during surgical operation, and 12 normal descending aorta specimens were taken from multi-organ donors. The GAPDH gene was used as control, and mRNA and protein expression of OPN was detected by using real-time polymerase chain reaction (PCR) and immunohistochemisty, respectively. Three low-powered fields of each specimen in beth groups were randomly chosen to count the cells positive for OPN protein. Results The expression levels of OPN in AD group was 5. 56 folds as those in the control group (P ＜0. 0l ). The protein expression levels of OPN was 3. 03 folds as those in the control group ( P ＜ 0. 01 ). Conclusion The gene and protein expression levels of OPN were down-regulated in AD group as compared with normal controls. OPN is one of the markers to identify smooth muscle cells as synthetic phenotype. The up-regulation of OPN may contribute to the development of AD.     

Fas/FasL在乳头状甲状腺癌组织中的表达

目的：探讨凋亡相关基因Fas/FasL在甲状腺癌组织中的表达与细胞凋亡的关系。方法：采用流式细胞技术检测43例乳头状甲状腺癌癌细胞凋亡及相关基因Fas及FasL表达。同时检测Fas及FasL在甲状腺癌组织肿瘤浸润淋巴细胞（TIL）中的表达。结果：43例乳头状甲状腺癌细胞中Fas低表达者19例,细胞凋亡率为3．71％,高表达者24例,细胞凋亡率为7．26％,高表达组癌细胞凋亡率明显高于低表达组（P＜0．05）,癌细胞中FasL表达明显高于甲状腺腺瘤组织（P＜0．01）,乳头状甲状腺癌组织TLL表达Fas及FasL的水平明显高于甲状腺腺瘤组织（P＜0．01）。结论：Fas系统参与乳头状甲状腺癌细胞中细胞凋亡的调节,Fas/FasL表达异常使甲状腺癌癌细胞逃避免疫监视,诱导Fas敏感的TIL凋亡,有助于癌细胞发生浸润及转移。     

骨桥蛋白和p21蛋白在直肠癌组织中的表达及意义

目的 检测骨桥蛋白(OPN)和p21蛋白在直肠癌组织中的表达及其临床意义,并探讨两种蛋白之间的相关性.方法 采用免疫组织化学染色法检测51例直肠癌手术标本和30例正常直肠组织中OPN和p21蛋白的表达情况.结果 ①OPN和p21蛋白在直肠癌组织中的阳性表达率分别为54.9%(28/51)和62.75%(32/51),在正常直肠组织中均未见有阳性表达.两蛋白在直肠癌和正常直肠组织中的阳性率差异有统计学意义(P<0.01).②OPN高表达与浸润深度、分化程度、淋巴结转移有关(P<0.05),与直肠癌患者的性别、年龄、肿瘤大小无关(P＞0.05);p21蛋白高表达与淋巴结转移显著相关(P<0.01),而与直肠癌患者性别、年龄、肿瘤大小、浸润深度、分化程度无关(P＞0.05).③OPN、p21蛋白均阳性表达的24例直肠癌中全部发生淋巴结转移,与两者均阴性表达的15例直肠癌中仅有2例(13.3%)发生转移相比较,差异有统计学意义(P<0.01).④OPN和p21蛋白在直肠癌中的表达呈正相关(r＝0.524,P<0.01).结论 OPN和p21蛋白高表达可能参与了直肠癌的发病,联合检测两者蛋白表达对评估直肠癌预后具有重要意义.     

聚集素在前列腺癌中的表达及意义

目的　探讨抗细胞凋亡因子聚集素 (clusterin)在前列腺癌中的表达及意义。　方法　RT PCR方法检测聚集素在前列腺癌组织 (3例 )、癌细胞系 (1株 )及正常前列腺组织 (3例 )中的表达水平。　结果　 3例前列腺癌组织及 1例前列腺癌细胞株中聚集素与内参基因 β actin相比较的相对表达量明显高于 3例正常前列腺组织。　结论　聚集素在前列腺癌中高表达 ,提示聚集素可能通过抗凋亡机制在前列腺癌的生物特性中发挥作用。     

PTEN基因在甲状腺癌组织中的表达及其意义

摘要：为探讨PTEN基因在甲状腺癌中的表达及其与甲状腺癌生物学行为的关系，笔者采用免疫组化方法检测PTEN基因在不同甲状腺组织中的表达。结果示，甲状腺癌组织PTEN基因的阳性表达率明显低于甲状腺正常组织和甲状腺腺瘤组织；PTEN基因表达与甲状腺癌的TNM分期、淋巴结转移呈负相关。提示PTEN基因表达的降低在甲状腺癌的发生和转移过程中起重要作用。     

Wnt5a在甲状腺乳头状癌中的表达及意义

目的：探讨Wnt5a在甲状腺乳头状癌（PTC）组织中的表达及意义。 方法：收集术后病理确诊为PTC的患者石蜡标本47例,包括癌组织及癌旁组织,以及手术切除的PTC新鲜标本及其癌旁组织10例。分别采用免疫组化法及real-time PCR检测Wnt5a在PTC及癌旁组织中的表达。 结果：47例患者的石蜡标本中,PTC及癌旁组织中,Wnt5a在PTC组织的阳性表达率为68.09%（32/47）,在癌旁甲状腺组织为6.38%（3/47）,两者间差异有统计学意义（P<0.01）;统计分析显示,Wnt5a的表达与患者的性别及年龄无关（均P>0.05）,而与肿瘤的TNM分期、淋巴结转移有关（P<0.05或P<0.01）。10例手术标本检测显示,PTC中Wnt5a mRNA的表达明显高于其的癌旁甲状腺组织（6.43±1.38 vs. 1.12±0.59,P<0.01）。 结论：PTC组织中Wnt5a表达水平增高,这可能对PTC的发生和发展有着重要的作用。     

多灶性甲状腺乳头状癌的生物学特性及治疗分析

目的 探讨多灶性甲状腺乳头状癌的临床特性及治疗.方法 回顾性分析1995-1997年间在天津市肿瘤医院手术治疗并经病理证实的86例多灶性甲状腺乳头状癌的临床资料,研究其临床生物学特征.结果 多灶性甲状腺乳头状癌者共86例,占同期甲状腺乳头状癌的23.4%.病灶位于单侧12例,位于双侧74例;颈部淋巴结转移51例(59.3%);病灶中含微小癌者46例(53.5%);合并桥本甲状腺炎者23例(26.7%);周围组织侵犯19例(22.1%);发生远处转移者1例(1.2%);10年生存率95.3%.美国癌症联合会(AJCC)分期与预后相关(x2=63.395,P=0.000).结论 多灶性甲状腺乳头状癌多发生于双侧甲状腺,病灶中含微小癌者及合并桥本甲状腺炎者较多,AJCC分期是多灶性甲状腺乳头状癌的重要预后因素.     

家族性甲状腺乳头状癌

目的：探索家族性甲状腺乳头状癌的临床特征,诊断标准和处理原则。方法：在随机的145例甲状腺乳头状癌患进行前瞻性的调查共发现家族性甲状腺乳头状癌有7个家族17例患者,其中14例患者为本院手术,3例外院手术,17例患者病例均经本院病理科证实,占同期的甲状腺乳头状癌的9．65％（14／145）,结果：本组年龄30－74岁,平均年龄45岁,原发灶大小0．8－2．8cm,平均1．7cm,单侧9例,双侧8例（47．5％）;3个家族同时有3例患病（42．8％）;有4个家族的成员患有甲状良性肿瘤和非肿瘤性甲状腺疾病,17例患者中伴有结节性甲状腺肿的10例,全甲状腺切除8例,腺叶加峡部切除9例,行甲状腺癌联合根治术的6例,14例有不同区域的淋巴结转移,占82．3％,（14／17）。结论：家族性甲状腺乳头状癌占甲状腺乳头状癌10％左右,双侧病变近50％,淋巴结转移率高,处理基本同于散发性甲状腺乳头状癌,但是,患病家族成员应长期随访。     

Renal papillary necrosis in thyroid carcinoma

A thirty-four-year-old man with progressive visual impairment was found to have thyromegaly and renal insufficiency at the time of admission. Subsequent evaluation demonstrated bilateral optic neuritis and a thyroid nodule which proved to be a follicular carcinoma. Nephrologic studies revealed bilateral papillary necrosis and chronic interstitial nephritis on biopsy. The patient's renal function stabilized and twenty-four-hour protein excretion diminished after hemithyroidectoiny. Carcinoma-related protein production may have played a role in the development of the observed renal lesions. Carcinoma should be a consideration in patients with unexplained papillary necrosis.     

甲状腺乳头状癌中PDK1、ZEB1和Vimentin的表达及其临床意义

目的:探讨磷酸肌醇依赖性蛋白激酶1 (PDK1)、E盒结合锌指蛋白1(ZEB1)和波形蛋白(Vi-mentin)在甲状腺乳头状癌(PTC)组织中的表达情况,并探究三指标与PTC临床病理参数的相关性.方法:免疫组化EnVision法检测206例PTC及45例癌旁组织中PDK1、ZEB1和Vimentin表达,分析其与PT...     

Warthin-like tumour papillary thyroid carcinoma

Aim-Background

With less than 100 cases reported in the English literature to date, Warthin-like tumour papillary thyroid carcinoma is a relatively uncommon variant of papillary thyroid carcinoma (PTC). This term was first coined on the basis of its close morphological resemblance to the Warthin tumour that characteristically occurs in the salivary glands.We present a case of this uncommon variety of PTC, and through a brief literature review we describe the diagnostic challenges presented in distinguishing between several varieties of PTC and benign lesions to provide optimal treatment.

Case Report

A 48-year-old woman was referred to our department for surgical treatment of an enlarged goitre that had presented over the last year. Dominant nodule FNA revealed suspicion of a follicular neoplasm, and she was submitted to total thyroidectomy.

Results

Histopathology showed multifocal PTC on chronic lymphocytic thyroiditis ground. Left lobe foci of 0.3 cm follicular variant of PTC, 0.6 cm isthmus foci of Warthin-like tumour PTC and 1.5 cm of conventional PTC with extrathyroidal extension were reported.

Conclusion/Discussion

Previous studies showed prognosis to be similar to that for conventional PTC. Distinction between Hurthle cell tumours, tall cell and oncocytic variants of PTC or medullary carcinoma, or even lymphocytic thyroiditis and this entity, is intriguing and poses diagnostic difficulties. Data from new studies will reveal more on this uncommon tumour.     

Aggressive variants of papillary thyroid carcinoma

A number of histologic variants of well‐differentiated papillary carcinoma have been found to be associated with more aggressive tumor behavior. Tall cell, columnar cell, diffuse sclerosing, solid/trabecular, and insular variants of well‐differentiated papillary thyroid cancer are all potentially more aggressive than conventional papillary thyroid cancer. When subjected to multivariate analysis, however, evidence that the histologic subtype of tumor is an independent predictor of outcome is weak. Rather, the aggressive variants tend to present with features recognized by other staging systems as associated with a worse prognosis, including higher histologic grade, extracapsular spread, large tumor size, and the presence of distant metastases. Prognosis is directly related to the presence of these features. The state of our knowledge is limited by the relatively small number of cases that have been studied. The presence of an aggressive variant of papillary carcinoma should alert the surgeon that he is dealing with a potentially aggressive tumor. Clinical treatment decisions should be based on the stage of the disease, influenced by the knowledge that the aggressive variants tend to be associated with higher risk factors. The surgeon must be prepared to perform at the first, or second stage, a total thyroidectomy, central compartment neck dissection, additional lymphadenectomy, and/or resection of invaded surrounding structures, and search for distant metastasis. Postoperative radioactive iodine should generally be administered for these variants as they will generally be intermediate to advanced tumors. The tall cell variant is often refractory to such treatment but may be susceptible to treatment targeted against BRAF mutation. External beam irradiation may be used in cases of incomplete resection. © 2010 Wiley Periodicals, Inc. Head Neck, 2011     

甲状腺乳头状癌的外科治疗

目的 探讨甲状腺乳头状癌的规范治疗方法.方法 回顾性分析我院2007年1月至2010年12月期间手术的58例甲状腺乳头状癌患者资料.所有患者均经病理诊断,先接受手术治疗,手术包括甲状腺的切除及功能性颈清扫术,术后采取辅助治疗.结果 58例患者中无死亡病例;甲状旁腺功能下降3例,2例为暂时性,1例为永久性;胸导管损伤1例,经非手术治疗痊愈;二次手术5例.随访期内局部复发2例,均再次手术治疗.结论 甲状腺乳头状癌的发病率逐年升高,手术是主要治疗手段,术后需要辅以综合治疗,预后良好.     

Lymph node surgery in papillary thyroid carcinoma

BACKGROUND: The impact of nodal disease remains controversial in papillary thyroid carcinoma (PTC). STUDY DESIGN: One surgeon treated 159 unselected patients, who were followed up for 1 to 27 years. We present a retrospective analysis with respect to nodal disease. Occult nodal disease was investigated, including metachronous nodal disease (mpN(1)) in primarily node negative patients (pN(0), clinical [c]N(0)). RESULTS: Therapeutic lymphadenectomies, prophylactic lymphadenectomies, or no lymphadenectomy were carried out in 42 (cN(1)), 29 (cN(0)), and 88 (cN(0)) patients, respectively, with stage pN(1) in 41 (98%), in 5 (17%), and in 2 (2.3%) patients, respectively (17% versus 2.3% p < 0.005). Sensitivity and specificity of clinical staging were 85% and 99%, respectively. More frequent prophylactic lymphadenectomy during the study period (p = 0.002) led to a nonsignificant increase in stage pN(1) (26% versus 30%). Immunohistochemistry led to upstaging of only 3% of histologically negative nodes and one (4%) pN(0) patient. Nodal recurrence occurred in 8 of 156 patients (5%) treated for cure, in 12% of pN(1) versus 3% of pN(0) cN(0) tumors (p = 0.009), in 15% of TNM high-versus 3% of low-risk patients (p = 0.006), and in 5% each of patients, younger than 45 and 45 years or more. In TNM high-risk patients, tumor-related survival was 50% for stage pN(1) versus 86% for stage pN(0), cN(0) (p = 0.03) (100% and 100% in low-risk patients). CONCLUSIONS: The rate of occult nodal disease might be relatively low, and it does not frequently progress to clinical recurrent disease. Clinical nodal status might be valid for deciding the extent and radicality of node dissection. Prophylactic (central) lymphadenectomy should be carried out without radicality-associated morbidity. Macroscopic nodal disease warrants more rigorous, compartment-oriented lymphadenectomy. There is no rationale for detection of occult disease and micrometastasis by frozen section or immunohistochemistry.