卵巢浆液性肿瘤中OCT4蛋白的表达及与化疗耐药的关系研究

目的:探讨OCT4蛋白在卵巢浆液性肿瘤组织中的表达与卵巢肿瘤发生发展及与化疗耐药的关系。方法:采用免疫组织化学链霉素抗生物素蛋白-过氧化酶连接法（SP法）检测OCT4蛋白在10例正常卵巢组织、10例卵巢良性浆液性囊腺瘤、10例卵巢交界性浆液性囊腺瘤和67例卵巢浆液性腺癌（其中化疗耐药30例,化疗敏感37例）的石蜡病理切片中的表达情况。结果:OCT4蛋白的阳性表达率在正常卵巢组织、卵巢良性浆液性囊腺瘤、卵巢交界性浆液性囊腺瘤和卵巢浆液性腺癌组织中分别为0、40.00%、50.00%和62.69%,差异有显著统计学意义（P=0.002）。在卵巢浆液性腺癌化疗耐药和化疗敏感组织中分别为83.33%和45.95%,差异有显著统计学意义（P=0.002）。OCT4蛋白的阳性表达率与卵巢浆液性腺癌的临床病理特征无明显相关性（P＞0.05）。结论:OCT4蛋白可能在卵巢浆液性肿瘤发生发展和卵巢癌化疗耐药中发挥重要作用,可能作为卵巢癌化疗耐药预测的一个重要参考指标。     

H3K9ac、H3K4me2在卵巢浆液性上皮性肿瘤中的表达及意义

目的:探讨组蛋白H3第9位赖氨酸残基乙酰化（H3K9ac）及组蛋白H3第4位赖氨酸残基二甲基化（H3K4me2）在卵巢浆液性囊腺瘤、卵巢交界性浆液性囊腺瘤和卵巢浆液性囊腺癌组织中蛋白表达与浆液性上皮性卵巢癌发生、发展的关系及两者之间有无相关性。方法:应用免疫组织化学链霉菌抗生物素蛋白-过氧化酶连接法（SP法）检测H3K9ac、H3K4me2在30例卵巢浆液性囊腺瘤组织、30例卵巢交界性浆液性囊腺瘤组织及40例卵巢浆液性囊腺癌组织中的表达,观察表达差异并进行统计学处理。结果:H3K9ac在卵巢浆液性囊腺瘤组织中阳性表达率为93.33%,在卵巢交界性浆液性囊腺瘤组织中阳性表达率为66.67%,在卵巢浆液性囊腺癌中阳性表达率为42.50%,良性、交界性、恶性组织间两两比较差异有统计学意义（P＜0.05）。在不同手术病理分期、不同组织学分级的卵巢浆液性囊腺癌组织中H3K9ac的阳性表达率有统计学差异（P＜0.05）。H3K4me2在卵巢浆液性囊腺瘤组织中阳性表达率为90%,在交界性浆液性囊腺瘤组织中阳性表达率为73.33%,在卵巢浆液性囊腺癌中阳性表达率为52.50%,良性与交界性、交界性与恶性组织间比较差异无统计学意义（P＞0.05）,良性与恶性组织间比较差异有统计学意义（P＜0.05）。在不同手术病理分期、不同组织学分级的卵巢浆液性囊腺癌组织中H3K4me2的阳性表达率无统计学差异（P＞0.05）。H3K9ac、H3K4me2在卵巢浆液性囊腺癌组织中的表达呈正相关（r=0.732,P＜0.001）。结论:H3K9ac、H3K4me2的低表达与浆液性上皮性卵巢癌的发生、发展有关,有可能成为浆液性上皮性卵巢癌诊断和治疗的新靶点。     

粘蛋白MUC1在卵巢浆液性肿瘤中的表达及其临床意义

目的:研究粘蛋白MUC1在卵巢浆液性肿瘤中的表达及其临床意义。方法:应用免疫组织化学SP法检测53例卵巢浆液性囊腺癌、20例交界性卵巢浆液性囊腺瘤、20例卵巢浆液性囊腺瘤、20例正常卵巢组织中MUC1的表达情况。结果:MUC1在卵巢浆液性囊腺癌中的阳性表达率为88.7%,略高于交界性浆液性囊腺瘤中的表达(70%)(P=0.1172),明显高于良性卵巢浆液性囊腺瘤(35%)及正常卵巢组织(30%)中的表达(P<0.05)。MUC1的阳性表达与卵巢浆液性囊腺癌的临床分期有关(P<0.05),与年龄、组织分级和淋巴结转移无关(P>0.05)。结论:粘蛋白MUC1在卵巢浆液性囊腺癌的发生、发展中起重要作用,MUC1可作为判断卵巢浆液性囊腺癌生物学行为和恶性潜能的参考指标。     

OCT4及BIM蛋白在卵巢浆液性肿瘤中的表达及其相关性研究

目的 研究OCT4及Bim蛋白在卵巢浆液性肿瘤中的表达及其相关性,并探讨两者在化疗耐药中的影响.方法 采用免疫组化sp法,对67例卵巢浆液性囊腺癌(化疗耐药30例,敏感37例)、卵巢浆液性囊腺瘤石蜡标本10例、卵巢交界性浆液性囊腺瘤者石蜡标本10例及正常卵巢组织石蜡标本10例,进行OCT4及Bim蛋白表达情况检测.结果 OCT4蛋白阳性表达率在恶性、交界性、良性、正常组织中依次递减,差异有统计学意义(P=0.002);在耐药组与敏感组阳性表达率分别为83.33％和45.95％,差异有统计学意义(P =0.002).Bim蛋白阳性表达率在恶性、交界性、良性、正常组织中依次递增,差异有统计学意义(P =0.002);在耐药组与敏感组阳性表达率分别为43.33％和70.27％,差异有统计学意义(P=0.026).在化疗耐药卵巢浆液性癌中,OCT4蛋白与Bim蛋白表达无明显相关性(γ=0.03;P=0.875);在化疗敏感卵巢浆液性癌中,OCT4蛋白与Bim蛋白表达亦无明显相关性(γ =0.006;P =0.97).OCT4蛋白与Bim蛋白表达与卵巢浆液性癌的发展呈负相关(P＜0.01).OCT4蛋白与Bim蛋白与卵巢浆液性癌临床病理因素无关.结论 OCT4及Bim蛋白与卵巢浆液性癌的发生与发展有关.OCT4蛋白与Bim蛋白表达在卵巢浆液性癌的发展呈负相关.OCT4与Bim蛋白在卵巢浆液性肿瘤的发生、发展相互作用.OCT4基因高表达,Bim基因低表达可能是造成卵巢浆液性癌对紫杉醇+铂类化疗耐药的因素之一.     

Lewis y抗原及整合素α5、β1在卵巢浆液性肿瘤中的表达及意义

目的:研究Lewis y抗原及整合素α5、β1在卵巢浆液性肿瘤中的表达及其意义.方法:应用免疫组织化学方法检测30例卵巢浆液性囊腺癌、11例交界性卵巢浆液性囊腺瘤、13例卵巢浆液性囊腺瘤、11例正常卵巢组织中Lewis y抗原及整合素α5、β1的表达情况.结果:Lewis y抗原在卵巢浆液性囊腺癌中的阳性表达率为90.0%,明显高于交界性(63.6%)、良性卵巢浆液性囊腺瘤(38.5%)及正常卵巢组织(0)中的表达(P均<0.05).整合素α5、β1在卵巢浆液性囊腺癌中的阳性表达率分别为86.7%和83.3%,高于两者在交界性(72.7%,72.7%)、良性卵巢浆液性囊腺瘤(69.2%,53.8%)及正常卵巢组织(36.4%,36.4%)中的表达(P均<0.05).Lewis y抗原及整合素α5、β1在卵巢浆液性囊腺癌中的表达呈显著正相关(P均<0.01).结论:Lewis y抗原及整合素α5、β1在卵巢浆液性囊腺癌中的阳性表达率普遍增高,且两者的表达呈显著性正相关.提示Lewis y抗原及整合素α5、β1在卵巢浆液性囊腺癌的发生、发展中起着重要作用.     

Twist蛋白在卵巢浆液性囊腺癌中的表达及临床意义

[目的] 分析 Twist 蛋白与卵巢浆液性囊腺癌的关系.[方法] 采用免疫组化方法检测 Twist 蛋白在卵巢浆液性囊腺癌、卵巢交界性浆液性囊腺瘤、卵巢浆液性囊腺瘤中的表达情况.[结果] Twist 蛋白在卵巢浆液性囊腺癌、交界性浆液性囊腺瘤、浆液性囊腺瘤中的阳性表达率分别为78.33％ (94/120)、37.50％ (3/8)、25.00％(2/8),经比较差异有统计学意义(x2=16.119,P＜0.01),但在交界性浆液性囊腺瘤、浆液性囊腺瘤中差异无统计学意义(x2=0.291,P=0.590).8例正常卵巢组织中未见 Twist蛋白阳性表达.Twist 蛋白在卵巢浆液性囊腺癌组织中的阳性表达率在有无淋巴结转移的组织间经比较差异有统计学意义(P＜0.05),而在绝经前后、不同的病理分期、不同组织学分级的卵巢浆液性囊腺癌组织中的阳性率经比较差异均无统计学意义(P＞0.05).[结论] Twist蛋白与卵巢浆液性囊腺癌发生发展有关,可作为有无淋巴结转移的间接预测指标之一.     

核转录因子E2F2在卵巢浆液性肿瘤组织中的表达及其临床意义

目的:探讨核转录因子E2F2在卵巢浆液性肿瘤组织中的表达及其临床意义.方法:采用免疫组化SP法检测33例卵巢浆液性囊腺癌、11例卵巢交界性浆液性囊腺瘤、13例卵巢浆液性囊腺瘤以及12例正常卵巢组织中E2F2蛋白的表达.结果:E2F2蛋白在卵巢浆液性囊腺癌、交界性浆液性囊腺瘤、浆液性囊腺瘤以及正常卵巢组织中的阳性表达率分别为72.73%(24/33)、54.55%(6/11)、15.38(2/13)%和8.3%(1/11),E2F2蛋白在卵巢浆液性囊腺癌组织、交界性浆液性囊腺瘤组织中的阳性表达率明显高于在浆液性囊腺瘤、正常卵巢组织中的阳性表达率(P均＜0.05),卵巢浆液性囊腺癌组的阳性表达率值虽然高于交界性浆液性囊腺瘤组,但是两组之间差异无统计学意义(P＞0.05),浆液性囊腺瘤的阳性表达率接近正常卵巢组的2倍,但是两组之间的阳性表达率差异也无统计学意义(P＞0.05);在卵巢浆液性囊腺癌组织中,E2F2蛋白的阳性表达率随手术病理分期的增加而增加(P＜0.05), 但与病理分级以及有无淋巴结转移无关( P均＞0.05);在卵巢浆液性囊腺癌组织中,E2F2蛋白的表达水平随手术病理分期的增加、病理分级降低而增加(P均＜0.05),与有无淋巴结转移无关(P＞0.05).结论:在卵巢浆液性囊腺癌组织、交界性浆液性囊腺瘤组织中核转录因子E2F2呈现明显的高表达,且其表达水平与手术分期、病理分级相关,提示E2F2在卵巢癌的发生发展中起到促进作用.     

卵巢浆液性癌发生过程中ARHI STAT3和E2F1蛋白表达的变化及意义

目的 研究卵巢浆液性癌由增生到癌变过程中,ARHI、STAT3和E2F1蛋白表达的变化规律及意义.方法 采用免疫组化法,检测25例正常卵巢上皮组织、35例卵巢浆液性囊腺瘤、18例卵巢交界性浆液性囊腺瘤和56例卵巢浆液性囊腺癌的石蜡包埋组织中,ARHI、STAT3和E2F1蛋白的表达,分析3种蛋白表达与卵巢浆液性癌临床病理特征的关系.结果 在25例正常卵巢上皮和35例浆液性囊腺瘤组织中,分别有22例和30例ARHI蛋白阳性表达,而在18例交界性囊腺瘤和56例浆液性囊腺癌组织中,只有10例和22例阳性表达,ARHI在浆液性癌和交界性囊腺瘤中的阳性表达率(39.3%和55.6%)明显低于其在正常卵巢和浆液性囊腺瘤中的表达(P<0.05).浆液性囊腺癌和交界性囊腺瘤组织中,STAl3蛋白的表达增强,其阳性表达率分别为87.5%(49/56)和77.8%(14/18),明显高于其在正常卵巢和卵巢浆液性囊腺瘤中的表达率(P<0.05).与正常卵巢、卵巢浆液性囊腺瘤和交界性囊腺瘤比较,卵巢浆液性癌中E2F1蛋白表达升高,阳性表达率为82.1%(46/56),明显高于前三者(P<0.05).统计分析显示,ARHI与STAT3和E2F1在卵巢浆液性癌中的蛋白表达呈显著的负相关关系.结论 抑癌印迹基因ARHI的蛋白表达在卵巢浆液性癌中存在不同程度的降低或缺失,而STAT3和E2F1蛋白的表达明显增强,三者可能相互协同,在卵巢浆液性肿瘤的发生中发挥重要作用.     

Lewis y抗原及整合素α_5、β_1在卵巢浆液性肿瘤中的表达及意义

目的：研究Lewis y抗原及整合素α5、β1在卵巢浆液性肿瘤中的表达及其意义。方法：应用免疫组织化学方法检测30例卵巢浆液性囊腺癌、11例交界性卵巢浆液性囊腺瘤、13例卵巢浆液性囊腺瘤、11例正常卵巢组织中Lewis y抗原及整合素α5、β1的表达情况。结果：Lewis y抗原在卵巢浆液性囊腺癌中的阳性表达率为90.0%,明显高于交界性（63.6%）、良性卵巢浆液性囊腺瘤（38.5%）及正常卵巢组织（0）中的表达（P均〈0.05）。整合素α5、β1在卵巢浆液性囊腺癌中的阳性表达率分别为86.7%和83.3%,高于两者在交界性（72.7%,72.7%）、良性卵巢浆液性囊腺瘤（69.2%,53.8%）及正常卵巢组织（36.4%,36.4%）中的表达（P均〈0.05）。Lewis y抗原及整合素α5、β1在卵巢浆液性囊腺癌中的表达呈显著正相关（P均〈0.01）。结论：Lewis y抗原及整合素α5、β1在卵巢浆液性囊腺癌中的阳性表达率普遍增高,且两者的表达呈显著性正相关。提示Lewis y抗原及整合素α5、β1在卵巢浆液性囊腺癌的发生、发展中起着重要作用。     

Ki67、PTEN在卵巢浆液性肿瘤中的表达及临床意义

目的探讨卵巢交界性浆液性囊腺瘤组织中Ki67和PTEN的表达及其意义。方法采用免疫组化SP法,检测32例卵巢交界性浆液性囊腺瘤组织和26例卵巢浆液性囊腺癌组织中Ki67和PTEN表达,并与10例卵巢浆液性囊腺瘤和11例正常卵巢组织进行比较。结果 Ki67和PTEN在卵巢交界性浆液性囊腺瘤组织中阳性表达率分别为65.6%和93.8%,与卵巢浆液性囊腺瘤组织（分别为60.0%和100.%）比较,无统计学意义（P〉0.05）,而与卵巢浆液性囊腺癌组织比较有统计学意义（P〈0.05）。Ⅰ、Ⅱ期卵巢交界性浆液性囊腺瘤患者PTEN阳性表达率,与Ⅲ期患者比较,有统计学意义（P=0.03）,而Ⅰ、Ⅱ期卵巢交界性浆液性囊腺瘤患者Ki67阳性表达率,与Ⅲ期患者比较,无统计学意义（P〉0.05）。结论 Ki67和PTEN可能在卵巢交界性浆液性囊腺瘤的发生、发展中起重要作用,可能成为卵巢交界性浆液性囊腺瘤预后评价的指标。     

A blueprint for cancer screening and early detection: Advancing screening’s contribution to cancer control

From the mid-20th century, accumulating evidence has supported the introduction of screening for cancers of the cervix, breast, colon and rectum, prostate (via shared decisions), and lung. The opportunity to detect and treat precursor lesions and invasive disease at a more favorable stage has contributed substantially to reduced incidence, morbidity, and mortality. However, as new discoveries portend advancements in technology and risk-based screening, we fail to fulfill the greatest potential of the existing technology, in terms of both full access among the target population and the delivery of state-of-the art care at each crucial step in the cascade of events that characterize successful cancer screening. There also is insufficient commitment to invest in the development of new technologies, incentivize the development of new ideas, and rapidly evaluate promising new technology. In this report, the authors summarize the status of cancer screening and propose a blueprint for the nation to further advance the contribution of screening to cancer control.     

Twinning and the Incidence of Breast and Gynecological Cancers (United States)

Increasing epidemiological and experimental evidence indicates that the carcinogenic pathway in the breast and female reproductive organs is driven, at least in part, by factors associated with reproduction. We conducted a retrospective cohort study, comparing the risk of ovarian, breast, endometrial, and cervical cancers among women who had records of at least one twin pregnancy, compared with women who had given birth to only single children. Subjects were selected from the Utah Population Database, which consists of multiple linked datasets including genealogy, births and deaths and cancer registries. We used Poisson regression to calculate relative risks, adjusted for the number of pregnancies and the age of the mother at the birth of first and last children, with singleton mothers as the reference group in each case. The risks of breast and ovarian cancers did not differ between mothers of twins and mothers of single children. The risk of endometrial cancer was slightly lower in mothers of twins than in mothers of singleton children (RR = 0.90, 95% CI 0.67-1.21). Conversely the risk of cervical cancer was higher among twin mothers (RR = 1.78, 95% CI 0.88-3.52). This latter finding supports previous data suggesting that reproductive hormones act as cofactors in the etiology of cervical cancer.     

Risk factors for colorectal cancer following breast cancer

Objective. To investigate risk factors for colorectal cancer following breast cancer. Methods. In this nested case-control study, all women (n=14,900) with a first primary breast cancer (1978–1992) were identified from the western Washington population-based Surveillance, Epidemiology, and End Results Cancer Registry. Cases (n=160) developed a second primary colorectal cancer before 1995, at least 6 months after the first cancer diagnosis. Controls (n=310, matched to the cases on calendar year, age and breast cancer stage) were randomly selected from those who did not develop a second primary cancer and who survived to the case's colorectal cancer diagnosis date. Characteristics of the cases and controls at initial diagnosis were compared using conditional logistic regression. Results. The incidence of colorectal cancer was associated with a family history of breast cancer (v.s. no family history, matched odds ratio (mOR)=2.1, 95% confidence interval (CI): 1.1–4.1), high body mass index (30 kg/m² v.s. <30 kg/m², mOR=2.2, CI: 1.2–3.9), and lobular breast cancer histology (v.s. ductal, mOR=2.0, CI: 0.9–4.4). Risk was unrelated to menopausal status, prior hormone replacement therapy and estrogen/progesterone receptor status of the breast tumors. Conclusions. The risk of developing a second primary colorectal cancer may be elevated among certain subsets of breast cancer patients.     

Neoplasms in skin and subcutis over the breast, simulating breast neoplasms: case reports and literature review

Twenty cases of neoplasms in skin and subcutaneous tissue over the breast were reviewed. There were 17 women, from 15 to 70 years of age, and three men, from 25 to 66 years of age. Among the benign skin neoplasms, superficial leiomyoma, granular cell tumor, and eccrine acrospiroma were misdiagnosed clinically as primary breast carcinoma. Among the malignant neoplasms in subcutaneous tissue, there were three metastatic malignant melanomas, one metastatic epidermoid bronchogenic carcinoma, and two malignant lymphomas. It is interesting that four of these six patients had no prior history of malignant lesion, the subcutaneous nodule presenting as the first manifestation of an occult primary. It is concluded that histological diagnosis of such tumors may lead to avoidance of unnecessary radical surgery.     

结直肠神经内分泌肿瘤的研究进展

结直肠神经内分泌肿瘤来源于结直肠神经内分泌细胞,发病率较低,但近年有上升趋势.WHO病理学将结直肠神经内分泌肿瘤分为神经内分泌瘤、神经内分泌癌、混合型腺-神经内分泌癌和增生性及肿瘤前病变.结直肠神经内分泌肿瘤细胞具有激素合成及分泌功能,但不一定都出现相应的临床症状.不同分类、分期的结直肠神经内分泌肿瘤的诊断及治疗方法也...     

Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening

Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates from the National Health Interview Survey, and select issues related to cancer screening. In this 2018 update, we also summarize the new American Cancer Society colorectal cancer screening guideline and include a clarification in the language of the 2013 lung cancer screening guideline. CA Cancer J Clin 2018;68:297–316 . © 2018 American Cancer Society .     

从高发现场视角看食管癌和贲门癌的临床研究趋势

我院流行病室开展食管癌和贲门癌高发现场研究已历30余年,所取得的最显著成绩主要有以下4个方面：（1）对食管癌癌前病变（即鳞状上皮不典型增生）及其逐级发展和演变规律的确认,以及对各级不典型增生诊断及处理的经验;（2）对食管癌早诊早治方法的探索,以及实践所得的优异效果;（3）食管鳞状细胞癌易发部位的发现及其对食管癌早期诊断的贡献;（4）胃贲门癌高发位点的发现及其对贲门癌早诊早治的贡献。在此基础上,结合我们长期在高发现场的实际工作经验,展望今后食管癌和贲门癌临床研究的趋势。     

子宫颈癌放疗后子宫体恶性肿瘤47例临床分析

Objective  To study the characteristics and clinical features of uterine neoplasms developed after radiation therapy for cervical carcinoma. Methods  Clinical data of 47 cases of uterine neoplasms occurred following radiation therapy for cervical carcinoma were retrospectively reviewed. Results  The median age at uterine neoplasms diagnosis was 62 years (range: 38–77 years), and the median latency period from initial therapy to development of uterine neoplasms was 14 years (range: 5–35 years). Thirty of 47 cases were endometrial carcinoma, of which 3 were uterine papillary serous carcinoma (UPSC). Seventeen of 47 patients were uterine sarcoma, all of those were carcinosarcoma. The distribution by stage, grade, and histology of 30 cases of endometrial carcinoma was as follows: stage Ib, 1 case; stage Ic, 2 cases; stage II, 6; stage IIIa, 4; stage IIIb, 2; stage IIIc, 11; stage IV, 4 cases; grade 1, two cases; grade 2, nine; grade 3 (include 3 UPSC patients), seventeen; unknown grade, two; endometriod, 27; UPSC, 3 cases; 7 of 30 cases of endometrial carcinoma had recurrences (23.3%), at median time to recurrence was 24 months, and their median survival time was 26 months. The overall 3- and 5-year survival rates were 60% and 38%, respectively. Of the 17 cases of uterine sarcoma, the median survival was 10 months, 6 patients occurred recurrence (35.9%), at a median time to recurrence was 9 months, and their median survival was 6 months. The overall 3- and 5-year survival rates were 12% and 0, respectively. Conclusion  The main uterine neoplasms development after radiation therapy for cervical carcinoma is endometrial carcinomas, of which there is a preponderance of high-risk histological subtypes and a poor prognosis. Most of the uterine sarcomas occurred following radiation therapy for cervical carcinoma are carcinosarcomas and the prognosis is very poor.