MMP-9和PCNA在涎腺肿瘤中的表达及意义

目的：探讨基质金属蛋白酶（MMP-9）和增殖细胞核抗原（PCNA）在涎腺肿瘤中的表达及意义,以及MMP-9、PC-NA之间的相关性。方法：采用免疫组化SP法检测30例涎腺恶性肿瘤和35例良性肿瘤,计算每例切片中癌细胞MMP-9的阳性率及增殖细胞核抗原阳性指数（PLI）。结果：MMP-9在30例涎腺恶性肿瘤和35例涎腺良性肿瘤中阳性表达率分别为73.33%、31.43%,差异有统计学意义（P〈0.01）。涎腺良、恶性肿瘤中PLI增殖指数分别为（30.95±8.53）、（70.13±19.52）,差异有统计学意义（P〈0.01）。两者在涎腺恶性肿瘤中表达呈正相关（P〈0.05）。结论：MMP-9与涎腺恶性肿瘤的浸润、转移有关,可作为预测转移潜能的指标,PCNA可作为恶性肿瘤增殖的指标。     

Angiogenesis in salivary gland tumors: from clinical significance to treatment

Introduction: Salivary gland tumors (SGTs) represent a rare cancer entity, consisting of various morphological features that complicate diagnosis. Their diversity in terms of morphology and clinical course makes defining risk factors difficult, while the molecular steps responsible for SGT development remain unclear. Angiogenesis, a hallmark of cancer development, is considered as an attractive target.

Areas covered: This review aims to summarize the available research regarding angiogenesis in SGTs from clinical significance to treatment options.

Expert opinion: The available data suggest that microvessel density (MVD) evaluation may be capable of discriminating between benign and malignant SGTs, while the use of CD105 antibody seems to be the most suitable. Substantial evidence also suggests that MVD and VEGF expression could be used as prognostic factors in malignant SGTs. Although several agents have shown antiangiogenic activities in adenoid cystic carcinoma cells and xenograft tumors, limited effectiveness in the existing clinical trials was noted. Further studies are strongly recommended for the validation of already well-known and the identification of novel prognostic and predictive angiogenic markers. There is also a strong demand for relatively larger cohorts, homogenous samples referring to same histological SGT subtypes and including an equivalent number of low- and high-grade SGTs.     

口腔小涎腺肿瘤87例临床分析

目的探讨口腔小涎腺肿瘤的临床诊治特点。方法对本科1 9 9 5~2 0 0 5年经病理确诊的8 7例口腔小涎腺肿瘤的临床资料进行回顾性分析。结果 8 7例口腔小涎腺肿瘤,良性肿瘤6 2例,占7 1.2 6%;恶性肿瘤2 5例,占2 8.7 4%。良性肿瘤均为混合瘤,恶性肿瘤中以腺样囊性癌多见,占恶性肿瘤的4 4.0 0%,8 7例均行手术治疗,恶性肿瘤5年生存率为8 8.8 2%。结论口腔小涎腺肿瘤中良性肿瘤多于恶性肿瘤。外科手术是口腔小涎腺肿瘤的主要治疗方法,恶性肿瘤可行手术＋术后辅助放疗的综合治疗。     

72例大涎腺肿瘤超声表现及诊断

目的探讨大涎腺肿瘤的超声表现及临床诊断价值。方法选择2007年1月～2011年12月在笔者所在医院就诊并手术确诊为大涎腺肿瘤的72例病例作为研究对象,对超声检查等资料进行回顾性分析。结果 72例大涎腺肿瘤经手术病理证实,多形性腺瘤43例,囊腺淋巴瘤(Warthin瘤)21例,嗜酸性腺瘤1例,基底细胞腺瘤1例,黏液表皮样癌3例,多形性腺瘤恶变2例,淋巴上皮癌1例。误诊9例,误诊率为12.5%。大涎腺肿瘤超声声像图表现各异,不容易区别具体病理类型,一般良性表现为形态规则、包膜完整、边界清晰,且容易与周围组织区别,偶尔出现血流信号,而恶性肿瘤一般表现为形态不规则、边界模糊、呈浸润性生长,内部血流信号清晰或出现多点血流信号。结论超声检查对于大涎腺良恶性肿瘤可以做出初步诊断判定,可为临床提供可靠依据,从而对临床治疗方案有一定的指导意义。     

定量唾液腺显像评价放射性碘治疗后唾液腺功能

目的观察分化型甲状腺癌（DTC）在首次接受不同剂量131I治疗后唾液腺功能情况。方法将40例确诊为DTC患者按照应用131I剂量不同分为两组,应用放射性核素唾液腺动态显像,对131I治疗前及治疗后3个月唾液腺功能进行定量分析。结果低剂量组（2．96GBq）治疗后仅腮腺30min摄取率（UR30）明显受损（P〈0．05）,高剂量组（5．55GBq）腮腺和颌下腺UR30、排泌分数（EF）、排泌率（ER）均明显降低,排泌时间（EP）显著延长（均P〈0．05）;腮腺较颌下腺受损更重。结论首次接受131I治疗DTC患者的唾液腺功能会受损,受损程度与使用131I剂量相关。     

Bradykinin and functional vasodilatation in the salivary gland.

1 The three-dimensional coordinates of the atoms in human haemoglobin are known, and there is a specific site in the deoxygenated form of the protein at which 2,3-diphosphoglycerate (DPG) interacts. 2 Molecular models of this site have been constructed and used to design compounds which should bind to the deoxy conformation and stabilize it. These compounds should therby promote oxygen liberation, as does DPG. 3The compounds so designed were found to promote oxygen liberation. Their relative potencies, as assessed by sigmoidal dose-response curves, are in the predicted sequence.     

小涎腺肿瘤的诊断与治疗

目的探讨小涎腺肿瘤的诊断与治疗。方法对本院1998～2003年收治的经病理检查确诊的60例小涎腺肿瘤患者的诊断与治疗进行了回顾性分析。结果60例口腔小涎腺肿瘤中,良性肿瘤26例占43.33%,恶性肿瘤34例占56.67%,良性肿瘤中的混合瘤多见,占良性肿瘤的69.23%,恶性肿瘤中以黏液表皮样癌为多,共14例,占恶性肿瘤的41.18%,手术 放疗者占恶性肿瘤的38.24%,5年生存率为34.48%。结论小涎腺肿瘤中恶性肿瘤多于良性肿瘤;术前X线检查和术中冰冻病理检查对诊断和治疗有指导意义;首次手术彻底性是防止复发的关键,术后辅助性放疗可降低恶性肿瘤复发率。     

Prognostic implications of NUMB immunoreactivity in salivary gland carcinomas

The gene numb encodes for a protein (Numb) involved in cell fate decisions in Drosophila, with proposed endocytic and developmental functions in mammalians. The distribution pattern of Numb in human tissues however, has not been fully characterized. We set out to explore the immunohistochemical expression of Numb in normal and neoplastic (28 adenoid cystic and 34 mucoepidermoid carcinomas) salivary glands, and correlated the results with the clinico-pathologic features of the neoplasms. Intense Numb immunoreactivity was detected in normal ductal cells and in a subset of acinar cells. In salivary carcinomas, we detected diffuse and intense Numb immunostaining in 5 adenoid cystic and 8 mucoepidermoid carcinomas. By contrast, the majority of adenoid cystic and mucoepidermoid cancers showed only moderate (14 and 5 cases) or focal staining (9 and 21 cases), respectively. The corresponding expression of Numb mRNA was documented in normal parotid gland and adenoid cystic carcinoma. Numb immunoreactivity was inversely correlated with the histological grade and Ki-67 immunoreactivity of both adenoid cystic and mucoepidermoid carcinomas. In addition, while tumor grade, stage, Ki-67 and Numb immunoreactivity were associated with disease-free survival in univariate analysis, only Numb and Ki-67 immunoreactivities retained independent prognostic significance in multivariate analysis. These data suggest that loss of Numb is implicated in aberrant differentiation programs of salivary gland carcinomas and may serve as a prognostic indicator in patients treated for these neoplasms.     

Pattern of acute abdomen in Yirgalem Hospital, southern Ethiopia

A retrospective analysis was undertaken on 229 cases of acute surgical abdomen surgically managed at Yirgalem hospital from January to December 1997. Small intestinal obstruction ranked the first and it was mainly due to small intestinal volvulus. Acute appendicitis was the second in the rank. Large intestinal obstruction was the third and it was mainly due to sigmoid volvulus. Typhoid perforation, primary peritonitis, perforated gastroduodenal ulcer, abdominal tuberculosis and empyema of the gallbladder in that order were the other observed causes of acute surgical abdomen. Analysis based on the specific causes of acute abdomen is of great value for early diagnosis and prompt treatment in clinical practice.     

Evaluation of salivary gland function in allergic rhinitis patients by [99mTc] pertechnetate salivary gland scintigraphy

The purpose of this study was to compare the quantitative parameters of salivary gland functions in patients with allergic rhinitis and healthy volunteers using [99mTc] pertechnetate salivary gland scintigraphy. Thirty-six patients with allergic rhinitis (14 males and 22 females, mean age 30.6 ± 5.2 years) and thirty-nine healthy controls (18 males and 21 females, mean age 32.2 ± 5.6 years) were evaluated. Dynamic salivary gland scintigraphy was performed after intravenous administration of 185 MBq (5 mCi) of [^99mTc] pertechnetate for 25 minutes. Lemon juice was used to stimulate the salivary glands. On the basis of the time-activity curves, the following glandular function parameters were calculated for the parotid and submandibular salivary glands: uptake ratio, maximum accumulation, and ejection fraction. Statistically, all the functional parameters of the parotid and submandibular glands obtained for the allergic rhinitis patients were significantly lower than those of the healthy controls group (p < 0.05). This study demonstrated that there was a significant difference in salivary gland function between patients with allergic rhinitis and healthy controls, which can easily be evaluated by [^99mTc] pertechnetate salivary gland scintigraphy.     

微波治疗涎腺粘液囊肿疗效观察

目的探讨微波治疗涎腺粘液囊肿的疗效。方法使用WB-100B型微波多功能治疗机对40例涎腺粘液囊肿患者进行治疗。术区常规消毒，用1％的卡因棉片置于囊肿表面及周围黏膜上表面麻醉后，将针状辐射探头直接插入囊腔内，进行烧灼治疗，至囊肿范围组织发白。所用微波频率为2450MHz，输出功率40W。根据囊肿大小酌情连续操作2～3次。术后常规口服抗生素3d。结果术中患者感到轻度疼痛(无需特殊处理)。术后7d复查无一感染，痂皮大部脱落，肉芽组织生长良好。15d创面愈合，口腔黏膜外形良好，无瘢痕挛缩、无畸形，随访1～2年无一复发，治愈率100％。结论微波治疗涎腺粘液囊肿，操作简便易行，疗效满意，值得推广应用。     

Regulation of metaraminol efflux from rat heart and salivary gland

1. The turnover rate of noradrenaline (NA) in heart and submaxillary salivary gland was studied in rats exposed to 4 degrees C or maintained at room temperature (22 degrees C). Cold exposure increased the turnover of the NA store in heart but not in salivary gland.2. In another series of experiments the decline of metaraminol (M) from heart and submaxillary salivary gland was studied in rats exposed to 4 degrees C or maintained at room temperature. Cold exposure accelerated the efflux of M from heart, but not from salivary gland. It is concluded that the accelerated decline of M from heart is the consequence of selective activation of the sympathetic nerves that innervate the heart.3. The turnover of NA was studied in rat heart after the administration of M (100 mug/kg intravenously) or its precursor alpha-methyl-meta-tyrosine (200 mg/kg intraperitoneally). Turnover remained essentially normal after these drugs.4. The administration of desipramine (DMI, 20 mg/kg intraperitoneally) 1 hr after M (100 mug/kg intravenously) induced a rapid sustained efflux of M from heart and salivary gland. The results of this study suggest that the slow decline of M from heart is the result of the great affinity of the amine retrieval mechanism in sympathetic nerve endings for M. DMI inhibits the retrieval mechanism, thus accelerating the efflux of M.     

COX－2在涎腺恶性肿瘤中的表达及其意义

目的：研究环氧化酶－2（cyclooxygenase－2,COX－2）在涎腺恶性肿瘤腺样囊性癌中的表达及其与肿瘤发生发展的关系。方法：采用免疫组织化学SP法检测15例涎腺腺样囊性癌及10例正常涎腺组织中COX--2的表达情况。结果：涎腺腺样囊性癌中COX--2表达阳性率为80％,并且随临床分期的增高而增加（P〈0．05）。结论：COX--2与涎腺腺样囊性癌的发生及恶变关系密切。