恶性淋巴瘤nm23、CD44表达及其预后意义

目的：探讨nm23、CD44在正常淋巴组织和不同恶性程度淋巴瘤中的表达及其预后意义。方法：采用免疫组化Envision法检测107例恶性淋巴瘤患者组织标本中nm23、CD44蛋白的表达水平，以染色阳性细胞数应用四级半定量法评估阳性强度并分为高、低表达组。结果(1)在正常淋巴组织中nm23、CD44呈低水平表达。(2)随淋巴瘤恶性程度的提高，nm23和CD44表达均增强(P＜0．01)。(3)CR率在nm23低表达组为74．5％，高表达组为45．2％；CD44低表达组为67．2％，高表达组为42．9％，差异均有显著性(P＜0．05)；两者均低表达组为75．6％，两者均高表达组为40．9％，差异有显著性(P＜0．01)。(4)nm23低表达组1、3、5年生存率均高于高表达组(P＜0．01)；CD44低表达组生存率也高于高表达组(P＜0．05)；而两者均低表达组、一者高表达组及两者均高表达组间1、3、5年生存率呈下降趋势(P＜0．01)。结论：nm23、CD44表达水平不仅可反映淋巴瘤的恶性程度，而且可作为淋巴瘤的预后指标。     

恶性血液病患者化疗前后淋巴细胞亚群测定及其意义

 目的 研究恶性血液病患者化疗前后淋巴细胞亚群的变化及其意义。方法 采用流式细胞术对21例急性淋巴细胞白血病（ALL）／非霍奇金淋巴瘤（NHL）患者和23例急性髓系白血病（AML）患者化疗前后淋巴细胞亚群（包括CD+4细胞、CD+8细胞、CD+4／CD+8比值、NK细胞）进行检测。结果 CR组白血病、淋巴瘤的CD+4／CD+8与NK细胞比例均明显高于初诊组和化疗后未缓解组白血病、淋巴瘤（P＜0.05）;CR组ALL／NHL的CD+4／CD+8明显低于CR组AML（P＜0.05）。结论 CD+4／CD+8与NK细胞比例可以作为判断恶性血液病患者病情严重程度和预后的指标,与AML相比,ALL／NHL的细胞免疫功能受损更为严重。     

B细胞淋巴瘤的Fas蛋白表达及意义

目的：探讨Fas蛋白在不同类型B细胞源性非霍奇金淋巴瘤（non-Hodgkon‘s Bcell lymphoma,B-NHL)中的分布及意义,为B－NHL诊治提供新的观察指标及实验依据。方法：对确诊为B－NHL的79例及良性淋巴组织20例的石蜡切片,用免疫组化方法进行Fas蛋白表达的检测。结果：发现B－NHL的Fas蛋白平均阳性表达率为65．8％,良性淋巴组织为60．0％,单从数量上,良恶两者之间差异无显著性（P＜0．05）,而从阳性细胞分布上良、恶性可见区别,良性分布有规律,主要集中在生发中心;恶性分布无规律性。淋巴瘤组内各亚组之间差异有显著性意义：弥漫大B细胞淋巴瘤（deffuse large B cell lymphoma,DLBL)组表达分别高于滤泡性淋巴瘤（follicular cell lymphoma,FCL)(P＜0．05）和小淋巴细胞性淋巴瘤（small lymphocytic lymphoma,SLL)组（P＜0．01）;FCL组表达高于SLL组（P＜0．05）。Fas蛋白的表达与性别、年龄及部位无相关性。结论：1、Fas的表达与B淋巴瘤的类型及恶性程度有关。2、Fas的表达半定量检测不能作为鉴别良恶性的指标,而分布规律不同可作参考。检测Fas蛋白的数量及注意阳性细胞分布规律,对病理确诊淋巴瘤疑难病例有一定应用价值,可为临床选择治疗方案提供参考。     

DICE方案与CHOP方案治疗中高度恶性非霍奇金淋巴瘤的随机对照研究

背景与目的：长期以来，CHOP方案被认为是治疗中、高度恶性非霍奇金淋巴瘤（non—Hodgkin，slym—phoma，NHL）的基本方案，近年有文献报道DICE方案可以提高中、高度恶性NHL的疗效。本研究中我们比较DICE方案与CHOP方案治疗中、高度恶性NHL的疗效与安全性，为中、高度恶性NHL的规范治疗提供依据。方法：选择经病理学或组织学证实的中、高度恶性NHL的患者74例，按信封法随机分为DICE组与CHOP组两组，分别采用上述两种方案治疗。结果：DICE组CR15例（40．5％），PR14例（37．8％），缓解率RR（CR＋PR）为78．3％（29／37）；CHOP组CR11例（29．7％），PR10例（27．0％），RR为56．7％（21／37）；两组比较有显著性差异（P〈0．05）。DICE组的1、3、5年生存率分别为89．2％、76．0％和46．7％，CHOP组分别为81．2％、52．6％和36．4％。两组比较有显著性差异（P〈0．05）。两组出现的主要不良反应为Ⅲ／Ⅳ度粒细胞和血小板减少及恶心等，两组比较无显著性差异（P〉0．05）。结论：与CHOP方案相比，DICE方案疗效较好，不良反应可以耐受，但是否可作为治疗中、高度恶性NHL的首选方案之一，值得进一步研究。     

肺癌组织中CD44v6和nm23的表达及临床意义

目的：探讨CD44v6和nm23有肺癌组织中的表达及意义。方法：应用免疫组织化学方法,检测51例肺癌组织中CD44v6和nm23的表达情况,并分析其临床意义。结果：在5例类癌和4例小细胞肺癌（SCLC）中未见CD44v6表达。在非小细胞肺癌（NSCLC）中,≤60岁和＞60岁组CD44v6的阳性率分别为84．0％和29．4％,两组间差异有非常显著性（χ^2＝12．79;P＜0．01）,低分化癌和高中分化癌中CD44v6的阳性率分别为87．0％和31．6％,两组间差异有显著性（χ^2＝13．53,P＜0．01）;有和无淋巴结转移组CD44v6和的阳性率分别为73．3％和33．3％,两组间差异有显著性（χ^2＝5．82,P＜0．05）;鳞癌和腺癌中CD44v6的阳性率分别为85．7％和50．0％,两组间差异有显著性（χ^2＝5．05,P＜0．05）;nm23在腺癌和鳞癌中的阳性率分别为64．3％和14．3％,两组间差异有显著性（χ^2＝9．35,P＜0．01）。结论CD44v6可反映NSCLC的生物学特性,是预测其侵袭转移潜能和预后的指标。m23能否作为肺癌的预后指标尚待扩大样本深入研究。     

非霍奇金淋巴瘤患者nm23蛋白检测的预后价值

目的：探讨nm23基因蛋白在非霍奇金淋巴瘤中表达的临床预后价值。方法：应用免疫组化EnVision法。结果：nm23在非霍奇金淋巴瘤组织中的表达强度与其恶性程度有关，呈正相关（P＜0．001）。nm23低水平表达组患者完全缓解率和1、3、5年生存率均明显高于高表达组（P＜0．01）。结论：nm23表达水平反映了非霍奇金淋巴瘤的恶性程度，可作为判定非霍奇金淋巴瘤的预后因子。     

CD44和nm23基因在滋养细胞肿瘤中的表达及临床意义

目的：探讨转移促进基因CD44和转移抑制基因nm23在预测滋养细胞肿瘤转移能力方面的意义。方法：采用SP免疫组织化学法检测57例滋养细胞疾病组织蜡块的CD44v6和nm23H1的表达情况。结果：57例滋养细胞疾病的石蜡标本中，nm23H1和CD44v6表达阳性率在葡萄胎组与滋细胞肿瘤组有显著性差异（P＜0．05），CD44v6表达阳性率在恶性滋养细胞肿瘤的临床I期和Ⅱ-Ⅲ期间有显著性差异（P＜0．05），结论：nm23H1的缺失和CD44v6过表达与滋养细胞肿瘤的恶性程度密切相关，CD44v6对预测滋养细胞肿瘤远处转移具有较高预测价值。     

非霍奇金淋巴瘤组织中Topo-Ⅱ的表达及临床意义

目的：探讨Topo—Ⅱ在非霍奇金淋巴瘤（NHL）组织中的表达情况及其与临床病理特征、预后的关系。方法：应用免疫组织化学方法检测52例NHL组织Topo—Ⅱ的表达，并将患者化疗后的疗效和生存资料与Topo—Ⅱ的表达进行比较分析。结果：Topo-Ⅱ在NHL中的表达阳性率为61．5％（32／52）；其表达与患者的年龄、性别及分期之间无相关性（P〉0，05）。Topo—Ⅱ在高度恶性NHL中的表达为77．4％（24／31），在低度恶性NHL中的表达为38．1％（8／21），两者相比P=0．04，差异有统计学意义。Topo—Ⅱ在Ⅰ、Ⅱ期组与Ⅲ、Ⅲ期组的表达率分别为44．5％（13／29），82．6％（19／23），P=0．03，差异有统计学意义。Topo-Ⅱ表达阴性组和表达阳性组的5年累积生存率分别为65％和44％，将两者生存曲线相比，Topo—Ⅱ表达阳性组具有较短的生存时间，P=0．05。结论：Topo-Ⅱ的表达与NHL的恶性程度和分期密切相关，分期晚者Topo-Ⅱ高表达。Topo—Ⅱ表达阳性者预后差。Topo—Ⅱ可作为判断NHL恶性程度和不良预后的参考因素。     

非霍奇金林巴瘤中细胞凋亡与细胞增殖的研究

目的 了解非霍奇金淋巴瘤（NHL）中细胞凋亡与细胞增殖间的关系，探讨两者在NHL发生与发展中的作用。方法 利用TdT介导的dUTP缺口末端标记（TUNEL）法和PCNA免疫组化技术原位检测60例NHL中的细胞凋亡和增殖水平，计算凋亡指数（AI）和增殖指数（PI）。结果 B细胞性NHL中，随着恶性度增高，AI和PI均增高（P＜0．05），T细胞性NHL中高度恶性组PI明显高于低度恶性组（P＜0．05），而AI在两组之间无显著性差异（P＞0．05）。AI和PI呈显著正相关（r=0．704，P＜0．01）。结论 在NHL中细胞凋亡与增殖之间可能存在密切的联系，共同参与了NHL的发生和恶性进展。对细胞凋亡和增殖水平的检测可能有助于NHL恶性度及预后的判断。     

食管癌组织中nm23-H1、CD44V6蛋白表达与区域淋巴结转移的关系

目的 研究食管癌组织中nm23-H1、CD44V6蛋白表达与食管癌区域淋巴结转移的关系。方法 应用流式细胞仪定量分析55例食管癌组织中nm23-H1、CD44V6蛋白的表达，同时检测DNA倍体状态。结果 有区域淋巴结转移组nm23-H1蛋白表达低于无转移组，而D44V6蛋白表达高于无转移组（均P＜0．05）；异倍体率与淋巴结转移及nm23-H1、CD44V6蛋白表达均无关（P＞0．05），增殖活性与淋巴结转移及nm23-H1、CD44V6蛋白表达均相关（P＜0．05）。食管癌组织中nm23-H1蛋白表达与CD44V6蛋白表达无关（P＞0．05）。结论 nm23和CD44基因在食管癌的发展转移中起重要作用。     

Bacteria and cancer--antagonisms and benefits

There is considerable historical and recent evidence concerning the antagonisms between acute bacterial infections or their toxins and cancer and allied diseases. These data provide renewed incentives to undertake clinical programmes with mixed bacterial vaccines in many countries at the present time.     

VEGF及KDR在大肠腺瘤和腺癌中的表达及意义

目的：探讨VEGF和KDR在大肠腺瘤和大肠腺癌中的表达及临床病理特征的关系。方法：大肠腺瘤和大肠腺癌组织标本各100例,采用免疫组织化学染色法检测VEGF和KDR在标本中的表达情况。结果：VEGF和KDR在大肠腺癌组中的阳性表达明显高于大肠腺瘤组（P〈0.05）;在正常大肠黏膜均未见VEGF和KDR表达的阳性染色;VEGF阳性表达组中KDR的阳性表达率为70%,显著高于VEGF阴性表达组中KDR的阳性表达率16%,两组比较有统计学意义（P〈0.01）。结论：大肠腺癌组织中KDR的表达与肿瘤大小、转移情况、浸润深度密切相关;VEGF和KDR在大肠腺瘤中的表达与患者的年龄、性别及分型均无相关性,而与增生程度相关（P〈0.05）。在大肠腺癌患者中VEGF及KDR表达更高,二者具有协同效应。     

Religiosity and physical and emotional functioning among African American and White colorectal and lung cancer patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

Genetic polymorphisms of alcohol and aldehyde dehydrogenases and risk for esophageal and head and neck cancers

Alcoholic beverages are causally related to cancer of the oral cavity, pharynx, larynx and esophagus. Ethanol is oxidized to acetaldehyde and then to acetate by alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), both of which have genetic polymorphisms. A review of case-control studies of the effects of ALDH2, ADH2 and ADH3 genotypes shows consistently positive associations between inactive heterozygous ALDH2 and the less-active ADH2 genotypes and the risk for esophageal cancer in East Asian heavy drinkers and this enzyme-related vulnerability may extend to light-to-moderate drinkers. Some studies suggest similar associations with the risk for head and neck cancer in moderate-to-heavy-drinking Japanese. An established carcinogen in experimental animals, acetaldehyde can interact with human DNA. ALDH2-associated cancer susceptibility fits into a scenario in which acetaldehyde plays a critical role in the development of human cancer. Alcohol flushing and drinking behavior may partly explain this carcinogenic effect in carriers of less-active ADH2 genotypes. Whether the ADH3 genotype influences head and neck cancer risk in Western nations is controversial. Professional and public education about risky conditions connected to the ALDH2 and ADH2 genotypes and environmental factors is important in a new strategic approach to the prevention of alcohol-related cancers in East Asians. The use of simple tests to identify inactive ALDH2 on the basis of alcohol flushing responses could benefit many people, by helping them to identify their own cancer risks. Such testing could also help clinicians diagnose esophageal cancer earlier, through the use of endoscopic screening in the high-risk population.     

Religiosity and Physical and Emotional Functioning Among African American and White Colorectal and Lung Cancer Patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

New and emerging radiosensitizers and radioprotectors

The combination of chemotherapy and radiation has led to clinical breakthroughs in several disease sites, and current work continues to define optimum combinations of proven chemotherapy as well as more recently available, noncytotoxic agents. Administration of systemic therapies allows modulation of radiation response to improve tumor control (radiosensitization) or to prevent normal tissue toxicity (radioprotection). Substantial progress has been made in identifying the targets of standard chemotherapeutic radiation sensitizers and protectors as well as in the introduction of a new generation of molecularly targeted therapies in combination with radiation. We have reviewed the most recent, predominantly early phase clinical trials combining systemic agents with radiation. Although the proof of an improved schedule ultimately needs to come from well-run Phase III trials, the search among schedules could be shortened by the use of surrogate endpoints such as presence of active drug metabolites in the tumor. This has been accomplished only in a few cases and needs to become a more standard part of radiation sensitizer and protector trials.