卵巢癌成纤维细胞通过肝细胞生长因子促进癌细胞侵袭作用的研究

目的:探讨卵巢癌相关成纤维细胞(CAFs)分泌因子,特别是肝细胞生长因子(HGF)对卵巢癌细胞株CAOV3侵袭迁移作用的影响。方法:通过RT-PCR检测CAFs和卵巢正常成纤维细胞(NFs)中HGF mRNA的表达及与CAOV3体外共培养后两种成纤维细胞中HGF表达的变化。利用Transwell模型检测CAFs和NFs对CAOV3侵袭迁移的影响。用HGF中和性抗体拮抗CAFs和NFs分泌的HGF,检测CAFs和NFs对CAOV3侵袭迁移影响的变化。结果:CAFs比NFs表达更多的HGF(P<0.01),与CAOV3共培养后,HGF表达均增多(P<0.05)。与NFs相比,CAFs具有更强的促进CAOV3侵袭迁移的能力(P<0.01),但在HGF抗体作用后,两者的促侵袭能力减弱(P<0.01)。结论:卵巢癌细胞可促进其间质成纤维细胞HGF表达,而HGF过表达又反过来促进了自身的侵袭和迁移。     

M2型肿瘤相关巨噬细胞在上皮性卵巢癌中的检测

目的:探讨M2型肿瘤相关巨噬细胞(TAMs)在上皮性卵巢癌组织中的分布,及其与临床病理特征及淋巴管(LV)生成的关系。方法:本研究共纳入74例样本,41例卵巢癌为实验组,18例交界性及15例良性肿瘤为对照组,采用免疫组化方法,用CD68标记巨噬细胞(CD68+)、CD163标记M2型TAMs(CD163+)、D2-40标记LV,了解其在实验组和对照组的分布,及与卵巢癌临床病理特征的关系。结果:卵巢癌组CD68+细胞数、CD163+细胞数、LV数均多于交界性和良性肿瘤组(P<0.01)。CD68+细胞分布于癌巢和癌间质,CD163+细胞和LV主要分布于癌间质,癌间质中三者数量明显多于癌巢(P<0.01)。癌巢和癌间质中CD68+、CD163+细胞数及癌间质LV数与临床分期、组织学分化、病理类型、手术切缘累及淋巴结转移有关(P<0.01)。癌间质LV数与CD68+和CD163+细胞数相关(r=0.759,P<0.01;r=0.888,P<0.01)。结论:卵巢癌组织中TAMs主要为M2型,主要分布于癌间质。其细胞数与肿瘤的临床分期、组织分化、病理类型、手术切缘累及和淋巴结转移有关,提示TAMs可能通过促进淋巴管生成,利于肿瘤的淋巴转移。     

CAFs联合LVD对早期宫颈鳞癌淋巴结转移的预测价值

目的:探讨肿瘤相关成纤维细胞(CAFs)联合淋巴管密度(LVD)对早期宫颈鳞状细胞癌(CSCC)淋巴结转移(LNM)的预测价值。方法:利用免疫组化及多重免疫荧光检测132例早期CSCC组织标本(手术切除标本92例，活检组织标本40例)中α-SMA⁺CAFs和D2-40⁺LVs表达水平。分析CAFs密度与LVD的相关性，并与临床病理资料进行相关性统计学分析。建立logistic回归模型，绘制受试者工作特征曲线(ROC)分析CAFs和LVD对早期CSCC淋巴结转移的预测价值，将手术标本的病理评估结果与术前活检结果进行比较，以明确活检标本的预测效果。结果:92例手术切除标本中，早期CSCC组织的CAFs密度与LVD呈正相关(Spearman’s rho=0.597,P<0.001),CAFs密度和LVD均与LNM、淋巴脉管浸润(LVI)密切相关(P<0.05)。ROC分析显示，与LVD单独诊断LNM相比，CAFs密度联合LVD具有更高的敏感性(84.40%vs 71.90%,P<0.05)和相当的特异性(96.70%vs 98.3...     

子宫内膜样腺癌中LYVE-1的表达与淋巴道转移关系

目的:观察子宫内膜样腺癌中淋巴管的分布特点及增殖状态,研究肿瘤淋巴管生成与淋巴道转移的关系。方法:收集80例子宫内膜样腺癌及其相应的正常子宫内膜组织标本,采用免疫组化双标记技术,运用淋巴管特异标记物LYVE-1检测微淋巴管密度(MLD),LYVE-1与Ki-67进行双标免疫组化染色检测淋巴管增殖活性。结果:子宫内膜样腺癌肿瘤边缘区淋巴管多呈管样扩张状,而肿瘤其他区域多为呈闭索状。子宫内膜样腺癌组织中MLD较正常子宫内膜组织显著性增高(P<0.05),MLD在肿瘤边缘区、低分化子宫内膜样腺癌组、伴淋巴结转移组中显著增高,在临床分组间无显著差异。子宫内膜样腺癌中淋巴管内皮细胞Ki-67指数较正常子宫内膜组织增高(P<0.05),肿瘤边缘区Ki-67阳性表达的微淋巴管比肿瘤其他区域、有淋巴结转移组比无淋巴结转移组有显著性增高(P<0.05)。结论:子宫内膜样腺癌组织中存在淋巴管生成,淋巴管主要分布在肿瘤边缘区且淋巴管内皮细胞增殖活性增高。淋巴管密度与子宫内膜样腺癌分化程度、淋巴道转移有关,与临床分期无明显关系。检测淋巴管密度和增殖状态对预测淋巴道转移可提供一定理论的依据。     

子宫内膜样腺癌中LYVE-1的表达与淋巴道转移关系

目的:观察子宫内膜样腺癌中淋巴管的分布特点及增殖状态,研究肿瘤淋巴管生成与淋巴道转移的关系。方法:收集80例子宫内膜样腺癌及其相应的正常子宫内膜组织标本,采用免疫组化双标记技术,运用淋巴管特异标记物LYVE-1检测微淋巴管密度(MLD),LYVE-1与Ki-67进行双标免疫组化染色检测淋巴管增殖活性。结果:子宫内膜样腺癌肿瘤边缘区淋巴管多呈管样扩张状,而肿瘤其他区域多为呈闭索状。子宫内膜样腺癌组织中MLD较正常子宫内膜组织显著性增高(P<0.05),MLD在肿瘤边缘区、低分化子宫内膜样腺癌组、伴淋巴结转移组中显著增高,在临床分组间无显著差异。子宫内膜样腺癌中淋巴管内皮细胞Ki-67指数较正常子宫内膜组织增高(P<0.05),肿瘤边缘区Ki-67阳性表达的微淋巴管比肿瘤其他区域、有淋巴结转移组比无淋巴结转移组有显著性增高(P<0.05)。结论:子宫内膜样腺癌组织中存在淋巴管生成,淋巴管主要分布在肿瘤边缘区且淋巴管内皮细胞增殖活性增高。淋巴管密度与子宫内膜样腺癌分化程度、淋巴道转移有关,与临床分期无明显关系。检测淋巴管密度和增殖状态对预测淋巴道转移可提供一定理论的依据。     

血管内皮生长因子C及其受体3mRNA在上皮性卵巢癌组织的表达及意义

目的 探讨血管内皮生长因子C（VEGF-C）及其受体3（VEGFR-3）mRNA在上皮性卵巢癌组织的表达及与癌周淋巴管生成及淋巴转移的关系。方法 2003-04—2004-06第三军医大学附属西南医院采用RT-PCR方法，检测VEGF-C及VEGFR-3mRNA在良、恶性上皮性卵巢肿瘤组织的表达及组织化学淋巴管染色并计数，分析其与VEGF-C mRNA表达及淋巴转移的关系。结果 VEGF-C mRNA和VEGFR-3 mRNA在卵巢良、恶性肿瘤的表达差异有显著性。VEGF-C mRNA表达阳性及有淋巴结转移组的癌组织淋巴管密度分别大于VEGF-CmRNA表达阴性及无淋巴结转移组的癌组织，二者差异均有显著性。结论 VEGF-CmRNA在上皮性卵巢癌组织的表达上调导致了癌周淋巴管生成，促进了肿瘤的淋巴道转移。     

血管内皮生长因子与血小板源性生长因子在卵巢上皮性癌淋巴管形成中的作用

目的 探讨血管内皮生长因子(VEGF)和血小板源性生长因子(PDGF)在卵巢上皮性癌(卵巢癌)淋巴管形成中的作用.方法 RT-PCR技术检测淋巴管内皮细胞核标志物Proxl和淋巴管形成相关因子VEGF-A、VEGF-C、VEGF-D及PDGF-A、PDGF-B、PDGF-C、PDGF-D在卵巢癌细胞株SKOV3、70例卵巢上皮性肿瘤(卵巢良性肿瘤15例、卵巢交界性肿瘤10例、卵巢癌45例)和20例正常卵巢组织中的表达情况.实时定量PCR技术检测卜述90例卵巢组织中Proxl、VEGF-A、-C、-D及PDGF-A、-B、-C、-D的表达水平,并进行相关性分析.结果 (1)Proxl在各种卵巢组织中均有表达,而在SKOV3细胞中无表达;VEGF-A、-C、-D及PDGF-A、-B、-C、-D在SKOV3细胞和各种卵巢组织中均有表达.(2)卵巢癌组织中Proxl(2.2±1.3)、VEGF.A(3.5±1.5)、VEGF-C(19 ±14)、VEGF-D(3.0±1.8)及PDGF-A(3.3±3.3)、PDGF-C(6.9±4.6)的表达水平高于卵巢良性肿瘤和交界性肿瘤(P均＜0.05).(3)Proxl、VEGF-A和PDGF-A在卵巢癌Ⅲ～Ⅳ期(Proxl:2.6±1.3,VEGF-A:4.0± 1.4.PDGF-A:4.1±3.7)、淋巴结转移阳性(Proxl:3.0±1.4,VEGF-A:4.1±1.7,PDGF-A:4.9±4.1)及腹膜转移阳性(Proxl:2.8±0.9,VEGF-A:4.0±1.8,PDGF-A:4.5±4.0)的组织中的表达水平,分别高于Ⅰ～Ⅱ期、淋巴结转移阴性和腹膜转移阴性者(P均＜0.05);VEGF-C、VEGF-D在淋巴结转移阳性卵巢癌组织中的表达水平(VEGF-c:24± 13,VEGF-D:3.9±2.0)高于淋巴结转移阴性者(P均＜0.05).(4)卵巢癌组织中Proxl的表达水平与VEGF-D(r=0.62,P＜0.01)、PDGF-C(r=0.91,P＜0.01)、PDGF-D(r=0.61,P＜0.01)的表达水平呈正相关关系.结论 VEGF-A、VEGF-C和PDGF-A可能通过参与淋巴管形成之外的机制促进卵巢癌的淋巴结转移;VEGF-D可以促进卵巢癌的淋巴管形成及淋巴结转移;PDGF-B与卵巢癌的淋巴管形成及淋巴结转移无关;PDGF-C、PDGF-D参与卵巢癌淋巴管形成,但无促进淋巴结转移的作用.     

微小RNA-7抑制人卵巢癌细胞株增殖及侵袭能力的研究

目的:探讨微小RNA-7(miR-7)对低转移人卵巢癌细胞株HO-8910、高转移人卵巢癌细胞株HO-8910pm增殖及侵袭转移能力的影响。方法:检测两种细胞株的miR-7表达情况,构建miR-7质粒,通过lipofectmin 2000瞬时转染miR-7低表达的细胞株,通过实时PCR检测转染前后细胞株miR-7以及EGFR mRNA表达情况,Western blot法检测EGFR蛋白表达。细胞划痕实验、transwell实验检测细胞体外迁移及侵袭能力;CCK-8检测增殖能力变化。结果:HO-8910细胞miR-7表达为HO-8910pm的(2.517±0.508)倍;转染后HO-8910pm的miR-7表达提高了(8.015±0.1805)倍,同时抑制EGFRmRNA及蛋白表达,抑制侵袭、迁移、增殖能力(P<0.05);而miR-7表达相对高的HO-8910体外迁移、侵袭及增殖能力均低于HO-8910pm。结论:miR-7可通过调控EGFR的表达抑制HO-8910、HO-8910pm的增殖及侵袭转移能力,miR-7可能为临床治疗卵巢癌提供新靶标。     

髓系细胞触发受体-1在人卵巢癌组织中的表达及其与淋巴结转移的相关性研究

目的:通过检测髓系细胞触发受体-1(TREM-1)在人卵巢癌组织中的表达及其与淋巴转移的相关性,探讨其参与调控肿瘤相关性炎症的可能机制。方法:选择2010年10至2011年10月南昌大学第一附属医院收治的卵巢癌患者30例与卵巢良性肿瘤患者20例。免疫组织化学法测定TREM-1在卵巢癌和卵巢良性肿瘤组织中的表达;用CD163标记M2型肿瘤相关巨噬细胞(TAMs);用D2-40标记微淋巴管,计算微淋巴管密度(LMVD)。分析TREM-1表达与卵巢癌临床病理资料的相关性。结果:卵巢癌组织中TREM-1蛋白的阳性表达率为100%,强阳性表达率为70%(21/30),阳性率显著高于卵巢良性肿瘤的10.0%(2/20)(χ2=42.19,P=0.000)。卵巢良性肿瘤组织中TREM-1和CD163很少表达。TREM-1定位于TAMs。TREM-1表达强度与淋巴转移存在相关性(P=0.01)。Logistic回归分析示,TREM-1评分是淋巴结转移的危险因素(P=0.009)。结论:TREM-1表达于卵巢癌组织的TAMs,其调控的炎症可能在促进卵巢癌淋巴转移中起着重要作用。     

M2型巨噬细胞调控卵巢癌腹膜内肿瘤血管生成的实验研究

目的:探讨上皮性卵巢癌(epithelial ovarian cancer,EOC)腹水中M2型巨噬细胞(M2 macrophage)调控腹膜内肿瘤血管生成的机制。方法:分离卵巢癌患者腹水中M2型巨噬细胞,体外无血清刺激后,收集上清M2作为条件培养基(M2 macrophage conditional medium,M2 CM),分别采用结晶紫染色实验、Transwell小室迁移实验和小管样结构形成实验,检测共培养刺激后其对人脐静脉血管内皮细胞系EA.hy926增殖、迁移以及小管样结构形成的影响;酶联免疫吸附试验(ELISA)检测刺激后EA.hy926细胞分泌促血管蛋白因子——白细胞介素8(IL-8)以及血管内皮生长因子(VEGF)的影响。结果:①经M2 CM刺激后,EA.hy926细胞的增殖能力提高,结晶紫染色后检测OD值为0.192 6±0.002(P<0.05)。②细胞迁移能力提高,迁移细胞数为84.81±2.04(P<0.001)。③M2 CM可显著促进内皮细胞小管样结构形成,与对照组差异有统计学意义(P<0.05)。④ELISA显示经M2 CM刺激后,EA.hy926分泌IL-8为(1 570.45±118.64)ng/L,VEGF分泌量也显著升高,为(502.21±133.61)ng/L,与对照组差异有统计学意义(P<0.001)。结论:EOC腹水中M2型巨噬细胞可能通过上调内皮细胞分泌VEGF及IL-8等促血管生成因子,增加血管内皮细胞增殖、迁移能力及小管样结构形成,从而促进卵巢癌腹膜内血管生成。     

卵巢上皮性癌淋巴结转移相关差异表达蛋白内质网氨基肽酶1的表达及意义

目的 从基因转录及蛋白表达的水平检测内质网氨基肽酶1(ERAP1)在卵巢上皮性癌(卵巢癌)细胞、组织中的表达,探讨其与卵巢癌转移的关系.方法 应用实时荧光定量PCR技术、蛋白印迹法检测在卵巢癌淋巴结非定向转移细胞系(SKOV3)与淋巴结定向高转移细胞系(SKOV3-pm2、SKOV3-pm3、SKOV3-pm4)中ERAP1 mRNA和蛋白的表达情况;并应用免疫组化方法在人卵巢癌原发灶与相应的淋巴结转移灶、裸鼠卵巢癌移植瘤原发灶与相应的淋巴结转移灶中对ERAP1的蛋白表达进行验证.结果 SKOV3、SKOV3-pm2、SKOV3-pm3、SKOV3-pm4细胞中ERAP1 mRNA和蛋白的表达呈下降趋势(分别为0.118±0.012、0.031±0.003、0.028±0.003、0.016±0.005;0.91±0.33、0.09±0.03、0.10±0.04、0.05±0.04),其中,SKOV3细胞中ERAP1 mRNA和蛋白的表达显著高于SKOV3-pm2、SKOV3-pm3、SKOV3-pm4细胞,分别比较,差异均有统计学意义(P<0.05).ERAP1蛋白在人卵巢痛原发灶(184±14)和相应的淋巴结转移灶、裸鼠卵巢癌移植瘤原发灶(143±22)和相应的淋巴结转移灶(97±12)中的表达均呈下降趋势,分别比较,差异均有统计学意义(P<0.05).结论 卵巢癌中ERAP1表达的下降或缺失与淋巴结转移有关.     

Biological markers in pT1 and pT2 ovarian cancer with lymph node metastases

OBJECTIVE: A relatively high incidence of pelvic and paraaortic lymph node metastases is found in patients with pT1 and pT2 ovarian cancer. This paper investigates the clinicomorphological parameters and the expression of various biological markers in these tumors in order to define possible risk factors for lymphatic dissemination. METHODS: In a retrospective study we identified 51 patients with pT1 and pT2 ovarian cancer. All patients underwent total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and systemic pelvic +/- paraaortal lymphadenectomy. The incidence of lymph node metastases in these patients and the clinicomorphological parameters of their tumors were examined. Immunohistochemistry was used to determine the expression levels of the cell proliferation marker Ki-67, the cell adhesion molecules CD44s and CD44v6, and the oncoprotein HER2/neu of the tumors and their respective lymph node metastases. RESULTS: Lymph node involvement was found in 5 of 26 patients with pT1 ovarian cancer and in 6 of 25 patients with pT2 ovarian cancer. Serous adenocarcinoma was associated with a significantly higher incidence of lymph node metastases than other histological types (chi(2) = 4.7, P = 0.03). No correlation was found between tumor grade and the lymph node status. High Ki-67 expression was significantly correlated with spread to the lymph nodes (chi(2) = 4.2, P = 0.04), whereas expression of CD44s, CD44v6, and HER2/neu was not related to the lymph node status. Survival analyses showed no difference in disease-free and overall survival in patients with lymph node metastases compared to those without lymph node metastases. No association was seen among histological type, tumor grade, and immunohistochemically detected Ki-67, CD44s, CD44v6, and HER2/neu expression on the one hand and disease-free and overall survival on the other hand. CONCLUSIONS: Our data suggest that in early stage ovarian cancer the serous histological type and tumors showing a high Ki-67 expression carry a high risk of lymph node metastases. With respect to prognosis our data showed a minor role for Ki-67, CD44s, CD44v6, and HER2/neu expression and the occurrence of lymph node metastases in pT1 and pT2 ovarian cancer.     

The relation of intraabdominal findings and retroperitoneal lymph node metastasis in the epithelial ovarian cancer patients

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Lymph node metastasis in stage I epithelial ovarian cancer

OBJECTIVES: A relatively high incidence of para-aortic and pelvic lymph node metastasis is found in epithelial ovarian cancer. This paper investigates the clinicomorphological features of intra-abdominal stage I epithelial ovarian cancer that may predict the occurrence of lymph node metastasis and the prognosis of patients in whom lymph node metastases are identified. METHODS: From November 1988 to December 1997 we performed systematic para-aortic and pelvic lymphadenectomy as primary surgery in 47 patients with intra-abdominal stage I epithelial ovarian cancer. The incidence of lymph node metastasis in these patients and the clinicomorphological features of the patients with lymph node involvement were examined. RESULTS: Five patients (10.6%) were metastasis positive (IC: four; IA: one), of whom four had serous adenocarcinoma. Serous adenocarcinoma was associated with a significantly higher incidence of metastases than other histological types (P < 0.05). The number of positive lymph nodes was one in four patients and two in one patient, and the metastatic sites ranged from the para-aortic to the suprainguinal lymph nodes. All five metastasis-positive patients were alive and disease free at the time of this report (survival 28-85 months: median 59 months). CONCLUSION: This clinical study suggests that serous adenocarcinoma carries a high risk of lymph node metastasis, requiring systematic lymphadenectomy for accurate staging in intra-abdominal stage I epithelial ovarian cancer.     

Risk of lymph node metastases in patients with ovarian cancer

AIM: The aim of this study was the assessment of incidence of the lymph node spread in patients with ovarian cancer. Additionally, some of clinical and histopathology factors, as well as patients age were analyzed in relation with lymph nodes metastases. MATERIAL AND METHOD: Based on 112 operations performed in patients with ovarian cancer FIGO stage I-IV, analysis of pelvic and paraaortic lymph node metastasis was carried out. In this group only in 70 patients paraaortic lymph nodes were removed. The rest of patients underwent pelvic lymphadenectomy only because of poor general condition or very intensive cytoreductive surgery. Statistical analysis was provided using unvaried regression test and Pearson test. RESULTS: In early stages of ovarian cancer (I and II) the percent of patients with involved lymph nodes was 17.4 and in advanced stages 37.9. Strong correlation between involvement of pelvic and paraaortic lymph nodes was seen. The most frequent localization of lymph node metastases was the site around intercrossing of left renal vein and aorta. It should be stressed that in 8 cases isolated paraaortic metastases were seen. Risk factors of lymph node metastases were clinical stage, tumor grade and age of patients. Clear cell carcinoma and mixed carcinoma had also prognostic significance. CONCLUSION: This analysis proved that incidence of lymph node metastases was high even in early stage, and therefore lymphadenectomy should be an integral part of standard surgical procedures in patients with ovarian cancer.     

Role of appendectomy in predicting lymph node metastases in patients with ovarian cancer

OBJECTIVE: The aim of this study was to assess the diagnostic accuracy of appendectomy in predicting lymph node metastases in women undergoing cytoreductive procedures for ovarian cancer. STUDY DESIGN: In 127 consecutive patients with ovarian carcinoma appendectomy was performed in 30 patients over a period of 5 years. Eight of them were found to have metastases to the appendix. Pelvic and paraaortic lymphadenectomy was performed in 34 patients, in 24 of them the appendix was removed during primary surgery. RESULTS: Among 19 patients without metastases to the appendix the lymph nodes were positive in five cases (26.3%) and among five patients with metastases to the appendix the lymph nodes were positive in four cases (80.0%), which is not a significant difference. Evaluation of the appendiceal metastases as a predictor of lymph node metastases in patients with ovarian cancer gives a sensitivity of 44%, a specificity of 93%, a positive predictive value of 80%, a negative predictive value of 74% and an accuracy of 75%. CONCLUSION: The possibility of predicting retroperitoneal lymph node metastases in ovarian cancer on the basis of histological examination of the appendix is limited.     

环氧合酶-2对宫颈癌淋巴管生成及预后的影响

目的:研究环氧合酶-2(Cox-2)在宫颈癌中的表达并探讨其对淋巴管生成及预后的影响。方法:用免疫组化SP法,分析59例宫颈癌石蜡标本中Cox-2、血管内皮生长因子-C(VEGF-C)及其受体VEGFR-3蛋白表达,并对微淋巴管密度行定量分析。结果:Cox-2蛋白在86.4%(51/59)的病例中呈阳性表达,与VEGF-C表达[66.1%(39/59)]呈显著正相关(r=0.424,P<0.001),且与淋巴结转移、术后生存期缩短有关;在Cox-2表达阳性组淋巴管密度明显高于阴性组(P=0.013)。结论:在宫颈癌中Cox-2可能上调VEGF-C表达,通过促进淋巴管生成与淋巴结转移有关。检测Cox-2可作为预测宫颈癌患者预后的一项指标。     

卵巢癌淋巴结定向转移裸鼠动物模型的建立

目的:在裸鼠体内建立人卵巢癌定向淋巴道转移动物模型。方法:将卵巢癌细胞株SKOV3移植于裸鼠爪垫下,待裸鼠卵巢癌发生转移时,取其淋巴结转移灶癌细胞再次移植裸鼠爪垫下传代,反复传3代。结果:SKOV3卵巢癌细胞在裸鼠体内传3代后,各代裸鼠的淋巴结转移率一直稳定,且转移途径较为单一;各代癌细胞的体内外增殖能力不断增强。结论:成功建立了人卵巢癌定向高淋巴道转移模型。