胃癌血管内皮生长因子和一氧化氮合酶的表达与胃癌血管生成及临床病理的关系

目的研究血管内皮生长因子(VEGF)、诱导型一氧化氮合酶(iNOS)和内皮型一氧化氮合酶(eNOS)在人胃癌中表达的相关性;探讨3者与人胃癌血管生成和临床病理特征的关系;研究一氧化氮(NO)和VEGF的相互作用及NO在VEGF促肿瘤生长中的作用机制。方法应用免疫组织化学方法检测34例人胃癌手术切除标本VEGF、iNOS和eNOS的表达,第Ⅷ因子相关抗原(FⅧRAg)血管内皮细胞特异性染色计数肿瘤微血管密度(MVD)。结果(1)31例胃癌组织表达VEGF,25例表达iNOS,28例表达eNOS;(2)VEGF与iNOS的表达正相关,与eNOS的表达无相关;(3)VEGF、iNOS的表达与胃癌MVD呈正相关,表达与不表达eNOS其胃癌MVD的差异无显著性意义;(4)VEGF的表达与胃癌淋巴结转移和肿瘤浸润深度呈正相关,与肿瘤分化程度无关;iNOS表达与胃癌的浸润深度呈正相关,与胃癌分化程度及有无淋巴结转移无关;eNOS表达与胃癌浸润深度、分化程度及有无淋巴结转移均无关。结论(1)iNOS对VEGF的生成和发挥作用的过程有重要影响;(2)MVD随着VEGF和iNOS表达的增强而增加,说明两者对胃癌血管生成具有促进作用。     

碱性成纤维细胞生长因子和血管生成与胃癌发展的关系

目的:探讨碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)和血管生成与胃癌发展的关系.方法:应用免疫组织化学方法检测56例人胃癌组织碱性成纤维细胞生长因子表达和微血管密度(microvasculardensity,MVD),分析bFGF和MVD及其与胃癌组织学分型、浸润深度、生长方式、淋巴结转移、远处转移和预后的关系.结果:bFGF阳性者MVD值显著高于bFGF阴性者(P<0.01),MVD值和bFGF表达与胃癌浸润深度(P<0.05)、淋巴结转移(P<0.01)和远处转移(P<0.05)密切相关;MVD≥43或bFGF表达阳性的胃癌患者5年生存率较低.结论:血管生成在胃癌发展中具有重要作用,bFGF不仅与胃癌的血管生成有关,而且与胃癌的生长和浸润转移也有关,MVD或bFGF可作为判断胃癌患者预后的指标.     

人胃癌VEGF和NOS的表达与肿瘤血管生成的关系

目的　研究血管内皮生长因子 (VEGF)、诱导型一氧化氮合酶 (iNOS)及内皮型一氧化氮合酶 (eNOS)在人胃癌表达的相关性及与胃癌血管生成的关系 ,探讨NO和VEGF的相互作用及NO在VEGF促肿瘤生长中的作用机理。方法　应用免疫组化方法检测 34例胃癌组织中VEGF、iNOS和eNOS的表达及分布 ,用血管内皮细胞第Ⅷ相关抗原 (FⅧRAg)行免疫特异性染色计数肿瘤微血管密度 (MVD)。 结果　 34例胃癌组织中 ,表达iNOS者占 73.5 % ,表达eNOS者占 82 .4 % ,表达VEGF者占 91.2 % ;VEGF与iNOS的表达具有相关性 (P<0 .0 0 5 ) ,VEGF与eNOS的表达则无相关性 (P>0 .0 5 ) ;表达VEGF的胃癌其MVD明显高于不表达VEGF的胃癌 (P<0 .0 2 5 ) ,表达iNOS的胃癌其MVD明显高于不表达iNOS的胃癌 (P<0 .0 5 ) ,表达eNOS的胃癌MVD与不表达eNOS的胃癌差异无显著性意义 (P>0 .0 5 )。结论　胃癌组织中MVD随着VEGF和iNOS表达的增加而增加 ,提示两者对胃癌的血管生成起促进作用 ;VEGF与iNOS的表达具有相关性 ,提示iNOS在VEGF的生成和发挥作用过程中起重要作用。     

胆管癌中一氧化氮合酶的表达及其意义

目的 探讨nNOS,iNOS,eNOS的表达与胆管癌临床病理特征及预后的关系.方法 检测和比较胆管癌与正常肝外胆管组织的nNOS,iNOS,eNOS表达.结果 (1)与正常胆管比较,胆管癌中iNOS及eNOS表达增强(P＜0.05),nNOS无表达增强(P＞0.05).(2)iNOS在晚期和中期胆管癌组间阳性表达率差异有显著性(P＜0.01);eNOS在晚期、中期、有无远处转移胆管癌组间阳性表达率差异均有显著性(P＜0.05).(3)eNOS阴性表达组预后明显优于阳性表达组(P＜0.01),nNOS及iNOS表达与预后无关(P＞0.05).结论 (1)胆管癌eNOS的过度表达与胆管癌的临床病理分期、远处转移及预后有关,提示检测胆管癌中eNOS表达可能有助于对胆管癌病情及预后的判断.(2)iOS表达与胆管癌的临床病理分期关系密切,与有无远处及淋巴结转移、预后无关,推测iNOS可能有促进胆管癌的局部浸润生长,促进病情发展的作用.     

神经源性膀胱组织中一氧化氮合酶表达的特点和意义

目的 探讨神经元型一氧化氮合酶(nNOS)、诱导型NOS(iNOS)和内皮型NOS(eNOS)在神经源性膀胱组织中表达状况,探讨一氧化氮在神经源性膀胱组织中产生及作用特点.方法 神经源性膀胱患儿30例.男18例,女12例.年龄(6.3±3.1)岁.30例均行手术治疗,术中留取膀胱组织标本,采用免疫组织化学方法检测膀胱组织中nNOS、iNOS和eNOS表达状况,10例正常膀胱组织标本作对照. 结果 正常膀胱体部组织nNOS阳性表达,走行在平滑肌纤维之间,分布于平滑肌细胞表面,膀胱基质也有表达,组织化学评分(HS)为2.8～4.0和1.2～2.7;平滑肌细胞iNOS阴性表达,平滑肌细胞基质有少量稀疏表达,HS为0～0.4和0～0.1;eNOS表达分布于血管内皮细胞中,分布稀疏,平滑肌细胞无表达.膀胱颈部组织表达高于膀胱体部组织,以nNOS表达为主.神经源性膀胱组织中以iNOS表达为主,nNOS表达明显减少;eNOS主要分布于膀胱基质的内皮细胞,膀胱平滑肌、成纤维细胞阴性表达;病变膀胱组织血管稀疏,微血管密度100倍视野下可见到(6.8±3.2)个血管灶,低于正常膀胱组织的(16.7±6.3)个(P＜0.01).结论 正常膀胱组织nNOS主要分布在膀胱颈中,NO合成主要受nNOS调节.神经源性膀胱患者膀胱组织中氮能神经元分布稀疏,nNOS表达减少,iNOS表达上调,NO的合成与调节可能主要来源于iNOS,受iNOS水平调节,eNOS表达下降,提示膀胱组织血供不良.     

角质细胞生长因子和环氧化酶-2在胃癌中的表达及其与血管生成的关系

目的检测角质细胞生长因子(KGF)和环氧化酶-2(COX-2)蛋白在胃癌组织中的表达及微血管密度(MVD),探讨KGF与COX-2在胃癌发生、发展中的作用及其机理。方法采用免疫组化SP法检测64例胃癌组织及30例正常胃黏膜组织中KGF和COX-2蛋白表达,并采用CD34抗体染色检测MVD。结果 KGF和COX-2蛋白在胃癌组织中的表达阳性率分别为65.6%(42/64)和79.7%(51/64),分别高于其在正常胃黏膜组织中的表达阳性率〔23.3%(7/30)和13.3%(4/30)〕,P=0.046、P=0.008。胃癌组织MVD为31.8±8.0,明显高于正常胃黏膜组织的14.3±6.1(P=0.000);KGF与COX-2蛋白均表达阳性者MVD为35.9±5.7,明显高于两者表达均为阴性者的25.7±7.0(P=0.000)。胃癌组织中KGF和COX-2蛋白表达均与淋巴结转移、浆膜浸润及TNM分期有关(P<0.05、P<0.01),MVD与淋巴结转移和TNM分期有关(P<0.01),但均与患者年龄、性别以及肿瘤分化程度无关(P>0.05)。KGF与COX-2联合表达者与胃癌的浆膜浸润、淋巴结转移和TNM分期有关(P<0.05),与患者年龄、性别以及肿瘤分化程度无关(P>0.05)。胃癌组织中KGF与COX-2蛋白表达呈正相关(r=0.610,P=0.000);胃癌组织MVD与KGF和COX-2蛋白表达均呈正相关(r=0.675,P=0.000;r=0.657,P=0.000)。结论 KGF和COX-2蛋白在胃癌组织中高表达,可能通过促进肿瘤新生血管的生成协同参与胃癌的浸润、转移。     

肿瘤组织VEGF表达和MVD与膀胱癌预后的关系

目的:探讨肿瘤组织中血管内皮生长因子(Vascular endothelial growth factor,VEGF)表达和微血管密度(Microvessel density,MVD)与膀胱癌预后的关系。方法:采用免疫组织化学方法检测62例膀胱癌手术标本中VEGF和MVD。结果:VEGF阳性表达率为63%,VEGF阳性表达的肿瘤组织中的MVD明显高于阴性者(P<0.01);VEGF表达和MVD与肿瘤的浸润生长、血行转移、淋巴结转移具有明显相关关系(P<0.05,P<0.01);VEGF阳性表达者的预后较阴性者差;多因素分析表明,VEGF和MVD可能成为判断膀胱癌预后的新因素。结论:VEGF表达和MVD与膀胱癌的恶性进程和不良预后有关,测定VEGF和MVD可能是判断膀胱癌预后有价值的指标。     

胃癌组织中p53和血管内皮生长因子的表达与血管生成的关系及其意义

目的　探讨胃癌组织中p53与血管内皮生长因子(VEGF)表达和血管生成的关系。方法　应用免疫组织化学技术对60例胃癌组织进行p53、VEGF表达和肿瘤组织微血管密度MVD检测。结果　MVD以及p53和VEGF的表达与胃癌病灶的大小(P＜0.05)、浸润深度(P＜0.01)、淋巴结转移(P＜0.01)和TNM分期(P＜0.01)密切相关。p53的表达与VEGF的表达显著相关（χ     

内皮抑素、bFGF及CD34在胆囊癌中的表达及其意义

目的 探讨内皮抑素及碱性成纤维细胞生长因子(bFGF)在胆囊癌发生、发展中的作用,为胆囊癌的生物学治疗探索理论依据.方法 运用免疫组化SP法检测内皮抑素、bFGF及CD34在61例胆囊癌组织和10例正常胆囊组织中的表达,并通过CD34的表达计算微血管密度(MVD),分析它们与胆囊癌临床病理特征的关系.结果 内皮抑素在正常胆囊组织及胆囊癌组织中的表达阳性率分别为40.00%(4/10)及77.05%(47/61),差异有统计学意义(P<0.05);胆囊癌组织中,内皮抑素的表达强度与其临床分期及淋巴结转移有关(P<0.05),与患者性别及年龄、肿瘤部位和大小及组织学分级无关(P>0.05).bFGF在正常胆囊组织和胆囊癌组织中的表达阳性率分别为20.00%(2/10)及67.21%(41/61),差异有统计学意义(P<0.05);胆囊癌组织中,bFGF的表达强度与其临床分期及淋巴结转移有关(P<0.05),与患者性别及年龄、肿瘤部位和大小及组织学分级无关(P>0.05).胆囊癌组织中MVD为(76.66±20.15)个/HP,明显高于正常胆囊组织的(29.53±5.03)个/HP(P<0.01).胆囊癌组织中,临床分期Ⅲ～Ⅴ期的MVD为(80.53±17.98)个/HP,明显高于Ⅰ+Ⅱ期的(46.79±5.38)个/HP(P<0.01);有淋巴结转移者的MVD为(94.60±7.28)个/HP,明显高于无淋巴结转移者的(58.12±9.24)个/HP(P<0.01);MVD在组织学分级G1[(60.59±14.71)个/HP3、G2[(83.08±15.30)个/HP3及G3E(96.53±6.92)个/HP]者间的差异均有统计学意义(P<0.01);MVD与患者性别及年龄、肿瘤部位及大小无关(P>0.05).胆囊癌组织中内皮抑素的表达与MVD有关(P<0.01),bFGF的表达亦与MVD有关(P<0.01).结论 内皮抑素、bFGF及CD34在胆囊癌的发生、发展过程中起不同程度的作用.它们的检测可给胆囊癌的早期诊断、恶性程度的判定和进一步治疗提供有效的依据.     

TIP30在胃癌组织中的表达及其对胃癌血管生成的影响

目的: 研究Tat作用蛋白30(Tat-interactive protein 30, TIP30)基因在胃癌组织中的表达及其对胃癌血管生成的影响.方法:运用免疫组织化学方法检测52例胃癌组织及47例癌旁正常组织中TIP30蛋白的表达水平,同时检测CD34标记的微血管密度(microvessel density,MVD).结果: TIP30在胃癌和癌旁正常组织中的阳性率分别为53.8%和85.1%,两者相比较差异有统计学意义(χ2=11.22,P﹤0.01),TIP30表达水平与患者年龄、性别、病理分化程度及肿瘤大小无关,与有无淋巴结转移及TNM分期有关.胃癌组织和癌旁正常组织中MVD值分别为27.37±2.68和21.87±4.11,两者比较差异有统计学意义(t=7.95,P<0.01),胃癌组织中TIP30表达阳性者较阴性者MVD值显著降低(t=-3.18,P=0.003).结论: TIP30在胃癌组织中表达降低,其可能通过抑制胃癌血管生成影响胃癌的发生发展.     

Comparative Anatomy of the Subsynovial Connective Tissue in the Carpal Tunnel of the Rat, Rabbit, Dog, Baboon, and Human

The tenosynovium in the human carpal tunnel is connected to the flexor tendons and the median nerve by the subsynovial connective tissue (SSCT). The most common histological finding in carpal tunnel syndrome (CTS), a compression neuropathy of the median nerve, is noninflammatory fibrosis of the SSCT. The relationship, if any, between the fibrosis and nerve pathology is unknown, although some have speculated that a change in the SSCT volume or stiffness might be the source of the compression. Yet, while animal models have been used to study the physiology of nerve compression, so far none have been used to study the relationship of the SSCT pathology to the neurophysiological abnormalities. The purpose of this study was to identify animal models that might be appropriate to study the interaction of SSCT and nerve function in the development of CTS. The front paws of a rat, rabbit, dog, and baboon were dissected. The carpal tunnel anatomy and SSCT of these animals were also examined by light and scanning microscopy and compared to the relevant human anatomy and ultrastructure. The carpal tunnel anatomy and contents of the baboon and rabbit are similar to humans. The canine carpal tunnel lacks the superficial flexor tendons and the rat carpal tunnel is very small. The human, baboon, and rabbit specimens had very similar organization of the SSCT, and content of the carpal canal. We conclude that, while both the baboon and rabbit would be good animal models to study the relationship of the SSCT to CTS, the rabbit is likely to be more practical, in terms of cost and animal care concerns.     

Priestley, the furious free thinker of the enlightenment, and Scheele, the taciturn apothecary of Uppsala

'The more elaborate our means of communication, the less we communicate'.
Joseph Priestley     

Effect of castration, DES, flutamide, and the 5 alpha-reductase inhibitor, MK-906, on the growth of the Dunning rat prostatic carcinoma, R-3327.

Male rats bearing implants of the Dunning rat prostatic carcinoma, R-3327, were used in a 42-day study to determine the effect of castration or orally administered flutamide (FL), DES (diethylstilbestrol) or the 5 alpha-reductase inhibitor, MK-906, on the growth of this androgen-responsive cancer. The rate of growth and final weights of the tumor and the ventral prostate (VP) were all reduced (P less than 0.05) by castration. Flutamide (25 mg/kg/day) significantly decreased tumor and VP weights in intact rats and castrates given 100 micrograms/day (SC) of testosterone propionate (TP) or dihydrotestosterone propionate (DHTP). It also significantly retarded tumor growth rate in TP- or DHTP-treated castrates and was marginally effective in intact animals. DES (100 micrograms/kg/day) reduced (P less than 0.05) tumor and VP weights of intact rats but did not significantly affect tumor growth rate or weight in castrates given TP or DHTP. These results indicated that the effect of DES on tumor growth is caused by its inhibition of the secretion or release of the gonadotropins necessary for testicular androgen production. MK-906 (25 mg/kg/day) affected neither the gross nor the histomorphology of the tumor in intact rats or castrates given TP or DHTP. Further, it caused no histological changes in the testes of intact rats. It did, however, significantly reduce VP weight in intact animals and TP-treated castrates but not in those given DHTP. This illustrates that the anti-androgenicity of MK-906 stems from its inhibition of DHT formation. The failure of MK-906 to influence tumor growth in the TP-treated castrates strongly suggests that the R-3327 tumor can respond to testosterone directly. If that is true, then its growth is unlikely to be affected by a pure 5 alpha-reductase inhibitor such as MK-906. In ancillary experiments, tumors from MK-906-treated animals were found to have reduced levels of DHT and, when assayed in vitro, to have a reduced capacity to convert [3H]-T to [3H]-DHT.     

Prostate cancer, the urologist, the patient, and treatment

Prostate cancer, particularly advanced prostate cancer, should be considered as a chronic disease that requires multidisciplinary management. Each health professional involved the urologist of course, but also the other therapists, especially the general practitioner and nurse, should place their activities within a therapeutic synergy. The onco-psychological dimension should not be underestimated. In particular, information about the disease, its course and the therapeutic solutions proposed should be given gradually and, above all, should be regularly recapitulated. Patients are more accepting of treatments when they know about them. The point of view of the patient with prostate cancer is approached here in two ways; firstly through the comments of a psychologist on the history of a patient with prostate cancer and the dialogue with an experienced urologist. The treatment should not only be understood, but also accepted and requested by the patient. In this chronic disease, the patient often feels the treatment to be a bond between the therapist and himself. A survey based on an auto-questionnaire was also conducted among 275 patients and 50 urologists in order to investigate these relationships. From the results of this survey, in the case of hormone treatment, a quarterly rhythm for LHRH agonist injections appears to be perfectly matched to patient requirements. Monthly injections involve too great an intrusion by the treatment into the life of a cancer patient, in contrast injections which are spaced at greater than quarterly intervals could be seen to much as desertion and also lead to forgetfulness and neglect.