基质金属蛋白酶9及其抑制物与大肠癌分期和预后的相关性研究

目的:探讨基质金属蛋白酶9及其抑制物的表达与大肠癌分期和预后的相关性,以期在分子水平上更准确判断患者的预后及寻找相应的基因治疗方法提供依据.方法:采用免疫组化SP法对70例大肠癌术后标本的MMP-9及TIMP-1蛋白进行检测.结果:大肠癌MMP-9和TIMP-1蛋白表达存在显著正相关(r=0.397,P＜0.05).MMP-9蛋白阳性表达在不同Dukes分期、浸润深度及淋巴结转移中的大肠癌有显著性差异(P＜0.05,P＜0.01).TIMp-1蛋白阳性表达在不同的组织学类型及分化程度的大肠癌中存在显著性差异(P＜0.05).不同年龄的大肠癌患者MMP-9和TIMP-1蛋白的表达存在显著性差异(P＜0.05).MMP-9蛋白阳性表达组5年生存率低于阴性组(P＜0.05).结论:大肠癌Dukes C期肿瘤组织中MMP-9蛋白的表达明显高于Dukes A期及B期,肿瘤浸润越深,MMP-9蛋白的表达越高.有淋巴结转移的大肠癌患者MMP-9蛋白阳性表达率明显高于无转移患者.在恶性度较低或分化程度较高的肿瘤组织中,其TIMP-1蛋白的阳性率明显较高.MMP-9蛋白阳性表达患者预后较差.MMP-9可作为预测大肠癌侵袭转移及预后的独立指标.     

CD147和MMP-9在乳腺癌中的表达及其与微血管生成的相关性研究

目的:探讨CD147和MMP-9在乳腺癌及癌旁组织中的表达及其与微血管密度(MVD)的关系.方法:应用免疫组化EnVision法检测50例乳腺癌及加例癌旁组织中CD147和MMP-9蛋白的表达情况,用CD34抗体标记乳腺癌血管内皮细胞,计算MVD.结果:乳腺癌组织中CD147的阳性表达率为60%(30/50);MMP-9的阳性表达率为66%(33/50),显著高于癌旁组织(P＜0.01);CD147表达与淋巴结转移、TNM分期显著相关(P＜0.05);与患者的年龄、肿瘤大小无明显相关性(P＞0.05).MMP-9表达与淋巴结转移、TNM分期、组织学分级显著相关(P＜0.05);与患者的年龄、肿瘤大小无明显相关性(P＞0.05).乳腺癌组织中CD147、MMP-9蛋白表达之间存在显著正相关(r=0.630,P＜0.01).CD147、MMP-9阳性的乳腺癌组织MVD高于阴性者,差异有统计学意义(P＜0.01).结论:乳腺癌组织中存在CD147、MMP-9的高表达,两者之间存在显著正相关;CD147蛋白可通过诱导MMP-9蛋白的表达上调,促进乳腺癌侵袭、转移.     

乳腺浸润性导管癌中COX-2、MMP-9的表达及临床意义

目的:探讨COX-2和MMP-9蛋白在乳腺浸润性导管癌组织中的表达及其相关性.方法:应用免疫组织化学法检测52例乳腺癌组织COX-2和MMP-9蛋白的表达.结果:乳腺浸润性导管癌组织中COX-2阳性表达率为76.9%(40/52),MMP-9阳性表达率为82.7%(43/52),COX-2阳性表达与患者的年龄、肿瘤大小、雌孕激素受体无明显相关性(P＞0.05),而与淋巴结转移、TNM分期、组织学分级有关(P＜0.05);MMP-9阳性表达与患者的年龄、雌孕激素受体无明显相关性(P＞0.05),而与肿瘤大小、淋巴结转移、TNM分期、组织学分级有关(P＜0.05);乳腺浸润性导管癌组织中COX-2、MMP-9蛋白的表达之间存在显著正相关(r=0.448,P＜0.01).结论:乳腺浸润性导管癌组织中COX-2、MMP-9蛋白高表达,且两者具相关性.COX-2蛋白可通过诱导MMP-9蛋白的表达上调,增加乳腺癌细胞的侵袭力,促进乳腺癌浸润、转移.     

大肠癌组织中MMP-2和CD147的表达

目的 探讨人大肠癌组织中基质金属蛋白酶-2(MMP-2)和细胞黏附因子CD147的表达与临床病理参数之间的关系.方法 应用免疫组织化学Evision法检测42例大肠癌组织和20例正常大肠黏膜组织中MMP-2和CD147的表达情况.结果 42例大肠癌组织中MMP-2和CD17的表达阳性率分别为92.9%(39/42)和88.1(37/42),明显高于在正常大肠黏膜组织中的阳性率(15.0%和5.0%).MMP-2和CD147在中、低分化癌中的强阳性表达率高于高分化癌(P＜0.01),Dukes分期C、D期的强阳性率明显高于Dukes分期A、B期的强阳性率(P＜0.01),淋巴结转移组的强阳性率高于无淋巴结转移组(P＜0.01).本组研究中MMP-2和CD147的表达一致率为89.7%(35/39),经Spearman等级相关性检验分析,大肠癌组织中MMP-2的表达和CD147的表达之间存在正相关(r=0.783,P＜0.01).结论 MMP-2和CD147的表达与大肠癌的组织学分级、侵润和转移密切相关,可作为判断大肠癌侵袭性的一个指标.     

TFPI-2和MMP-9在非小细胞肺癌中的表达及临床意义

目的：研究组织因子途径抑制物-2（tissue factor pathway inhibitor-2,TFPI-2）、基质金属蛋白酶-9（matrix metalloproteinase-9,MMP-9）在非小细胞肺癌（non-small cell lung cancer,NSCLC）中的表达及之间的相关性.方法：采用免疫组化法检测60例NSCLC组织TFPI-2和MMP-9的表达,并分析TFPI-2和MMP-9的表达水平与性别、年龄、组织类型、分化程度、肿瘤直径、TNM分期及淋巴结转移的关系.结果：NSCLC中临床分期为Ⅰ、Ⅱ、Ⅲ期的患者中TFPI-2表达阳性率分别为75.8％、25.0％和40.0％ （P ＜0.01）,无淋巴结转移和有淋巴结转移的患者中TFPI-2表达阳性率分别为66.7％、38.1％ （P ＜0.01）,肿瘤直径＞5cm和≤5cm的患者TFPI-2表达阳性率分别为15.0％、77.5％ （P ＜0.01）.临床分期为Ⅰ、Ⅱ、Ⅲ期的患者中MMP-9表达阳性率分别为48.5％、83.3％和93.3％ （P＜0.01）,无淋巴结转移和有淋巴结转移的患者中MMP-9表达阳性率分别为56.4％、85.7％ （P ＜0.01）,肿瘤直径＞5cm和≤5cm的患者MMP-9表达阳性率分别为95.0％、52.5％ （P ＜0.01）.NSCLC组织中TFPI-2的低表达与MMP-9的高表达呈负相关（r=-0.476,P=0.001）.结论：TFPI-2的低表达和MMP-9的高表达与NSCLC临床分期、肿瘤大小及淋巴结转移密切相关.TFPI-2可能通过抑制MMP-9的表达,从而抑制NSCLC的生长、浸润和转移.     

RECK基因和基质金属蛋白酶2在食管鳞癌中的表达及其临床病理意义

目的 探讨RECK基因和基质金属蛋白酶2(MMP-2)在食管鳞癌发生、发展中的作用.方法 收集河南省肿瘤医院食管鳞癌标本57例,同时取患者相应的癌旁正常食管黏膜组织作为对照.应用组织芯片法与免疫组织化学法,检测每例食管鳞痛标本和正常食管黏膜组织中RECK和MMP-2的表达情况.结果 RECK在食管鳞癌组织中的表达率为36.8%(21/57),在正常食管黏膜组织中的表达率为61.4%(35/57),两组间差异有统计学意义(χ2=6.879,P＜0.05);RECK的表达与患者的年龄、性别、肿瘤组织学分级、淋巴结转移无关(均P＞0.05),但与临床病理分期有关(P＜0.05).MMP-2在食管鳞癌组织中的阳性表达率为42.1%(24/57),在正常食管黏膜组织中的阳性表达率为19.3%(11/57),两组间差异有统计学意义(χ2=6.968,P＜0.05);MMP-2的表达与患者的年龄、性别、肿瘤组织学分级无关(均P＞0.05),但与肿瘤临床病理分期和肿瘤淋巴结转移有关(P＜0.05).此外,RECK和MMP-2在食管鳞癌中阳性表达差异无统计学意义(P＞0.05).结论 RECK和MMP-2的异常表达在食管鳞癌的发生中有重要作用,RECK的低表达和MMP-2的高表达与食管鳞癌临床病理进展有关.     

VEGF与MMP-2在大肠癌组织的表达及相互关系的研究

目的：检测血管内皮生长因子(vascular endothelial growth factor，VEGF)和基质金属蛋白酶-2(matrix metalloproteinase-2，MMP-2)在大肠癌组织中的表达及其与肿瘤进展的关系。方法：应用免疫组化SP法检测了18例正常大肠黏膜、18例大肠腺瘤样息肉和51例大肠癌组织中VEGF、MMP-2的表达。结果：大肠腺瘤样息肉、大肠癌中VEGF、MMP-2阳性表达率显著高于正常大肠黏膜组织，P＜0．05。VEGF、MMP-2阳性袁达率与大肠癌的淋巴结转移、Duke’s分期有关，P＜0．05。VEGF、MMP-2在大肠癌中的表达有相关性，P＜0．05。结论：VEGF、MMP-2可能成为反映大肠癌进展的生物学指标及其治疗的理想靶点。     

食管癌组织KLF4和Survivin蛋白表达及其相关性研究

目的:通过对KLF4和Survivin蛋白在食管癌中表达的研究,结合临床病理特征,探讨KLF4和Survivin的临床意义及相关性.方法:应用免疫组织化学SP法检测85例食管癌组织及正常食管黏膜中KLF4和Survivin的表达.结果:KLF4在癌旁正常黏膜阳性表达率为89.4％,食管癌组织为42.3％(P＜0.05).低、中高分化癌的阳性表达率差异有统计学意义,P＜0.05;有、无淋巴结转移者的阳性表达率分别为30.4％和56.4％(P＜0.05);与肿瘤WHO临床分期之间有统计学意义,P＜0.05.随着临床分期等级的增加,KLF4表达呈现递减趋势;与患者的性别、年龄无关(P＞0.05).Survivin在食管癌组织的阳性表达率为53.0％,癌旁正常黏膜为7.1％(P＜0.05);低、中高分化癌的阳性表达率无统计学意义,P＞0.05;有、无淋巴结转移者的阳性表达率分别为65.2％和38.4％(P＜0.05);其表达与肿瘤的临床分期差异有统计学意义,P＜0.05,与患者的性别、年龄无关(P＞0.05).Survivin和KLF4在食管癌中的表达呈负相关(r=-0.337,P＜0.01).结论:KLF4低表达及Survivin的过表达与食管癌的发生及其生物学行为密切相关,可作为食管癌诊断及分期预后的客观指标.     

鼻咽癌中Maspin和Bmi-1基因表达及其临床意义

目的 探讨鼻咽癌组织中Maspin和Bmi-1的表达及其与临床病理特征的关系。方法 应用免疫组织化学法检测Maspin和Bmi-1在60例鼻咽癌及40例正常鼻咽组织中的表达情况,探讨两者表达的相关性及与鼻咽癌临床病理特征的关系。结果 Maspin在鼻咽癌及正常鼻咽组织中的阳性表达率分别为45.0%（27/60）和90.0%（36/40）,差异有统计学意义（P＜0.05）。Bmi-1在鼻咽癌及正常鼻咽组织中的阳性表达率分别为75.0％（45／60）和25.0％（10／40）,差异有统计学意义（P＜0.05）。Maspin和Bmi-1表达与年龄无关（P＞0.05）,而与肿瘤分化程度、淋巴结转移及临床分期有关 （P＜0.05）。Maspin与Bmi 1在鼻咽癌组织中的表达呈负相关（r=-0.406,P＜0.05）。结论 Maspin和Bmi-1表达可能在鼻咽癌的发生、增殖和转移中起重要作用。     

P38蛋白在大肠癌中的表达及其临床意义

目的:探讨人大肠癌中有丝分裂原激活蛋白激酶P38的表达及其临床意义.方法:应用免疫组织化学SABC法检测46例大肠癌组织及其癌旁正常粘膜中P38蛋白表达情况.结果:P38蛋白的表达定位于胞质中,胞核中无表达.P38在大肠癌中的阳性表达率为95.65%,在癌旁组织中阳性表达率为33.13%.P38在大肠癌中的表达明显高于癌旁组织,有显著的统计学差异(P＜0.01).P38的表达与年龄、性别、肿瘤大小、肿瘤位置无明显相关(P＞0.05).P38的表达与Dukes分级,组织分化程度及有无淋巴结转移有显著差异(P＜0.01).结论:大肠癌组织中P38蛋白处于过度表达状态,与大肠癌的发生,发展和转移密切相关.     

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.     

Fruit and vegetables and cancer risk

The possibility that fruit and vegetables may help to reduce the risk of cancer has been studied for over 30 years, but no protective effects have been firmly established. For cancers of the upper gastrointestinal tract, epidemiological studies have generally observed that people with a relatively high intake of fruit and vegetables have a moderately reduced risk, but these observations must be interpreted cautiously because of potential confounding by smoking and alcohol. For lung cancer, recent large prospective analyses with detailed adjustment for smoking have not shown a convincing association between fruit and vegetable intake and reduced risk. For other common cancers, including colorectal, breast and prostate cancer, epidemiological studies suggest little or no association between total fruit and vegetable consumption and risk. It is still possible that there are benefits to be identified: there could be benefits in populations with low average intakes of fruit and vegetables, such that those eating moderate amounts have a lower cancer risk than those eating very low amounts, and there could also be effects of particular nutrients in certain fruits and vegetables, as fruit and vegetables have very varied composition. Nutritional principles indicate that healthy diets should include at least moderate amounts of fruit and vegetables, but the available data suggest that general increases in fruit and vegetable intake would not have much effect on cancer rates, at least in well-nourished populations. Current advice in relation to diet and cancer should include the recommendation to consume adequate amounts of fruit and vegetables, but should put most emphasis on the well-established adverse effects of obesity and high alcohol intakes.     

Occupational and environmental radiation and cancer

Epidemiologic evidence on the relation between occupational and environmental radiation and cancer is reviewed. Studies of pioneering radiation workers, underground miners, and radium dial painters revealed excess cancer deaths and contributed to the setting of radiation protection standards and to theories of carcinogenesis. Occupational exposures today are generally much lower than in the past, thus any associated increases in cancer will be difficult to detect. Pooling investigations of these more recently exposed workers, however, has the potential to validate current estimates of risk used in radiation protection. New information on the effects of chronic radiation exposure also may come from studies in the former Soviet Union of Chernobyl clean-up workers and of workers at the Mayak nuclear facilities. Studies of environmental radiation exposures, other than radon, are largely inconclusive, due mainly to the difficulties in detecting the low risks associated with low dose exposures. Thyroid cancer, however, has been linked to environmental radiation from the Chernobyl accident and from nuclear weapons tests. Low-level radiation released during normal operations at nuclear plants has not been found to increase cancer rates in surrounding populations. Radon, a human carcinogen, is the most ubiquitous exposure to human populations; remediating high residential-radon levels is recommended, recognizing that the exposure can never be removed completely because it occurs naturally.     

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。     

Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: A comprehensive review and meta-analysis

Vitamin D is formed mainly in the skin upon exposure to sunlight and can as well be taken orally with food or through supplements. While sun exposure is a known risk factor for skin cancer development, vitamin D exerts anti-proliferative and pro-apoptotic effects on melanocytes and keratinocytes in vitro. To clarify the role of vitamin D in skin carcinogenesis, we performed a review of the literature and meta-analysis to evaluate the association of vitamin D serum levels and dietary intake with cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) risk and melanoma prognostic factors. Twenty papers were included for an overall 1420 CM and 2317 NMSC. The summary relative risks (SRRs) from random effects models for the association of highest versus lowest vitamin D serum levels was 1.46 (95% confidence interval (CI) 0.60–3.53) and 1.64 (95% CI 1.02–2.65) for CM and NMSC, respectively. The SRR for the highest versus lowest quintile of vitamin D intake was 0.86 (95% CI 0.63–1.13) for CM and 1.03 (95% CI 0.95–1.13) for NMSC. Data were suggestive of an inverse association between vitamin D blood levels and CM thickness at diagnosis. Further research is needed to investigate the effect of vitamin D on skin cancer risk in populations with different exposure to sunlight and dietary habits, and to evaluate whether vitamin D supplementation is effective in improving CM survival.     

肾上腺素能β受体与肿瘤生长及转移

大量研究表明肿瘤细胞可表达β受体，而一些神经递质、药物和社会心理因素可能通过β受体影响肿瘤的生长和转移，β受体激动剂、β受体阻滞剂以及抑郁等社会心理因素可加强或削弱这种作用。这为表达β受体肿瘤的治疗开辟了新的道路，提供了新的治疗靶点。     

Cell and tissue interactions in carcinogenesis and metastasis and their clinical significance

This review describes a new vision for future directions in the study of metastatic cancer biology and pathology. It is based upon clinical and experimental observations on the constituent cell lineages within a neoplasm and on tumour-host interactions. The vision incorporates information from studies in population biology, developmental biology and experimental pathology as well as investigations upon human malignant disease. The assembled information reveals that invasion and metastasis are supra-cellular manifestations of "emergent behavior" among combinations of normal and malignant cell lineages in vivo. Emergent behavior is a combinatorial interactive process in which a population displays new traits which cannot be achieved by individuals acting separately and which subside when the specific population mix disaggregates. Disruption of such pathological interactions in the field of a developing primary or secondary tumour is, therefore, required to disable the malignant population and arrest progression without tissue destruction. These conclusions originate, in part, from principles which govern the sociobiology and group behavior of bees, ants, fish, birds and human societies. In all these social organisms, external factors can disrupt signaling mechanisms and induce expanding self-perpetuating rogue behavior, leading to social disintegration. These principles also apply to cellular societies composing higher animals, which likewise need intrinsic rules to maintain social order and avoid anarchy, and recognition of this is essential for advancing future research on the mechanisms involved in carcinogenesis and metastasis. Summarised evidence is presented here to support the conclusion that miscommunications between cells and tissues in the region of the developing tumour and its metastases are the main direct perpetrators of malignant disease. Genetic lesions (mutations, deletions, translocations, reduplications, etc.), commonly seen in cancers, can significantly disrupt important molecular pathways in the networks of communications needed to sustain orderly tissue/organ structure and function. However, genetic lesions can also, themselves, be induced by abnormal cell interactions initiated by extrinsic carcinogenic agents such as chemicals, viruses, hormones and radiation. The evidence shows that, irrespective of the initiating cause, it is this miscommunication in the region of a developing tumour and its metastases that is ultimately responsible for the emergence and progression of the disease. The article describes how this information collectively, provides a framework for designing specific novel therapeutic approaches targeting the cell and tissue interactions driving tumour metastasis and its manifold effects on the whole body.