胃癌及癌前病变细胞凋亡与Caspase-9，Bax表达的关系

目的：探讨细胞凋亡基因Caspase-9和Bax在胃癌前病变和胃癌发展中的作用。方法：应用免疫组化S—P法检测Caspase-9和Bax在57例胃癌及48例非癌胃黏膜组织的表达,用原位末端标记法（TUNEL法）检测相应胃组织细胞凋亡。结果：Caspase-9蛋白在非癌胃黏膜组（慢性浅表性胃炎、慢性萎缩性胃炎、肠上皮化生、不典型增生）阳性表达率分别为100．00％、86．67％、50．00％、42．85％,呈逐渐下降趋势。慢性浅表性胃炎组中Caspase-9蛋白阳性表达率与肠上皮化生、不典型性增生有显著性差异（P〈0．05）,肠上皮化生组Caspase-9蛋白阳性表达率高于不典型增生组,但无统计学差异（P〉0．05）。Bax蛋白在48例非癌胃组织中的阳性表达率分别为：慢性浅表性胃炎100．00％、慢性萎缩性胃炎80．00％、肠上皮化生56．25％、不典型增生57．14％,呈逐渐下降趋势,其中慢性浅表性胃炎组Bax蛋白阳性表达率与肠上皮化生、不典型增生有显著性差异（P〈0．05）。慢性浅表性胃炎、慢性萎缩性胃炎、肠匕皮化生、不典型增生、胃癌组织中,AI值（细胞凋亡指数）分别为（14．72±2．68）％、（10．02±2．34）％、（7．55±2．80）％、（6．09±2．35）％、（3．26±1．23）％,呈逐渐下降趋势,有显著性差异（P〈0．05）。结论：Caspase-9和Bax可能参与胃癌癌前病变的形成,促进胃癌的发生。     

癌前病变Caspase-3表达下调与胃黏膜癌变的关联

目的观察Caspase-3蛋白在胃癌及其癌前病变组织中的表达,分析它与细胞凋亡和细胞增殖的关系,探讨Caspase-3蛋白在胃癌发生过程中的生物学意义及相关分子病理学机制。方法选取184例胃黏膜活检和手术切除组织标本,其中胃癌20例,慢性萎缩性胃炎6例,萎缩性胃炎伴肠上皮化生(简称肠上皮化生)31例,萎缩性胃炎伴不典型增生(简称不典型增生)114例;正常对照13 例。采用SABC法检测Caspase-3蛋白的表达;通过图像域值分析计算其阳性指数,分析其与细胞增殖(Ki67蛋白阳性指数)和凋亡(TUNEL指数)的相关关系。结果 Caspase-3蛋白在重度不典型增生组织中的阳性指数(29．8％±3．9％)显著低于轻度(58．3％±4．2％)和中度不典型增生(50．4％± 4．8％)及萎缩性胃炎(68．3％±3．3％)或肠上皮化生(70．9％±4．3％),差异有统计学意义(P<0．05); 而与胃癌(26．9％±3．0％)相比,差异无统计学意义(P>0．05)。Caspase-3蛋白表达与细胞凋亡呈显著正相关(r=0．94,P<0．05),Caspase-3蛋白阳性组细胞增殖指数(18．3％±2．2％)显著低于阴性组(48．9％±3．1％;P<0．05)。结论 Caspase-3蛋白在萎缩性胃炎、肠上皮化生和(或)轻中度不典型增生黏膜中表达上调,而在重度不典型增生及胃癌组织中表达下调,且这种变化与细胞凋亡呈显著正相关。Caspase-3失活或表达下调相关的细胞凋亡和增殖紊乱可能在胃黏膜损伤及癌变过程中起某种作用。     

RASSF1A在胃癌中的甲基化检测及表达

目的:探讨RASSF1A基因在胃癌及癌前病变组织中的表达及与启动子区甲基化的关系.方法: RT-PCR方法检测40例胃癌、20例中-重度慢性萎缩性胃炎伴肠上皮化生和不典型增生组织及20例癌旁正常组织RASSF1A mRNA表达,甲基化特异性PCR方法检测RASSF1A启动子区CpG岛甲基化状态;Western blot方法检测RASSF1A蛋白表达.结果: RASSF1AmRNA和蛋白表达水平在胃腺癌组织中明显低于中-重度慢性萎缩性胃炎伴肠上皮化生和不典型增生组及癌旁正常组织;RASSF1A在胃癌组织、中-重度慢性萎缩性胃炎伴肠上皮化生和不典型增生组织和正常组织中的甲基化频率分别为80%、25%和5%, 差异有显著性 (P<0.01);在胃癌组织中,RASSF1A mRNA阳性表达组甲基化明显低于表达缺失组.结论: 胃癌组织RASSF1A mRNA和蛋白表达缺失或低下与其启动子甲基化程度增高有关,启动子甲基化参与了胃癌的发生发展.     

环氧合酶-2在胃癌与癌前病变和其他胃黏膜组织中表达的研究

目的:研究胃癌与癌前病变和其他胃黏膜组织中环氧合酶-2(COX-2)的表达情况,探讨COX-2蛋白作为肿瘤分子标记物对胃癌和癌前病变进行辅助诊断的意义.方法:收集胃镜活检的正常胃黏膜、慢性浅表性胃炎、慢性萎缩性胃炎、胃黏膜肠化生、胃黏膜不典型性增生和胃癌组织,用免疫组织化学染色法检测COX-2蛋白在各种组织中的阳性表达情况.以正常胃黏膜组织和正常兔血清作阴性对照.结果:COX-2蛋白在胃癌前病变和和胃癌组织中的表达阳性率为48%-84%.胃癌和胃黏膜不典型性增生标本中COX-2蛋白表达阳性率显著高于正常胃黏膜、慢性浅表性胃炎、慢性萎缩性胃炎和胃黏膜肠上皮化生标本(P<0.05).而胃癌组织COX-2蛋白表达的阳性率与胃黏膜不典型性增生组之间无显著性差异(P>0.05).此外,慢性萎缩性胃炎和胃黏膜肠化生标本与正常胃黏膜和慢性浅表性胃炎标本之间COX-2蛋白表达阳性率亦有显著性差异(P<0.05);所有病变组的COX-2蛋白表达阳性率均比正常胃黏膜组显著性地升高 (P<0.05).结论:胃癌与癌前病变组织中COX-2蛋白的表达显著升高,COX-2蛋白可作为肿瘤标记物对胃癌和胃癌前病变进行辅助诊断.     

CREB1和CREB3在胃癌及癌前病变组织中的表达及其临床意义

目的 探究环磷腺苷反应元件结合蛋白1(CREB1)和环磷腺苷反应元件结合蛋白3(CREB3)在胃癌及癌前病变组织中的表达及临床意义。方法 收集慢性浅表性胃炎40例,慢性萎缩性胃炎伴肠化生40例,异型增生40例,胃癌50例,采用免疫组化法检测CREB1和CREB3在四种组织中的表达,并分析其与临床病理参数的关系。另收集同期新鲜组织慢性浅表性胃炎、慢性萎缩性胃炎伴肠化生、胃癌共30例,应用蛋白印迹法(Western blot)检测CREB1和CREB3在不同胃组织中的表达。利用Kaplan-Meier plotter分析CREB1和CREB3的表达与胃癌患者总生存时间(OS)和无进展生存时间(FP)的相关性。利用STRING数据库分析CREB1和CREB3在信号通路中的位置以及与之相关的上下游基因。结果 免疫组化显示：胃癌组、异型增生组、萎缩性胃炎伴肠化生组CREB1、CREB3阳性表达率明显高于慢性浅表性胃炎组(P<0.05);并且CREB1、CREB3在胃癌组的阳性表达率明显高于慢性萎缩性胃炎伴肠化生组(P<0.05),但与异型增生组无统计学差异(P>0.05)。临床...     

表皮生长因子受体在胃癌及癌前病变中的表达及意义

[目的]探讨表皮生长因子受体(EGFR)表达在胃癌发生中的作用及与胃癌侵袭转移之间的关系。[方法]运用免疫组化SP法研究50例胃癌、20例不典型增生、20例慢性萎缩性胃炎伴肠化生和20例慢性浅表性胃炎EGFR的表达。[结果]慢性萎缩性胃炎伴肠化生组、不典型增生组和胃癌组中EGFR表达明显高于慢性浅表性胃炎组<0.05和P<0.01)。胃癌中EGFR表达与癌浸润深度和淋巴结转移呈正相关(P<0.05)。[结论]EGFR在胃癌发生中起一定的作用。EGFR表达阳性的胃癌前病变可能有较高的癌变易感性；胃癌组织中EGFR的表达可作为预测预后的指标。     

syndecan-1在胃黏膜癌变不同阶段组织中的表达及意义

目的探讨黏附分子syndecan-1在胃癌癌变各阶段的表达及其在胃癌发生和转移中的意义。方法选取56例慢性浅表性胃炎、50例慢性萎缩性胃炎、59例肠化生、61例中重度异型增生、55例无淋巴结转移胃癌、57例有淋巴结转移胃癌的病理组织蜡块,采用免疫组化ABC法检测syndecan-1在胃黏膜癌变各阶段组织中的表达。结果慢性浅表性胃炎组、慢性萎缩性胃炎组、肠化生组、中重度异型增生组、无淋巴结转移胃癌组、有淋巴结转移胃癌组syndecan-1阳性表达率分别为96.43%、98.00%、100.00%、91.80%、45.45%和24.56%。慢性浅表性胃炎组、慢性萎缩性胃炎组、肠化生组3组间差异无统计学意义(P>0.05);肠化生组与中重度异型增生组、中重度异型增生组与无淋巴结转移胃癌组、无淋巴结转移胃癌组与有淋巴结转移胃癌组之间差异均有统计学意义(P均< 0.05)。低分化胃癌组syndecan-1阳性表达率为24.62%,明显低于中、高分化胃癌组(42.55%)。结论黏附分子syndecan-1表达下调与胃癌的发生有关,并可能进一步促进胃癌转移。     

胃癌和胃癌前病变中NHE1蛋白的表达及其意义

目的探讨NHE1蛋白在胃癌和胃癌前病变中的表达及意义。方法对收集的65例各类胃病标本的NHE1蛋白表达进行检测,高倍镜视野下阳性细胞数占视野10%以下视为阴性,10%以上视为阳性。结果在65例标本中,NHE1蛋白阳性表达率在正常胃黏膜中0%(0/10);异型增生20.00%(1/5);肠上皮化生23.08%(3/13);慢性萎缩性胃炎16.67%(2/12);胃癌80.00%(20/25)。胃癌与正常胃黏膜和各型胃癌前病变相比,差异具有统计学意义(P<0.01)。结论 NHE1在慢性萎缩性胃炎、肠上皮化生、异型增生中的表达不断上调,在胃癌组织中NHE1蛋白超表达;NHE1可能是肿瘤治疗的一个有效的靶点。     

金属蛋白酶组织抑制剂-3在胃癌和胃癌前病变中的表达

目的探讨金属蛋白酶组织抑制剂-3(TIMP-3)在胃癌发生、发展中的作用。方法用免疫组化SABC法检测了TIMP-3蛋白在54例慢性浅表性胃炎、16例慢性萎缩性胃炎(伴肠上皮化生、不典型增生)、67例胃癌中的表达。结果胃癌和慢性萎缩性胃炎中TIMP-3蛋白表达水平减低,且胃癌组的TIMP-3表达水平更低,胃癌病理分级与TIMP-3蛋白表达水平呈负相关。结论 TIMP-3表达减低可能在胃癌的早期发生中发挥一定作用;另外,TIMP-3有望作为恶性程度的指标用于胃癌的临床诊断。     

p21WAF1/CIP1和p53蛋白表达在胃癌发生发展过程中的研究

目的研究p21WAF1/CIP1和p53蛋白在胃癌发生发展过程中的作用及表达的临床病理意义.方法采用免疫组化SP法对正常胃粘膜、萎缩性胃炎伴肠上皮化生、萎缩性胃炎伴不典型增生组织各20例和78例胃癌组织标本进行p21WAF1/CIP1和p53蛋白检测.结果胃癌组织中p53蛋白阳性表达率高于正常胃粘膜、萎缩性胃炎伴肠上皮化生和不典型增生组(P＜0.05),而p21WAF1/CIP1蛋白阳性表达低于正常胃粘膜、萎缩性胃炎伴肠上皮化生组(P＜0.01)p21WAF1/CIP1、p53蛋白表达与胃癌的分化程度相关(P＜0.05);有淋巴结转移组p21WAF1/CIP1蛋白表达率低于无淋巴结转移组(P＜0.05),而有淋巴结转移组p53蛋白表达率高于无淋巴结转移组(P＜0.05);p53蛋白表达与胃癌浸润深度有关.结论p53蛋白高表达与p21WAF1/CIP1蛋白失表达可能参与胃癌的发生发展过程;检测p53和p21WAF1/CIP1蛋白作为反映胃癌病理学特点的参考指标可能有一定意义;p21WAF1/CIP1蛋白表达在胃癌可能存在非p53诱导表达途径.     

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.     

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。     

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。     

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.     

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.     

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.