血清白蛋白及尿素氮水平与肺癌不同临床病理特征和预后的关系

背景与目的 肺癌作为全球男女性中致死率最高的肿瘤之一,严重威胁着人类的健康.本研究旨在分析肺癌患者血清白蛋白及尿素氮水平与临床病理特征及生存期的关系.方法 收集2008年1月-2013年12月四川大学华西医院病理确诊原发性肺癌患者1,098例,检测患者血清中白蛋白及尿素氮水平,按检测水平是否正常分为阳性组及阴性组,分别分析白蛋白及尿素氮水平与肺癌临床病理特征及生存期的相关性.结果 1,098例患者的年龄、性别、病理学分型、肝转移、胸膜转移与血清白蛋白水平差异有统计学意义(P<0.05);312例鳞癌患者的年龄、肺内转移以及612例腺癌患者的年龄、性别、临床分期、胸膜转移与白蛋白水平差异有统计学意义(P<0.05).尿素水平与各临床特征均无统计学意义.不同病理学类型的肺癌患者血清白蛋白水平在阴性组与阳性组中位生存时间分别为鳞癌36个月和19个月,腺癌35个月和15个月,前者中位生存期明显高于后者.尿素氮水平与肺癌患者生存期无相关性.结论 多种影响因素与血清白蛋白阳性程度相关,血清白蛋白水平与肺癌的生存相关,其是肺癌患者预测预后的一个指标.     

Ⅲa期肺鳞癌生存因素分析

目的 分析Ⅲa期肺鳞癌的治疗模式.方法 回顾性分析102例Ⅲa期肺鳞癌患者的病历资料,并对临床信息及治疗情况等因素对患者生存的影响进行分析.结果 102例Ⅲa期肺鳞癌患者中,行根治性手术患者65例(63.7%),非根治性手术患者37例(36.3%).根治性手术组与非根治性手术组患者的中位OS分别为27.9个月和19.0个月,差异有统计学意义(P=0.005).单因素分析结果显示:N2淋巴结转移个数和N2淋巴结转移组数对行根治性手术的Ⅲa/N2期肺鳞癌患者的OS有影响(P<0.05),而N2淋巴结转移个数≥3个的患者术后死亡风险更高(RR=3.342).结论 对于Ⅲa期肺鳞癌患者,如果患者体力情况较好,建议行手术治疗.纵隔N2淋巴结转移个数是影响患者术后生存率的主要因素.     

大肠癌血管内皮生长因子检测与肝转移相关性研究

目的:探讨检测血清中血管内皮生长因子(VEGF)水平在判断直肠癌发生肝转移中的价值。方法:用ELISA法测定42例直肠癌患者和30例正常人血清VEGF水平。直肠癌患者术后随访6个月,按照是否发生肝转移分为3个研究组:肝转移组12例,无肝转移组30例,正常对照组30例。结果:3组血清VEGF中位数分别为587.9pg/mL、257.3pg/mL和168.0pg/mL。肝转移组血清VEGF水平明显高于无转移组和对照组(P<0.05),而无转移组和对照组差异无显著性(P>0.05)。结论:血清VEGF与直肠癌的远位转移生长有关。     

血清1,25-二羟维生素D3水平与肺癌临床病理特征及预后的关系

目的探讨血清1,25-二羟维生素D3水平与肺癌临床病理特征及预后的关系。方法将103例肺癌患者纳入肺癌组,另将同期体检的62例健康体检者作为对照组,采集2组晨起空腹外周静脉血,应用酶联免疫吸附法(ELISA)检测血清1,25-二羟维生素D3水平,比较2组血清1,25-二羟维生素D3水平,并分析肺癌患者血清1,25-二羟维生素D3水平与临床病理特征及预后的关系。结果ELISA检测结果显示,肺癌组的血清1,25-二羟维生素D3水平[(29.24±5.37)μg/l]明显低于对照组[(40.16±6.26)μg/l],2组相比差异具有统计学意义(P<0.05)。不同性别、年龄、肿瘤直径、病理分型的肺癌患者血清1,25-二羟维生素D3水平相比,差异无统计学意义(P>0.05);但不同TNM分期、组织分化程度、有无淋巴结转移及远端转移的肺癌患者血清1,25-二羟维生素D3水平相比,差异有统计学意义(P>0.05)。1,25-二羟维生素D3缺乏组(≤20μg/l)2年生存率为30.00%(18/60),正常组(>20μg/l)患者的2年生存率为63.83%(30/47),缺乏组患者2年生存率明显低于正常组患者(P<0.05)。结论血清1,25-二羟维生素D3水平降低可能与肺癌的发生及恶性程度有关,提高1,25-二羟维生素D3水平可能有助于改善肺癌患者的预后。     

EphA2蛋白在新疆哈萨克族与汉族食管鳞癌组织及血清中的表达及意义

背景与目的：哈萨克族食管癌发病率高于汉族。EphA2是在促红细胞生成素产生肝细胞(erythropoietin-producing human hepatocellular,Eph)中发现的具有酪氨酸酶活性的基因编码产物,与多种恶性肿瘤有关。本研究拟采用免疫组化法及酶联免疫吸附实验法(ELISA)检测EphA2蛋白在哈萨克族和汉族食管鳞癌患者肿瘤组织及血清中的表达,从而探讨EphA2蛋白在新疆哈萨克族和汉族食管鳞癌组织和血清中表达水平的差异及其与临床病理特征之间的关系。方法：采用免疫组织化学法检测EphA2蛋白在100例新疆哈萨克族和汉族食管鳞癌组织(患者组)及其对应的癌旁食管组织(对照组,距瘤>5 cm)中的表达;并采用ELISA法测定患者组血清中EphA2蛋白含量及60名体检健康者(健康对照组)血清中EphA2蛋白表达水平。结果：EphA2蛋白在哈萨克族患者食管鳞癌组织及对应癌旁组织中阳性表达率分别为72.0%和28.0%,在汉族中分别为62.0%和26.0%,在两民族中该蛋白在食管鳞癌组织及对应癌旁组织中的表达差异均有统计学意义(P=0.000)。EphA2蛋白在哈萨克族患者组及健康对照组血清中的表达水平分别为(58.36±12.60)和(29.39±7.34) pg/mL,在汉族中分别为(58.79±13.29)和(29.39±7.34) pg/mL,该蛋白在患者组及健康对照组血清含量差异均有统计学意义(P=0.000)。在两民族食管癌组织中,EphA2蛋白的表达水平与淋巴结转移、TNM分期及肿瘤浸润深度有关(P<0.05)。在两民族食管鳞癌患者血清中,EphA2蛋白的表达水平与TNM分期均有关(P<0.05),而在哈萨克族食管癌患者血清中,该蛋白表达水平还与肿瘤的浸润深度有关(P=0.001)。EphA2蛋白在哈萨克族和汉族食管鳞癌组织标本和血清中的表达水平差异均无统计学意义(P>0.05)。结论：EphA2蛋白的高表达可能促进哈萨克族和汉族食管癌的发生、浸润及转移。EphA2蛋白在食管癌患者组织及血清中的高表达可能与原发灶浸润深度、淋巴结转移及TNM分期有关。另外EphA2蛋白在哈萨克族食管癌患者外周血中的高表达可能与其浸润深度有关。     

非小细胞肺癌组织p53蛋白Ser15磷酸化表达的研究

[目的]探讨人非小细胞肺癌组织中突变型p53蛋白15位丝氨酸位点（p53Ser15）的磷酸化状况,p53Ser15磷酸化、p53蛋白和血清p53抗体水平之间的关联以及与非小细胞肺癌临床病理特征和预后的关系。[方法]应用酶联免疫吸附实验（ELISA）检测40例非小细胞肺癌组织、相应正常肺组织及10例肺良性疾病组织中p53Ser15磷酸化、p53蛋白以及血清p53抗体水平。随访观察40例非小细胞肺癌组的转移复发情况。[结果]p53Ser15磷酸化、p53蛋白水平在非小细胞肺癌组高于正常肺组织组和肺部良性疾病组,差异有统计学意义（P〈0.05,P〈0.01）。非小细胞肺癌组p53Ser15磷酸化、p53蛋白及血清p53抗体水平两两之间均有正相关性（P〈0.05）。非小细胞肺癌组中p53抗体阳性率为42.5%,在鳞癌中的阳性率高于腺癌和腺鳞癌（P〈0.05）。随访期内5例出现复发或远处转移的病例p53Ser15磷酸化、p53蛋白表达水平高于未复发转移病例（P〈0.05）。[结论]突变型p53蛋白在人体内也可如野生型p53一样被磷酸化,而且这种磷酸化有助于突变型p53蛋白的稳定。p53Ser15磷酸化及p53蛋白高水平表达可能会有助于肿瘤进展更快。     

新疆地区汉族、维吾尔族晚期非小细胞肺癌患者血清中CA125表达的差异性

目的:通过对晚期非小细胞肺癌患者血清中CA125的监测,探讨在维吾尔族、汉族晚期非小细胞肺癌患者之间其表达是否有差异性。方法:新疆维吾尔自治区人民医院2010年5月-2012年12月确诊的晚期非小细胞肺癌患者101例,其中维吾尔族50例,汉族51例,采用全自动免疫化学发光仪检测血清CA125的水平,与我院体检中心体检合格的汉族及维吾尔族健康者各50例进行比较。结果:汉族、维吾尔族健康组CA125与同民族晚期非小细胞肺癌组CA125结果比较,差异有统计学意义（P<0.05）。汉族Ⅲ期、Ⅳ期非小细胞肺癌组CA125与维吾尔族同期别非小细胞肺癌组CA125结果比较,差异无统计学意义（P>0.05）。汉族与维吾尔族晚期肺鳞癌组、肺非鳞癌组CA125结果比较,差异无统计学意义（P>0.05）。结论:CA125在汉族、维吾尔族健康人群与同民族晚期非小细胞肺癌患者血清中的表达有差异。CA125在汉族与维吾尔族Ⅲ期、Ⅳ期非小细胞肺癌及肺鳞癌、肺非鳞癌患者血清中的表达无差异。     

新疆地区汉族、维吾尔族晚期非小细胞肺癌患者血清中CEA表达的差异性研究

目的：通过对晚期非小细胞肺癌患者血清中CEA的监测,探讨在维吾尔族、汉族晚期非小细胞肺癌患者之间其表达是否有差异性。方法：新疆维吾尔自治区人民医院2005年5月-2010年5月确诊的晚期非小细胞肺癌患者101例,其中维吾尔族50例,汉族51例,采用全自动免疫化学发光仪检测血清CEA的水平,与我院体检中心体检合格的汉族及维吾尔族健康者各50例进行比较。结果：汉族、维吾尔族健康组CEA与同民族晚期非小细胞肺癌组CEA结果比较差异均有统计学意义（P〈0.05）;汉族Ⅲ期、Ⅳ期非小细胞肺癌组CEA与维吾尔族同期别非小细胞肺癌组CEA结果比较差异均无统计学意义（P〉0.05）;汉族与维吾尔族晚期肺鳞癌组、肺非鳞癌组CEA结果比较差异均无统计学意义（P〉0.05）。结论：CEA在汉族、维吾尔族健康人群与同民族晚期非小细胞肺癌患者血清中的表达有差异;CEA在汉族与维吾尔族Ⅲ期、Ⅳ期非小细胞肺癌及肺鳞癌、肺非鳞癌患者血清中的表达无差异。     

中性粒细胞弹性蛋白酶与结肠癌肝、肺转移的关系

目的 探讨中性粒细胞弹性蛋白酶(neurtophil elastase,NE)与结肠癌肝、肺转移的关系.方法 选择进行手术切除的120例结肠癌患者为研究对象,根据癌症是否发生转移,分为结肠癌不转移组(n=52)、结肠癌肝转移组(n=32)、结肠癌肺转移组(n=36).采用ELISA法测定3组患者血清及组织上清中NE、IL-6和TNF-α水平,并进行比较,同时进行NE与IL-6和TNF-α相关性的分析.结果 ①结肠癌患者NE、IL-6及TNF-α明显高于正常对照组(P＜0.05).结肠癌不转移患者NE、IL-6及TNF-α明显低于结肠癌肝转移和结肠癌肺转移患者NE的水平,差异具有统计学意义(P＜0.05),但NE、IL-6及TNF-α的水平在结肠癌肝转移和结肠癌肺转移患者之间均无统计学差异(P＞0.05).②相关性的分析结果显示,NE与IL-6(y =0.9919,P=0.0009)及TNF-α(γ=0.9587,P=0.01)呈明显的正相关.结论 中性粒细胞弹性蛋白酶的水平与结肠癌发生侵袭转移密切相关,特别是肝、肺的转移.     

血清CYFRA21-1、SCC-Ag、LDH联合检测对肺鳞癌与肺部感染鉴别诊断的价值初探

目的:探讨血清SCC-Ag、CYFRA21-1、LDH联合检测对肺鳞癌与肺部感染鉴别诊断的价值。方法:回顾性分析2017年1月至2018年3月北京市和平里医院消化科及呼吸科住院或门诊就诊的110例患者,其中肺鳞癌患者55例,肺部感染患者55例,使用化学发光法和速率法分别检测血清CYFRA21-1、SCC-Ag、LDH表达水平,以及肺鳞癌患者Ⅰ-Ⅳ期CYFRA21-1、SCC-Ag表达水平,经统计学处理后对比分析。结果:肺鳞癌组患者血清CYFRA21-1高于肺部感染组患者,差异有统计学意义(P<0.05);同时肺部感染组患者血清SCC-Ag表达高于肺鳞癌组,有统计学差异(P<0.05);Ⅰ期、Ⅱ期肺鳞癌组患者血清CYFRA21-1较Ⅳ期患者相比差异显著,随着肿瘤的进展,血清CYFRA21-1、SCC-Ag均有上升的趋势;肺鳞癌组患者血清LDH表达水平显著高于肺部感染组患者(P<0.01)。结论:独立的每个肿瘤标志物因其自身的特异性和敏感性,可能导致诊断的局限性,血清CYFRA21-1、SCC-Ag、LDH联合检测对肺鳞癌与肺部感染辅助鉴别诊断可能具有一定临床价值。     

Establishment of highly metastatic human tumor cell line in nude mice

A total of 22 adult nude mice (7 approximately 17 weeks old) of BALB/cA origin were inoculated subcutaneously (SC) with human tumor cell lines derived from rhabdomyosarcoma and lung carcinomas, including squamous cell carcinoma, bronchiolo-alveolar carcinoma, small cell carcinoma, giant cell carcinoma and 2 types of adenocarcinoma. 12 neoplasms (54.5%) was confirmed at the initial transplantation and 7 serially transplantable tumors were established in 201 nude mice. Metastatic behavior of 7 human tumor cell lines grown in nude mice was judged histologically after sacrifice and SC transplanted tumors could either be highly metastatic (giant cell carcinoma), moderately metastatic (adenocarcinoma PAb), poorly metastatic (squamous cell carcinoma and adenocarcinoma PAa) or non-metastatic (small cell carcinoma and bronchiolo-alveolar carcinoma). The tumor from SC inoculated giant cell carcinoma (PG) could produce regional and/or distant lymph node metastases (12/12) and lung metastases (9/12) in BALB/cA nude mice maintained under semi-barrier system conditions. Six NIH nude mice developed metastatic tumor nodules both in the lymph node and lung (6/6) under the same condition. The highly metastasizing property of PG transplanted tumors remained after passage for as many as 18 times. The limitations of nude mice as an in vivo model for the study of tumor biology are discussed, eg. malignant neoplasms rarely metastasize when transplanted into nude mice. The use of such model (PG) could lead to a better understanding of the biology of metastasis, thus contributing to the development of new approaches to the therapy of metastasis.     

Relationship between Expression of CEA,E-cadherin and Liver Metastasis in Colorectal Cancer

Objective  To investigate the expression of E-cadherin and CEA in serum in colorectal carcinoma and their relationship with liver metastasis. Methods  CEA level was measured post-operatively by radioimmunoassay of 60 patients with colorectal cancer. Immunohistochemical analysis was used to evaluate the expression of E-cadherin. Results  In liver metastasis group, 24 patients (24/26, 92.3%) were high level of CEA, but only 9 patients in non-liver metastasis group. The difference is significant (P = 0.004). Expression of E-cadherin significantly correlated with differentiation, but was not associated with T stage or N stage. Liver metastatic rate in negative expression was higher than that in positive expression. And the survival analysis showed that time of liver metastasis was significant different in two groups (P < 0.05). Conclusion  The expression of CEA in serum can be used to predict liver mestatasis of colorectal cancer after operation. E-cadherin, associated with tumor differentiation, is also a hopeful indicator for the prediction of liver metastasis in patients with colorectal cancer.     

Liver metastasis at the time of initial diagnosis of lung cancer

In order to evaluate clinicopathological features associated with liver metastases from lung cancer, we reviewed our experience of lung cancer patients seen in our division. Of the 1073 lung cancer patients diagnosed between October 1976 and May 2002, 62 (5.8%) patients had liver metastasis. The incidence of liver metastasis was 17.5% in small-cell lung cancer (SCLC) patients, whereas the incidence in non-small-cell lung cancer patients was 3.8%. Of the 62 patients, 17 had sole liver metastasis, and the remaining 45 had synchronous spread to the liver and one or more other organs. Six of 12 squamous cell carcinoma patients and 10 of 28 SCLC patients had sole liver metastasis. However, 19 of 20 adenocarcinoma patients showed liver metastasis with one or more other organs. In morphological liver metastasis, 26 of the 28 SCLC patients had multiple nodules, whereas 16 of the 34 non-small-cell lung cancer patients had a solitary liver nodule (p = 0.0006). Liver is a possible site of extrathoracic spread of disease for some patients with lung cancer, especially with SCLC. When the histological types are squamous cell carcinoma or SCLC, it would also be considered likely that an isolated liver mass represents a metastasis even though there is no metastatic disease elsewhere.     

血清肝细胞生长因子水平与乳腺癌转移的关系

目的:研究血清肝细胞生长因子(hepatocytegrowthfactory,HGF)与乳腺癌转移的关系。方法:应用双抗体夹心ELISA方法检测80例术后复发转移乳腺癌患者,50例术后无复发乳腺癌患者和20例献血员的血清肝细胞生长因子水平。结果:术后复发转移组血清HGF水平(0.90±0.52ng/ml)显著高于无复发组(0.38±0.30ng/ml;P<0.01)和正常对照组(0.22±0.36ng/ml;P<0.01)。肝转移组患者血清HGF水平(1.25±0.57ng/ml)显著高于其它转移组(0.78±0.48ng/ml;P<0.01)。多处转移组血清HGF水平(1.10±0.66ng/ml)显著高于其它转移组(0.78±0.48ng/ml;P<0.05)。结论:血清HGF水平与乳腺癌肝转移和多处转移发生密切相关。     

食管鳞癌患者远处转移部位与预后的相关性及生存分析

目的:探讨食管鳞癌患者远处转移部位与预后的相关性及生存分析。方法:从SEER数据库中提取2010年至2015年共439例食管鳞癌伴远处转移患者的临床资料,回顾性分析比较食管鳞癌远处转移部位与预后的相关性,通过χ2检验比较两组变量的差异,采用Kaplan-Meier法绘制生存曲线,Log-rank检验进行单因素分析,COX回归进行多因素分析。结果:肺转移、骨+肺转移、肝+肺转移患者预后较好;骨转移、脑转移、骨+脑转移、骨+脑+肝+肺转移患者预后较差。单因素分析显示:年龄、原发灶部位、T分期、手术情况、多器官转移情况与食管鳞癌远处转移患者的预后有关（P＜0.05）;多因素分析显示:年龄、手术情况与多器官转移情况是影响食管鳞癌远处转移患者总生存时间（OS）的独立危险因素。结论:食管鳞癌伴远处转移的患者整体预后较差,但年龄在60~69岁区间、接受手术治疗与较好的预后相关。仅单器官转移的食管鳞癌患者中,骨转移、脑转移患者预后较差;合并多器官转移的患者中,骨+脑转移、骨+脑+肝+肺转移患者预后较差。     

口腔鳞癌颈淋巴结转移的临床病理学特点及其对预后的影响

背景与目的口腔癌淋巴结转移率在50%～59%之间,对其处理好坏关系到患者的预后。本研究拟探讨影响口腔鳞癌颈淋巴结转移的临床病理因素及其对预后的影响。方法对191例口腔鳞癌患者的临床病理学因素与颈淋巴结转移的关系进行回顾性研究,并对颈淋巴结转移状态、转移颈淋巴结大小、转移颈淋巴结数目、转移颈淋巴结累及区域、转移颈淋巴结最低受累区域等淋巴结病理学因素对预后生存的影响进行Cox回归分析。结果口腔鳞癌患者5年生存率为48.7%。χ2分析显示,仅肿瘤浸润深度与发生颈淋巴结转移有关。Cox回归分析表明,临床N分期、颈淋巴结转移状态、转移颈淋巴结累及区域数、转移颈淋巴结最低受累区域因素影响患者预后,特别是临床N分期、转移颈淋巴结最低受累区域因素与口腔鳞癌患者预后明显相关。结论口腔鳞癌颈淋巴结转移是影响患者预后的重要因素,了解其颈淋巴结转移的规律,并对影响预后的淋巴结因素采取相应治疗措施,对提高口腔鳞癌治疗效果具有重要意义。     

An evaluation of serum microelement concentrations in lung cancer and matched non-cancer patients to determine the risk of developing lung cancer: a preliminary study.

In a case-control study to determine the risk of developing lung cancer, the serum levels of vitamins A and E, carotene and selenium were determined in 31 patients, newly diagnosed as having lung cancer, and in matched controls, the said controls being selected from outpatients with no cancer. A significant, inverse association was found between serum vitamins A and E and lung cancer. The relative risk for the low vs high tertiles were, respectively, 5.94 for serum vitamin A and 8.44 for serum vitamin E. Taking histological cancer subtype into account, no relation was revealed between the microelements and squamous cell carcinoma of the lung. The relative risk for lung cancer was 6.50, however, when three, or all four, microelement levels were in the lowest tertile, compared with there being fewer than three in the lowest tertile. Even when three microelements, excluding vitamin E which had the most significant inverse association with lung cancer, were considered, the relative risk was 7.50 when any two or all three were in the lowest tertile, compared with there being just one microelement or none at all in the lowest tertile. A combined effect of vitamins A and E, carotene and selenium on the development of lung cancer has, therefore, been suggested. Further studies will thus be necessary to elucidate the cumulative effect of the serum micronutrients and trace elements, as well as the effect of single elements, on the development of lung cancer.     

大肠癌并肝硬化与大肠癌不并肝硬化发生肝转移癌对照研究

目的 探讨大肠癌并肝硬化患者发生肝转移癌的规律。方法 回顾性分析我院1990年1月～2001年1月10年间诊治的大肠癌856例,均有病理组织学检查确诊。其中大肠癌并肝硬化患者(肝硬化组)74例,伴肝转移癌者2例;其余为不并肝硬化患者(非肝硬化组)782例,伴肝转移癌者168例。结果 肝硬化组肝转移癌发生率为2.7％(2/74);非肝硬化组肝转移癌发生率为21.5％(168/782,P<0.001)。结论 大肠癌不并肝硬化患者的肝转移癌发生率同大肠癌并肝硬化患者的肝转移癌发生率比较,前者肝转移癌发生率明显地高,后者很少发生肝转移癌。