肿瘤与弓形虫感染的关系探讨

弓形虫病（Toxoplasmosis）是一种人兽共患性疾病,临床表现复杂多样,人体多为隐性感染,当机体受到其它疾病侵害或免疫力降低时,可转为急性发作。肿瘤病人伴发弓形虫感染,甚至造成死亡,文献已有报道。为了探讨恶性肿瘤与弓形虫感染的关系,我们特搜集国内外有关文献,对肿瘤患者弓形虫的易感性、以及肿瘤与弓形虫并存的相互关系等问题作一综述,以供参考。 肿瘤患者弓形虫的易感情况 天津医学院赵红等用ELISA法对肿瘤病人进行了血清弓形虫抗体的检测,以了解天津地区肿瘤患者弓形虫的感染情况。肿瘤患者240例,阳性40     

恶性肿瘤患者弓形虫感染调查及关系探讨

恶性肿瘤患者,免疫功能低下,特别在进行放疗、化疗时更甚,因此癌症病人容易感染弓形虫,这个道理易被临床所理解,况且恶性肿瘤死于弓形虫脑炎、弓形虫肺炎均有文献报道,人体感染了弓形虫后(弓形虫可寄生于人体各脏器)是否易患癌症?目前虽有少数文献报道,但这个问题值得临床进一步研究探讨。近年,上海放射免疫分析技术研究所研制并供应了弓形虫循环抗原、抗体IgM、IgA、IgG系列酶联免疫诊断试剂盒,对研究恶性肿瘤病人弓形虫感染情况和机理探讨均有帮助)     

精神病与弓形虫感染的关系探讨

弓形虫病（Toxoplasmosis）是由弓形虫所引起的一种人兽共患性疾病,病原体为弓形虫（Toxoplasma gondii）,属球虫类原虫,广泛分布于世界各地。据文献报道全世界约有5～10亿人受     

SMARCA4缺失型非小细胞肺癌1例

<正>患者男性，48岁。2017年6月在外院行右侧颈部淋巴结清扫术，术后分别行6个疗程化疗和1个疗程放疗。2019年5月20日我院CT示：右肺上纵隔旁占位性病变。实验室检查：癌胚抗原(CEA)、非小细胞肺癌抗原(LTA)、神经元特异性烯醇化酶(NSE)均稍高。胸部增强CT示：右肺上叶尖段近纵隔旁结节状软组织低密度影，呈分叶状，有毛刺，密度不均匀，大小2.4 cm×2.3 cm, 增强可见不均匀中度强化，内见不强化坏死区(图1)。     

非小细胞肺癌中EGFR突变与临床病理特征的关系

目的 观察非小细胞肺癌(non-small cell lung cancers,NSCLC)患者肿瘤组织中表皮生长因子受体(epidermal growth factor receptor,EGFR)19号和21号外显子突变情况,探讨其与临床病理特征的关系.方法 应用显微切割技术及扩增阻滞突变系统检测108例石蜡包埋NSCLC组织中EGFR基因第19号和21号外显子突变情况.结果 108例NSCLC患者中,EGFR基因突变率为36.1%(39例),其中19号外显子突变率为13.0%(14例),21号外显子突变率为23.1%(25例);EGFR基因突变的患者多为不吸烟、肿瘤直径较小(<3 cm)、腺癌、无远处转移及临床分期较早(P<0.05),与患者性别、病理分级及淋巴结转移无显著相关性(P>0.05);所有鳞癌标本中均无EGFR基因突变;EGFR突变的患者应用吉非替尼靶向治疗后原发肿瘤和脑转移灶明显缩小.结论 EGFR基因19号和21号外显子突变作为有效的NSCLC靶向治疗的临床筛选指标,很可能参与NSCLC的发生、发展,与相关的临床病理指标结合可为NSCLC的靶向治疗提供更可靠的依据.     

非小细胞肺癌个体化治疗的靶向分子检测

非小细胞肺癌(non-small cell lung cancer, NSCLC)的个体化治疗是目前肿瘤研究领域的热点之一.以EGFR体系突变活化和ALK重排为分子学特征的NSCLC对酪氨酸激酶抑制剂(tyrosine kinase inhibitors, TKIs)如吉非替尼(gefitinib)、埃洛替尼(erlotinib)以及可卓替尼(crizotinib)有良好的反应性,而EGFR突变和ALK重排也成为筛选TKIs治疗对象和预测治疗反应性的最有价值指标.近年来,欧洲、北美和亚洲地区先后公布EGFR突变检测的共识,我国也于2011年达成了EGFR突变检测的专家共识[1-4].     

非小细胞肺癌中PD-L1表达及其与肺癌相关驱动基因的关系

目的探讨程序性死亡配体-1(programmed death ligand-1,PD-L1)在非小细胞肺癌(non-small cell lung cancer,NSCLC)中的表达,及其与临床病理特征、肺癌相关驱动基因的关系。方法采用免疫组化En Vision法检测323例NSCLC肿瘤细胞、肿瘤浸润性免疫细胞PD-L1的表达;应用二代测序技术检测肺癌相关驱动基因(EGFR、KRAS、ALK)突变情况;分析PD-L1在肿瘤细胞、肿瘤浸润性免疫细胞中的表达,及与NSCLC临床病理特征及肺癌驱动基因的关系。结果 NSCLC肿瘤浸润性免疫细胞PD-L1的表达明显高于肿瘤细胞(P 0.001);肿瘤细胞PD-L1在鳞状细胞癌(squamous cell carcinoma,SCC)中的表达高于腺癌(P 0.05)。当NSCLC肿瘤细胞中PD-L1阳性率≥50%时,PD-L1表达与患者性别、吸烟、肿瘤大小及淋巴结转移有关(P 0.05);腺癌中PD-L1表达仅与肿瘤大小及淋巴结转移相关(P 0.05)。肿瘤细胞PD-L1的表达与EGFR、KRAS基因突变相关(P 0.01)。NSCLC肿瘤浸润性免疫细胞PD-L1阳性率≥10%,PD-L1的表达与EGFR、KRAS基因突变有关(P 0.05),而腺癌PD-L1的表达仅与KRAS基因突变相关(P=0.036)。结论当肿瘤细胞PD-L1阳性率≥50%或肿瘤浸润性免疫细胞PD-L1阳性率≥10%,NSCLC、腺癌中PD-L1的表达与KRAS基因突变相关,提示伴KRAS基因突变的肺癌患者有可能从抗PD-1/PD-L1免疫治疗中获益,从而提高生存率。     

患儿弓形虫感染与多系统疾病的关系

近年来,小儿弓形虫感染的报道日见报端,先天性弓形虫致畸致残的研究亦逐渐深入,但有关小儿多系统疾病与弓形虫感染关系的报道却并不多见。本文对780例住院患儿进行了三项弓形虫血清学(IgG、IgM、CAg)检查,现报道如下。     

先天性畸形与弓形虫感染关系的调查

对５６例先天性畸形儿进行了多项弓形虫检测，发现弓形虫感染儿５４例，感染率达９６．４％。认为弓形虫感染与先天性畸形的发生具有一定的关系，本文还对弓形虫感染引起的病理变化及其致畸特点进行了讨论。     

人非小细胞肺癌细胞中端粒酶活性的检测与研究

目的 研究非小细胞肺癌细胞癌组织中端粒酶活性表达,探讨端粒酶生表达与非小细胞肺癌发生发展的关系。方法 收集经手术及病理证实的非小细胞肺癌４８例标本,１２例肺癌癌旁肺组织、７例非肿瘤病例所取正常肺组织作对照。用端粒酶检测试剂盒检测组织本端粒酶活性。结果 ７５．００％（３６／４８）非小细胞肺癌组织标本检出端粒酶活性,８．３３％（１／１２）癌旁肺组织检出端粒酶活笥,７例非肿瘤标本所取的正常肺组织均未检出     

刚地弓形虫培养上清抑制肺癌A549细胞系增殖

目的研究刚地弓形虫(Toxoplasma gondii)培养上清对体外培养的肺癌细胞A549增殖及细胞周期的影响。方法取对数生长期的A549细胞(浓度为5×104mL-1)分别接种于不同细胞培养板,对照组加入RPMI-1640孵育,试验组加入相同体积不同数量(4×107mL-1、8×107mL-1、16×107mL-1)弓形虫速殖子培养上清孵育不同时间后,四甲基氮噻唑蓝(MTT)法检测吸光度(A490值);PI染色后检测细胞周期;以Western blot检测细胞周期蛋白cyclinB1、cdc2表达或活性。结果弓形虫培养上清呈时间剂量依赖性抑制A549细胞系增殖,处理组细胞周期在G2/M期产生阻滞;A549细胞系的cyclinB1、cdc2蛋白表达量下降。结论刚地弓形虫培养上清能够抑制肺癌A549细胞系增殖,并通过调节cyclinB1、cdc2等蛋白表达或活性改变引起肺癌A549细胞系G2/M期阻滞。     

非小细胞肺癌患者CD44及其变异体V6的测定

目的：探讨测定粘附分子CD44及其变异体V₆在非小细胞肺癌（non-smallcelllungcarcinoma, NSCLC）中的意义。方法：采用酶联免疫吸附试验检测血清中可溶性CD44S（sCD44S）和可溶性CD44V₆（sCD44V₆）含量;流式细胞术测定细胞表面CD44S、CD44V₆的表达。结果：NSCLC患者血清CD44S、CD44V₆水平明显高于肺良性疾病（P<0.05, P<0.01）。原发肺鳞癌（SCC）和腺癌（ADC）细胞的CD44S表达率明显高于对照组（P<0.01）;3组的CD44V₆表达率均低,差异无显著。NSCLC原发癌细胞表面CD44S、CD44V₆表达与其血清的可溶性含量之间均无相关性。结论：提示血清CD44S、CD44V₆水平可作为鉴别NSCLC和肺良性疾病的辅助指标。     

Development of granulomatous common variable immunodeficiency subsequent to infection with Toxoplasma gondii

Common variable immunodeficiency (CVID) is a heterogeneous immunodeficiency that is accompanied by granulomatous lesions in 5-10% of cases. Why some patients develop granulomatous disease remains unclear. Here we describe a 12-year-old previously healthy girl who presented with pancytopenia and granulomatous lymphoproliferation subsequent to infection with Toxoplasma gondii. Loosely arranged non-fibrosing granulomas were observed in the liver, lymph nodes and lung, but no Toxoplasma tachyzoites could be demonstrated and polymerase chain reaction (PCR) and culture were negative for Toxoplasma and a wide range of other pathogens. While the patient had a normal peripheral B cell status at presentation, the development of CVID could be observed during the following months, leading to a loss of memory B cells. This was accompanied by an increasingly activated CD4(+) T cell compartment and high serum levels of angiotensin-converting enzyme (ACE), tumour necrosis factor (TNF) and sCD25. Steroid therapy reduced pancytopenia, granulomatous lymphoproliferation and cytokine elevations, but did not improve the B cell status. This is the first report of an association of Toxoplasma infection with granulomatous CVID and provides one of the rare examples where the onset of CVID could be documented subsequent to an infectious disease.     

Different manifestations of Toxoplasma gondii infection in F344 and LEW rats

There is evidence that not only the immune status, but also the genetic predisposition of certain hosts influence the clinical outcome of Toxoplasma gondii infection. By far the majority of our knowledge on genetic and immunological mechanisms involved in control of T. gondii infection has been obtained by studying mouse models, which in terms of clinical outcome of infection differ considerably from humans. Rats which show a rather similar course of infection in comparison to humans have not so far been investigated for effects of genetic differences on course of the infection. In this study we show that, like mice, different strains of rats exhibit a remarkable variation in the number of brain cysts arising from chronic infection. LEW rats seem to be highly resistant to cyst formation, in contrast to F344 rats that are susceptible. In addition, F344 rats express high numbers of γδ T cells during the acute phase of infection, whereas LEW rats express elevated but comparably low numbers of γδ T cells. The RT1 (rat MHC) haplotypes of both strains are identical in the RT1A and RT1B/D regions, which encode the restriction elements for conventional peptide antigens. Consequently, rat strain-specific differences may be useful to define MHC-independent mechanisms of resistance against T. gondii, which may also act in humans. Received: 24 July 1998     

Cardiotoxicity of cisplatin-based chemotherapy in advanced non-small cell lung cancer patients

Cardiotoxicity is a well known consequence of cancer chemotherapy. Cisplatin-based combinations are standard regimens in the therapy of advanced non-small cell lung cancer. Administration of cisplatin-containing chemotherapy causes significant oxidative and nitrosative stress in some patients. Cardiac blood biomarkers can be used to evaluate cardiac status, may help to identify patients at risk myocardial damage evaluation and are able to detect subclinical, early-stage cisplatin-induced cardiotoxicity. The relevance of cardiovascular complications in cancer patients and identification of individual risk factors for developing cardiovascular toxicity merit further evaluation and a longer follow-up is needed.     

hnRNP A2/B1 mRNA在非小细胞肺癌和转移淋巴结中表达及意义

目的：探讨肺癌早期诊断基因核内不均一核糖体表达对肺癌淋巴结微转移的作用。观察hnRNP A2/B1 在各组织类型肺癌中的表达。方法：42例非小细胞肺癌患者开胸手术纵隔淋巴结清扫获取原发灶及纵隔淋巴结病理标本,12例肺良性病变手术切除标本作正常对照。荧光定量PCR检测切除肿块和淋巴结的hnRNP A2/B1 mRNA表达。结果：(1)转移性淋巴结中hnRNP A2/B1 mRNA 表达水平561.393显著高于无转移淋巴结156.669 (P＜0.05)。(2)Ⅲ期肺癌组织中hnRNP A2/B1 mRNA 表达水平305（249,533）显著高于Ⅰ期和Ⅱ期肺癌组织(2＝13.453,P＜0.01)。(3)hnRNP A2/B1 mRNA在鳞癌和腺癌中的表达水平分别为207(152,305)和249(177,476), Z=-0.899,P>0.05。(4)58组淋巴结阳性,84组阴性,42个病人142组区域淋巴结hnRNP A2/B1 mRNA阳性率为40.84%(58/142),12例肺良性疾病组织均阴性,HE染色42个病人的50组转移淋巴结阳性率为35.21%,与FQ-PCR 58枚（52.11%）无显著差异（P>0.05）。结论：NSCLC 癌组织存在着hnRNP A2/B1 的过度表达。NSCLC癌组织中hnRNP A2/B1表达水平与淋巴结转移状态及P-TNM 分期有关。 hnRNP A2/B1 检验敏感性、特异性高,可用于肺癌的辅助诊断的标记。     

Amygdalin-mediated inhibition of non-small cell lung cancer cell invasion in vitro

Lung cancer is a common malignant tumor claiming the highest fatality worldwide for a long period of time. Unfortunately, most of the current treatment methods are still based on the characteristics of cancer cells in the primary lesion and the prognosis is often much poorer in patients with metastatic cancers. Amygdalin, a natural product of glycosides and lots of evidence shows that amygdalin can inhibit the proliferation of some kinds of cancer cells. In this study, we first obtained the highly metastatic NSCLC cell lines H1299/M and PA/M and further treated these cells with amygdalin. We found that the in vitro proliferability of H1299/M and PA/M was inhibited, but such inhibition required higher concentration of amygdalin. When lower concentration of amygdalin was used for the experiments, we observed that the in vitro invasive and migration capacities of H1299/M and PA/M were significantly inhibited. These results strongly suggested that amygdalin was likely to have anti-metastatic NSCLC effect. This study offers information of the role of amygdalin that may be useful as a therapeutic target in lung tumors.     

Activation mediated CD4+ T cell unresponsiveness during acute Toxoplasma gondii infection in mice

infection of mice with Toxoplasma gondii has been shown to inducea transient state of immune down-regulation. Earlier reportshave demonstrated the role of cytokines, in particular IL-10,in this host response. Here evidence is presented that T.gondll,a major opportunistic pathogen of the newborn and those withAIDS, is able to induce CD4⁺ T cell population Increased involume by day 7 post-infection and expressed T cell maturationmarkers (CD44^hl, Il-2r^hl,Mel-14^fo). Further noted was a clonalactivation of several CD4+ T cells subsets expressing the V_ßchain of the TCR. At day 7 post-infection, partial reductionof all CD4⁺ T cells to mltogen or parasite antigen stimulationwas observed, In particular V_ß5 T cells. Additionof rlL-2 partially restored the CD4⁺ T cell proliferative responsein Vitro. The T cell activation marker CTLA-4 could not be detectedand te co-stimulatory molecule, CD28, was down-regulated. Elctrophoneticand morphologic analysis of these cells post0culture demostrateda DNA fragmentation pattern and cell death consistent with apoptosis.These studies demonstrate for the first time in a protozoanparasite that activation-induced CD4⁺ T cell unresponslvenessoccurs during actue T.gondll infection in mice, and may be importantin immune down-regulation and parasite persistence in the infectedhost.0     

Toxoplasma gondii infection in pregnancy: opportunities and pitfalls of serological diagnosis

Because of its life cycle, the recovery of Toxoplasma gondii from biological samples is often impracticable. Consequently, a serological diagnosis represents the first and the most widely used approach to defining the stage of infection. The detection of IgG, IgM, IgA, IgE and IgG avidity by different methods offers this opportunity. However, the results may be affected by difficulties in interpretation, as the same antibody pattern may have a different valency, contingent upon subjects and clinical settings, e.g., pregnant women vs. neonates, and treated vs. untreated patients. This review describes the various factors that should be taken into account when performing serological tests for T. gondii, as well as the pitfalls that may be encountered during the interpretative process.