Ki67和FHIT在肾上腺皮质肿瘤组织中的表达及相关性研究

应用免疫组化方法检测15例肾上腺皮质腺癌、42例肾上腺皮质腺瘤、6例肾上腺皮质增生及10例瘤旁正常组织标本中Ki67及FHIT的表达情况.结果 显示Ki67在肾上腺皮质腺癌表达最高,腺瘤次之,瘤旁正常组织和增生组织中均不表达;FHIT在瘤旁正常肾上腺组织表达最高,增生和腺瘤次之,腺癌最低,Ki67和FHIT在肾上腺皮质肿瘤表达的结果比较差别有统计学意义(P<0.05),呈负相关关系(r=-0.712,P<0.05).Ki67的过表达与FHIT的表达缺失可能共同参与了肾上腺皮质腺癌的发生和发展.联合检测Ki67和FHIT的表达在临床上有助于肾上腺皮质肿瘤良、恶性的鉴别.     

Ki-67和P21在肾上腺皮质癌中的表达及意义

目的　探讨肾上腺皮质癌 (ACC)中Ki 67和P2 1的表达及其意义。方法　采用免疫组化SP法和图像分析技术对 8例正常肾上腺组织、2 0例肾上腺腺瘤 (ACA)、19例肾上腺皮质癌中Ki 67、P2 1进行检测。结果　Ki 67和P2 1的表达在肾上腺腺瘤与肾上腺皮质癌间差异均有统计学意义 (P <0 .0 1,P <0 .0 5 )。Ki 67的表达与肾上腺皮质癌分期、浸润或转移、2年生存情况相关(P <0 .0 1) ,与肿瘤大小无关 (P >0 .0 5 )。P2 1的表达与肾上腺皮质癌的大小、分期、浸润或转移、2年生存情况均无显著相关 (P >0 .0 5 )。结论　Ki 67和P2 1对肾上腺皮质良恶性肿瘤具有重要的鉴别诊断作用 ,Ki 67可作为判断肾上腺皮质癌预后不良的指标。     

PCAF和E-Cadherin在肾上腺皮质肿瘤中的表达及意义

目的探讨肾上腺皮质肿瘤中p300/CBP相关因子(PCAF)和E-钙黏蛋白(E-Cadherin)的表达及其意义。方法采用免疫组化Envision法对正常肾上腺12例、肾上腺腺瘤30例、肾上腺皮质癌14例中PCAF和E-Cadherin的表达水平进行检测,比较二者在不同肾上腺组织的表达情况。结果 PCAF和E-Cadherin在肾上腺皮质癌组织中的表达阳性率较正常肾上腺、肾上腺腺瘤组织均明显降低,差异均有统计学意义(P均<0.05)。PCAF的表达与肾上腺皮质癌TNM分期相关(P<0.05),E-Cadherin的表达与肾上腺皮质癌的TNM分期、肿瘤转移、2年生存情况均显著相关(P均<0.05)。结论 PCAF和E-Cadherin联合检测可以提高肾上腺皮质癌诊断的灵敏度,PCAF和E-Cadherin有可能作为判断肾上腺皮质癌预后情况的指标。     

肾上腺皮质肿瘤VEGF、TSP-1的表达及其与微血管密度的关系

目的 研究血管内皮生长因子(VEGF)、血小板反应素1(TSP-1)在肾上腺皮质肿瘤中的表达及其与微血管密度(MVD)的关系.方法 采用免疫组化方法检测13例肾上腺皮质癌、30例肾上腺皮质腺瘤和7例正常肾上腺组织中VEGF、TSP-1及MVD(以CD34为标记)的表达.结果 肾上腺皮质癌VEGF表达高于肾上腺皮质腺瘤,差异有统计学意义(P＜0.01);TSP-1在正常肾上腺皮质表达明显高于肾上腺皮质癌(P＜0.01);MVD在肾上腺皮质癌为(107.67±11.91)/视野,显著高于肾上腺皮质腺瘤(59.46±21.31)/视野和正常肾上腺皮质组织(25.10±3.94)/视野(均P＜0.01);VEGF的表达与MVD呈正相关(P＜0.01),TSP-1的表达与MVD呈负相关(P＜0.01),VEGF与TSP-1的表达呈负相关(P＜0.01).结论 VEGF和TSP-1在肾上腺皮质肿瘤的表达失衡是其肿瘤血管异常生成的重要原因.     

质谱技术筛选肾上腺皮质肿瘤差异蛋白研究

目的比较正常肾上腺组织、肾上腺皮质腺瘤组织和肾上腺皮质癌组织的蛋白质组学差异,探讨肾上腺皮质肿瘤的鉴别诊断和肾上腺皮质癌的发病、转移机制以及治疗靶点。方法分别提取9例正常肾上腺皮质组织、9例肾上腺皮质腺瘤标本以及9例肾上腺皮质癌标本总蛋白,蛋白经纯化后用固相p H梯度双向凝胶电泳分离肾上腺皮质癌和肾上腺皮质腺瘤组织蛋白质,银染显色,通过PDQUEST 2DE软件分析获取双向凝胶电泳图谱,找出差异表达的蛋白质点。切取差异蛋白质点进行MALDI TOF/TOF质谱鉴定,获取肽质指纹图谱并查询Swiss Prot数据库寻找匹配蛋白质。结果所获得的双向电泳银染图谱重复性较好,正常肾上腺皮质组织蛋白质点约为(2 247±87),肾上腺皮质腺瘤组织蛋白质点数约为(2 375±142),肾上腺皮质癌组织蛋白质点数约为(2 143±107)。在三组组织中,发现表达递减的蛋白有ATP合酶α亚单位(ATPA)、线粒体1Q补体结合蛋白(C1QBP)、组织蛋白酶D(CATD);而14-3-3ζ/δ在腺癌组中表达最低,在腺瘤组中表达最高;PI-PLC X蛋白结构域3在三组间依次递增(P0.01)。结论正常肾上腺组织、肾上腺皮质腺瘤和肾上腺皮质癌差异表达的蛋白与能量代谢、组织结构以及一些作用蛋白酶有关,表达差异的蛋白在肾上腺皮质肿瘤中参与肿瘤的形成及侵袭作用,其可能可作为潜在的鉴别肾上腺皮质肿瘤良恶性的分子标志,成为肿瘤的生物治疗靶点。     

乳腺癌组织中Survivin、Ki67的表达变化及意义

目的 观察乳腺癌组织中凋亡抑制蛋白生存素(Survivin)、细胞核增殖抗原(Ki67)的表达变化,并探讨其意义.方法 采用免疫组化法检测10例正常乳腺组织(正常组)、20例乳腺增生性病变组织(增生组)和82例乳腺癌组织(肿瘤组)中的Survivin、Ki67,分析两指标的相关性;观察Survivin阳性表达与乳腺癌临床病理参数及预后的关系.结果 与正常组比较,增生组及肿瘤组Survivin OD值、Ki67标记指数(LI)明显升高(P均＜0.01);与增生组比较,肿瘤组Survivin OD值、Ki67 LI明显升高(P均＜0.01).Spearman相关性分析显示Survivin表达与Ki67表达呈正相关(r=6.821,P＜0.05).Survivin阳性表达与乳腺癌TNM分期及淋巴结转移相关(P均＜0.05).与Survivin阴性表达患者比较,Survivin阳性患者5年生存率明显降低(P＜0.05).结论 乳腺癌组织中Survivin、Ki67表达增加;Survivin和Ki67的高表达在乳腺癌的发生、发展中起重要作用,两者可作为判断其预后的参考指标.     

Mina53在结肠癌组织中的表达意义及与肿瘤增殖的关系

目的:研究Mina53在结肠癌中的表达及与各临床病理特征和肿瘤增殖活性的关系.方法:运用实时定量PCR分别检测51例结肠癌、19例结肠腺瘤和20例正常结肠组织Mina53mRNA的表达,及结肠癌组织中Ki67mRNA的表达.结果:结肠癌、结肠腺瘤和正常结肠组织中Mina53mRNA的表达水平分别为1.369±0.874、0.453±0.233、0.347±0.128,结肠癌组织Mina53mRNA的表达明显高于结肠腺瘤及正常结肠组织;而与肿瘤的组织分化程度、临床分期、远处转移和淋巴结转移均相关(均P<0.05);结肠癌中Ki67mRNA表达水平为1.117±0.805,通过相关分析Mina53mRNA的表达与Ki67mRNA呈正相关(r=0.727,P<0.01).结论:Mina53在结肠癌中高表达,其表达与肿瘤的增殖活性相关,在结肠癌发生发展中Mina53可能起着重要作用.     

miR-214在肾上腺皮质肿瘤组织中的表达及意义

目的探讨miR-214在肾上腺皮质肿瘤组织中的表达及意义。方法选择21例行肾上腺皮质肿瘤手术患者的术后切除组织,其中肾上腺皮质腺瘤组织8份,其瘤旁正常组织8份,肾上腺皮质癌组织5份;另选人肾上腺皮质癌SW-13细胞系(SW-13细胞系)和裸鼠皮下移植瘤组织6份。采用RT-PCR技术检测各组织中的miR-214表达。结果与肾上腺皮质腺瘤组织和瘤旁正常组织比较,肾上腺皮质癌组织、SW-13细胞系、裸鼠皮下移植瘤组织中的MiR-214表达明显降低(P均<0.01);与肾上腺皮质癌组织和SW-13细胞系比较,裸鼠皮下移植瘤组织中的MiR-214表达降低(P<0.05)。结论 miR-214表达下调可能参与肾上腺皮质癌的发生、发展,深入探讨其功能和作用机制有重要意义。     

COX-2、EGFR和Ki67在大肠癌组织中的表达及其意义

目的 探讨环氧合酶-2(COX-2)、表皮生长因子受体(EGFR)和Ki67在大肠癌组织中的表达及其意义.方法 选取大肠癌70例、大肠腺瘤21例和正常大肠组织15例,采用免疫组织化学Envision方法检测COX-2、EGFR和Ki67的表达.结果 在正常大肠黏膜、大肠腺瘤和大肠癌组织中,COX-2的阳性表达率分别为33.3%、71.4%和80.0%,大肠癌和腺瘤组显著高于正常组(P均＜0.05);EGFR的阳性表达率依次为0、23.8%和65.7%,两两比较有统计学差异(P均＜0.05);Ki67的阳性表达率依次为40.0%、76.2%和82.8%,大肠癌和腺瘤组织中的表达均高于正常大肠组织(P均＜0.05).COX-2在有淋巴结转移的大肠癌组中的表达明显高于无淋巴结转移组(P＜0.05);EGFR在低分化、高分期和有淋巴结转移大肠癌中的表达明显增强(P均＜0.05),且COX-2与EG-FR、COX-2与Ki67、EGFR与Ki67之间均具有相关性(r=0.316,0.435,0.314,P均＜0.05).结论 COX-2、EGFR和Ki67对大肠癌的发生、发展有协同作用.     

CD68+巨噬细胞表达与肺腺癌侵袭性及临床病理分期相关性分析

目的通过肺腺癌肿瘤实质中CD68~+巨噬细胞浸润情况的分析,及肿瘤实质中Ki67指数表达情况,探讨肿瘤相关巨噬细胞(TAMs)与肺腺癌临床病理分期及肿瘤侵袭能力相关性。方法选取南京市胸科医院2017年间130例肺腺癌组织切片,应用免疫组织化学技术观察并计数CD68~+巨噬细胞在肺腺癌肿瘤实质及间质浸润情况及Ki67指数表达情况分析其相关性。结果 (1)肺腺癌肿瘤实质内TAMs表达低于肿瘤癌旁间质内TAMs表达(P0.05)。(2)肺腺癌肿瘤实质及间质内TAMs表达与Ki67表达有相关性(P=0.0416)。(3)Ⅲ～Ⅳ期NSCLC肿瘤实质组织中CD68~+阳性TAMs表达显著高于Ⅰ～Ⅱ期,差异有统计学意义(P0.05)。结论结果显示CD68~+巨噬细胞浸润情况与肿瘤TNM分期、及Ki67表达有一定相关性。肿瘤相关巨噬细胞(TAMs)浸润肿瘤实质及间质导致肺内炎症微环境,与肿瘤侵袭能力正相关。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。