肾盂输尿管癌蛋白激酶C表达的临床意义

目的 探讨蛋白激酶Ｃ（ＰＫＣ）、ＰＫＣα在肾盂输尿管癌中表达的临床意义。方法 采用免疫组化ＳＡＢＣ法和原位杂交技术检测４５例肾盂输尿管癌中ＰＫＣ、ＰＫＣα表达。结果 肾盂输尿管癌ＰＫＣ、ＰＫＣα阳性表达率分别为６０．０％和５７．８％。其中Ｔ２～Ｔ３为６８．６％（２４／３５）、６８．６％尿管癌ＰＫＣ、ＰＫＣα阳性表达率分别为６０．０％和５７．８％。其中Ｔ２～Ｔ３为６８．６％（２４／３５）、６８．６％     

MK-1基因在胃癌肝转移中的表达及其临床意义

为研究MK-1基因在胃癌肝转移中的表达及其临床意义,通过免疫组织化学方法研究来自日本福冈大学附属医院的64例胃癌肝转移患者的组织标本中MK-1的表达情况,并分析其与胃癌肝转移患者临床预后的关系。MK-1在43例标本中表达,肠型胃癌中的表达明显高于弥漫型癌（73％1：L33％,P=0．049）。多因素分析显示,MK-1阳性表达和淋巴结转移为影响预后的独立危险因素,MK-1表达与患者总体生存及无瘤生存相关（P〈0．01）。     

胃癌组织中p53蛋白表达的临床意义

目的：观察ｐ５３蛋表达通融作为判断胃癌病的预后指标,为该指标的合理应用提供科学依据。方法 利用免疫组化技术检测１７１例胃癌切除标本内ｐ５３蛋白的表达,分析ｐ５３蛋白表达与临床病理及承后之间的关系,探讨ｐ５３蛋白表达与传统ＴＮＭ分期在预后中的关系。结果 ４３．３％的胃癌组织有ｐ５３蛋白表达,弥漫型胃癌中的ｐ５３蛋白表达率高于肠型胃癌（Ｐ〈０．０５）;有ｐ５３蛋白表达的胃癌组织易于发生洒巴结转移（Ｐ〈     

转录抑制因子Snail表达与胃癌Lauren分型的关系研究

目的探讨转录抑制因子Snail表达与胃癌Lauren分型的关系。方法Western印迹检测肠型胃癌细胞系（N87）和弥漫型胃癌细胞系（AGS）中Snail和上皮型E钙黏蛋白（E-cadherin）的表达。将糖原合酶激酶．3B（GSK-3B）质粒转染胃癌细胞系,检测Snail和E-cadherin的表达变化。收集2000年2月至2005年12月间在复旦大学附属中山医院行胃癌根治术的77例术后组织标本．采用免疫组织化学染色检测Snail在胃癌组织中表达．并分析其与胃癌Lauren分型之间的关系。结果Snail在N87中低表达,在AGS中高表达;E-cadherin表达与Snail相反。转染GSK-3B后,胃癌细胞Snail表达显著下调,E-cadherin表达显著上调（P〈0．01）。使用不同浓度的GSK-3B抑制剂氯化锂处理后．胃癌细胞Snail表达显著上调,且具有明显浓度依赖性（P〈0．01）。21例肠型胃癌中Snail低表达16例,高表达5例;56例弥漫型胃癌中Snail低表达21例,高表达35例;肠型胃癌中Snail表达明显弱于弥漫型,差异有统计学意义（P〈0．01）。结论Snail的表达与胃癌Lauren分型有关．是一种潜在的确定胃癌分型的分子标志物。     

胃癌端粒酶活性检测的临床意义

目的　探讨端粒酶在胃癌组织中的活性及其临床意义。方法　应用银染 Ｔ Ｒ Ａ Ｐ 方法检测９４ 例胃癌组织、１２ 例胃腺瘤、９ 例胃溃疡和５８ 例癌旁正常胃粘膜中端粒酶活性。结果　９４ 例原发胃癌组织中检出端粒酶阳性８１ 例,阳性率为８６ ．２ ％ 。正常粘膜无１ 例检测到端粒酶表达,１２ 例胃腺瘤有１例表达端粒酶阳性,在９ 例胃溃疡组织中有１ 例检测到端粒酶表达,１２ 例胃腺瘤有１ 例表达端粒酶阳性,在９ 例胃溃疡组织中有１ 例检测到阳性端粒酶表达。胃癌与正常粘膜组端粒酶表达率差异有显著性（ Ｐ＜ ０ ．００１） 。端粒酶活性与肿瘤大小、分化程度、浸润深度、淋巴结转移和 Ｔ Ｎ Ｍ 分期无明显相关（ Ｐ＞ ０ ．０５） 。结论　测定胃癌端粒酶活性对胃癌的诊断有一定意义。     

恶性梗阻性黄疸时内毒素血症,肾功能损害及乳果糖治疗的临床研究

观察了３２例恶性梗阻性黄疸病人内毒素血症（ＥＴＭ）发生率及其与肾功能损害的关系．并对乳果糖对ＥＴＭ的治疗作用进行了随机性、前瞻性研究。治疗组术前１ｄ周围静脉血ＥＴＭ发生率为４１．２％．对照组为５３．３％（Ｐ＞０．０５）；术中分别为４７．１％及６０％（Ｐ＞０．０５）；术后ｄ３分别为４１．２％及８０％（Ｐ＜０．０５）．治疗组门静脉血ＥＴＭ发生率为４７．１％，对照组为８６．７％（Ｐ＜０．０５）。乳果糖治疗组无术后肾衰；对照组１例肾衰并死亡．乳果糖治疗组发生术后肾功能损害１例（５．９％），对照组５例（３３．３％）．Ｐ＝０．０６２．结果显示，恶性梗阻住黄疸病人术后肾功能损害的发生与ＥＴＭ密切相关．在梗阻未解除、高胆红素血症的状态下，术前口服乳果糖可明显降低门静脉及术后周围静脉血ＥＴＭ发生率．保护肾功能。     

单克隆抗体检测膀胱移行细胞癌相关抗原与肿瘤病理分级关系的探讨

为探讨膀胱移行细胞癌相关抗原与肿瘤病理分级及之间的关系，作者应用膀胱移行细胞癌（ＴＣＣ）单克隆抗体（ＭｃＡｂ）１９Ａ２１１和Ｍ３４４，对５１例（１０２个）膀胱ＴＣＣ组织切片进行免疫组化染色。５１例中包括膀胱ＴＣＣ１级１７例、２级１８例、３级１６例。结果１９Ａ２１１抗原表达阳性率在１级是８２．４％（１１／１７），２级是７７．７％（１４／１８），３级是３７．５％（６／１６）。１级阳性表达率与３级相比，Ｐ＜０．０１。２级阳性表达率与３级相比，Ｐ＜０．０５。Ｍ３４４抗原表达阳性率在１级是８８．２％（１５／１７），２级是８３．３％（１５／１８），３级是３７．５％（６／１６）。１级阳性表达率与３级相比，Ｐ＜０．０１。２级阳性表达率与３级相比，Ｐ＜０．０５。１９Ａ２１１和Ｍ３４４联合应用对５１例膀胱ＴＣＣ进行检测，抗原表达阳性率１级是１００％（１７／１７），２级是８８．８％（１６／１８），３级是６８．８％（１１／１６）。结果表明，ＭｃＡｂ１９Ａ２１１、Ｍ３４４适用于膀胱ＴＣＣ的诊断，特别是有利于１、２级表浅性膀胱ＴＣＣ。联合应用２种ＭｃＡｂ可明显提高检测１、２表浅性膀胱ＴＣＣ的阳性率。     

膀胱癌谷胱甘肽转移酶π的表达及其临床意义

为了探讨谷胱甘肽转移酶π（ＧＳＴπ）的表达与膀胱生物学行为的关系，应用免疫组化法观察４９例膀胱癌，３０例正常膀胱粘膜ＧＳＴπ的表达。结果显示：４４例（８９．８％）膀胱癌及１８例（６０．０％）正常膀胱粘膜ＧＳＴπ呈阳性表达，其中５例膀胱癌呈强阳性表达。Ｇ１～２４２例阳性表达３４例（８０．９％），Ｇ３７例均阳性。１４例再发者阳性１３例（９２．９％）。Ｔ２～３期１９例中１０例有核染色。结果表明：膀胱癌中ＧＳＴπ含量及强度明显大于正常粘膜（Ｐ＜０．００５），提示膀胱癌患者对化疗耐药可能与其ＧＳＴπ异常表达有关。其表达与肿瘤病理分级明显相关，再发肿瘤表达有增加趋势（但Ｐ＞０．０５），核染色可能与膀胱癌进展有关。     

p27^kip1在胃癌中的表达异常及其与胃癌临床病理因素的 …

目的 研究ｐ２７＾ｋｉｐ１在胃癌中的表达及其与胃癌临床病理因素的关系，了解ｐ２７＾ｋｉｐｌ在胃癌进展中的作用。方法 用免疫组化方法检测４０例胃癌组织中ｐ２７＾ｋｉｐｌ和ｃｙｃｌｉｎ Ｅ的表达，所有数据用卡方检验。结果 ４０例胃癌组织中有２５例（６２．５％）ｐ２７＾ｋｉｐｌ蛋白表达阴性，在弥漫型癌、肿瘤穿透浆膜、淋巴结转移阳性以及Ⅲ、Ⅳ期胃癌中ｐ２７＾ｋｉｐｌ的表达显著降低（ｐ〈０．０５）。在ｃｙｃ     

前列腺癌MDR—PGP170与突变P53表达

应用单克隆抗体（ＭＤＲ－Ｃ２１９，ＰＡｂ－ＤＯ－１）免疫组化技术对３８例石蜡包埋的前列腺癌与１５例良性前列腺增生（ＢＰＨ）组织切片中的ＭＤＲ－ＰＧＰ与突变Ｐ５３的表达进行了比较研究。结果显示：在３８例前列腺癌切片中ＭＤＲ－ＰＧＰ与突变Ｐ５３蛋白的阳性表达率７１．０％和６０．５％，１５例ＢＰＨ组织中仅３例（２０．０％）显示ＭＤＲ－ＰＧＰ阳性染色，突变Ｐ５３在所有ＢＰＨ中未见阳性染色。在高分化，中等分     

Helicobacter pylori and gastric cancer. The incidence of infection in personal experience

BACKGROUND: Helicobacter pylori is an identified carcinogen for gastric cancer, but the underlying mechanisms remain to be defined. The aim of this study is to analyze the incidence of Hp infection in our series of patients with gastric carcinoma. METHODS: Between 1988 and 1998, 60 patients with diagnosis of gastric adenocarcinoma underwent partial or total gastrectomy. Forty-one were males and 19 females with an average age of 62 years (range 36-79). Twenty-seven cancers (45%) were localized in the lower third of the stomach, 17 (28%) in the middle third and eight (13%) in the upper third or cardias. In six patients (10%) the tumor was multicentric, while a recurrence on gastric stump after subtotal gastrectomy was present in two cases (3%). According to Lauren's criteria 39 cancers (65%) were of intestinal type, 16 (27%) of diffuse type and five (8%) of mixed type. The histologic preparations have been re-examined in order to verify the presence or not of Hp on gastric mucosa around neoplasm. RESULTS: Hp was found in 35 (58%) of the analyzed specimens and therefore a significant percentage of patients was Hp-positive at the time of diagnosis and surgery. Between 35 Hp-positive samples, 24 were adenocarcinomas of intestinal type, nine of diffuse type and two of mixed type, with a prevalence of Hp in intestinal type cancer. CONCLUSIONS: This study confirmed the high incidence of Hp infection in patients with gastric carcinoma, particularly in those with intestinal type cancer.     

细胞周期素D1,Rb及p16在早期胃癌中的表达及意义

目的 观察细胞周期素Ｄ１、Ｒｂ及ｐ１６在早期胃癌发生中的作用及相互关系。方法 采用免疫组化ＳＰ法对３９例早期胃癌癌旁肠化组织及３４例非癌胃粘膜肠化组织进行对比研究。结果 癌组织中３３／３９例（８４．６％）显示细胞周期素Ｄ１过度表达,癌旁肠化组织也显示细胞周期素Ｄ１过度表达。１２／３９例ｐ１６表达阴性,３例中弱阳性。２６例Ｒｂ阳性的肿瘤中,１５例显示ｐ１６不表达或低表达,而９例Ｒｂ阴性的肿瘤中则ｐ１６显示表达增高。结论 细胞周期素Ｄ１是早期胃部发生过程中常见的分子异常,细胞周期素Ｄ１的激活及Ｒｂ的失活在早期胃癌中可共同存在;Ｒｂ失活与ｐ１６表达之间存在负相关关系;早期早胃癌的发生可能与细胞周期素Ｄ１、ｐ１６及Ｒｂ负反馈调节环路的异常有关。     

Gastric carcinoma after surgical treatment for benign ulcer disease: some pathologic-anatomic aspects

The study presents the autopsy findings on 55 patients with carcinoma of the operated stomach. This figure corresponds to a proportion of about 0.12% of the total number of autopsies (46,593) in the period under review (1950-1982), and of about 7.24% of the overall number of gastric carcinoma patients autopsied during that period. The male:female ratio was 5.1:1. The average "free interval" until the manifestation of cancer was 22.6 years after Billroth II resection, 23.4 years after Billroth I resection, and 34.4 years in the case of patients upon whom gastroenteroanastomosis had been performed without resection. The older the patient was at the time of the operation, the shorter was the interval before the occurrence of gastric cancer. In the majority of cases the carcinoma was localized in the gastric stump (65.4%), whereas in a quarter of the cases (25.5%) the carcinoma occurred in the area of the anastomosis itself, and in 9.1% of cases it was localized in the region of the cardia. Histologic classification of the tumors revealed 52.7% as being predominantly of the intestinal type, and 38.2% as being predominantly of the diffuse type. The organs most frequently affected by direct tumor infiltration "per continuitatem" were the pancreas (18.2%), liver (16.4%) and colon transversum (14.6%). The lymph nodes most often affected were the paragastric (63.6%) and parapancreatic lymph nodes (49.1%), those at the porta hepatic (38.2%) and the para-aortal (34.6%) lymph nodes. Haematogenous metastases were found most frequently in the liver (30.9%), skeletal system (16.4%), adrenal gland (10.9%) and lung (9.1%).(ABSTRACT TRUNCATED AT 250 WORDS)     

内镜活检对胃癌组织学分类术前诊断的价值

目的 探讨内镜活检对胃癌组织学分类术前诊断的价值。方法 术前对141例胃癌患的内镜活检标本分别根据Lauren分类和世界卫生组织（WHO）分类判断组织学分类，并与手术标本结果对照。结果 内镜活检对胃癌Lauren分类术前诊断的准确率为76.6%。对肠型胃癌诊断的敏感性和特异性分别为85.4%和80.6%。而对弥漫型胃癌则分别为82.7%和80.3%，在59例术前诊断为肠型胃癌的病例中，18例（30.5%)在手术标本中呈弥漫性行生长，而在75例术前诊断为弥漫型胃癌的病例中，仅6例（8.0%)术后诊断为肠型胃癌，内镜活检对胃癌WHO分类术前诊断的准确率为87.2%，其中对乳头状/管状腺癌，黏液腺癌和印戒细胞癌的敏感性分别为91.9%。33.3%和66.7%。结论 内镜活检对胃癌组织学分类的术前诊断具有较高的临床应用价值。     

青年人胃癌

目的 探讨40岁以下青年人胃癌的临床病理特征。方法 回顾性分析了10年间收治的304例41岁以下青年人胃癌病例,结果 40岁以下病例占同期全部病例的4.9%,其中36岁以下患占2.4%,病理分类中以弥漫型癌多见,占196例,肠型胃癌98例;肿瘤的TNM分期中Ⅳ期病例占53.95%,进展期病变占全部的83.2%;手术切除率为73.9%,根治手术率为56.0%,全组5、10年总生存率分别为28.7%和24.9%,多因素回归分析表明远处转移,肿瘤病理分期以及肿瘤的根治度是影响预手的独立因素,结论 青年人病例类型以弥漫型癌占多数,进展期病变占绝大多数,手术切除率较低,年龄不是影响预后的独立因素。但是30岁以下患预后不良。     

p53 Accumulation Is a Prognostic Factor in Intestinal-Type Gastric Carcinoma but Not in the Diffuse Type

Background: The prognostic value of p53 nuclear accumulation in gastric cancer is still unclear, as shown by the discordant results still reported in the literature. In this study, we evaluated the correlation between p53 accumulation and long-term survival of patients resected for intestinal and diffuse-type gastric cancer.Methods: Eighty-three patients with carcinoma of the intestinal type and 53 patients with carcinoma of the diffuse type were included in the study. Immunohistochemical staining of the paraffin sections was performed by using monoclonal antibody DO1; cases were considered positive when nuclear immunostaining was observed in 10% or more of the tumor cells. Prognostic significance of different variables was investigated by univariate and multivariate analysis.Results: p53 positivity was found in 51.8% of intestinal-type and 50.9% of diffuse-type cases. No significant correlation between the rate of p53 overexpression and age, sex, tumor location, tumor size, depth of invasion, lymph node involvement, distant metastases, and surgical radicality was found in the two groups of patients. A statistically significant difference in survival rate was observed between p53-negative and p53-positive cases in the intestinal type (P < .05), confirmed by multivariate analysis (P < .005; relative risk = 3.09). On the contrary, no correlation with survival was found in diffuse-type cases according to p53 overexpression.Conclusions: These results suggest that the immunohistochemical detection of p53 accumulation is a useful indicator of poor prognosis in the intestinal but not in the diffuse type of gastric cancer, and are indicative of distinct molecular pathways and pattern of progression in the two histotypes.     

转移相关基因CD_(44)V_6在胃癌中的表达意义

目的探讨转移相关基因 CD_(44) V_6与胃癌某些生物学行为的关系。方法采用免疫组化 SP 法对42例进展期胃癌进行标记分析。结果 CD_(44) V_6阳性表达率,肠型胃癌(70.83%)明显高于弥漫型胃癌(33.33%),(P<0.05);淋巴结转移组(82.35%)明显高于无淋巴结转移组(36.0%),(P<0.01);CD_(44)V_6阳性表达率与肿瘤大小无相关(P>0.05)。结论CD_(44)V_6在胃癌的淋巴结转移及癌细胞分化过程中起着重要的作用,litertan 对早期预测癌细胞的转移潜能,诊断癌复发具有重要的临床意义。     

检测胃癌组织中多基因表达的临床病理意义

目的 探讨指示胃癌临床病理学特征和预后的分子学指标。方法 应用生物素－卵白素复合物法（ＡＢＣ法）检测１７１例胃癌标本中ｐ５３、ＣｅｒｂＢ－２、表皮生长因子受体（ＥＧＦＲ）、ｎｍ２３和Ｅ－钙粘蛋白（Ｅ－ｃａｄ）的表达。结果 ⑴癌组织浸润越深,ｎｍ２３和Ｅ－ｅｒｂ表达越少（Ｐ〈０．０５）,ｎｍ２３和Ｅ－ｃａｄ表达与淋巴结转移和远处转移呈负相关（Ｐ〈０．０５）,Ｃ－ｅｒｂＢ－２和ＥＧＦＲ表达与远处转移呈     

胃癌及癌前病变中肝肠钙黏蛋白的表达及其意义

目的 研究胃癌及肠化生组织中肝肠钙黏蛋白(liver-intestine cadherin. LI-cadherin)的表达,探讨胃黏膜癌前病变及癌变的分子机制. 方法应用SP免疫组化方法检测244例不同胃组织中(包括正常胃黏膜28例、慢性浅表性胃炎30例、慢性萎缩性胃炎42例、肠化生胃黏膜58例、胃腺癌46例、癌旁组织30例、胃间质瘤10例) LI-cadherin蛋白的表达.结果 LI-cadherin蛋白在正常胃黏膜、慢性胃炎、癌旁组织及胃间质瘤组织中不表达;在肠化生组织中阳性表达率为83%,在胃腺癌组织中阳性表达率为65%.按Laurien分型,肠型胃癌中LI-cadherin蛋白阳性表达率(78%)高于弥漫型胃癌(35%),两者之间差异有统计学意义(P<0.05).LI-cadherin与淋巴结转移及临床分期明显正相关(P<0.01). 结论LI-cadherin的异常表达与肠化生及胃腺癌的发生有关;LI-cadherin高表达者淋巴结转移率高.有助于判断胃癌恶性程度及预后.     

血栓调节蛋白在肾脏肿瘤组织中的表达及临床意义

目的研究血栓调节蛋白（TM）在肾盂移行细胞癌及肾细胞癌中的表达及临床意义。方法选择40例不同分期、不同分级的肾盂移行细胞癌及20例不同分期、不同分级的肾细胞痛标本，应用免疫组织化学SP法研究TM的表达。结果40例肾盂移行细胞癌，TM表达者37例（92．5％），20例肾细胞癌，TM表达1例（5％），其两组表达率明显不同（P〈0．01）。肾盂移行细胞癌组织TM表达阳性细胞百分数随病理分级、临床分期的上升而下降（P〈0．01或P〈0．05）。另外TM表达阴性者再发膀胱癌发生率为66．7％，TM表达细胞百分数小于41．7％的患者中再发膀胱癌发生率为62．5％，TM表达细胞百分数大于41．7％的患者中再发膀胱癌发生率为3．4％，前两者与后者相比，其再发膀胱癌发生率明显升高（P〈0．01）。结论TM表达量与肾盂移行细胞癌的恶性程度、病程情况等生物学行为有关。TM表达阴性及TM表达阳性细胞百分数小于41．7％的肾盂移行细胞癌再发膀胱癌可能性大，应对此类肾盂移行细胞癌患者术后按膀胱肿瘤对待。TM可以作为一种瘤标来鉴别诊断肾盂移行细胞癌与肾细胞癌。