胰腺癌中p21WAF1、cyclinD1和CDK4的表达意义及其相互关系

目的:探讨胰腺癌中p21WAF1、cyclinD1和CDK4的表达意义及其相互关系.方法:应用免疫组织化学二步法检测p21WAF1、cyclinD1和CDK4在48例胰腺癌和14例慢性胰腺炎中的表达.结果:胰腺癌组织中p21WAF1、cyclinD1、CDK4的阳性表达率分别是52.08%(25/48)、70.85%(34/48)、62.50%(30/48),同慢性胰腺炎组比较p21WAF1的表达明显降低(P＜0.01),而cyclinD1和CDK4的表达明显升高(P＜0.01).高分化、无淋巴结转移、临床分期Ⅰ、Ⅱ期的胰腺癌组织中p21WAF1的阳性表达率明显高于低分化、有淋巴结转移、临床分期Ⅲ、Ⅳ期的胰腺癌(P＜0.05);而cyclinD1和CDK4则相反(P＜0.05).p21WAF1的表达和cyclinD1、CDK4的表达呈明显的负相关(相关系数分别为r=-0.340,P＜0.05和r=-0.571,P＜0.01);cvclinD1和CDK4的表达则呈明显的正相关(r=0.450,P＜0.01).结论:p21WAF1的缺失表达和cyclinD1、CDK4的过表达在胰腺癌的发生、发展过程中起重要的协同作用.三种蛋白质主要以p21WAF1/cyclinD1/CDK4通路的方式作用于细胞的转化,参与肿瘤的形成.     

人胰腺癌组织中DPC4/Smad4、p21wafI、p16蛋白表达的检测

背景与目的：近一半的胰腺癌存在DPC4／Smad4失活,使肿瘤细胞增殖的抑制作用丧失;p21^warI是Smad4调控的下游靶基因,而PC4和p16基因在胰腺癌的发生中可能有协同作用。本研究拟通过研究DPC4／Smad4、p21^wafI、p16蛋白在人胰腺癌中的表达情况,探讨三者之间的关系及它们的胰腺癌中的可能作用机制。方法：用免疫组化技术检测56例石蜡包埋人胰腺癌组织Smad4,p21^wafI,p16的蛋白表达情况。结果;用石蜡包埋人胰腺癌组织免疫组化显示Smad4,p21^wafI和p16阳性率分别为58．93％,48．21％和42．86％,对应癌旁非癌胰腺组织阳性率分别为89．29％,87．55和76．79％;P3,P4,P7人胰腺腺癌细胞系DPC4／Smad4的原位杂交,免疫组化及Western blot均为阳性,而1,P2均为阴性。统计学分析显示胰腺癌及癌旁非癌胰腺之间3种蛋白表达均有显著性差异（P＜0．05）,胰腺癌中Smad4与p21^wafI表达之间有一定相关性（P＜0．05）,Smad4与p16表达之间有一定相关性（P＜0．05）,但p21^wafI与p16表达之间无显著相关（P＞0．05）。结论：胰腺癌与正常胰腺相比,Smad14,p21^wafI,p16蛋白表达明显下降,其改变在胰腺癌的发生发展中可能起重要作用。     

胰腺癌中和的p21WAF1、cyclinD1CDK4表达意义及其相互关系

目的:探讨胰腺癌中p21W A F1、cyclinD1和CD K4的表达意义及其相互关系。方法:应用免疫组织化学二步法检测p21W A F1、cyclinD1和CD K4在48例胰腺癌和14例慢性胰腺炎中的表达。结果:胰腺癌组织中p21W A F1、cyclinD1、CD K4的阳性表达率分别是52.08%(25/48)、70.85%(34/48)、62.50%(30/48),同慢性胰腺炎组比较p21W A F1的表达明显降低(P<0.01),而cyclinD1和CD K4的表达明显升高(P<0.01)。高分化、无淋巴结转移、临床分期Ⅰ、Ⅱ期的胰腺癌组织中p21W A F1的阳性表达率明显高于低分化、有淋巴结转移、临床分期Ⅲ、Ⅳ期的胰腺癌(P<0.05);而cyclinD1和CD K4则相反(P<0.05)。p21W AF1的表达和cyclinD1、CDK4的表达呈明显的负相关(相关系数分别为r=-0.340,P<0.05和r=-0.571,P<0.01);cyclinD1和CDK4的表达则呈明显的正相关(r=0.450,P<0.01)。结论:p21W A F1的缺失表达和cyclinD1、CD K4的过表达在胰腺癌的发生、发展过程中起重要的协同作用。三种蛋白质主要以p21W AF1/cyclinD1/CDK4通路的方式作用于细胞的转化,参与肿瘤的形成。     

胰腺癌组织乙酰肝素酶表达及其与肿瘤血管形成及预后关系的研究

目的:研究乙酰肝素酶(heparanase,HPSE)在胰腺癌组织中的表达及其与肿瘤血管形成及预后的关系.方法:采用免疫组织化学方法,分别应用HPSE抗体和CD34单克隆抗体检测47例胰腺癌、24例癌旁胰腺和10例正常胰腺组织中HPSE蛋白的表达.同时检测胰腺癌组织中CD34及微血管密度(MVD),分析HPSE蛋白的表达与胰腺癌临床病理学特征的关系,以及CD34在胰腺癌组织中的表达及微血管的分布特点及HPSE表达与MVD之间的相关性.结果:47例胰腺癌组织HPSE表达阳性率为59.6%(28/47),明显高于癌旁组织(20.8%,5/24 )和正常胰腺组织(20.0%,2/10),χ2值分别为9.59和3.90;P值分别为0.002 0和0.0487 1.HPSE表达阳性率与胰腺癌的大小和组织学分级无关,χ2值分别为1.09和2.89; P值分别为0.580 4和0.235 8.HPSE阳性表达率在有周围脏器浸润的胰腺癌组织中为73.3%,无浸润者为35.2%,两者间差异有统计学意义,χ2=6.52, P=0.010 7;伴淋巴结和远隔脏器转移者的胰腺癌组织HPSE阳性表达率为80.0%,高于无转移者的36.4%,差异有统计学意义,χ2=9.25, P=0.002 4 .生存期≤1年的胰腺癌组织中HPSE阳性率(70.54 %)明显高于生存期>1年(30.76%),χ2=6.19, P=0.012 8.47例胰腺癌组织中MVD为37.61±14.32,HPSE表达和胰腺癌组织中的MVD呈显著的正相关性,t= 5.09,P=0.000 0.结论:HPSE在胰腺癌的发生、侵袭转移和血管生成中发挥重要作用,可作为判断胰腺癌生物学行为和预后的有用指标.     

miR-34a、CD133在胰腺癌中的表达及临床意义

目的:检测胰腺癌肿瘤组织中微小RNA-34a与CD133表达情况,并探究其临床意义。方法:选取2012年12月至2014年2月本院收治的胰腺癌患者74例,取胰腺癌肿瘤组织及癌旁组织。采用实时定量PCR（qRT-PCR）法检测胰腺癌肿瘤组织及癌旁组织中miR-34a表达水平,采用免疫组化法检测CD133表达水平。结果:胰腺癌肿瘤组织miR-34a表达水平低于癌旁组织（P＜0.05）,CD133 mRNA表达水平较癌旁组织显著升高（P＜0.05）;CD133在胰腺癌肿瘤组织中阳性表达率显著高于癌旁组织（P＜0.05）。miR-34a、CD133表达与胰腺癌肿瘤分化程度、肿瘤大小、淋巴结转移有关（P＜0.05）;miR-34a、CD133表达与胰腺癌患者年龄、性别无显著相关性（P＞0.05）。miR-34a低表达胰腺癌患者3年总生存率显著低于高表达患者（P＜0.05）,CD133高表达胰腺患者3年总生存率显著低于CD133低表达者（P＜0.05）。miR-34a、CD133表达、肿瘤大小和肿瘤分化程度是影响胰腺癌患者预后的独立危险因素。胰腺癌肿瘤组织miR-34a与CD133 mRNA相对表达水平显著负相关（P＜0.05）。结论:miR-34a在胰腺癌组织中低表达,CD133高表达,与患者肿瘤分化程度、肿瘤大小、临床分期有关,可能作为胰腺癌病情监测及术后预后的生物学指标。     

CD105和CD34在胃癌微血管中的表达及与VEGF的关系

目的 探讨CD105与CD34在胃癌微血管中的表达及与血管内皮生长因子(Vascular endothelial grouth factor,VEGF)表达的相关性.方法 采用CD105、CD34和VEGF通过免疫组化S-P法,对50例胃癌及10例正常胃组织进行标记,检测CD105及CD34的微血管密度(MVD)及其与VEGF表达的相关性.结果 进展期胃癌、早期胃癌中CD105抗体标记的MVD分别为26.49±7.26,13.07±3.13;CD34标记的MVD分别为53.32±23.05,18.35±13.46,VEGF阳性率分别为82.5%,53.33%.正常胃组织CD105、CD34标记的MVD分别为3.54±2.69,8.79±8.83,VEGF阳性率为20%.胃癌与正常胃组织之间各指标均有显著性差异(P＜0.01);在进展期胃癌中CD105和CD34有显著性差异(P＜0.05);与CD34比较,CD105标记的MVD在胃癌浸润深度中的表达有差异(P＜0.05),并在淋巴结有/无转移组中,显著性高于CD34标记的MVD(P＜0.01,P＜0.05).两者标记的MVD与VEGF表达均呈显著正相关(均P＜0.01).结论 CD105比通常用的总内皮标记物CD34更好,是一种更有特异性的肿瘤血管内皮标记,CD105和CD34标记的MVD与VEGF密切相关,为患者预后提供有价值的信息.     

ARHI基因对人胰腺癌组织血管生成的影响

目的 探讨ARHI基因与胰腺癌组织血管密度和临床病理的相关性.方法 收集23例胰腺癌石蜡标本作为实验组,27例正常胰腺石蜡标本作为对照组.然后采用免疫组化方法检测两组标本ARHI、CD34蛋白表达情况;分析ARHI、CD34蛋白表达与胰腺癌的关系;分析ARHI与MVD的相关性.结果 对照组和实验组标本中ARHI阳性率分别为88.9%(24/27)、21.7%(5/23),实验组标本中ARHI基因表达下降,两组比较差异具有统计学意义(P<0.05);对照组MVD值显著低于实验组,差异具有统计学意义(P<0.05);ARHI表达与胰腺癌分化程度呈负相关(P<0.05),其中肿瘤分化程度越低,ARHI表达缺失概率越大;实验组标本中CD34阳性表达较高,多数具有管腔结构,且MVD值明显高于对照组标本,差异具有统计学意义(P<0.001);胰腺癌组织中,MVD与ARHI的表达无相关性(P>0.05);而所有统计病例中,ARHI阴性者比阳性者的MVD值高,且MVD与ARHI的表达呈负相关(P<0.001).结论 ARHI可能通过抑制胰腺癌微血管的生成进而抑制胰腺癌生长.     

p53蛋白表达和肿瘤微血管生成与肝癌发展及预后的关系

目的探讨p53蛋白表达和肿瘤微血管生成与肝细胞癌(HCC)发展及预后的关系.方法采用免疫组化方法检测50例肝细胞癌组织中p53蛋白的表达,并用抗CD34抗体标记癌组织血管内皮细胞,计算肿瘤微血管密度(microvessl density,MVD).分析p53蛋白和MVD与HCC临床病理学特征之间的关系.结果 p53阳性表达为癌细胞核棕黄色着色,CD34染色定位在血管内皮细胞上,HCC的p53表达及MVD与肿瘤大小、病灶数目、病理分级、门静脉癌栓形成、包膜是否完整显著相关(P＜0.05).p53蛋白表达阳性者MVD值显著高于阴性者(P＜0.05);p53蛋白表达阳性或MVD≥148的肝癌患者术后生存时间比p53蛋白表达阴性或MVD＜148者短(P＜0.05).结论 p53与肿瘤血管生成密切相关,p53蛋白及MVD可作为肝癌预后判断的一个重要指标.     

TGF-β1、CD105、CD34在胰腺癌中的表达及其临床意义

目的:探讨TGF-β1、CD105、CD34在胰腺癌中的表达及临床意义。方法:应用免疫组化SP法检测三者在52例胰腺癌和10例非肿瘤性胰腺组织中的表达,并分析它们与胰腺癌临床病理参数及患者生存率间的关系。结果:TGF-β1在非肿瘤性胰腺组织、胰腺癌中的阳性表达率分别为30%、80.77%,两者间的差异具有统计学意义(P<0.01)。胰腺癌中,CD105、CD34标志的微血管密度(MVD)均明显高于非肿瘤性胰腺组织。TGF-β1、CD105、CD34的表达水平与胰腺癌临床分期及淋巴结有无转移呈正相关,且CD105与胰腺癌的病理分级有关。TGF-β1与CD105、TGF-β1与CD34在胰腺癌中均有协同表达,CD105在胰腺癌中的表达较CD34特异性高。此外,生存单因素分析TGF-β1、CD105、CD34均与胰腺癌的预后有关。结论:TGF-β1、CD105、CD34在胰腺癌生长、浸润和转移过程中发挥了一定作用。CD105较CD34能更准确的反映内皮细胞的增殖状况。     

TFPI-2与VEGF在胰腺癌中的表达

目的探讨胰腺癌中TFPI-2表达对胰腺癌肿瘤血管生成的影响.方法采用免疫组织化学方法检测41例胰腺癌组织中TFPI-2、VEGF的表达及CD34单克隆抗体标记的微血管密度(MVD).结果Ⅰ、Ⅱ期胰腺癌及无远处转移的胰腺癌组织中TFPI-2阳性表达率分别为65.4%和57.1%,Ⅲ、Ⅳ期及有远处转移的胰腺癌组织中的TFPI-2阳性表达率分别为13.3%和23.1%,TFPI-2表达率,Ⅰ、Ⅱ期高于Ⅲ、Ⅳ期,无远处转移高于有远处转移,差异有统计学意义(P＜0.05);VEGF阳性表达率在Ⅰ、Ⅱ期及无远处转移的胰腺癌组织分别为23.0%和32.1%,在Ⅲ、Ⅳ期及有远处转移的胰腺癌组织分别为66.7%和61.5%,两者比较,差异有统计学意义(P＜0.05);Ⅲ、Ⅳ期及有远处转移的胰腺癌组织MVD值分别为28.47±2.23和19.00±2.58,高于Ⅰ、Ⅱ期的26.92±1.06及无远处转移的16.68±1.79,差异有统计学意义(P＜0.05);胰腺癌组织中的TFPI-2的表达与VEGF的表达呈负相关(r=-0.54),差异有统计学意义(P＜0.05);MVD与TFPI-2表达有关,TFPI-2阳性表达的胰腺癌组织MVD值为33.33±3.23,低于TFPI-2阴性表达的胰腺癌组织36.00±3.17,两者比较,差异有统计学意义(P＜0.05).结论胰腺癌中TFPI-2可能通过下调VEGF的表达抑制肿瘤新生血管的形成,从而抑制胰腺癌的生长、转移.     

E-钙粘蛋白及PTEN基因编码蛋白与胃癌浸润转移

目的:观察抑癌基因PTEN蛋白和ECD在胃癌组织中的表达,探讨其与胃癌生物学行为及预后的关系。方法:以兔抗人PTEN多克隆抗体、鼠抗人ECD单克隆抗体,采用SABC免疫组化法,检测100例胃癌手术切除标本中拟测指标的表达。以χ2和Logrank检验对结果做统计学分析。结果:ECD、PTEN蛋白在非癌胃粘膜中均见表达;在胃癌组织中表达下调或缺失。ECD异常表达率为42.0%;弥漫型胃癌异常表达率(48.57%),明显高于肠型胃癌(26.67%),(P<0.05);ECD异常表达与浸润深度有关(P<0.05)。胃癌组织中PTEN蛋白缺失率为59%;弥漫型胃癌缺失率(65.71%)明显高于肠型胃癌(43.33%),(P<0.05);伴淋巴结转移的胃癌缺失率(64.47%)明显高于无淋巴结转移者(41.67%),(P<0.05);PTEN蛋白缺失的患者比阳性表达者预后差(P=0.0066)。65.85%PTEN阳性表达者同时伴ECD正常表达。结论:两种标志物与胃癌浸润转移有关,PTEN表达与胃癌患者预后密切相关。将两种指标联合检测,可作为正确判断胃癌患者预后,指导临床治疗的分子生物学指标。     

Cytologic classification of precancer and cancer of the endometrium and esophagus and of malignant lymphomas

The paper discusses cytological classifications of precancer and cancer of the endometrium, esophagus and malignant lymphomas presented by cytologists from five Soviet research institutes of oncology. The classifications were based on the data of 4400 cases in conformity with WHO histologic classifications.     

世界卫生组织骨质疏松症防治工作报告和防治建议

引 言 作为对第51号综合处理非传染性疾病预防与控制的世界卫生组织决议的反应,1998年7月WHO成立了致力于不断完善对骨质疏松预防和治疗策略的工作小组。小组成员来自世界各国致力于骨质疏松研究的知名专家。Harry K.Genant为本届主席。这一项世界范围内的骨质疏松教育计划旨在通过世界范围的研究,不断改善对骨质疏松的诊断水平和发展并完善对骨质疏松病人的合理治疗。其重点将以发展中国家为主。并为各国政府及其卫生部门和病人群体提供世界性有关骨质疏松症的总体的、完整的指导性资料。该项研究、教育计划的实施将由世界各国的骨质疏松症研究和治疗机构共同完成,并经权威学术机构、政府和非政府组织进行有针对性的回顾研究,最终由WHO审议通过。     

Schwannomas of Head and Neck and Review of Literature

Benign nerve cell tumours have been given various names like schwannoma, neurilemmoma, neurinoma, neurofibroma, spindle cell tumours etc. Extra cranial head and neck schwannomas usually present as solitary and well-demarcated lesions. The lesion can cause secondary symptoms, such as nasal obstruction, dysphasia, and hoarseness, depending upon the location of the lesion. Fine needle aspiration cytology, CT scans, and MRI may be of limited help in the diagnosis of schwannomas. The treatment is complete surgical excision of the benign tumour and postoperative histopathological examination establishes the final diagnosis.     

Quality of life and care in leukemia,myeloma and non-malignant disease. Opinions of patients and relatives,and effects of geography and time

In a questionnaire study 140 subjects answered 4200 questions in 1980 and 1986. They consisted of patients with myeloma, acute leukemia, lung carcinoma, and non-malignant disease and their relatives. In 22 additional cases the questionnaire was not answered. The results show that myeloma patients are less content with the general care than leukemia patients (P < 0.05). Similarly, relatives of deceased myeloma patients are less satisfied with the information given to them than relatives of deceased leukemia patients (P < 0.001). The information has improved with time, however, since the patients were more satisfied in 1986 than in 1980 (P < 0.001) and relatives of myeloma patients still alive were more satisfied than relatives of patients who had died earlier (P < 0.001).     

A comparative study of knowledge and awareness of colorectal and breast cancerA comparative study of knowledge and awareness of colorectal and breast cancer

Aims: To assess and compare knowledge and awareness of colorectal cancer and breast cancer in a sample of the general population. Methods: Eleven hundred visitors to six different outpatient clinics, in a University Hospital, were given a study-specific questionnaire, based on educational material from the British Association of Cancer United Patients (CancerBACUP). The questionnaire consisted of 12 statements on the incidence, presentation, detection, treatment and prognosis of colorectal and breast cancer. Results: One thousand and sixty-eight individuals returned the questionnaire. One thousand and four completed questionnaires were analysed. The mean age (SD) of respondents was 50.1 (17.2) years, and the male to female ratio was 2:3. Respondents had read more about breast than about colorectal cancer (60.3%vs 32.4%,P <0.0001, McNemar's test). The proportion of correct answers for each statement on breast cancer was higher than for answers to corresponding items on colorectal cancer. Mean overall scores (95% CI) for breast and colorectal cancer were 88.1 (86.9, 89.2) and 64.4 (62.5, 66.3) respectively, the mean difference (95% CI) being 23.7 (22.0, 25.5). Scores were higher for breast cancer irrespective of age or gender. Conclusion: There is a low level of understanding of colorectal cancer in the general population when compared to breast cancer. This highlights the importance of public education in this common cancer.     

Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers

BACKGROUND: Frequent consumption of fruit and vegetables has been associated with a reduced risk of colorectal cancer in many observational studies. METHODS: We prospectively investigated the association between fruit and vegetable consumption and the incidence of colon and rectal cancers in two large cohorts: the Nurses' Health Study (88 764 women) and the Health Professionals' Follow-up Study (47 325 men). Diet was assessed and cumulatively updated in 1980, 1984, 1986, and 1990 among women and in 1986 and 1990 among men. The incidence of cancer of the colon and rectum was ascertained up to June or January of 1996, respectively. Relative risk (RR) estimates were calculated with the use of pooled logistic regression models accounting for various potential confounders. All statistical tests were two-sided. RESULTS: With a follow-up including 1 743 645 person-years and 937 cases of colon cancer, we found little association of colon cancer incidence with fruit and vegetable consumption. For women and men combined, a difference in fruit and vegetable consumption of one additional serving per day was associated with a covariate-adjusted RR of 1.02 (95% confidence interval [CI] = 0.98-1.05). A difference in vegetable consumption of one additional serving per day was associated with an RR of 1.03 (95% CI = 0.97-1.09). Similar results were obtained for women and men considered separately. A difference in fruit consumption of one additional serving per day was associated with a covariate-adjusted RR for colon cancer of 0.96 (95% CI = 0.89-1.03) among women and 1. 08 (95% CI = 1.00-1.16) among men. For rectal cancer (total, 244 cases), a difference in fruit and vegetable consumption of one additional serving per day was associated with an RR of 1.02 (95% CI = 0.95-1.09) in men and women combined. None of these associations was modified by vitamin supplement use or smoking habits. CONCLUSIONS: Although fruits and vegetables may confer protection against some chronic diseases, their frequent consumption does not appear to confer protection from colon or rectal cancer.