食管鳞癌患者血清Stathmin的表达及临床意义

目的:探讨血清Stathmin的表达水平对食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)的诊断价值及临床意义.方法:采用酶联免疫吸附法(enzyme-linkedimmunosorbent assay,ELISA)检测74例ESCC与81例健康对照血清Stathmin含量;采用ELISA检测34例食管鳞癌与40例健康对照血清角蛋白19片段抗原21-1(cytokeratin 19 fragment antigen 21-1,Cyfra21-1)的水平;采用化学发光法检测血清癌胚抗原(carcinoembryonic antigen,CEA)、癌抗原19-9(cancer antigens19-9,CA19-9)、癌抗原72-4(cancer antigens7 2-4,C A 7 2-4)水平;统计学分析血清中Stathmin浓度与临床参数的相关性.结果:ESCC组血清Stathmin水平显著高于健康对照组(P<0.001),ESCC组血清Stathmin水平与伴有淋巴结转移相关(P=0.036),血清Stathmin水平与患者性别、年龄、分化程度、TNM分期和肿瘤大小无显著相关.比较Stathmin和Cyfra21-1的受试者工作特性曲线(receiver operating characteristic curve,ROC曲线),提示Stathmin的灵敏度和特异性均优于Cyfra21-1,血清Stathmin水平对ESCC的诊断灵敏度可达94.6%.结论:血清Stathmin升高在食管鳞癌的发生发展中起重要作用,食管癌患者血清的Stathmin检测,对ESCC的诊断和预后判定具有一定意义.Stathmin可作为食管鳞癌诊断、治疗和判断预后的一个新的血清标志物,辅助临床诊断.     

子宫内膜腺癌患者血浆CA125、Periostin水平变化及意义

目的 研究CA125、Periostin(PN)在子宫内膜腺癌中的表达,以及二者与子宫内膜腺癌临床病理的关系.方法 提取91例血浆标本,子宫内膜腺癌组(A组)27例、不典型增生组(B组)24例、健康对照组(C组)40例,用酶联免疫吸附测定(ELISA)方法检测各组CA125、PN表达情况.结果 A、B、C组CA125表达阳性率分别为48.1％、37.5％、5.0％,两两比较P均＜0.05;PN表达阳性率分别为40.7％、4.2％、2.5％,A组与B组、A组与C组比较差异有统计学意义(P＜0.05),B组与C组比较未见明显差异(P ＞0.05);CA125+ PN联合检测表达阳性率分别为55.6％、37.5％、7.5％,两两比较P均＜0.05.CA125阳性表达与手术病理分期、组织学分期、淋巴结转移情况、肌层浸润深度有关(P＜0.05).PN阳性表达与手术病理分期、肌层浸润深度有关(P＜0.05).结论 CA125、PN在子宫内膜腺癌患者血浆中呈现高表达,联合检测可大大提高敏感性,有助于子宫内膜腺癌的诊断.     

肺癌患者血浆Fas 水平的检测及临床意义

目的 探讨肺癌患者血浆Fas测定的临床价值.方法 采用酶联免疫吸附试验(ELISA)检测60例肺癌患者血浆Fas水平,应用双抗体免疫荧光剂、采用流式细胞仪(FACS)测定肺癌患者T淋巴细胞亚群,分析其临床价值.结果 40%患者血浆Fas水平升高,血浆Fas水平与病理类型无关,受临床分期的影响,进展期显著高于早期患者(P＜0.05),进展期CD3+、HLA-DR+细胞及CD+16、CD+56细胞比例亦显著高于早期患者,其CD+4、CD-8细胞比例显著低于早期患者.初诊时血浆Fas升高的小细胞肺癌患者疗效较好.治疗后有效、病情稳定的患者,血浆Fas水平降至正常.结论 肺癌患者血浆Fas水平显著升高,并与患者T细胞亚群有关,可作为判断病情和疗效的一项指标.     

2型糖尿病患者血浆脂联素和抵抗素水平的测定及意义

为探讨2型糖尿病患者血浆脂联素和抵抗素水平的变化及意义。将60例2型糖尿病患者分为非肥胖糖尿病组30例(体质指数<25kg/m2)和肥胖糖尿病组30例(体质指数>25kg/m2);并选择28例健康者作对照。用酶联免疫吸附检测法测空腹血浆脂联素和抵抗素浓度;并测定各组的空腹血糖、胰岛素和血脂的水平;根据HOMA稳态模型提出的公式,计算胰岛素抵抗指数和胰岛素敏感指数,分析各指标间的相关性。结果发现,①糖尿病各组血浆脂联素的水平明显低于对照组,且肥胖糖尿病组低于非肥胖组,差异有显著性(P<0.01)。②糖尿病各组血浆抵抗素的水平明显高于对照组,而且肥胖糖尿病组明显高于非肥胖组,差异有显著性(P<0.01)。③相关分析发现,血浆脂联素浓度与体质指数、空腹血糖、胰岛素抵抗指数和甘油三酯呈显著负相关(分别为r=-0.55,P<0.01;r=-0.51,P<0.01;r=-0.52,P<0.01;r=-0.39,P<0.05),而与胰岛素敏感指数呈显著正相关(r=0.45,P<0.01);抵抗素则与体质指数、空腹血糖、胰岛素抵抗指数和甘油三酯呈显著正相关(r=0.40,P<0.01;r=0.52,P<0.01;r=0.46,P<0.01;r=0.27,P<0.05);与胰岛素敏感指数)呈显著负相关(r=-0.32,P<0.01)。此结果提示,脂联素和抵抗素都参与了胰岛素抵抗的发生过程,可能与2型糖尿病的糖脂代谢紊乱有关。     

趋化因子CXCL13在系统性红斑狼疮患者的血浆表达水平及临床意义

目的 检测系统性红斑狼疮(SLE)患者血浆趋化因子CXCL13表达,分析CXCL13表达与SLE疾病活动性及脏器受累的关系,探讨CXCL13在SLE发病机制中的可能作用.方法 酶联免疫吸附法(ELISA)检测60例SLE患者血浆CXCL13水平,并与21名健康体检者对照.组间计量资料比较采用Mann-Whitney检验,组间计量资料相关性分析采用Pearson相关性分析.结果 血浆趋化因子CXCLl3在SLE患者组表达水平明显高于健康对照组[(501±446)和(102±121) pg/ml,P＜0.01].有肾脏及中枢神经系统受累的SLE患者较无相应器官受累的SLE患者有着较高水平的血浆CXCL13表达(P=0.038,0.026).另外,分析发现血浆CXCL13表达水平与SLE疾病活动指数呈正相关(r=0.585,P=0.001).结论 趋化因子CXCL13在SLE发病机制中具有重要作用,可能参与了SLE肾脏及中枢神经系统受累过程;CXCL13可作为判断SLE病情活动性的指标.     

食管鳞癌患者血清VEGF、Endostatin水平变化及意义

目的观察食管鳞癌患者血清血管内皮生长因子（VEGF）和内皮抑素（Endostatin）的水平变化,并探讨其意义。方法采用ELISA法检测126例食管鳞癌患者和14例健康对照者血清VEGF及Endostatin。结果食管鳞癌患者血清VEGF为（20.68±3.09）μg/L、Endostatin为（4.96±1.72）μg/L,健康对照者分别为（3.82±6.28）μg/L（、1.60±0.37）μg/L,两组相比,P均〈0.05。食管鳞癌患者血清中VEGF、Endostatin水平与肿瘤分化程度、TNM分期、肿瘤直径、淋巴结转移有关（P均〈0.01）,其血清VEGF与Endostatin的水平呈正相关（r=0.594,P〈0.01）。结论食管鳞癌患者血清VEGF、Endostatin水平升高,可作为食管鳞癌恶性程度及肿瘤负荷的预测指标。     

可溶性尿激酶型纤溶酶原激活物受体在RA患者血浆和滑液的水平及其临床意义

目的检测可溶性尿激酶型纤溶酶原激活物受体(suPAR)在类风湿关节炎(RA)患者血浆和滑液中的含量,并结合临床资料和实验室指标分析其临床意义。方法采用酶联免疫吸附试验(ELISA)法分别检测了66例RA、23例骨关节炎(OA)和20名健康体检者的血浆,以及15例RA、9例OA患者滑液中suPAR的水平,比较不同病情活动组之间suPAR含量的变化,分析血浆和滑液中suPAR的含量与RA临床和实验室指标的相关性联系。同时观察其中16例RA患者治疗后血浆中suPAR的变化。结果RA患者血浆中suPAR的含量明显高于OA组和正常对照组(P均＜0．01),且血浆中suPAR水平随着RA病情活动程度的增强而增高。RA和OA滑液中suPAR水平均高于相应外周血水平(P＜0．01和P＜0．05),而RA滑液suPAR水平明显高于OA滑液(P＜0．01)。RA血浆和滑液中suPAR水平均与反映RA病情活动的指标如关节肿胀数、血沉(ESR)和C反应蛋白(CRP)呈正相关。治疗后RA患者血浆中suPAR水平明显下降(P＜0．05)。结论RA患者血浆和滑液中suPAR水平明显增高,提示其在RA病理过程中发挥重要作用,而且血浆suPAR水平与RA患者病情严重程度相关,可以作为判断RA病情活动的有效指标。     

心力衰竭患者血清cTnT的检测及意义

采用酶联免疫吸附分析法检测88例心力衰竭患者血清肌钙蛋白T（cTnT）水平，彩色多普勒测定左室射血分数（LVEF），评定cTnT水平与LVEF、心功能分级及死亡率的关系。发现血清cTnT阳性组（n=53）LVEF显著低于cTnT阴性组（n=35），死亡率也明显升高；cTnT水平与心功能的严重程度相关。提示cTnT是心力衰竭患者心肌损伤的一种标志物，可作为判断心力衰竭患者病情严重程度及预后的重要指标。     

原发性高血压患者血浆儿茶酚抑素水平及作用

目的探讨原发性高血压患者血浆儿茶酚抑素(CST)水平的变化及其与高血压左心室肥厚的关系。方法选择原发性高血压患者136例(高血压组),健康体检者31例(对照组)。高血压组又分为左心室肥厚27例和非左心室肥厚109例。采用酶联免疫吸附法测定血浆CST水平,高效液相色谱分析法测定血浆去甲肾上腺素(NE)水平。结果与对照组比较,高血压组患者血浆CST及NE水平明显升高,血浆CST/NE比值明显降低(P<0.01)。高血压组左心室肥厚患者血浆NE水平较非左心室肥厚患者明显升高(P<0.01);CST/NE比值明显降低(P<0.01)。结论原发性高血压患者血浆CST水平明显升高,但CST/NE在高血压及高血压左心室肥厚患者中均明显降低,CST可能参与了高血压及左心室肥厚的发生。     

食管鳞癌组织中Langerhans细胞水平及意义

采用免疫组化SP法检测39例正常食管上皮、23例不典型增生及39例食管鳞癌组织中S-100蛋白的表达,以观察其中Langerhans细胞（LC）的水平。结果正常食管上皮、癌旁不典型增生和鳞癌组织中LC阳性率分别为64.10%、30.43%、41.03%,P〈0.05。高、中、低分化鳞癌中LC阳性率分别为77.78%、45.45%、21.05%,P〈0.01;侵犯浅肌层、深肌层和纤维膜的鳞癌中LC阳性率分别为33.33%、40.00%、42.86%,P〈0.05;无和有淋巴转移的鳞癌中LC阳性率分别为53.85%、15.38%,P〈0.01。认为鳞癌中LC数量减少;LC数量减少程度与食管鳞癌的分化程度及是否发生淋巴转移有关,而与浸润深度无关。     

Changes of serum p53 antibodies and clinical significance of radiotherapy for esophageal squamous cell carcinoma

AIM： To explore the relationship between serum p53 antibodies （p53-Abs） and clinicopathological characteristics and therapeutic effect in patients with esophageal carcinoma （EC）, and to investigate sequential changing regularity of serum pS3-Abs after radiotherapy.
METHODS： The serum pS3-Ab levels were detected in 46 EC patients and 30 healthy adults by enzyme linked immunosorbent assay （ELISA）. The blood samples were collected on the day before radiotherapy and on the administration of an irradiation dose of 20 Gy/10 f/12 d, 40 Gy/20 f/24 d and 60 Gy/30 f/36 d after radiotherapy.
RESULTS： The level and positive rate of serum pS3-Abs in EC patients were significantly higher than those in normal individuals （P 〈 0.05）. Serum anti-p53 antibodies were positive in 18 of 46 EC patients （39.1%）. The positive rate of pS3-Abs in EC was related to histological grade, disease stage and lymph node metastasis （P 〈 0.05）, but it was not significantly related to sex, age and to the size and site of tumor. The level and positive rate of p53-Abs had significant differences between before radiotherapy and after administration of an irradiation dose of 40 Gy/20 f/24 d and 60 Gy/30 f/36 d （P 〈 0.05 orP 〈 0.01）. The positive rate of p53-Abs in EC patients with effect was significantly lower than that in those without effect after radiotherapy （P 〈 0.0001）.
CONCLUSION： Detection of serum p53-Abs is helpful to the diagnosis of esophageal carcinoma. Monitoring for sequential change of serum p53-Abs before and after radiotherapy in patients with esophageal carcinoma is also useful to evaluate the response to the treatment and prognosis of the patients.     

抑癌基因PTEN在人食管鳞癌中的表达及其意义

目的 研究食管鳞癌中PTEN的表达，探讨其与临床病理参数的关系及对患者预后的判断价值。方法 应用免疫组织化学S-P法检测62例食管鳞癌组织标本中PTEN的表达水平。结果 （1）PTEN的表达与食管壁浸润程度、淋巴结转移情况、远处转移情况、pTNM分期、肿瘤分化程度呈负相关关系（P〈0．05）。（2）高表达组患者的术后3年生存率明显低于低表达组，组间比较有统计学意义（P〈0．01）。结论 PTEN表达与反映食管鳞癌恶性度的临床病理参数呈负相关关系，是独立的预后评价因素之一。     

血清增殖诱导配体在原发性干燥综合征中的临床意义

目的 探讨血清增殖诱导配体(APRIL)对原发性干燥综合征(pSS)患者的临床意义.方法 采用ELISA法分别检测38例pSS确诊患者和40名正常健康体检者的血清APRIL水平,并分析其与pSS患者临床指标相关性.结果 PSS患者的血清APRIL高于健康对照组[(26.37±16.18)ng/ml比(16.33±15.61)ng/ml,P＜0.05],且与pSS患者ESR(r=0.427,P＜0.05) 、唇腺淋巴细胞灶数(r=0.446,P＜0.05)呈一定程度相关性,与外周血白细胞(WBC)、血小板(PLT)计数呈负相关(P＜0.05).结论 pSS患者血清APRIL水平异常增高,与临床指标的相关性,提示该系统可能参与pSS的发病过程.     

抑癌基因PTEN在食管癌中的表达及其临床意义

目的　研究食管癌中第 10号染色体丢失的张力蛋白同源的磷酸脂酶基因 (PTEN基因 )的表达及其临床意义。方法　用免疫组化方法检测 68例食管癌和癌旁正常组织中PTEN蛋白的表达水平。结果　食管癌中PTEN蛋白表达率为 70 .6% ,而癌旁正常组织为 10 0 % ,PTEN蛋白表达与肿瘤分化程度、浸润深度、淋巴结转移及TNM分期相关 (P <0 .0 5 )。PTEN蛋白在高中低分化组的阳性表达率分别为 90 .17%、66.67%和 5 0 %。单变量分析PTEN蛋白阳性表达组 3、5年生存率分别为 70 .3 %和 5 4.6% ,高于阴性表达组的 40 .2 5 %和 16.1%。经long rank时序检验差异有显著性(P =0 .0 2 5 8) ,Cox回归模型多变量分析显示 ,PTEN是一个独立预后指标 (P =0 .0 12 )。结论　从蛋白水平证明PTEN基因表达缺失或降低与食管癌的发生发展有关 ,PTEN蛋白表达的检测可能成为判断食管癌细胞生物学行为及部分患者预后的参考指标之一     

原发性高血压患者脂联素水平变化及临床意义

目的：探讨原发性高血压（EH）患者血清脂联素（APN）含量的变化及意义。方法：采用酶联免疫法测定41例EH患者和23例正常健康人的血清APN值。结果：1级EH患者血清中APN水平明显下降（与对照组比较P〈0．01）．2级及3级EH患者血清中APN水平进一步下降（与1级比较P〈0．05），但2级及3级间差异无显著性（P〉0．05）。结论：EH患者脂联素水平降低，提示脂联素与EH的发生、发展过程有关，可作为评价原发性高血压严重程度的一个新指标。     

食管鳞癌组织诱导型一氧化氮合酶和增殖细胞核抗原的表达及意义

目的探讨食管鳞癌组织诱导型一氧化氮合酶（iNOS）和增殖细胞核抗原（PCNA）的表达与食管癌临床病理因素的关系。方法用免疫组化法检测2009年1至4月山东省泰安市中心医院52例食管鳞癌组织和20例癌旁正常组织iNOS与PCNA的表达,计数PCNA标记指数（PCNA LI）。食管鳞癌组织及癌旁正常组织iNOS蛋白阳性表达率、PCNA LI比较分别采用χ2检验、t检验;食管癌组织iNOS阳性表达者与iNOS阴性表达者PCNA LI比较采用t检验;不同临床病理因素食管鳞癌组织iNOS蛋白表达、PCNA LI比较分别采用χ^2检验、t检验、方差分析,进一步两两比较采用SNK-q检验;食管鳞癌组织iNOS蛋白与PCNA蛋白表达的关联性分析采用χ^2检验。结果食管鳞癌组织iNOS阳性表达率、PCNA LI均高于癌旁正常组织,且差异均有统计学意义[63.5%（33/52）与10.0%（2/20）比较,χ^2=14.455,P〈0.01;（53.29±14.55）与（2.65±1.82）比较,t=24.593,P〈0.05]。食管癌组织中,iNOS阳性表达者的PCNA LI高于iNOS阴性表达者,且差异有统计学意义[（60.89±9.98）与（40.08±11.53）比较,t=6.842,P=0.000]。不同临床分期、分化程度、有无淋巴结转移患者的食管鳞癌组织iNOS蛋白表达差异有统计学意义（χ^2=9.372,P=0.025;χ^2=12.784,P=0.002;χ2=6.361,P=0.012）。随着食管鳞癌组织癌细胞分化程度的降低PCNA LI升高,中分化和低分化的食管鳞癌组织PCNA LI明显高于高分化的食管鳞癌（q=6.000、7.378,P均〈0.05）。有淋巴结转移的食管鳞癌组织PCNA LI高于无淋巴结转移的食管鳞癌组织,且差异有统计学意义[（56.26±13.14）与（45.21±15.62）比较,t=2.556,P=0.014]。iNOS的表达与PCNA的表达有关联（χ^2=20.022,P=0.000）。结论 iNOS与PCNA蛋白在食管鳞癌组织中均有较高的阳性表达,且表达有关联。两者可能存在共同的激活机制,iNOS和PCNA蛋白表达与食管癌的恶性进程有关。     

Elevated serum levels of human relaxin-2 in patients with esophageal squamous cell carcinoma

AIM: To assess the prognostic value of serum human relaxin 2 (H2 RLN) level in patients with esophageal squamous cell carcinoma (ESCC). METHODS: From October 1998 to September 2009, 146 patients with histopathologically confirmed ESCC were enrolled in this study. One hundred patients underwent en bloc esophagectomy, and 46 patients with unresectable tumors underwent palliative surgery. Five of the 146 patients died of surgical complications. Serum levels of H2 RLN were measured by enzyme linked immunosorbent assay. The relationship between serum H2 RLN level and each of the clinicopathological parameters was analyzed using the χ2 test. Patients were classified into two groups according to their H2 RLN level (< 0.462 ng/mL vs ≥ 0.462 ng/mL). When any analysis cell had fewer than five cases, the Fisher’s exact test was used. The statistical difference between groups A and B in each clinicopathological category was determined by the Student’s t test (two-tailed) or analysis of variance. Survival curves were plotted using the Kaplan-Meier method. The statistical difference in survival between the different groups was compared using the log-rank test. Survival correlation with the prognostic factors was further investigated by multivariate analysis using the Cox proportional hazards model with backward stepwise likelihood ratio. RESULTS: ESCC patients tended to have significantly higher serum H2 RLN concentrations (0.48 ± 0.17 ng/ mL, n=141) compared with the healthy control group (0.342 ± 0.12 ng/mL, n=112). There was a significant difference between patients with lymph node involvement (0.74 ± 0.15 ng/mL, n=90), distant metastasis (0.90 ± 0.19 ng/mL, n=32) and those without lymph node involvement (0.45 ± 0.12 ng/mL, n=51), and distant metastasis (0.43 ± 0.14 ng/mL, n=109), respectively (P < 0.01). Patients with high H2 RLN levels (≥ 0.462 ng/mL) had a poorer prognosis than patients with low serum H2 RLN levels (< 0.462 ng/mL; P=0.0056). The H2 RLN level was also correlated with survival and     

脂联素在肺癌患者血清中的表达及意义

目的 观察肺癌患者血清脂联素水平的变化,并探讨其意义.方法 酶联免疫吸附法测定54例肺癌患者和24名健康人的脂联素浓度.结果 对照组及肺癌患者血清脂联素水平分别为(191.86±24.38)μg/L、(183.39±51.34) μg/L,两组之间差异无统计学意义(P＞0.05);不同病理类型及TNM分期的肺癌患者血清脂联素水平差异无统计学意义(P值均＞0.05);发生远处转移后肺癌患者血清中脂联素的表达水平[(158.52±57.82)μg/L]与未远处转移的肺癌患者血清脂联素水平[(192.96±45.89) μg/L]比较差异有统计学意义(P＜0.05);多因素同归分析显示,低血清脂联索水平与肺癌发生远处转移相关(OR =0.19,P=0.013).结论脂联素水平的降低提示肺癌患者具有更高的侵袭性和转移性,可能成为反映肺癌患者疾病进展的一个血清指标.     

Relationship between proliferative activity of cancer cells and clinicopathological factors in patients with esophageal squamous cell carcinoma

AIM: To assess whether the molecular markers of malignant tumors could improve the understanding of tumor characteristics, and to observe the characteristics of expression of cell cycle markers Ki-67 and cyclin A in esophageal carcinoma and to analyze the relationship between proliferative activity of cancer cells and clinicopathological factors. METHODS: Seventy of surgically resected esophageal squamous cell carcinoma (SCC) were examined by immun-ohistochemistry utilizing commercially available antibodies. Nuclear staining was regarded as a positive result. At least 50 fields in each tumor and non-tumor section were evaluated at a medium power (×200) to determine the proportion of tumor cells and the staining intensity of nuclei in the entire sections. RESULTS: Ki-67 and cyclin A were only expressed in base cells of normal esophageal mucosa. The positive immuno-staining of nuclei of SCC was significantly higher than that in normal esophageal mucosa (t = 13.32 and t = 7.52, respectively, P<0.01). The distribution of positively stained was more diffuse and stronger in poorly differentiated SCC. Both Ki-67 and cyclin A expressions were related to histological grades of tumors (t = 3.5675 and t = 3.916; t = 2.13, respectively, P<0.05) but not to the sex and age of the patients, tumor size, lymphatic invasion, location, or stage grouping. CONCLUSION: The proliferative activity of cancer cells may be understood by immunohistochemistry of Ki-67 and cyclin A in Chinese patients with esophageal SCC. These cell cycle markers may serve as an indicator of cancer cell proliferation rate. The overexpression of cell cycle markers Ki-67 and cyclin A suggests the poor SCC differentiation in patients with esophageal carcinoma.