VEGF在周围型肺癌癌组织中的表达及意义

采用免疫组织化学S-P法检测58例周围型肺癌患者癌组织中血管内皮生长因子（VEGF）的表达,并分析其与临床病理特征及多层螺旋CT（SCT）征象的关系。结果VEGF阳性表达35例,细胞分化Ⅰ～Ⅱ级和Ⅲ～Ⅳ级者阳性表达率分别为53．12％、23．08％,P〈0．05。VEGF异常表达与毛刺征、棘突征、血管集束征、空洞征、胸膜侵犯、淋巴转移明显相关（P〈0．05）;与肿瘤大小、胸膜凹陷征、分叶征无关。提示VEGF异常表达在肺癌发生、发展及SCT表现中可能起重要作用,检测VEGF可作为临床诊断及预后评估指标。     

NSCLC患者螺旋CT征象与癌组织中p53蛋白表达的关系

目的探讨非小细胞肺癌（NSCLC）患者螺旋CT（SCT）征象与癌组织中p53蛋白表达的关系。方法对67例NSCLC患者术前行螺旋CT扫描,采用免疫组化SP法检测手术或穿刺癌组织标本中的p53蛋白。结果本组患者SCT检查,发现毛刺征40例,棘突征38例,血管集束征35例,空洞征25例,胸膜受侵征象28例,胸膜凹陷征36例,分叶征34例,淋巴结转移征象22例;p53蛋白阳性39例,阳性率为58.62%。p53蛋白表达与NSCLC患者SCT检查的毛刺征、棘突征、血管集束征、空洞征、胸膜侵犯和淋巴转移明显相关（P均〈0.05）,而与胸膜凹陷征及分叶征无关（P均〉0.05）。结论根据NSCLC的SCT征象可在一定程度上预测p53蛋白表达情况。     

周围型肺癌CT征象与肿瘤细胞增殖活性的相关性探讨

分析30例周围型肺癌患者癌组织中增殖性细胞核抗原(PCNA)表达与其CT征象的相关性.结果 PCNA的表达与肿瘤的分化程度及CT肿瘤直径、分叶征、棘状突起、血管集束征、胸膜凹陷征、纵隔淋巴结转移均密切相关(P均<0.05),而与毛刺征无关(P>0.05).肺癌强化程度与PCNA蛋白表达之间无显著性关系.提示周围型肺癌部分CT征象与PCNA表达有密切关系,可作为评价肿瘤恶性程度的一种方法.     

周围型肺癌CT特征与PCNA、VEGF及Bcl-2表达水平的相关性

目的 分析周围型肺癌组织中增殖细胞核抗原(PCNA)、血管内皮生长因子(VEGF)及B细胞淋巴瘤因子2(Bcl-2)与周围型肺癌CT特征的相关性。方法 选择2018年12月至2020年12月于我院进行手术治疗的周围型肺癌患者74例。采用免疫组织化学SP法检测PCNA、VEGF及Bcl-2。分析周围型肺癌CT特征与PCNA、VEGF及Bcl-2的相关性。结果 周围型肺癌PCNA、VEGF及Bcl-2阳性细胞百分率高于癌旁组织(P<0.05);癌组织PCNA、VEGF及Bcl-2阳性率高于癌旁组织阳性率(P<0.05);肿瘤直径、淋巴结转移、分叶征、空洞征为PCNA表达(P<0.05);肿瘤直径、淋巴结转移、分叶征为VEGF表达(P<0.05);毛刺征和胸膜凹陷征为Bcl-2表达(P<0.05)。结论 PCNA、VEGF及Bcl-2在周围型肺癌中表达上调,与周围型肺癌病灶的CT特征相关,CT特征可用于判断肿瘤的恶性生物学行为。     

胃癌组织中肝素酶和血管内皮生长因子-C的表达及其临床意义

目的探讨胃癌组织中肝素酶和血管内皮生长因子（VEGF）-C蛋白表达及其临床意义。方法采用免疫组化S-P法检测97例原发性胃癌组织、癌旁组织及20例正常胃黏膜组织中肝素酶和VEGFC蛋白的表达，并分析其与临床病理特征和预后的关系。结果胃癌组织肝素酶和VEGF—C蛋白表达阳性率分别为61．9％和66．0％，显著高于癌旁组织的7．2％和5．0％，正常胃组织的8．3％和5．0％（P值均〈0．01）；肝素酶表达与肿瘤分化程度无关，但与肿瘤直径、淋巴结转移、静脉侵犯、淋巴管侵犯、远处转移、浆膜面受累和TNM分期等密切相关；VEGF—C表达与肿瘤直径、分化程度、静脉侵犯及远处转移等无关，但与淋巴结转移、淋巴管侵犯、浆膜面受累和TNM分期等密切相关；肝素酶和VEGF—C阳性表达组术后生存率明显低于阴性组；在胃癌中肝素酶和VEGF—C阳性表达呈正相关。结论肝素酶及VEGF-C蛋白的阳性表达，可作为胃癌预后不良的参考指标。     

胃癌浸润转移的螺旋CT征象与nm23-H1表达的相关性

目的探讨胃癌浸润转移的螺旋CT（SCT）征象与nm23-H1蛋白和mRNA表达的关系.方法对57例不同SCT征象胃癌患者的癌组织采用免疫组化和原位杂交法行nm23-H1蛋白和mRNA表达检测.结果SCT上有、无浆膜侵犯者其nm23-H1蛋白和mRNA表达均有显著差异（χ2值分别为4.22和8.73,P分别为0.04和0.003）;SCT上有、无转移者nm23-H1蛋白和mRNA表达均有显著差异（χ2值分别为10.97和13.87,P分别为0.001和0.000）;SCT上浆膜侵犯并淋巴结转移有、无者nm23-H1蛋白和mRNA表达均差异显著（χ2值分别为5.42、4.01,P值分别为0.020、0.045）.结论nm23-H1蛋白和mRNA表达均与胃癌SCT浸润和转移征象密切相关;根据胃癌浸润转移螺旋CT征象可以推测胃癌组织的nm23-H1基因表达情况,对两者进行联合分析可为判断肿瘤是否具有淋巴结转移倾向提供依据.     

肺癌肺内转移的多形性CT影像表现

目的评价肺癌肺内转移在CT影像上的各种形态表现。方法194例病例，其中男106例，女88例，平均45岁。原发肿瘤包括鳞癌56例（28．9％），腺癌107例（55．2％），小细胞肺癌26例（13．4％），腺鳞癌5例（2．6％）。结果肺癌肺内血行转移主要以实性结节最为常见，其少见影像可表现为空洞转移、磨玻璃转移、转移病灶边缘毛糙和/或胸膜凹陷征以及转移灶内可见含气支气管气像，并主要见于肺腺癌；淋巴道转移表现为支气管血管柬不规则结节状增厚。小叶间隔增厚呈串珠状或胸膜下多角形细线结构。结论肺癌肺内转移可呈多形性影像表现。     

p16和VEGF在老年肺癌组织中的表达及临床意义

目的研究抑癌基因p16和血管内皮生长因子（VEGF）在肺癌组织中的表达及与临床病理学参数之间的关系。方法采用链霉素抗生物索蛋白-过氧化物酶（streptaridin pemxidase，SP）免疫组织化学法检测80例肺癌石蜡包埋组织中VEGF和p16的表达情况。结果①p16主要表达于肿瘤细胞胞核。VEGF主要表达于肿瘤细胞胞浆或胞膜，二者的表达都与肺癌淋巴结转移、临床分期有关（P〈0．05）；②p16和VEGF的表达都与患者的性别，年龄，组织类型，组织分化级别和肿瘤大小无关（P〉0．05）；③p16表达与VEGF呈负相关（P〈0．05）。结论VEGF促进肿瘤血管生成，VEGF表达上调或p16表达下调对肺癌发生、发展及转移起霞要作用．为判宦肿瘤的牛物学行为和转耨潜能棍世了雷霉括标．     

20例周围型肺癌影像学分析

目的 探讨周围型肺癌影像学表现及其鉴别要点,进一步提高影像学对周围型肺癌的诊断.方法 回顾性分析20例经手术病理证实的周围型肺癌患者的影像及临床资料,提出其诊断及鉴别诊断要点.全部病例均做了胸片及CT检查.结果 周围型肺癌主要征象:(1)分叶征;(2)毛刺征;(3)胸膜凹陷征.次要影像学表现为:血管支气管集束征、空洞征、棘突征、空气支气管征及空泡征等.结论 周围型肺癌有典型影像学表现,但肺部病变表现较复杂,故要注意鉴别诊断.     

Survivin、COX-2、VEGF在非小细胞肺癌中表达的相关性研究

目的探讨Survivin、COX-2、VEGF三种蛋白在非小细胞肺癌组织中的表达及其与临床病理因素的相关性。方法用免疫组化方法检测40例非小细胞肺癌组织中Survivin、COX-2、VEGF的表达，并与临床病理因素进行相关性分析。结果1．三者在不同年龄、性别、病理类型中表达的差异无统计学意义（P均〉0．05）。2．Survivin、VEGF在不同的肿瘤直径、有无淋巴结及远处转移中的表达差异有统计学意义。COX-2在不同的肿瘤直径、有无淋巴结及远处转移中的表达差异无统计学意义。3．三者的表达互呈正相关。结论Survivin、VEGF、COX-2三者相互作用，是较好的预测肿瘤负荷及其远方转移的指标。     

Syndrome differentiation in traditional Chinese medicine and E-cadherin/ICAM-1 gene protein expression in gastric carcinoma

AIM To explore the syndrome differentiation in traditional Chinese medicine (TCM) and gene protein expression in gastric carcinoma METHODS Preoperative data of gastric cancer cases were collected from the General Surgery Department and classified according to the criteria for syndrome differentiation in TCM. E-cadherin (E-cad) and ICAM-1 gene protein expressions were detected in postoperative specimens from these cases by the immunohistochemical EnVision two-step method.RESULTS The E-cad positive expression rate was 90% in 100 cases of gastric carcinoma. The difference in E-cad expression was significant between thedifferent syndrome differentiation types in TCM (P ＜0.01). Further group-group comparison showed that there was a significant difference in E-cad expression between the stagnation of phlegm-damp type and the deficiency in both qi and blood and the deficiency-cold of stomach and spleen types, where E-cad expression was high. There was no significant difference between the internal obstruction of stagnant toxin type and the in-coordination between liver and stomach type, where E-cad expression was relatively low. The ICAM-1 positive expression rate was 58%, and there was no statistically significant difference between the two groups (χ2= 8.999,P ＞ 0.05).CONCLUSION E-cad expression is relatively low in the internal obstruction of stagnant toxin type and the incoordination between liver and stomach type, where tumor development and metastasis may be associated with low E-cad expression, or with low homogeneous adhesiveness between tumor cells.     

血管内皮生长因子、细胞角蛋白19片段鉴别良恶性胸腔积液的临床价值

目的探讨联合检测血清和胸腔积液中血管内皮生长因子、细胞角蛋白19片段对鉴别结核性与肺癌性胸腔积液的临床价值。方法分别采用双抗体夹心酶联免疫吸附和电化学发光免疫法检测肺癌性和结核性胸腔积液患者血清和胸腔积液中血管内皮生长因子及细胞角蛋白19片段的表达水平。结果肺癌性胸腔积液患者血清和胸腔积液中血管内皮生长因子及细胞角蛋白19片段的表达水平比较有统计学意义（P〈0．01）,联合检测可使敏感性提高至92．00％,特异性提高至86．84％。结论联合检测胸腔积液和血清中血管内皮生长因子、细胞角蛋白19片段,对鉴别肺癌性与结核性胸腔积液具有重要的临床价值。     

Vascular endothelial growth factor (VEGF) is one of the cytokines causative and predictive of hepatic veno-occlusive disease (VOD) in stem cell transplantation

Hepatic veno-occlusive disease (VOD) is one of the most serious complications in patients receiving stem cell transplantation (SCT). However, the cause of VOD remained to be elucidated. Vascular endothelial growth factor (VEGF) has been reported to have various physiological effects including neovascularization and acceleration of vasopermeability. Because we postulated that VEGF could be one of the causative factors in VOD after SCT, serum VEGF levels were measured by ELISA in 50 patients receiving SCT. Six of the patients showed typical manifestations of VOD and four of them died due to VOD. The mean maximum serum VEGF level in the six patients with VOD was markedly increased compared to that in the patients without VOD (P < 0.001) and in normal controls (P < 0.001). Moreover, the mean maximum serum VEGF level in patients with VOD before conditioning chemoradiotherapy for SCT was also high compared to patients without VOD (P = 0.0012) in the same period. Similarly, serum VEGF levels were significantly higher in patients whose plasma protein C activities decreased below 40% (P < 0.001). During the clinical course of VOD after SCT, the increase of serum VEGF synchronized fairly well with the development of VOD. Since VEGF causes the expression of tissue factor on circulating monocyte/macrophages and results in hypercoagulability, our observation suggests that in the patients with VOD who showed high serum VEGF it might account for the development of VOD. Furthermore, this observation may indicate a novel therapeutic strategy for prevention of VOD.     

老年肺栓塞的螺旋CT肺动脉造影诊断研究

目的探讨螺旋CT肺动脉造影在老年肺动脉栓塞(PE)诊断中的临床应用价值。方法采用螺旋CT对66例老年PE患者行肺动脉增强扫描,其中多层、单层螺旋CT(MSCT,SCT)肺动脉造影检查者各为21和45例。结果分析66例老年PE患者的2728支肺动脉,MSCT、SCT肺动脉造影共显示926支肺动脉受累。直接征象为中心型充盈缺损、部分型充盈缺损、完全性阻塞、附壁性充盈缺损,约占33.9%;1206支段以上肺动脉中,依据直接征象MSCT、SCT分别检出240支/384支(62.5%)和481支/822支(58.5%),共721支/1206支,两者检出率无明显差别(P=0.037);1522支亚段肺动脉中,MSCT、SCT分别检出121支/484支(25.0%)和84支/1038支(8.1%),共205支/1522支,前者检出率明显高于后者(P=0.632)。平扫示间接征象共125例次。结论MSCT、SCT对段以上PE的诊断二者均有较高的准确度,MSCT对亚段PE的诊断有其优势。     

E-钙粘素、γ-连环素及基质金属蛋白酶-9的表达与原发性肝癌侵袭转移的关系

目的研究细胞粘附分子E-钙粘素（E-cadherin,E-cad）、γ-连环素（γ-catenin,γ-cat）及基质金属蛋白酶-9（matrix metallo-proteinase9,MMP-9）与原发性肝癌侵袭转移的关系。方法采用免疫组织化学方法,对经过石蜡包埋的40例原发性肝细胞癌组织和40例癌旁正常肝组织标本进行检测,并结合相关临床病理指标进行半定量分析。结果 E-cad、γ-cat及MMP-9在肝癌中的阳性表达率分别为30.0%（12/40）、32.5%（13/40）、77.5%（31/40）,在癌旁正常肝组织中的阳性表达率分别为100%（40/40）、100%（40/40）、17.5%（7/40）。E-cad、γ-cat在肝癌组织中不同程度的表达减弱或缺失,在癌旁正常肝组织中全部正常表达,MMP-9在肝癌组织呈现高表达,在癌旁正常肝组织中呈现低表达或不表达,三者的表达随肝癌的侵袭转移而有显著性差异（P〈0.05）,且E-cad、γ-cat在肝癌组织中的表达都与MMP-9的表达水平呈负相关（r=-0.562,P〈0.05;r=-0.649,P〈0.05）。结论 E-cad、γ-cat及MMP-9参与肝癌的侵袭转移过程,在原发性肝癌恶性进展方面起着重要作用。     

Ezrin、FAK及E-cadherin在大肠癌组织中的表达及其临床意义

目的:探讨大肠癌组织中埃兹蛋白(Ezrin),黏着斑激酶(FAK)及上皮细胞钙黏蛋白(E-cadherin)的表达及其与肿瘤侵袭和转移的关系.方法:大肠癌组织标本50例,其中高分化腺癌13例,中低分化腺癌37例;无淋巴结转移30例,淋巴结转移20例.采用免疫组织化学方法检测50例大肠癌组织中Ezrin,FAK及E-cadherin的蛋白表达,并运用统计学方法分析Ezrin,FAK及E-cadherin的表达与大肠癌各种临床病理特征的关系及三者的相关性.结果:Ezrin在中低分化、伴有淋巴结转移及Dukes C D期大肠癌的阳性表达率显著高于高分化、无淋巴结转移及Dukes A B期大肠癌(83.78% vs 46.15%,P<0.01;95.00%vs 60.00%,P<0.01;95.00% vs 60.00%,P<0.01),而E-cadherin在以上组织中的表达正好相反(24.32% vs 69.23%,P<0.01;10.00% vs 53.33%,P<0.01;10.00% vs 53.33%,P<0.01),其均与患者性别及年龄大小均无关(P>0.05).FAK在Dukes C D期、伴有淋巴结转移大肠癌组织中的阳性表达显著高于Dukes A B、无淋巴转移组织(100.00% vs 63.33%,P<0.01;100.00% vs 63-33%,P<0.01),而与肿瘤的分化程度、患者性别及年龄大小均无关(P>0.05).经Spearman相关分析,Ezrin与FAK在大肠癌组织中的表达呈正相关(r=0.346,P<0.05),E-cadherin与Ezrin、FAK在大肠癌组织中的表达均呈明显负相关(r=-0.410,P<0.01;r=-0.406,P<0.01).结论:Ezrin,FAK及E-cadherin在大肠癌组织中的异常表达与肿瘤组织的浸润和转移密切相关,联合检测可以作为一组有效的大肠癌肿瘤标记和预后指标.     

Radiologically guided fine needle lung biopsies in the evaluation of focal pulmonary lesions in allogeneic stem cell transplant recipients

Lung problems are common in allogeneic stem cell transplant (SCT) recipients. To evaluate the feasibility and diagnostic yield of radiologically guided fine needle lung biopsy (FNLB) in allogeneic SCT recipients with focal pulmonary lesions, a retrospective analysis was carried out. Between 1989 and 1998, radiologists performed a total of 30 FNLBs in 21 allogeneic SCT recipients, guided either by ultrasound (n = 17) or computed tomography (n = 13). The median time from SCT to the first FNLB was 131 days (20-343 days). Prophylactic platelet transfusions were given in 19 procedures (66%). The complications of FNLB included clinically insignificant pneumothorax in four procedures (13%) and self-limiting haemoptysis in one case (3%). The first FNLB was suggestive of invasive pulmonary aspergillosis (IPA) in five patients (24%). Additional clinically useful findings of FNLB included Pseudomonas (two patients) and Nocardia (one patient). The final diagnosis of pulmonary lesions was IPA in 14 patients, immunological lung problems in four patients and other in three patients. Radiologically guided FNLB is feasible in allogeneic SCT recipients and has a low complication rate. The diagnostic yield is high especially for IPA.     

Airway reactivity in children before and after stem cell transplantation

Stem cell transplantation (SCT) is associated with pulmonary complications. We encountered several children post‐SCT with a clinical picture suggestive of airway hyper‐reactivity (AHR) and evidence of reversible airway obstruction that was not reported pre‐transplant. We evaluated the possibility of increased AHR as assessed by methacholine challenge test (MCT) following the course of SCT, and assessed a possible correlation between AHR and pulmonary complications. This was a prospective study evaluating consecutive patients referred for SCT to the Department of Pediatric Hemato‐Oncology. Evaluation included pulmonary function test and MCT before and after SCT, and assessment of pulmonary complications. Twenty‐one of 33 patients completed the study. The mean PC₂₀ was 14.3 ± 4.1 mg/ml prior to SCT; afterward the mean PC₂₀ decreased to 11.2 ± 5.6 mg/ml (P = 0.018). The number of patients with airway reactivity (PC₂₀ ≤ 8 mg/ml) increased from 2/21 patients before SCT to 8/21 patients after SCT (P = 0.043; McNemar test with Yates correction). Pulmonary complications and hospitalization were recorded in 33.3% of the patients (7/21 patients): 62.5% of the patients (5 patients) with AHR compared to 15.4% (2 patients) in the group without AHR (P = 0.041; Fisher exact test). There were 10 hospitalizations among the 8 patients with positive MCT compared to 2 hospitalizations in 13 patients with negative MCT (median 1 vs. 0, P = 0.045; Mann–Whitney U‐test). Increased airway reactivity was observed in our study following the course of SCT. Positive MCT after SCT may be associated with increased risk of pulmonary complications. Larger prospective studies are needed to evaluate the possible mechanisms responsible for increased AHR and the clinical importance of these findings. Pediatr Pulmonol. 2009; 44:845–850. © 2009 Wiley‐Liss, Inc.     

Pulmonary complications after T-cell-depleted allogeneic stem cell transplantation: low incidence and strong association with acute graft-versus-host disease

Lung injury limits the success of allogeneic stem cell transplantation (SCT). The overall incidence varies from 30 to 50% and non-infectious causes occur in one-third to one-half of these. We reviewed pulmonary complications in 369 consecutive patients who received a partially T-cell-depleted myeloablative allogeneic hematopoietic SCT at our institution between 1993 and 2003. All patients were treated uniformly with cyclophosphamide followed by total body irradiation. Control subjects were matched on sex, underlying diagnosis, age, type of transplantation and cytomegalovirus (CMV)-serostatus. Sixty-one patients (16.5%) developed pulmonary complications. Twenty-one patients (5.7%) developed infectious pneumonia. Forty patients developed non-infectious complications which were further subclassified as bronchiolitis obliterans (3.5%), bronchiolitis obliterans-organizing pneumonia (0.5%), diffuse alveolar hemorrhage (0.8%), idiopathic pneumonia syndrome (5.5%) or mixed etiology (0.5%). Acute graft-versus-host disease (GVHD) > or =grade II was significantly more common in pulmonary patients than in the controls (36/61 versus 22/61 patients, P=0.02). There was no significant difference in the incidence of chronic GVHD (P=0.09). CMV reactivation was significantly more frequent in patients with lung injury (P=0.02). Median survival was 41 weeks for the pulmonary patients and 350 weeks for the controls (P=0.001). Altogether, the incidence of pulmonary complications is low after T-cell-depleted SCT and is associated with acute GVHD and CMV reactivation.     

利用组织芯片技术研究PTEN和VEGF在胃癌中的表达及意义

目的研究PTEN和血管内皮生长因子（vascular endothelial growth factor，VEGF）在胃癌中的表达及临床意义。方法应用组织微阵列仪制作97孔胃癌组织芯片（tissue microarray）。用免疫组织化学S—P法检测PTEN、VEGF在72例胃癌和25例正常胃黏膜中的表达。结果胃癌组织中PTEN蛋白阳性表达率显著低于正常胃黏膜（45．8％ VS 100％，P〈0．01）；VEGF的阳性表达率显著高于正常胃黏膜（75％VSl2％，P〈0．01），PTEN在胃癌中的表达与VEGF呈负相关（P〈0．01）。PTEN、VEGF的表达在中高分化腺癌分别为68．8％、62．5％（P〉0．05），在低分化及未分化腺癌分别为27．5％、85．0％（P〈0．05）；伴淋巴结转移者分别为31．6％、86．9％（P〈0．05），无淋巴结转移者分别为61．8％、61。8％（P〉0．05）；临床病理分期Ⅰ＋Ⅱ期分别为57．1％、61．9％（P〉0．05），Ⅲ＋Ⅳ期分别为30．0％、93．3％（P〈0．05）；与性别、年龄、肿瘤大小和组织分型无显著差异（P〉0．05）。结论PTEN失活或蛋白表达降低、VEGF的高表达与胃癌临床病理特征和生物学行为有密切关系。PTEN在低分化或未分化以及伴淋巴结转移和临床Ⅲ＋Ⅳ期胃癌中的表达与VEGF呈负相关。联合检测PTEN、VEGF对胃癌的恶性程度及预后判断具有一定的临床参考意义。应用组织芯片大规模高效检测临床组织样本是可行的，具有快速、准确、方便经济的特点。