周围型肺癌CT征象和动态CT增强与微血管密度关系的研究

目的　探讨周围型肺癌螺旋CT征象和动态CT增强与肿瘤内微血管密度 (MVD)的关系。方法　 3 3例经手术和病理证实的周围型肺癌 (鳞癌 14例 ,腺癌 19例 )术前行螺旋CT平扫和动态增强扫描 ,病理标本采用LSAB免疫组化法检测其MVD。结果　周围型肺腺癌MVD明显高于鳞癌 ,其MVD分别为 63 .4± 11.9和 5 0 .2± 16.3 (P <0 .0 5 ) ,边缘区和间质部分的MVD高于坏死区、瘢痕区和实质部分。肺癌MVD值与CT影像上肿瘤直径、分叶征、血管集束征、胸膜凹陷征及纵隔淋巴结转移均有密切关系 (P均 <0 .0 5 )。肺腺、鳞癌平均CT强化值分别为 ( 4 3 .4± 11.8)HU和 ( 3 4.6± 10 .7)HU (P <0 .0 5 ) ,与其相应的MVD值均呈正相关 (r =0 .719,P <0 .0 1;r =0 .819,P <0 .0 1)。结论　周围型肺腺癌的部分CT征象和CT增强幅度与其MVD值有密切关系 ,可用于预测肿瘤的组织学类型和评价其恶性程度。     

NSCLC的微血管密度及结构与预后的关系

目的　探讨非小细胞肺癌 (NSCLC)组织内微血管密度 (MVD)和微血管结构 (MVS)特征与患者预后的关系。方法　采用免疫组化LsAB法 ,以Von Willebrand因子抗体显示血管内皮细胞 ,镜下观察 49例NSCLC患者肿瘤组织中微血管的数量与结构特征。根据其形态的不同 ,把微血管分为A、B两型 ,A型主要表现为血管壁较厚或较完整 ,管形较规则 ,常分散存在 ;B型主要表现为血管壁薄或不完整 ,管形不规则 ,常丛状或网状分布。结果　①原发NSCLC组织内MVD与患者pTNM分期和淋巴结受累与否密切相关 ,P值分别为0 .0 43和 0 .0 3 8,而MVS与原发瘤大小密切相关 ,P =0 .0 0 2 ;②原发NSCLC组织内MVD较高者 (>5 2 /2 0 0×视野)的生存期 (2 3 .2月± 18.4月 )明显短于MVD较低者 (<5 2 /2 0 0×视野) (3 5 .9月± 2 0 .9月 ) ,P =0 .0 1;③原发NSCLC组织内MVSA型者的生存期 (3 9.4月± 17.2月 )明显长于MVSB型者 (2 3 .5月± 2 0 .3月 ) ,P =0 .0 0 8;④原发NSCLC组织内MVD <5 2 /2 0 0×视野 且MVSA型者的生存期 (4 2 .9月± 19.3月 )明显长于MVD >5 2 /2 0 0×视野 且MVSB型者 (15 .7月± 16.8月 ) ,P =0 .0 0 2。结论　原发NSCLC组织内MVD和MVS特征与患者预后密切相关 ,提示MVD和MVS特征可以作为临床估价患者预后和设计术后辅助治     

脑膜瘤血管生成与瘤周水肿,复发和预后的关系

目的　探讨脑膜瘤血管生成与脑膜瘤瘤周水肿、复发和预后的关系。方法　对 5 7例脑膜瘤的 CT、 因子相关抗原抗体免疫组化染色和病理学资料以及 32例脑血管造影结果进行脑膜瘤微血管密度 (MVD)与病理类型、瘤周脑水肿及患者术后复发率、生存期之间的关系研究。结果　 5 7例脑膜瘤患者平均微血管密度 (MVD)为 34 .5。其中良性、不典型性和恶性脑膜瘤微血管密度分别为 2 6 .8± 9.3、41.2±12 .9和 5 2 .7± 14.6 ,三种病理类型 MVD均有显著差异 (P<0 .0 1) ;中、重度脑水肿组其瘤组织 MVD分别为 (39.4±11.3和 47.9± 12 .6 )与轻度和无脑水肿组 MVD(30 .1± 9.7和 2 5 .2± 8.5 )相比有显著性差异 (P<0 .0 5 ) ;有颈外动脉供血或肿瘤染色者易发生瘤周水肿。 MVD≥ 34 .5组三年 ,五年复发率均高于 MVD<34 .5组 (P<0 .0 5 ) ,且前者五年生存率明显低于后者 (P<0 .0 5 )。结论　脑膜瘤微血管密度可作为判断肿瘤侵袭力及评价患者术后复发和预后的良好指标。     

检测肺癌中的微血管密度及其临床意义

目的　研究肺癌组织中微血管密度 (micro vasculardensity ,MVD)与肺癌病理生理特征及预后的关系。方法　采用免疫组化LSAB法 ,检测 114例肺癌组织、3 0例肺良性病变组织中的MVD。结果　①肺癌组织中MVD( 3 0 .3 7± 10 .5 6)显著高于肺良性病变组织 ( 10 .2 3± 6.2 9) (P <0 .0 1) ;②MVD与肺癌原发肿瘤大小 ,淋巴结转移状态 ,P TNM分期 ,细胞分化程度等均有密切关系 (P <0 .0 1) ,而与肺癌患者性别、年龄、吸烟史、肺癌原发部位、组织学类型等均无明显关系 (P >0 .0 5 ) ;③肺癌组织中MVD高密度(MVD≥ 3 0 )组患者 5年生存率 ( 17.2 7% )明显低于低密度 (MVD <3 0 )组 5年生存率 ( 5 2 .74% ) (P <0 .0 1) ;④MVD与肺癌患者术后生存期呈显著负相关 (r =-0 .5 2 1,P <0 .0 1) ;⑤多因素COX模型分析发现 :P TNM分期和MVD是判断肺癌预后最有价值的指标。结论　MVD在肺癌的发生、发展、转移中起重要作用 ,可作为肺癌生物学行为的一项评估指标 ,检测肺癌中MVD有助于预测肺癌预后及指导术后多学科综合治疗。     

非小细胞肺癌的CT增强值与p53表达的关系研究

目的:探索非小细胞肺癌中CT增强值与微血管密度及突变型p53表达的关系.方法:对54例非小细胞肺癌进行了CT扫描和因子、p53表达的免疫组化染色(S-P法),因子用来标记微血管内皮细胞.结果:54例非小细胞肺癌(NSCLC)中,CT增强值与微血管密度(MVD)呈正相关,γ=0.631 3;p53阳性组的平均MVD、平均CT增强值显著高于p53阴性组,P=0.007、P=0.000.结论:非小细胞肺癌的CT增强值与微血管密度有关,也与p53表达有关.     

肺癌血管内皮生长因子的表达及其临床意义

目的探讨血管内皮生长因子(VEGF)在人肺癌组织中的表达及其与微血管密度(MVD)、肿瘤复发和转移以及患者预后的关系.方法应用免疫组化的方法检测42例肺癌组织中MVD和VEGF表达的情况.结果VEGF在肺癌组织中的阳性表达率为81.0%;VEGF阳性表达组的肺癌组织平均MVD为(45.68±9.23)/每高倍视野,而阴性表达组的MVD为(34.58±10.22)/每高倍视野,两组之间的差异具有显著性(P＜0.01);VEGF的表达水平与肿瘤复发和转移呈正相关(P＜0.01),与术后生存时间呈负相关(P＜0.05).结论VEGF能促进肺癌组织中微血管的形成,因而在肺癌的复发和转移中起重要作用;VEGF可作为判断肺癌患者临床预后的参考指标.     

一氧化氮合酶与浸润性乳腺癌血管形成的关系及临床意义

目的:探讨一氧化氮合酶(nitrioxide synthase,NOS)与浸润性乳腺癌新生血管形成的关系及其临床意义。方法:采用分光光度法检测30例浸润性乳腺癌及其相应癌旁乳腺组织和30例良性乳腺病变组织的 NOS活性,应用免疫组织化学SP法,以抗第8因子相关抗原(ⅧRAg)抗体标记血管内皮细胞,根据ⅧRAg阳性的血管内皮细胞计数来测定微血管密度(microvessel density, MVD)。结果:1)浸润性乳腺癌 NOS活性(2. 22±1 .39)显著高于相应癌旁乳腺组织(1. 29±0 .48)及良性乳腺病变组织(0 .50±0. 14),P=0 .004,P=0. 000;相应癌旁乳腺组织NOS活性高于良性乳腺病变组织,P=0 .000。2)乳腺癌 MVD计数(40. 53±8. 29)明显高于相应癌旁乳腺组织(18. 07±4. 90),P=0 000。3)有腋淋巴结转移者 NOS活性(2 .60±1 .66)高于无淋巴结转移者(1 .72±0 .41),P=0 .048,且明显形成更多的微血管,P=0 000。4)乳腺肿瘤组织NOS活性和MVD与肿瘤大小、分化程度和ER、PR表达状况无关。5)浸润性乳腺癌NOS活性与肿瘤 MVD呈正相关,r=0 .494,P=0 .014。结论:1)浸润性乳腺癌NOS活性、MVD与其淋巴结转移密切相关,一氧化氮(nitric oxide, NO)生成可促肿瘤新生血管形成,并促其生长、发展和侵袭转移。2)肿瘤微环境中 NO合成增加可能促肿瘤生长。3)NOS活性增加可作     

食管癌原发灶及转移淋巴结血管内皮生长因子和微血管形成的测定

目的 :探讨食管鳞状细胞癌原发灶和淋巴结转移灶血管内皮生长因子 (VEGF)表达及微血管形成的规律。方法 :用免疫组化方法测定 35例食管癌标本原发灶和转移灶VEGF表达水平及微血管密度(MVD)。结果 :淋巴结转移灶VEGF表达水平高于原发灶 (P <0 .0 1) ;淋巴结转移灶、原发灶及阴性淋巴结MVD分别为 11 33± 4 .4 4、13 85± 5 57、18 6 1± 6 6 7,淋巴结转移灶与后两者相比差异均有显著性 (P <0 .0 1)。结论 :转移灶VEGF表达水平高于原发灶 ,淋巴结内可能存在抗肿瘤血管生成因素。     

垂体腺瘤的血管生成、c-myc表达与侵袭性的相关意义

目的　探讨微血管密度 (microvesseldensity,MVD)、c -myc表达与肿瘤侵袭性的关系。方法　应用EnVision二步法免疫组化技术检测 5 8例垂体腺瘤的MVD、c-myc表达情况 ;分为侵袭组和非侵袭组进行统计学分析 ,并对MVD与c-myc的表达强度进行相关性分析。结果侵袭性垂体腺瘤MVD为 6 .78± 1.6 7;非侵袭性垂体腺瘤MVD为 3.72± 1.0 2 ;差异有显著性 (P <0 .0 0 1)。各型垂体腺瘤中c -myc均有表达 ,总阳性率为 37.9% ;其中侵袭性垂体腺瘤的阳性率为 5 5 .5 6 % ,非侵袭性垂体腺瘤的阳性率为 2 2 .5 8%。差异有显著性 (P <0 .0 5 ) ,侵袭性垂体腺瘤c -myc高表达。直线相关分析显示 ,c -myc表达强度与MVD呈显著正相关 (r=0 .5 5 4 ,P <0 .0 1)。结论　侵袭性垂体腺瘤MVD增高、c -myc高表达 ,是反映垂体瘤侵袭能力及预后的有用指标。侵袭性垂体腺瘤MVD与c -myc表达强度密切相关 ,提示c -myc表达强度与垂体腺瘤MVD在判定垂体腺瘤侵袭性方面有意义     

环氧化酶-2在非小细胞肺癌的表达及与肿瘤血管生成的研究

目的　为探讨COX 2对非小细胞肺癌发生发展的影响 ,我们对肺癌患者与肺部良性疾病患者肺组织中COX 2表达情况进行了比较 ,并研究了COX 2与肺癌临床病理特征的关系及对肿瘤血管生成的影响。方法　免疫组化检测非小细胞肺癌COX 2表达、血管内皮生长因子 (VEGF)表达 ,并测定肿瘤微血管密度 (MVD)。结果　非小细胞肺癌组织COX 2蛋白阳性表达率为 69.2 % (5 4/78) ,显著高于良性对照组织的14 .3 % (2 /14 ) (χ2 =15 .0 44 ,P <0 .0 1)。COX 2表达阳性组MVD计数 (19.41± 8.5 6)显著高于COX 2表达阴性组 (12 .0 0± 5 .3 7) (t=3 .90 6,P <0 .0 1)。COX 2表达与肺癌患者性别、年龄、吸烟史及TNM分期无明显关系 (P >0 .0 5 ) ;在不同肿瘤的病理类型中 ,腺癌组织COX 2表达率为 88.9% (3 2 /3 6) ,显著高于鳞癌的5 0 .0 % (2 0 /4 0 ) (χ2 =13 .2 62 ,P <0 .0 1) ;鳞癌组织中低分化癌组织表达率为 81.0 % (17/2 1) ,显著高于中高分化癌组织的 15 .8% (3 /19) (χ2 =16.942 ,P <0 .0 1) ;腺癌组织中低分化癌组织表达率为 10 0 .0 % (18/18) ,显著高于中高分化癌组织的 77.8% (14 /18) (χ2 =6.0 46,P <0 .0 5 )。相关关系分析显示肺癌COX 2表达与VEGF表达呈显著正相关 (r =0 .5 0 9,P <0 .0 1) ;VEGF表达与MVD呈     

Bacteria and cancer--antagonisms and benefits

There is considerable historical and recent evidence concerning the antagonisms between acute bacterial infections or their toxins and cancer and allied diseases. These data provide renewed incentives to undertake clinical programmes with mixed bacterial vaccines in many countries at the present time.     

Religiosity and physical and emotional functioning among African American and White colorectal and lung cancer patients

The literature suggests that religiosity helps cope with illness. The present study examined the role of religiosity in functioning among African Americans and Whites with a cancer diagnosis. Patients were recruited from an existing study and mailed a religiosity survey. Participants (N = 269; 36% African American, 56% women) completed the mail survey, and interview data from the larger cohort was utilized in the analysis. Multivariate analyses indicated that in the overall sample religious behaviors were marginally and positively associated with mental health and negatively with depressive symptoms. Among women, religious behaviors were positively associated with mental health and negatively with depressive symptoms. Religiosity was not a predictor of study outcomes for men. Among African Americans, religious behaviors were positively associated with mental health and vitality. Among Whites, religious behaviors were negatively associated with depressive symptoms. These findings suggest a mixed role of religious involvement in cancer outcomes. The current findings may have applied potential in the areas of emotional functioning and depression.     

VEGF及KDR在大肠腺瘤和腺癌中的表达及意义

目的：探讨VEGF和KDR在大肠腺瘤和大肠腺癌中的表达及临床病理特征的关系。方法：大肠腺瘤和大肠腺癌组织标本各100例,采用免疫组织化学染色法检测VEGF和KDR在标本中的表达情况。结果：VEGF和KDR在大肠腺癌组中的阳性表达明显高于大肠腺瘤组（P〈0.05）;在正常大肠黏膜均未见VEGF和KDR表达的阳性染色;VEGF阳性表达组中KDR的阳性表达率为70%,显著高于VEGF阴性表达组中KDR的阳性表达率16%,两组比较有统计学意义（P〈0.01）。结论：大肠腺癌组织中KDR的表达与肿瘤大小、转移情况、浸润深度密切相关;VEGF和KDR在大肠腺瘤中的表达与患者的年龄、性别及分型均无相关性,而与增生程度相关（P〈0.05）。在大肠腺癌患者中VEGF及KDR表达更高,二者具有协同效应。     

Renal irradiation and the pharmacology and toxicity of methotrexate and cisplatinum

We used a rat model to study the effects of renal irradiation on the pharmacology of methotrexate (MTX) and cisplatinum (cis-Pt). Unanesthetized rats were given bilateral kidney irradiation (20 Gy in 9 fractions). At 9 months after irradiation, 3% of the animals had died and survivors showed moderately impaired renal function. At 15 months, 30% of the animals had died and survivors showed severely impaired renal function. Some animals were given i.v. MTX 1 week to 15 months after irradiation. In irradiated rats, the area under the MTX plasma clearance curve equaled that of controls through 6 months, and was significantly above controls from 9 months on. Other animals were given i.p. cis-Pt 1 week to 9 months after irradiation. The acute toxicity of cis-Pt was the same in control and irradiated rats when cis-Pt was given immediately before or after irradiation. Beginning 3 months after irradiation there was a progressive increase in cis-Pt toxicity and a simultaneous decrease in urinary platinum excretion. Irradiated animals that survived cis-Pt treatment showed increased radiation nephritis; the greatest effect occurred when cis-Pt was given 3 months or more after irradiation. MTX and cis-Pt clearance decreased when renal dysfunction was first observed and changes in renal function preceded changes in drug clearance and toxicity.     

Morphine and tumor growth and metastasis

Morphine is an analgesic widely used to alleviate cancer pain. In addition, the perioperative management of pain in cancer surgery patients most often includes opioids. However, there are reports that these drugs may alter cancer recurrence or metastasis. Several mechanisms have been proposed, such as the modulation of the immune response or cellular pathways that control the survival and migratory behavior of cancer cells. The published literature, however, presents some discrepancies, with reports suggesting that opioids may either promote or prevent the spread of cancer. It is of great importance to determine whether opioids, in particular the most widely used, morphine, may increase the risk of metastasis when used in cancer surgery. This review examines the available data on the effects of morphine which influence cancer metastasis or recurrence, including immunomodulation, tumor cell aggressiveness, and angiogenesis, with special emphasis on recently published clinical and laboratory based studies. We further discuss the parameters that may explain the difference between reports on the effects of morphine on cancer.     

肾上腺素能β受体与肿瘤生长及转移

大量研究表明肿瘤细胞可表达β受体，而一些神经递质、药物和社会心理因素可能通过β受体影响肿瘤的生长和转移，β受体激动剂、β受体阻滞剂以及抑郁等社会心理因素可加强或削弱这种作用。这为表达β受体肿瘤的治疗开辟了新的道路，提供了新的治疗靶点。