环氧合酶-2、bcl-2蛋白在宫颈鳞癌组织中的表达及意义

目的:探讨宫颈鳞癌组织中环氧合酶(COX-2)、bcl-2蛋白的表达及其与宫颈癌临床分期、病理分级、淋巴转移的关系。方法:采用免疫组化法对40例宫颈癌组织中COX-2和bcl-2蛋白的表达进行检测分析,以10例正常宫颈组织作为对照。结果:COX-2和bcl-2蛋白在正常宫颈组织中阳性表达率均为0(0/10)。COX-2在宫颈原位癌、Ⅰ~Ⅱ期及Ⅲ期的阳性表达率分别为50.0%、54.5%和66.7%,宫颈鳞癌及正常宫颈组织组之间比较差异有显著性(P<0.05),宫颈原位癌、宫颈鳞癌Ⅰ、Ⅱ、Ⅲ期间差异无显著性(P>0.05)。COX-2在Ⅰ~Ⅱ期宫颈鳞癌表达与淋巴结转移有关(P<0.05)。bcl-2在宫颈原位癌、宫颈鳞癌Ⅰ~Ⅱ期、Ⅲ期癌细胞胞浆中未着色,但在癌间质有不同程度染色。bcl-2在宫颈癌及正常宫颈组织组之间差异有显著性(P<0.05)。宫颈原位癌、宫颈癌Ⅰ、Ⅱ、Ⅲ期间差异无显著性(P>0.05)。bcl-2与癌细胞分化程度及淋巴结转移无关(P>0.05)。COX-2与bcl-2在宫颈鳞癌组织中表达无相关性(P>0.05)。结论:COX-2和bcl-2蛋白在正常宫颈组织中均不表达。COX-2在宫颈鳞癌中的表达与临床分期和病理分级无关,与淋巴结转移有关。二者在宫颈癌中的表达无相关性。检测宫颈鳞癌组织中COX-2的表达有利于早期诊断及估计宫颈癌患者的预后。     

环氧合酶-2在子宫内膜癌组织中的表达

目的　探讨环氧合酶COX 2与子宫内膜癌发生、发展的关系。方法　应用免疫组织化学、蛋白印迹法和逆转录聚合酶链反应 (RT PCR)技术 ,检测增生期内膜 2 5例 (增生期组 ) ,分泌期内膜2 5例 (分泌期组 ) ,内膜炎内膜 2 5例 (内膜炎组 ) ,非典型增生内膜 2 3例 (非典型增生组 ) ,子宫内膜癌34例 (内膜癌组 )组织中COX 2蛋白和mRNA的表达。结果　COX 2在增生期组、分泌期组、内膜炎组、非典型增生组、子宫内膜癌组的表达率分别为 :6 7、6 4、6 0、6 0、6 7% ,免疫组织化学染色强度分别为(5 4 6± 0 12 )、(3 2 0± 0 18)、(4 78± 0 12 )、(6 10± 0 2 5 )、(8 70± 0 93)分 ;COX 2蛋白表达水平分别为 0 75± 0 2 3、0 4 1± 0 4 5、0 5 6± 0 31、1 10± 0 5 6、1 4 6± 0 4 1;COX 2mRNA含量分别为 (93± 8)、(6 5± 11)、(79± 6 )、(2 99± 11)、(493± 30 )fpg μg。内膜癌组COX 2蛋白和mRNA表达强度明显高于其他 4组 ,差异均有极显著性 (P <0 0 0 1)。内膜癌组中高分化细胞COX 2表达高于低分化细胞 ,差异有显著性 (P <0 0 5 )。非典型增生组显著高于增生期组、分泌期组和内膜炎组 ,增生期组显著高于分泌期组 ,差异均有显著性 (P <0 0 5 )。结论　COX 2在子宫内膜癌的发生、发展中起重     

环氧合酶-2蛋白在卵巢浆液性肿瘤组织中的表达及其临床意义

环氧合酶 2 (ｃｙｃｌｏｏｘｙｇｅｎａｓｅ 2 ,ＣＯＸ 2 )是前列腺素生物合成过程中的一个重要限速酶 ,它将花生四烯酸代谢成各种前列腺素产物。近年研究表明 ,ＣＯＸ 2在多种肿瘤中过度表达。ＣＯＸ 2与卵巢肿瘤的关系国内外报道尚少。本研究应用免疫组织化学 (组化 )法进行ＣＯＸ 2蛋白检测 ,以探讨ＣＯＸ 2蛋白表达与卵巢浆液性肿瘤发生、发展的关系及其临床意义。一、材料与方法1 标本来源 :选择中国医科大学第一、第二临床学院2 0 0 0年 3月至 2 0 0 1年 1月间收治的患者 6 4例。其中 ,卵巢浆液性肿瘤 (良性肿瘤 9例 ,交界性肿瘤 9例…     

子宫肌瘤中环氧合酶-2的表达与前列腺素E-2的测定及临床意义

目的探讨子宫肌瘤、肌瘤假包膜组织及肌瘤周围正常子宫肌层组织中环氧合酶2(COX2)的表达及其相关产物前列腺素E2(PGE2)水平与子宫肌瘤发生的关系。方法对2002年12月至2003年5月东莞市人民医院53例子宫肌瘤组织、46例肌瘤假包膜组织及肌瘤周围正常子宫肌层组织用SP免疫组化方法检测COX2表达,放射免疫法测定PGE2水平。结果(1)COX2在子宫肌瘤组织中的阳性表达率明显高于子宫肌层组织及肌瘤假包膜组织(P<0.05);COX2表达与患者的年龄、肌瘤大小、肌瘤个数及其类型无明显相关(P>0.05)。(2)肌瘤组织的PGE2水平明显高于子宫肌组织及肌瘤假包膜组织(P<0.05)。(3)肌瘤组织中COX2表达与PGE2水平成正相关,而肌瘤假包膜和肌层组织中则无明显相关性。结论COX2蛋白高表达可能导致前列腺素类物质生物合成增加,可能与子宫肌瘤的发生相关。     

环氧合酶-2在卵巢肿瘤中的研究

研究表明,环氧合酶-2(COX-2)过表达与肿瘤的发生发展密切相关.阐述COX-2结构功能、基因表达与调控,并且通过研究前列腺素E2(PGE2)、p53基因以及肿瘤血管生成等机制,了解COX-2在卵巢肿瘤发生发展中的作用及选择性COX-2抑制剂在卵巢肿瘤预后治疗中的应用前景.     

环氧合酶-2和前列腺素类物质在子宫内膜异位症的表达研究

目的:研究环氧合酶-2(Cox-2)、6-酮-前列腺素F1α(6-k-PGF1α)和血栓素B2(TXB2)与子宫内膜异位症(EMs)的发生及临床病理因素的关系。方法:采用免疫组织化学SABC法检测45例EMs和30例正常子宫内膜Cox-2蛋白的表达;采用放射免疫法检测组织液6-k-PGF1α和TXB2的含量。结果:Cox-2在腺上皮的胞浆中表达,EMs组Cox-2表达明显高于对照组(P<0.001);EMs的AFS分期、疼痛分级以及瘤体大小之间Cox-2表达差异无统计学意义(P>0.05)。EMs组TXB2和6-k-PGF1α的含量明显高于对照组(P<0.001);有症状组6-k-PGF1α的含量高于无症状组,差异有统计学意义(P<0.05);TXB2含量两组无差别。Cox-2蛋白的表达与6-k-PGF1α和TXB2的含量相关。结论:Cox-2、6-k-PGF1α及TXB2的高表达可能与EMs的发生相关。6-k-PGF1α可能与痛经相关。     

COX-2和VEGF-C在宫颈癌中的表达及其意义

目的探讨环氧合酶2(COX2)、血管内皮生长因子C(VEGFC)在宫颈癌及正常宫颈组织的表达情况及其与宫颈癌生物学行为之间的关系。方法采用免疫组化SP法检测郑州大学第一附属医院2000年1月至2003年3月期间76例宫颈癌和19例正常宫颈组织中COX2、VEGFC的表达。结果COX2和VEGFC蛋白在宫颈癌和正常宫颈组织中的表达差异有显著性意义(P<001);COX2表达与宫颈癌淋巴结转移、组织学分级和组织学类型显著相关,VEGFC的表达与淋巴结转移、组织学分级和临床分期显著相关。COX2与VEGFC的表达之间呈正相关(r=0553,P<001)。结论COX2和VEGFC2种蛋白表达与宫颈癌的发生发展相关,并对宫颈癌的淋巴结转移可能起重要作用。     

环氧合酶-2与宫颈癌

环氧合酶-2(COX-2)是一个炎症诱导酶,参与肿瘤的发生发展,是联系炎症与肿瘤发生的纽带之一.COX-2与宫颈癌的发生、浸润、转移、复发和预后关系密切,深入研究二者的关系有助于进一步探讨应用非甾体类抗炎药等特异性COX-2抑制剂防治肿瘤的有效性与可能性.     

环氧合酶-2在卵巢肿瘤中的研究

研究表明，环氧合酶-2(COX-2)过表达与肿瘤的发生发展密切相关。阐述COX-2结构功能、基因表达与调控，并且通过研究前列腺素E2(PGE2)、p53基因以及肿瘤血管生成等机制，了解COX-2在卵巢肿瘤发生发展中的作用及选择性COX-2抑制剂在卵巢肿瘤预后治疗中的应用前景。     

子宫内膜癌的环氧合酶-2表达

通过测定环氧合酶2(COX-2)的表达,探讨其表达与初治子宫内膜癌临床病理特征和临床结果及微卫星不稳定(MI)情况的关系。     

High expression of cyclooxygenase-2 in uterine fibroids and its correlation with cell proliferation

Objective

To investigate the expression of cyclooxygenase-2 (COX-2) in uterine fibroids and healthy uterine smooth muscle as well as its role in the pathogenesis of uterine fibroids.

Methods

We collected uterine fibroid tissues and their paired adjacent healthy uterine smooth muscle tissues from 30 cases of uterine fibroids. We used immunohistochemistry and quantitative real-time PCR, as well as western blot to detect COX-2 expression. Using the COX-2 inhibitors NS-398 and celecoxib, we observed the response to the inhibitors in the healthy and fibroid smooth muscle cell pairs.

Results

COX-2 was detected by immunohistochemistry in both uterine fibroids and uterine smooth muscle, with higher immunoreactivity in uterine fibroids; the positive index of the smooth muscle cells was 11.90 and the positive index of uterine fibroids cells was 46.50 (P < 0.05). The expression of COX-2 mRNA in uterine fibroids was higher (0.122 ± 0.062) than in normal smooth muscle tissue (0.025 ± 0.009; P < 0.05). Also, the western blot results showed that COX-2 expression was significantly higher in uterine fibroid cases, as compared to the expression in uterine smooth muscle. Immunofluorescence showed that the occurrence of COX-2 was obviously higher in smooth muscle cells of uterine fibroids than in the healthy smooth muscle cells. NS-398 or celecoxib significantly inhibited the proliferation of smooth muscle cells of uterine fibroids, but did not inhibit the proliferation of healthy smooth muscle cells. Accordingly, NS-398 or celecoxib significantly reduced the expression of the downstream metabolite of COX-2, PGE2, in the smooth muscle cells of uterine fibroids, but not in healthy smooth muscle cells.

Conclusion

COX-2 expression in uterine fibroids was significantly higher than in healthy uterine smooth muscles. The inhibition of COX-2 activity significantly reduced the proliferation of smooth muscle cells of the uterine fibroids, suggesting that COX-2 plays an important role in the pathogenesis of uterine fibroids.     

子宫肌瘤复发问题

子宫肌瘤剔除术后复发常见,复发机制不明,复发率可能与肌瘤数目、大小及类型等因素相关。复发性子宫肌瘤的治疗同原发肌瘤,目前尚无有效预防复发的方法及药物,手术同时应评估复发风险,并做好术后指导及随访     

Endoscopic management of uterine fibroids

Uterine fibroids are the most common benign tumours of the uterus. Management depends on the symptoms, location and size of the fibroids, and the patient's desire to conceive. Surgical management of uterine fibroids has changed from laparotomy to minimally invasive surgery. Uterine fibroids are usually asymptomatic and do not require treatment. Laparoscopic myomectomy is the best treatment option for symptomatic women with uterine fibroids who wish to maintain their fertility. The authors' criteria for laparoscopic myomectomy are a fibroid of <15 cm in size, and no more than three fibroids with a size of 5 cm. Compared with laparotomy, laparoscopic myomectomy has the advantages of small incisions, short hospital stay, less postoperative pain, rapid recovery and good assessment of other abdominal organs. Due to the concern of decreased ovarian reserve, uterine artery embolization is not advisable for these women. In addition, it is associated with high risks of miscarriages, preterm delivery and postpartum bleeding. Laparoscopic myolysis causes severe adhesion formation. Women with submucous fibroids receive myomectomy by hysteroscopy. For women who have completed their family, laparoscopic hysterectomy could be performed. Most fibroids can be managed endoscopically either by laparoscopy or hysteroscopy. Surgeon expertise, especially laparoscopic suturing, is crucial. Laparoscopic myomectomy is still the best treatment option for symptomatic women with uterine fibroids who wish to maintain their fertility. Hysteroscopic myomectomy is an established surgical procedure for women with excessive uterine bleeding, infertility or repeated miscarriages.     

Radiological treatment of symptomatic uterine fibroids

Uterine artery embolization (UAE) is a relatively new alternative treatment for symptomatic fibroids. Recent Level 1 evidence from two major randomized controlled trials has established UAE as a safe and effective alternative to hysterectomy. Technical aspects, choice of embolic agent, safety, contra-indications and complications of the procedure will be reviewed. The available data on the effects on ovarian function, fertility and pregnancy outcomes following UAE will be presented.     

腹腔镜下子宫动脉阻断术联合肌瘤切除术治疗子宫肌瘤的临床研究

目的评价腹腔镜下子宫动脉阻断联合肌瘤切除术治疗子宫肌瘤的临床可行性及中远期疗效。方法对520例子宫肌瘤患者的临床资料进行回顾性分析,其中348例行腹腔镜下子宫动脉阻断联合肌瘤切除术（LUAO-M）;172例行腹腔镜下单纯肌瘤切除术（LM）,比较两种术式的相关手术指标及随访结果。结果LUAO组术中出血量（88．2±52．7）ml少于LM组（103．2±54．9）ml（P=0．003）;LUAO组术后病率5．7％低于LM组19．2％（P〈0．05）;LUAO组术后住院天数（7．7±2．5）d低于LM组（8．6±3．2）d（P=0．001）。LUAO组术后子宫体积缩小率（48．9±38．6）％大于LM组体积缩小率（39．2±41．6）％（P=0．019）;LUAO组月经过多缓解率97．0％高于LM组86．4％（P〈0．05）;LUAO组术后肌瘤复发率3．0％低于LM组10．7％（P=0．001）。结论腹腔镜下子宫动脉阻断术联合肌瘤切除术有助于拓宽腹腔镜下子宫肌瘤切除术的手术适应证,减少术中出血量,降低术后病率及子宫肌瘤复发率。     

Treatment of uterine fibroids for abnormal uterine bleeding: myomectomy and uterine artery embolization

Uterine myoma is a common benign tumour in women and most cases do not require treatment. Excessive uterine bleeding is usually due to a submucous myoma or an intramural myoma that is encroaching into the uterine cavity. After eliminating endometrial malignancy, perimenopausal women could be managed expectantly or with gonadotrophin-releasing hormone agonist until menopause. Hysteroscopic myomectomy is highly effective in controlling menorrhagia that is related to submucous myoma. Concomitant endometrial ablation improves menorrhagia; however, the subsequent hysterectomy rate remains the same. For those with an intramural myoma, abdominal myomectomy results in good bleeding control. It could also be done by laparoscopic approach; however, the surgeon should have expertise in laparoscopic suturing and the uterine incision should be properly sutured. In women who have completed their family, hysterectomy remains the most effective treatment for excessive uterine bleeding. Compared with uterine artery embolization (UAE), it is associated with better improvement in pelvic pain. Nevertheless, UAE is a good alternative to hysterectomy.     

Retroperitoneal uterine leiomyoma occurring 5 years after hysterectomy for fibroids

We encountered a 49-year-old, multiparous female with a very rare isolated retroperitoneal uterine leiomyoma measuring 72 x 43 mm in diameter occurring 5 years after hysterectomy for fibroids. The case was preliminarily diagnosed as right ovarian cancer or fibroma. An edematous, isolated solid tumor in the right retroperitoneal cavity was surgically resected. Pathological findings demonstrated uterine leiomyoma.     

数字化三维影像学与子宫肌瘤子宫动脉栓塞治疗

子宫肌瘤子宫动脉栓塞（UAE）治疗是通过栓塞肌瘤的动脉血管网而达到治疗的目的,因疗效确切、微创,深受要求保留子宫的肌瘤患者欢迎。但该术式仍有10%的患者效果不佳以及一定的并发症发生率。在术前筛选合适的病例、评估手术可行性及判断预后是进一步提高疗效、降低并发症发生的关键。传统的影像学手段不能达到上述目的,但应用数字化三维重建技术对患者的影像学原始数据集进行重建,可再现患者子宫及肌瘤的个体化血管解剖,为UAE的操作提供可视化动脉血管网模型,是解决上述关键问题的新兴手段。