HSP60和nm23蛋白在结肠癌中的表达及意义

目的探讨热休克蛋白60（HSP60）和nm23蛋白在结肠癌及癌旁组织中的表达及其临床病理意义。方法采用免疫组化法分别检测HSP60和nm23蛋白在60例结肠癌、45例癌旁不典型增生及20例正常黏膜组织中的表达,并分析两者的表达水平与结肠癌临床病理因素的关系。结果 HSP60在结肠癌、癌旁不典型增生及正常黏膜组织中的阳性表达率依次降低,分别为78.3%、37.8%、20.0%;相反nm23蛋白的阳性表达率依次增高,分别为56.7%、83.2%、91.7%,两者在组间的表达差异均有统计学意义（P〈0.01）。在癌组织中HSP60的表达与淋巴结转移有关（P〈0.05）,nm23蛋白表达与肿瘤浸润深度及淋巴结转移有关（P〈0.05）。HSP60与nm23在结肠癌中的表达无相关性（P〉0.05）。结论 HSP60及nm23蛋白在结肠癌组织中的表达状态与结肠癌发生发展有关,联合检测两者对结肠癌的预后判断具有重要意义。     

DR-nm23在大肠癌组织中的蛋白表达及意义

目的:探讨DR-nm23蛋白在大肠癌组织中的表达及其与大肠癌发生发展和转移的关系.方法:应用SP免疫组织化学法检测98例大肠癌、57例大肠腺瘤及42例正常大肠黏膜组织中DR-nm23蛋白的表达,统计学分析比较DR-nm23蛋白表达差异与大肠癌的发生、进展、淋巴结转移以及大肠癌组织学分型、病理分级的相关性.结果:DR-tnm23蛋白在正常组、腺瘤组和大肠癌组的表达逐渐下调,3组间表达差异具有显著性(71.4% vs 38.6%,35.7%,均P<0.01).腺瘤组中,高级别上皮内肿瘤的表达率低于低级别上皮内肿瘤(25.7% vs 59.1%,P<0.05);大肠癌无淋巴结转移组表达率高于淋巴结转移组,表达与淋巴结转移呈负相关(44.1% vs 23.1%,P<0.05);DR-nm23表达与组织学分型(χ2=13.731,P<0.01)及病理分级(χ2=12.198,P<0.01)均有相关性.转移组中,淋巴结转移癌DR-nm23蛋白表达率较原发癌高,但二者差异无显著性(P>.05).结论:DR-nm23参与大肠癌细胞的分化,其表达下调与大肠癌发生发展转移密切相关,可作为反映大肠癌生物学行为和判断预后的潜在重要指征.     

胆囊癌组织中PTEN的表达及意义

采用免疫组化SP法检测10胆例囊炎和40例胆囊癌患者胆囊组织中PTEN的表达。结果显示PTEN蛋白主要定位于细胞质,胆囊炎组织PTEN蛋白表达强度显著高于胆囊癌组织（P〈0.01）。胆囊癌组织中PTEN蛋白表达强度与肿瘤浸润深度、肿瘤分化程度、淋巴结转移情况和病理分级有相关性（P均〈0.05）。认为PTEN基因在胆囊癌组织中表达降低。PTEN表达下调在胆囊癌的发生发展中发挥作用。     

Ezrin蛋白在膀胱癌中的表达及意义

用EnVision免疫组织化学方法检测Ezrin蛋白在膀胱癌中的表达。结果膀胱癌组织Ezrin蛋白阳性表达率高于癌旁组织,癌旁组织高于正常膀胱组织（P均〈0．05）;Ezrin蛋白的表达与组织学分级和病理学分期无相关性（P〉0．05）。提示Ezrin蛋白可能参与膀胱癌的发生,但其表达水平与肿瘤恶性程度无关。     

胆囊癌组织中nm23H1和PTEN基因蛋白表达及其临床意义

目的:探讨nm23H1和PTEN基因蛋白在胆囊癌中表达的意义.方法:应用免疫组化方法,检测52例胆囊腺癌、20例胆囊腺瘤和10例慢性胆囊炎组织中nm23H1和PTEN表达水平.结果:在胆囊癌中nm23H1和PTEN表达阳性率分别为51.9%和42.3%,其表达阳性率均明显低于胆囊腺瘤和慢性胆囊炎(P＜0.05).nm23H1和PTEN表达与胆囊癌的分化程度、浆膜浸润和转移密切相关(P＜0.05).nm23H1和PTEN蛋白表达呈正相关(γ=0.56,P＜0.05).结论:检测nm23H1和PTEN基因蛋白表达可作为评价胆囊癌生物学行为的参考指标.     

老年眼睑基底细胞癌患者癌组织中空泡膜蛋白1、磷酸酶及张力蛋白同源蛋白和抗转移蛋白23的表达及意义

目的检测老年眼睑基底细胞癌患者癌组织空泡膜蛋白(VMP)1、磷酸酶及张力蛋白同源蛋白(PTEN)和抗转移蛋白(NM)23的表达及相关性。方法 97例老年基底细胞癌患者术后存档的蜡块组织及临床资料为观察组,上述肿瘤组织周边切缘为正常鳞状上皮组织患者60例为对照组,采用免疫组织化学染色方法检测VMP1、PTEN和NM23表达。结果观察组VMP1、PTEN和NM23表达阳性率明显低于对照组,观察组VMP1、PTEN和NM23表达阳性率与肿瘤最大径、是否侵犯皮肤外结构、转移及Ki67表达密切相关。观察组VMP1、PTEN和NM23表达具有正相关性。结论老年眼睑基底细胞癌患者癌组织中VMP1、PTEN和NM23蛋白表达均下调,三者具有协同正向作用,共同促进肿瘤的发生和进展。     

肿瘤抑制基因PTEN蛋白在乳腺癌中的表达及意义

采用免疫组化法检测 138例乳腺癌患者的 PTEN蛋白、ER和 PR的阳性表达。结果示 PTEN阳性率(4 7.83% )与 ER阳性率 (39.86 % )和 PR阳性率 (4 2 .0 3% )接近。PTEN阳性病例中淋巴结转移率 (2 7.6 9% )远低于 PTEN阴性者 (6 1.6 4% ) ,两者差异显著 (P〈0 .0 5 )。认为 PTEN、ER和 PR表达具有较强的一致性 ,推测 PTEN基因的突变和缺失可能与乳腺癌的发生、发展有关 ;PTEN与 ER的表达与淋巴结转移有明显相关性 ,可作为判断乳腺癌预后的指标。     

乳腺癌组织中nm23、cyclin E的表达及意义

目的探讨nm23、cyclinE在乳腺癌组织中的表达及其意义。方法构建乳腺癌组织芯片,应用免疫组织化学SP法检测96例乳腺癌患者癌组织中nm23、cyclinE的表达。结果乳腺癌组织中nm23、cyclinE的表达均与组织学分级、淋巴结转移、无病生存期密切相关（P均〈0．05）。结论nm23和cyclinE的表达与乳腺癌的生物学行为有关,同时检测nm23和cyclinE可能对乳腺癌预后的判断及靶向治疗的选择提供更大帮助。     

残胃癌nm23、p53、C-erbB-2癌基因产物的表达及意义

目的：探讨残胃癌中nm23、p53、C-erbB-2癌基因产物的表达与临床病理特点的关系。方法：应用免疫组织化学S-P法检测52例残胃癌中nm23、p53、C-erbB-2癌基因产物的表达。结果：52例残胃癌中，nm23阳性率65．4％，p53阳性率25％，C-erbB-2阳性率40．4％。三者的阳性表达水平与肿瘤的病理组织学分级差异显著。结论：nm、p53、C-erbB-2在残胃癌中的表达与肿瘤组织学分级有关。三者均可作为判断肿瘤恶性度的客观指标。残胃癌中C-erbB-2、p53过表达nm23低表达是其易于浸润和转移的原因之一。C-erbB-2和p53过表达提示残胃癌分化较低。     

Ezrin蛋白在结肠癌组织中的表达及意义

目的进一步探讨结肠癌的发生、发展机制。方法应用免疫组织化学染色法检测69份结肠癌组织及其对应癌旁良性组织、23份转移淋巴结组织中Ezrin蛋白、Ki-67蛋白表达,分析Ezrin蛋白表达与结肠癌临床病理特征及Ki-67蛋白表达的关系。结果Ezrin、Ki-67蛋白在结肠癌组织及转移淋巴结组织中的阳性表达率均明显高于癌旁组织（P均〈0．01）,Ezrin蛋白在结肠癌组织中的表达与组织分化程度及有无淋巴结转移、浆膜侵犯有关（P均〈0．01）;Ezrin蛋白与Ki-67蛋白表达呈显著正相关,P〈0．05（r=0．317）。结论Ezrin蛋白在结肠癌发生、发展中起重要作用;此为结肠癌的分子靶向治疗提供了依据。     

Magnitude of Combination Therapy of Radical Resection and External Beam Radiotherapy for Patients With Carcinomas of the Extrahepatic Bile Duct and Gallbladder

The present study sought to identify the therapeutic efficacy of adjuvant external beam radiotherapy (EBRT) for carcinomas of the extrahepatic bile duct (EHBD) and gallbladder. Twenty-one patients with pathologically verified EHBD carcinoma and 18 patients with gallbladder carcinoma were analyzed retrospectively by Cox regression analysis for predictors of survival. The overall 5-year survival rates after resection were 33% for EHBD carcinoma and 56% for gallbladder carcinoma. The overall 5-year survival rate for EHBD carcinoma was 60% in 8 patients without microscopic residual disease (R0), 15% in 9 patients with microscopic residual tumor (R1), and 0% in 4 patients with macroscopic residual tumor (R2). The overall 5-year survival rate of gallbladder carcinoma patients was also decreased with R status equal to 73%, 40%, and 0% for R0, R1 and R2, respectively. Adjuvant radiotherapy significantly improved the 5-year survival rate in 7 patients with R1 disease of EHBD carcinoma (P= .035), compared with survival in 2 patients who underwent resection alone. However, no significant difference was noted in the 5-year survival rate between the resection plus EBRT group and the resection alone group for gallbladder carcinoma. Multivariate analysis revealed that histopathologic grade (G) was an independent predictor of survival for EHBD carcinoma and that direct invasion of liver parenchyma was a predictor of survival for gallbladder carcinoma. This study suggests that curative resection provides the best survival for patients with EHBD and gallbladder carcinoma, and that radiotherapy may play a beneficial role in controlling local–regional residual EHBD carcinoma tumors. However, new strategies for adjuvant therapy are needed to improve survival in patients with gallbladder carcinoma.     

A Study of Malignant Bile Duct Stenosis Using Percutaneous Transhepatic Cholangioscopy

Abstract: From June, 1987 to November, 1989, 11 patients with malignant bile duct stenosis, which was later confirmed by surgery or autopsy, were examined by percutaneous transhepatic cholangioscopy (PTCS) and by an endoscopic biopsy. The endoscopic findings obtained with the usual observation methods and methylene blue staining and the histological findings of the biopsy specimens were compared. A fine vascular proliferation was seen in all of the patients and a granular appearance was noted in patients with carcinoma of the major papilla. The papillary appearance was noted in one case each of pancreatic carcinoma, bile duct carcinoma and carcinoma of the major papilla. Marginal protrusion was not noted in patients with pancreatic carcinoma. A distorted narrow segment was seen only in cases of pancreatic carcinoma. The presence of a granular appearance indicated that the carcinoma was exposed on the surface. A high degree of fine vascular proliferation and a papillary appearance tended to indicate a carcinoma which invaded mainly into the fibromuscular layer without invasion of the mucosa. The methylene blue staining method was simple and effective for better visualization of the surface structure of the abnormal area, normal mucosa and the border zone.     

Superficial Epithelium in the Biopsied Sections Taken from Malignant Bile Duct Stenosis

Abstract: Although percutaneous transhepatic cholangioscopy (PTCS) with biopsy is useful for the diagnosis of superficial spreading carcinoma of the bile duct, sections of biopsy specimens sometimes do not contain superficial epithelium. We sought to clarify the factors influencing the presence of superficial epithelium in biopsy specimens in a retrospective microscopic analysis of 168 hematoxylin and eosin-stained sections of specimens from 54 patients with malignant bile duct stenosis. We correlated the presence of superficial epithelium with various factors using logistic regression analysis. Factors examined were whether the site was stenotic, the mucosal pattern at the biopsy site (papillo-granular or smooth), specimen size, and whether the biopsy specimen was the first one taken at that same site. Bile duct tissues were present in 165 of 168 specimens (98%), and 93 (55%) contained superficial epithelium. By logistic regression analysis, mucosal pattern and order of biopsy at the same site were significantly related to presence of superficial epithelium on the histologic section (odds ratio with papillogranular mucosal pattern, 6.082; with first biopsy at the site, 2.628). Therefore, it is important to carefully choose biopsy forceps and to take multiple specimens at various sites to obtain superficial epithelium, especially with the smooth bile duct mucosal pattern.     

Proliferative Activity of Bile Duct Epithelium after Bacterial Infection in Dogs

Ohta T, Nagakawa T, Tsukioka Y, Sanada H, Miyazaki I, Terada T. Proliferative activity of bile duct epithelium after bacterial infection in dogs. Scand J Gastroenterol 1992;27:845-851.

To clarify the relationship between proliferative activity in bile duct epithelia and bacterial infection in the dog, we induced obstructive cholestasis with a bacterial infection in two lobes of the liver. The bile duct branch draining the left lateral lobes of the liver was cannulated in all mongrel dogs. The dogs were divided into three groups and treated as follows: in group 1 the cannula was clamped after the injection of 10⁷ Escherichia coli (aerobic bacteria) and 10⁷ Bacteroides fragitis (anaerobic bacteria) cells; in group 2 the cannula was clamped after the injection of 10⁷ E. coli cells; and in group 3 the cannula was clamped without the injection of any bacteria. Three months and 9 months later dogs from each group were killed, and their livers were examined. In the group 1 dogs papillary hyperplasia and severe dysplasia were noted in association with chronic cholangitis at 3 months and 9 months, respectively, after operation. In the group 2 dogs periductal fibrosis was severe, but epithelial papillary hyperplasia was less pronounced than in the group 1 dogs at each period. In the group 3 dogs no periductal fibrosis or epithelial papillary hyperplasia was seen at either 3 or 9 months postoperatively. These findings suggest that papillary hyperplasia and/or severe dysplasia of the bile duct epithelium may be caused by aerobic and anaerobic bacterial infection of the biliary tract in combination with bile stasis.     

细胞粘附分子在胆囊癌中表达的意义

研究胆囊癌组织中细胞粘附分子CEA和CD44v6蛋白表达的意义。用免疫组化法检测 44例胆囊癌组织中CEA和CD44v6蛋白的表达。 44例胆囊组织中CEA和CD44v6蛋白表达的阳性率分别为 75 %和 48% ;两者的表达与肿瘤浸润外膜和淋巴结转移均呈正相关 (P <0 0 5 ) ;胆囊癌组织中CEA和CD44v6蛋白呈协同表达 (P<0 0 5 )。CEA和CD44v6蛋白与胆囊癌的发展和淋巴结转移密切相关。     

胆囊腺癌中原癌基因C—erbB—2产物的表达及意义

本文应用抗原癌基因Ｃ－ｅｒｂＢ－２蛋白产物的抗体，检测３８例胆囊腺癌。结果发现，相当数量的胆管腺癌有Ｃ－ｅｒｂＢ－２过度表达，提示该肿瘤有Ｃ－ｅｒｂＢ－２基因的扩增。阳性产物定位于细胞膜。     

急性胰腺炎与胆管结石相关因素探讨及内镜治疗

目的探讨胆管结石与急性胰腺炎的相关因素及内镜治疗。方法回顾性分析了我院196例胆管结石患者的临床资料。根据结石梗阻部位和结石大小分组,比较各组的急性胰腺炎发病率。结果各组胰腺炎发病率有明显差异。结论小结石是胆源性胰腺炎的危险因素,结石梗阻于乳头部,易引起胰腺炎。早期内镜综合治疗效果明显。     

Small Cell Carcinoma of the Gallbladder Arising in a Patient with Pancreaticobiliary Maljunction without Bile Duct Dilatation

We report a 36–year-old female patient with small cell carcinoma of the gallbladder with liver metastasis, that was associated with pancreaticobiliary maljunction (PBM) without bile duct dilatation. On admission, a gallbladder mass and multiple liver tumors were detected by US, CT and ERCP. Moreover, ERCP clearly demonstrated an abnormally long common channel between the pancreatic and bile ducts, indicating PBMwithout choledochal dilatation. US-guided biopsy of the tumor histopathologically confirmed small cell carcinoma. The serum neuron-specific enolase (NSE) level was very high. Transarterial chemo-embolization followed by systemic chemotherapy resulted in marked tumor reduction, but this was followed by rapid exacerbation. The patient died of the tumor 145 days after admission. The proposed mechanism of the car-cinogenesis of this rare gallbladder malignancy under the preexisting condition of PBM was discussed. (Dig Endosc 1999, 11: 246–249)     

Variations in Pigment and Carbohydrate Content of Gallbladder Bile Affect Accurate Quantitation of Total Protein When Using the Fluorescamine Method

Background: Despite solute dilution and reduced total lipid concentrations, an unexplained increase in protein concentration has been reported to occur in the gallbladder bile of cholesterol gallstone patients. Methods: Solutes in gallbladder bile from gallstone-free controls and from four study groups were measured using standard methods. Total proteins were measured using amino acid analysis and a conventional fluorescamine method. Results: Bile salts and pigment content were greater in gallstone-free controls than in all other study groups, including morbidly obese gallstone-free subjects. Total biliary protein concentration, as determined by amino acid analysis in the gallstone-free control group was higher than in non-obese gallstone patients with multiple stones and in morbidly obese gallstone-free subjects. Total biliary proteins as measured with fluorescamine, however, did not show intergroup differences. A major problem of the conventional fluorescamine assay is shown to be an artefact arising from the high pigment content of the more concentrated samples. Conclusions: Very dilute gallbladder bile samples are often found in the presence of gallstone disease. This also occurs in morbidly obese subjects, even in the absence of gallstones. Although the contribution of protein secretion/absorption by the gallbladder can also be relevant, especially in the presence of morbid obesity, the protein concentration in gallbladder bile, when accurately measured, generally parallels the concentrations of non-absorbed biliary solutes, reflecting the efficiency of fluid absorption. Measurement of biliary proteins by the conventional fluorescamine method is unreliable in clinical studies in which intergroup differences in pigment content are commonly present.