宫颈鳞癌和腺癌中微血管密度和基质金属蛋白酶-2 、9及其抑制剂-1、2表达的研究

目的通过观察肿瘤微血管密度(MVD)及MMP-2、MMP-9和TIMP-1、TIMP-2在宫颈鳞癌与腺癌组织中的表达情况,在蛋白水平探讨宫颈腺癌较鳞癌恶性程度高的可能原因.方法采用免疫组织化学方法(SP) 检测40例宫颈鳞癌和20例宫颈腺癌组织的MVD和MMP-2、MMP-9、TIMP-1、TIMP-2蛋白的表达情况.结果MVD在宫颈腺癌中较鳞癌高.MMP-2在宫颈鳞癌的阳性表达强度较腺癌高(P=0.006);MMP-9、TIMP-1在腺癌的阳性表达较鳞癌高(P=0.078,P=0.000);TIMP-2在两组间比差异无显著性(P＞0.05).在宫颈癌的临床病理特征中,MMP-2和MMP-9在鳞癌和腺癌中的表达不一,而TIMP-1始终是在腺癌中的表达较鳞癌高.结论宫颈腺癌较鳞癌恶性程度高的原因,可能与较高的MVD和TIMP-1的高表达有关.     

子宫颈癌组织中水通道蛋白8和bcl-2蛋白的表达及其相关性

目的 探讨水通道蛋白(AQP)8、bcl-2蛋白在宫颈癌组织中的表达及其相关性.方法 采用免疫组化Envision二步法检测AQP8和bcl-2蛋白在74例宫颈癌(其中鳞癌46例、腺癌28例)、34例宫颈上皮内瘤变(CIN)和15例正常宫颈组织中的表达情况,并分析两者的相关性.结果 AQP8和bcl-2蛋白主要在CIN异型细胞和宫颈癌细胞的细胞质内表达,AQP8蛋白在宫颈鳞癌、腺癌、CIN和正常宫颈组织中的阳性表达率分别为98%、61%、71%和53%,鳞癌高于腺癌、CIN和正常宫颈组织,差异有统计学意义(P＜0.01);腺癌与CIN、正常宫颈组织比较,CIN与正常宫颈组织比较,差异均无统计学意义(P＞0.05).bcl-2蛋白在宫颈鳞癌、腺癌、CIN和正常宫颈组织中的阳性表达率分别为74%、71%、53%和20%,鳞癌与腺癌组织比较,差异无统计学意义(P＞0.05);鳞癌、腺癌高于CIN、正常宫颈组织,CIN也高于正常宫颈组织,差异均有统计学意义(P＜0.01).AQP8和bcl-2蛋白在宫颈癌组织中的表达呈明显正相关(rs=0.463,P=0.000).结论 AQP8和bcl-2蛋白在宫颈癌组织中的表达呈明显正相关,AQP8蛋白表达上调可能与宫颈癌的发生、发展有一定的关系.     

nm23-H1在子宫颈原位癌及浸润癌中的表达

目的探讨nm23-H1表达与宫颈鳞癌发展转移的关系.方法采用免疫组织化学方法检测23例宫颈原位癌及55例浸润鳞癌中nm23-H1的表达情况.结果原位癌nm23-H1阳性表达率高于浸润癌(P＜0.05).浸润癌中,nm23-H1阳性表达率随FIGO临床分期升高而有下降趋势,Ⅰ、Ⅱ期与Ⅲ期比较,差异显著(P＜0.05);有淋巴结转移者其原发灶阳性表达率明显低于无淋巴结转移者(P＜0.01);组织学分化程度高者阳性率高于分化程度低者(P＜0.05).结论nm23-H1基因可抑制宫颈癌发展及淋巴结转移.     

荧光定量RT-PCR检测早期宫颈鳞癌组织中MMP-7和CK20的表达

目的:检测宫颈癌组织中基质金属蛋白酶7(MMP-7)mRNA和细胞角蛋白(CK20)mRNA的表达水平,并探讨其临床意义.方法:采用实时荧光定量RT-PCR检测33例宫颈鳞癌和12例正常宫颈组织中MMP-7 mRNA和CK20 mRNA的表达水平.结果:MMP-7 mRNA在宫颈鳞癌组织中的表达水平高于正常宫颈组织(P=0.018),与宫颈鳞癌病理分级、淋巴结转移有关(P均<0.05),而与临床分期、年龄因素无关(P均0.05);CK20 mRNA在宫颈鳞癌组织中的表达水平高于正常宫颈组织(P=0.002),与宫颈鳞癌分期、病理分级、淋巴结转移有关(P均<0.05),而与年龄无关(P0.05);MMP-7 mRNA与CK20 mRNA之间存在正相关(r=0.427,P=0.026).结论:MMP-7 mRNA及CK20 mRNA的高表达与宫颈鳞癌的侵袭转移有关.     

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。     

CD44v6与人乳头瘤病毒在宫颈鳞癌及癌前病变中的相关性研究

目的:观察CD44v6与人乳头瘤病毒(HPV)在宫颈鳞癌及癌前病变中的相关性,以探讨两者联合检测在宫颈癌早期诊断中的意义。方法:采用免疫组化(SP)法检测宫颈鳞癌、宫颈上皮内瘤变(CIN)Ⅰ、CINⅡ、CINⅢ及正常宫颈组织各20例石蜡标本中CD44v6的表达,同时用荧光定量聚合酶链反应(FQ-PCR)法检测上述组织中HPV-DNA的相对含量,将两者检测的结果进行统计学分析并研究其相关性。结果:CD44v6在对照组、CINⅠ组、CINⅡ组、CINⅢ组及宫颈鳞癌组中细胞表达的阳性率逐渐升高,5组比较差异有统计学意义(P<0.05);HPV感染率也逐渐升高,5组比较差异有统计学意义(P<0.05);CD44v6与HPV感染呈正相关(rs=0.341,P=0.01)。结论 :CD44v6的异常表达和HPV感染与宫颈癌的发生、发展关系密切,两者联合检测对宫颈癌的早期诊断有一定的临床意义。     

肌动蛋白聚合蛋(fascin)和CD44V6在子宫内膜样腺癌组织中的表达及意义

目的:探讨肌动蛋白聚合蛋白(fascin)和CD44V6在子宫内膜样腺癌中的表达情况及其临床意义.方法:应用免疫组化SP法检测46例子宫内膜样腺癌(A组),19例子宫内膜增生症(B组)以及17例正常子宫内膜(C组)组织中fascin和CD44V6的表达情况.结果:①A组中fascin的表达率(71.74%)明显高于B组(15.79%)及C组(5.88%)(P＜0.01).fascin在A组中的表达率与子宫内膜样腺癌的临床分期、组织学分级及淋巴结转移情况相关(P＜0.05),而与肌层浸润深度无关(p＞0.05).②A组中CD44V6的表达率(43.48%)明显高于B组(5.26%)及C组(5.88%)(P＜0.01).CD44V6在A组中的表达率与子宫内膜癌的淋巴结转移情况及肌层浸润深度相关(P＜0.05),而与临床分期、组织学分级无关(P＞0.05).③fascin与CD44V6在子宫内膜样腺癌组织中的表达呈正相关(r=0.453,P＜0.05).结论:fascin及CD44V6在子宫内膜样腺癌的发生、发展过程中起重要的作用.     

MMP-1/PAR-1通路在宫颈癌侵袭转移中的作用

目的:探索基质金属蛋白酶-1(MMP-1)/蛋白酶活化受体-1(PAR-1)通路在宫颈癌侵袭转移中的作用。方法:RT-PCR法检测59例临床宫颈鳞癌组织和15例正常宫颈组织的MMP-1mRNA表达;Transwell实验检测添加重组人MMP-1及干扰PAR-1对宫颈癌Hela细胞转移侵袭能力的影响。结果:宫颈癌组织中的MMP-1(rhMMP-1)表达高于正常宫颈组织,并与侵袭转移程度相关;rhMMP-1能促进Hela细胞的转移能力,并与浓度相关;干扰PAR-1后能抑制MMP-1介导的Hela细胞转移能力。结论:MMP-1/PAR-1通路参与宫颈癌的侵袭转移,可能成为宫颈癌治疗的新靶点。     

Survivin与Fas在宫颈不典型增生和宫颈癌中的表达及临床意义

目的探讨凋亡抑制蛋白Survivin、促细胞凋亡蛋白Fas在正常宫颈、宫颈上皮内瘤样变(CIN)和宫颈癌中的表达及其临床意义。方法应用免疫组化S-P法,检测Survivin、Fas蛋白在9例正常宫颈、15例CIN、34例宫颈鳞癌组织中的表达。所有标本均取自2000～2002年间在中国医科大学附属第一医院及辽宁省肿瘤医院就医的患者。结果Survivin、Fas在正常宫颈组织中的阳性表达率分别为0、88.89%;在CIN中的阳性表达率分别为40.00%、53.33%;在宫颈鳞癌中阳性表达率分别为67.67%、44.12%,二者在宫颈不同组织的表达差异有显著性(P<0.05)。Survivin表达与宫颈鳞癌临床分期及病理分级成正相关(P<0.05),Fas表达仅与病理分级成正相关(P<0.05)。Survivin表达随宫颈疾病发展有明显增加趋势,Fas表达有明显降低趋势,二者的阳性表达呈负相关。结论Survivin表达引起的细胞凋亡抑制,在宫颈癌的发生发展中起一定作用。Survivin基因的表达与宫颈癌组织中Fas蛋白的表达呈负相关。     

宫颈鳞癌组织C-Fos、PDGFR蛋白的表达及意义

目的探讨宫颈鳞癌组织C-Fos、PDGFR蛋白的表达及意义。方法选取2015年1月至2017年10月河北省承德医学院附属医院保存的宫颈癌组织58例,宫颈上皮内瘤变(CIN)组织47例,正常宫颈组织43例,采用免疫组化染色检测C-Fos、PDGFR蛋白阳性表达,western blot检测C-Fos、PDGFR蛋白表达量。结果宫颈癌组织C-Fos和PDGFR蛋白阳性表达率分别为58.62%和62.07%,C-Fos和PDGFR蛋白表达量分别为(0.987±0.221)和(0.872±0.206),明显高于CIN和正常宫颈组织(P 0.05);CIN组织C-Fos和PDGFR蛋白阳性表达率分别为21.28%和27.66%,C-Fos和PDGFR蛋白表达量分别为(0.344±0.157)和(0.550±0.214),明显高于正常宫颈组织(P 0.05);Ⅲ～Ⅳ期宫颈癌C-Fos和PDGFR蛋白表达量分别为(1.012±0.220)和(1.012±0.220),明显高于Ⅰ～Ⅱ期宫颈癌(P 0.05);中低分化宫颈癌PDGFR蛋白表达量为(0.892±0.184),明显高于高分化宫颈癌(P 0.05);宫颈癌组织C-Fos和PDGFR蛋白表达量无相关性(P0.05)。结论宫颈鳞癌组织C-Fos、PDGFR蛋白表达明显高于CIN和正常宫颈,与临床分期和分化程度具有一定的相关性,可能在宫颈癌发生过程中发挥一定的作用。     

Prevalence and cytologic manifestations of human papilloma virus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56 among 500 consecutive women.

The prevalence and associated cytologic manifestations of cervical infection with human papillomavirus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56 were studied among 500 consecutive women attending the Harborview Medical Center Sexually Transmitted Diseases (STD) Clinic in Seattle, WA. Using radiolabeled-probes without prior amplification of DNA, HPV DNA was detected in cervical specimens from 120 (24%) of the women and was found to be more prevalent than Chlamydia trachomatis (13%), Neisseria gonorrhoeae (12%), or mucopurulent cervicitis (20%). High-risk HPV types 16 or 18 were present alone in 5% of the women; intermediate-risk types 31, 33, 35, 45, 51, 52, or 56 in 3%; and low-risk types 6, 11, 42, 43, and 44 in 5%. In an additional 8% HPV DNA was detected but could be characterized only as being type 6, 11, 16, 18, 31, 33, or 35. Each grouping of HPV types was equally associated with squamous intraepithelial lesions (SILs) of the cervix. In the absence of SIL and koilocytosis, the cytologic changes associated with HPV infection included frequent binucleation and variation in nuclear size and chromatin distribution. Parakeratosis and hyperkeratosis without nuclear atypia were not associated with HPV DNA. The natural history and clinical significance of these HPV-associated lesions remain to be defined.     

Severe, gestational, non-familial, non-genetic hypertriglyceridemia

Severe hypertriglyceridemia is a rare condition in pregnancy. All the cases of severe gestational hypertriglyceridemia that have been reported previously in the literature were caused by genetic mutations or familial hypertriglyceridemia secondary to lipoprotein lipase deficiency or apolipoprotein C-II deficiency. We report the first case of severe, non-genetic, non-familial, pregnancy-induced hypertriglyceridemia. The genetic underlying causes were excluded by molecular genetic investigation. The reported case was managed solely by strict dietary control. Hypertriglyceridemia was diagnosed incidentally during pregnancy, in this case, while taking a blood sample to check her hemoglobin level. Acute pancreatitis, which is a relatively common life threatening complication of this condition, was avoided. This report reviews the subtypes of hyperlipidemia, clinical picture, antenatal management and its effect on pregnancy and vice versa. It is important that the clinician has a clear understanding of the normal lipid profile during pregnancy, the clinical picture, the potential complications, available treatment options of hypertriglyceridemia particularly during pregnancy. The timing and route of delivery should be individualized.     

Cystosarcoma phyllodes: epidemiology, pathohistology, pathobiology, diagnosis, therapy, and survival

Cystosarcoma phyllodes is a very rare tumor which maybe difficult to diagnose clinically. The epidemiology and pathobiology are different from those of breast carcinoma. Risk factors, multicentricity, bilaterality, as associated with breast carcinoma, are not observed in patients with cystosarcoma phyllodes. Although the term "sarcoma" indicates a malignant tumor, only 10%-30% of cystosarcomas are histologically diagnosed as malignant; clinical diagnosis of malignancy does not exceed 10%. Axillary node involvement is rare, but hematogenous spread of cystosarcoma occurs into lung, pleura, bone, and liver. Clinically, cystosarcoma is a large (usually 3-5 cm in diameter) painless tumor with sudden growth acceleration especially during pregnancy. Cystosarcoma is usually circumscribed, containing firm and soft areas. The differential diagnosis has to include fibroadenoma, fibrocystic disease, mastitis, abscess, and medullary carcinoma. Neither clinical, mammographic or sonographic signs exist to predict a benign or malignant tumor. Therapy of cystosarcoma is not uniformly agreed upon. Radical, modified-radical, and simple mastectomy and tumorectomy are typical treatments; therapeutic results are the same for each treatment modality. For histologically diagnosed malignant cystosarcoma, the relative 5-year survival rate is about 80%. Clinically, malignant metastatic cystosarcoma is incurable; radiotherapy, endocrine treatment, and polychemotherapy are all ineffective. Because of the specific tumor pathobiology of cystosarcoma and its rarity, evaluation of treatment modalities and comparison of survival rates are difficult.     

Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole.

Because many antibiotics are excreted into breast milk, it can be difficult for a practitioner to choose an antibiotic for a lactating patient that will have minimal risks to her nursing infant. This article is the second of a three-part series discussing the use of anti-infective agents during lactation. The authors review general information regarding use and common side effects for several classes of antibiotics. They also summarize information, including documented milk concentrations, milk-to-plasma ratios, and other pharmacokinetic properties, in a table that can help practitioners choose antibiotics that may be considered safe to use in the lactating mother.     

Contraceptive knowledge and behavior of conventionalists, careerists, idealists, bouncers, desperadoes, and outsiders

The aim of the survey was to determine the contraceptive behavior and knowledge on contraceptive methods of adolescents. We defined six clusters according to personality, leisure activities, and sociodemographic characteristics: conventionalists, careerists, idealists, bouncers, desperadoes, and outsiders. 1010 Austrian adolescents aged 14–24 years participated in the survey. 96%–100% indicated that they were familiar with the condom and the contraceptive pill. The two most popular contraceptive methods cited were the condom (39%) and OC (34%). Whereas 40% of conventionalists reported that OC were their preferred method of contraception, 53% of idealists indicated that they preferred the condom. 66% of the desperadoes indicated that they considered the pill expensive. 85% of conventionalists and careerists believe that OC offer the best protection against pregnancy. Clusters with higher self-esteem and those with a higher educational level were more likely to believe that this method is unreliable. The results obtained indicate that outsiders, desperatoes, and bouncers show deficits in sex education; only careerists and idealists appeared to be better informed. Research on adolescent contraceptive behavior should drop the traditional stratifying criteria and appreciate the diversity of adolescent populations in order to be better able to classify adolescents according to their contraceptive attitudes. Received: 22 March 1999 / Accepted: 24 March 1999