胸腹水涂片中良恶性细胞AgNOR的研究

目的探计AgNOR染色对胸腹水涂片中良、恶性细胞诊断和鉴别诈断的意义。方法应用银染方法对20例癌性胸腹水涂片和10例良性胸腹水涂片进行了AgNOR检测和观察。结果癌细胞核内的AgNOR颗粒平均数为7.2±1.38,明显高于增生间皮细咆核内的AgNOR平均数1.36±0.21,两组间差异有高度显著性(P<0.001);在形态上癌细胞颗粒大小不一,形态不规,畸形明显,以聚集型和弥散型为主,增生间皮细胞的颗粒形态规则。大小一致,以单一型为主。结论应用AgNOR颗粒计数结合颗粒形态观察分型综合分析对胸腹水中良、恶性细胞的鉴别诊断具有一定的实用价值。     

恶性滋养细胞肿瘤中表皮生长因子的表达与胎盘激素含量的关系

 应用免疫组化方法，采用抗表皮生长因子(EGF)、绒毛膜促性腺激素(hCG)、胎盘泌乳素(hPL)及妊娠特异性β₁糖蛋白(SP₁)抗体，分别检测91例恶性滋养细胞肿瘤(侵蚀性葡萄胎29例，绒毛膜癌29例，转移性侵蚀性葡萄胎12例，转移性绒毛膜癌21例)中EGF和三种胎盘激素的含量。结果表明，不同肿瘤性滋养细胞中EGF的表达以合体滋养细胞(ST)最强，中间型滋养细胞(IT)居中，细胞滋养细胞(CT)最弱。EGF在侵蚀性葡萄胎中的表达明显高于绒毛膜癌(P<0.1)，而在上述二种恶性滋养细胞肿瘤的原发瘤和转移瘤中的表达无差异性(P>0.1)。EGF表达越强，hPL和SP₁的含量越高。由于EGF在侵蚀性葡萄胎中的表达明显高于绒毛膜癌，所以hPL和SP₁的含量在前者显著高于后者(P<0.01)。根据本文和我们较早的观察，我们认为EGF对恶性滋养细胞肿瘤的分化、增生及胎盘激素的分泌均具有一定促进作用。     

AgNOR定量分析在细胞学辅助诊断中的意义

目的利用核仁组成区技术(AgNOR)区分良性、中至重度不典型增生及恶性细胞,并探讨AgNOR分型与癌细胞类型的关系.方法应用胶银染色技术检测439例细胞学涂片.结果良性细胞均数(2.96±0.76)与恶性细胞均数(9.90±2.43)差异有极显著性(P＜0.001),说明产生假阳性机会很小.良性细胞与中度不典型增生细胞均数(3.90±0.66)和重度不典型增生细胞均数(5.88±0.98)差异有极显著性(P＜0.001),有助于识别可疑癌细胞.AgNOR在腺癌细胞中颗粒粗大、色深;在鳞癌及小细胞癌中颗粒多为弥散型,细小、色浅.AgNOR分型与癌细胞分型有显著相关性(P＜0.001).用AgNOR计算标准判断良恶性其敏感性为96.4%,特异性为95.5%.结论细胞学普通染色诊断困难时,AgNOR银染技术可以辅助诊断.     

滋养细胞肿瘤PP_（11）、PP_（19）、PP_（25）和PP_（26）的免疫

通过免疫组织化学方法研究了４种胎盘蛋白（ＰＰ１１、ＰＰ１９ＰＰ２５和ＰＰ２６）在滋养细胞肿瘤中的表达情况。发现ＰＰ１１在恶性葡萄胎中的表达明显低于葡萄胎（Ｐ＜０．０５），ＰＰ２５和ＰＰ２６在绒癌中的表达低于葡萄胎（Ｐ＜０．０５），ＰＰ１９在各种滋养细胞肿瘤中皆有强表达，提示联合检测４种胎盘蛋白有助于滋养细胞肿瘤间的鉴别诊断。ＰＰ１９还是中间型滋养细胞肿瘤的优良标志物。     

滋养细胞肿瘤PP11,PP19,PP25和PP26的免疫组织化学研究

通过免疫组织化学方法研究了４种胎盘蛋白（ＰＰ１１、ＰＰ１９ＰＰ２５和ＰＰ２６）在滋养细胞肿瘤中的表达情况，发现ＰＰ１１在恶性葡萄胎中的表达明显低于葡萄胎（Ｐ＜０．０５）、ＰＰ２５和ＰＰ２６在绒癌中的表达低于葡萄胎（Ｐ＜０．０５）；ＰＰ１９在各种滋养细胞肿瘤中皆有强表达，提示联合检测４种胎盘蛋白有助于滋养细胞肿瘤间的鉴别诊断。ＰＰ１９还是中间型滋养细胞肿瘤的优良标志物。     

不同滋养细胞在恶性滋养细胞肿瘤中的分布

 应用免疫组化方法,采用抗细胞角蛋白(CK)、绒毛膜促性腺激素(hCG)、胎盘泌乳素(hPL)抗体,检测了91例恶性滋养细胞肿瘤不同类型滋养细胞的分布情况.结果显示,侵袭性葡萄胎和绒毛膜癌的滋养细胞组成不同.二者除了均具有较多合体滋养细胞(ST)外,前者中间型滋养细胞(IT)数量较后者明显增多,而后者细胞滋养细胞(CT)则较前者明显增多.转移性侵袭性葡萄胎与原发瘤在滋养细胞组成上无显著差异,但转移性绒毛膜癌ST较原发瘤明显增多,CT较原发瘤显著减少,IT数量虽有一定增加,但与原发瘤无显著差异.作者认为,合体滋养细胞在恶性滋养细胞肿瘤中的作用尚须进一步探讨.     

妊娠滋养细胞疾病诊断与治疗指南(2021年版)

妊娠滋养细胞疾病(gestational trophoblastic disease,GTD)是一组来源于胎盘滋养细胞的疾病,包括良性的葡萄胎及恶性滋养细胞疾病等.流行病学调查显示,葡萄胎在中国及亚洲某些地区发病率为2/1000次妊娠;而在欧洲和北美发病率通常小于1/1000次妊娠.近年来,亚洲某些国家葡萄胎的发生率有...     

大肠良恶性病变核仁组成区相关嗜银蛋白观察研究

本文对151例大肠良恶性病变应用核仁组成区相关嗜银蛋白(AgNOR)技术进行了观察研究。结果良性病变AgNoR数目最高值是8.03个,每例每100个细胞中每个细胞银颗粒超过4个的数目在50以下,银颗粒比较小而一致;恶性病变AgNOR的最高值是19.75个,每个细胞银颗粒均在4个以上,银颗粒大而不规则,良恶性病变差异有显著性(P<0.001)。提示AgNOR染色对增生活跃细胞的监视和区别大肠粘膜良恶性病变的诊断和鉴别诊断,有临床实用性。     

nm23基因在恶性滋养细胞肿瘤中的表达及其意义

 目的　研究nm2 3基因在恶性滋养细胞肿瘤中的表达和意义。方法　采用LSAB免疫组化染色方法 ,检测nm2 3基因在 91例恶性滋养细胞肿瘤中的表达水平。结果　nm2 3在侵袭性葡萄胎的阳性表达率 ( 10 0 % )显著高于绒毛膜癌 ( 68 63% ) (P <0 0 1)。在不同肿瘤性滋养细胞中 ,合体滋养细胞 (ST)基本不表达 ,中间型滋养细胞 (IT)和细胞滋养细胞 (CT)部分表达 ,但侵袭性葡萄胎中IT阳性表达率 ( 62 50 % )极明显高于绒毛膜癌 ( 3 92 % ) (P <0 0 1)。侵袭性葡萄胎原发瘤强阳性表达率 ( 82 76% )明显高于转移瘤 ( 2 7 2 7% ) ,原发性绒毛膜癌阳性表达率 ( 84 37% )明显高于转移性绒毛膜癌 ( 4 2 11% ) ,差异均具有高度显著性 (P <0 0 1)。结论　nm2 3基因的表达水平与恶性滋养细胞肿瘤的分化呈正相关 ,与肿瘤的转移能力呈负相关     

纤溶酶原激活剂在妊娠滋养细胞疾病中的表达及其与肿瘤侵袭的关系

目的:明确尿激酶型纤溶酶原激活剂(uPA)在妊娠滋养细胞肿瘤中的表达及其与恶性滋养细胞肿瘤侵袭的关系。方法:应用分子原位杂交技术检测葡萄胎、侵蚀性葡萄胎及绒毛膜癌标本中uPA的表达情况,并分析其与恶性滋养细胞肿瘤侵袭的关系。结果:①uPA在葡萄胎、侵蚀性葡萄胎及绒毛膜癌中的表达差异有显著性(P<0.001);②通过秩和检验对各组进行两两比较,uPA在侵蚀性葡萄胎及绒毛膜癌中的表达比葡萄胎均显著增高(P<0.001)。③侵蚀性葡萄胎及绒毛膜癌浸润子宫肌层的深度与uPA的表达状况差异有显著性(P<0.05)。结论:滋养细胞的恶性生物学行为与uPA的表达异常之间存在着一定的相关性。     

恶性淋巴瘤和正常淋巴结中核仁组成区相关蛋白的研究

采用嗜银染技术对23例恶性淋巴瘤、8例淋巴结反应性增生和10例正常淋巴结的核仁组成区相关蛋白进行了显示(AgNOR)。结果显示恶性淋巴瘤的AgNOR核均数较高,与正常淋巴结和反应性淋巴结增生相比较有非常显著性差异(P<0.01)。不同恶性程度的非何杰金氏恶性淋巴瘤的AgNOR之间也有差异(P<0.05或P<0.01)。AgNOR方法有助于鉴别淋巴结的良恶性病变,在对恶性淋巴瘤的诊断和分型上有一定价值。     

胃癌和胃粘膜异型增生核仁组织区嗜银蛋白定量和形态研究

目的探讨核仁组织区嗜银蛋白（ＡｇＮＯＲ）染色技术在胃癌、癌前病变、慢性胃炎中鉴别诊断价值和意义。方法应用ＡｇＮＯＲ染色技术，观察１３２例胃良恶性病变和癌前病变细胞核中ＡｇＮＯＲ颗粒含量和形态。结果胃癌、胃粘膜异型增生、慢性胃炎三组间细胞核内ＡｇＮＯＲ颗粒均数差异非常显著（Ｐ＜０．０１），正常胃壁粘膜与慢性胃炎ＡｇＮＯＲ颗粒均数无明显差异（Ｐ＞０．０５）。胃癌和胃粘膜异型增生ＡｇＮＯＲ颗粒形态以弥散型为主，而慢性胃炎和正常胃粘膜以核仁型为主。结论细胞核内ＡｇＮＯＲ颗粒含量和分型对于区别胃良恶性及癌前病变有重要参考价值。     

砷致皮肤癌的核形态变化及其AgNOR颗粒形态定量分析

目的 :探讨砷致皮肤癌的核形态变化及其AgNor颗粒的形态定量分析。方法 :利用自动图像分析技术分别对 18例砷致皮肤癌、8例非砷致皮肤癌、9例皮内痣组织细胞的核浆面积比 (核浆比 )及核仁组成区嗜银蛋白 (AgNOR)的形态计量学参数 (灰度、形状因子、最小直径、最大直径、周长、面积、颗粒数 )进行自动测定。结果 :皮肤癌 (砷致、非砷致 )与皮内痣的核浆比、AgNOR的各参数之间有显著差异 (p <0 .0 5 ) ,而砷致皮肤癌与非砷致皮肤癌之间的核浆比、AgNOR的各参数之间无显著差异 (p >0 .0 5 )。结论 :核浆比、AgNOR的形态计量学参数 (特别是平均颗粒数与平均面积 )可为鉴别良、恶性肿瘤提供一种有用的手段。     

Argyrophilic nucleolar organizer region (AgNOR) area per nucleus as a prognostic factor in breast cancer

Whether argyrophilic nucleolar organizer region (AgNOR) is a predictor of prognosis in breast cancer is controversial. The semiquantitative procedure used to calculate interphasic argyrophilic dots optically is neither reliable nor reproducible. We measured the mean area of AgNOR dots, the mean AgNOR area per nucleus (MA), and the mean AgNOR number per nucleus (MN) by automated image analysis in specimens from 131 patients with breast cancer. Higher MA (>7.41 pun²), detected in 22 (16.8%) of 131 patients, did not correlate with clinicobiologic variables, except for DNA ploidy status. Overall survival was significantly better in patients with lower MA than in those with higher MA. On multivariate analysis, MA was a significant independent factor, followed by nodal status. These findings indicate that expression of AgNOR should be evaluated in terms of area occupied and that the mean area of AgNOR per nucleus (MA) is an important prognostic factor in the overall survival of breast cancer patients. © 1995 Wiley-Liss, Inc.     

Argyrophilic nucleolar organizer regions in breast carcinoma. Correlation with DNA flow cytometry, histopathology, and lymph node status.

Argyrophilic nucleolar organizer regions (AgNOR) have been correlated with proliferative activity of neoplasms. Increased AgNOR may reflect increased proliferative activity of cells or ploidy. To explore this hypothesis, 41 breast carcinomas were processed for AgNOR silver staining and DNA flow cytometry. AgNOR counts were expressed as mean AgNOR/nucleus and percentage of tumor cells with more than five AgNOR/nucleus. The first count was designated mean AgNOR or mAgNOR, and the second count was designated AgNOR proliferative index or pAgNOR. Using Mantel-Haensel statistical analysis, carcinomas that exhibited mAgNOR of 2.4 or more had a high likelihood of aneuploidy (P less than 0.0001), an S-phase fraction of more than 5.8% (P less than 0.003), or a diameter greater than 2 cm (P less than 0.007). In addition, tumors with pAgNOR of 8% or more showed a statistically significant correlation with aneuploidy (P less than 0.004), tumor grade (P less than 0.04), and a more significant one with high S-phase fraction (P less than 0.0001). No significant correlation was obtained between pAgNOR and tumor size or lymph node status. These data indicate that AgNOR quantitation reflects changes in DNA ploidy and cell proliferation. They also suggest that the mean AgNOR counts correlate best with the DNA mass or ploidy and that the frequency of cells with higher AgNOR count best reflects proliferative activity or S-phase fraction.     

图像分析检测滋养细胞瘤嗜银蛋白的临床意义

本文选取妊娠滋养细胞肿瘤石蜡包埋的组织块100例，共分5组：（1）正常绒毛（对照组）20例；（2）葡萄胎未恶变组40例；（3）葡萄胎恶变组40例；（4）恶性葡萄胎10例；（5）绒毛膜癌组10例。上述组织切片先按Ploton’s法行核仁组成区银染。再用图像分析法行核仁组成区嗜银蛋白颗粒计数和面积测量，两者结果均显示：组2高于组1（P＜0．001），组3高于组2（P＜0．001），组4高于组3（P＜0．05），组4和组5间无显著差异（P＞0．05），提示图像分析法检测滋养细胞肿瘤嗜银蛋白对预测葡萄胎恶变有一定意义。     

Nucleolar organizer region count and subjective AgNOR pattern assessment (SAPA) score in skin tumors.

OBJECTIVE: To study the argyrophilic nucleolar organizer region (AgNOR) count and subjective AgNOR pattern assessment (SAPA) score in cytologic and histologic specimens of various skin tumors. STUDY DESIGN: The study group consisted of 37 patients (14 benign and 23 malignant) of various skin tumors. In all cases, cytology by fine needle aspiration cytology (FNAC), and histological specimens were studied by conventional staining and silver staining for AgNOR. RESULTS: The mean count in benign tumors in cytologic specimens was 2.08 +/- 0.01, compared with 5.50 +/- 1.12 in malignant tumors (P<0.001). In histologic specimens, mean count was 2.13 +/- 0.51 in benign, compared with 5.38 +/- 1.10 in malignant tumors (P<0.001). The SAPA score in benign tumors (P<0.001) in cytologic specimens, was 6.07 +/- 0.83, compared with 10.65 +/- 1.27 in malignant tumors, and in histology, it was 6.07 +/- 0.87 in benign, compared with 10.83 +/- 1.15 in malignant tumors (P < 0.001). Melanoma showed the higher AgNOR count compared with squamous cell carcinoma and basal cell carcinoma. The parameters were statistically significant between the grade of tumor in squamous cell carcinoma and the positivity of lymph nodes as demonstrated by SAPA score. No correlation was found between the clinical stage and Clark level of melanoma. Although, AgNOR count and SAPA score showed similar results, the indicators of validity were higher in SAPA than AgNOR count. CONCLUSION: Although, AgNOR count and SAPA score gave similar results, but the indicators of validity were higher in SAPA score than AgNOR count.     

大肠乳头状肿瘤AgNOR的观察与探讨

对87例大肠乳头状肿瘤(腺瘤19例,腺瘤伴不典型增生8例,腺癌60例)行核仁组成区相关嗜银蛋白(AgNOR)观察分析。提示,AgNOR随细胞增生的程度而增加,在良恶性病变之间有显著差异(P<0.001)。因此,对病理学诊断和科研为一有用手段。     

胃良,恶性上皮核仁组成区嗜银蛋白定量研究

使用胶银染色技术对88例胃良、恶性病变及正常胃粘膜进行核仁组成区定量研究。结果表明:慢性胃溃疡之修复性增生上皮及癌旁粘膜平均每核含AgNOR量及AgNOR异形率均高于正常胃粘膜上皮(P<0.05),慢性胃溃疡增生上皮及癌旁粘膜上皮两者之间无明显差异。高分化腺癌与正常胃粘膜上皮、慢性胃溃疡修复上皮及癌旁粘膜上皮相比,平均每核含AgNOR量、AgNOR异形率及AgNOR颗粒在核内的大小及位置分布等均差异非常显著(P<0.01),提示AgNOR定量研究对区分胃良、恶性上皮有重要参考价值。