结直肠癌浸润转移与癌胚抗原的关系

目的研究结直肠癌浸润转移患者与癌胚抗原（ＣＥＡ）的关系．方法结直肠癌患者６０例，男３６例，女２４例；年龄２７岁～８０岁，平均５４９岁±１３２岁，皆经手术及病理证实．ＤｕｋｅｓＡ１６例，Ｂ２０例，Ｃ１４例，Ｄ１０例．用ＲＩＡ测定血清ＣＥＡ水平，并用免疫组织化学方法检测肿瘤组织ＣＥＡ的表达．结果血清ＣＥＡ水平及肿瘤组织ＣＥＡ表达均与肿瘤浸润及转移有关．有转移的患者血清ＣＥＡ水平（１１４６μｇ／Ｌ±７９１μｇ／Ｌ）明显高于无转移的患者（４５３μｇ／Ｌ±３２３μｇ／Ｌ，Ｐ＜００１），肿瘤组织ＣＥＡ表达强度在有转移与无转移患者中亦有明显差异（强阳性率８７５ｖｓ３８９％，Ｐ＜００１）．肿瘤组织ＣＥＡ表达类型也与肿瘤转移有关，呈胞浆型表达者发生淋巴结转移（５４１％）及远处转移（２７０％）明显高于呈顶端型表达者（１９０％，０％，Ｐ＜００１）．结论ＣＥＡ与结直肠癌浸润转移呈正相关，肿瘤组织ＣＥＡ表达类型亦可作为一项预后指标     

从大肠癌病理与纵向浸润关系看手术切除范围

从大肠癌病理与纵向浸润关系看手术切除范围张伟栋１郭文君１刘雨清１纪小龙２Ｓｕｂｊｅｃｔｈｅａｄｉｎｇｓｃｏｌｏｎｉｃｎｅｏｐｌａｓｍｓ／ｐａｔｈｏｌｏｇｙ；ｃｏｌｏｎｉｃｎｅｏｐｌａｓｍｓ／ｓｕｒｇｅｒｙ；ｒｅｃｔａｌｎｅｏｐｌａｓｍｓ／ｐａｔｈｏ...     

结直肠癌细胞粘附分子CD15表达的预后意义

我们应用免疫组化法,检测了结直肠癌组织中ＣＤ１５的表达状况,观察与临床和病理参数之间的关系及对患者预后的影响．１材料和方法１．１材料收集１９９３０４／１９９８０４之间手术切除结直肠标本．其中原发癌９０例（结肠癌５４例,直肠癌３６例）、淋巴结转移癌...     

肿瘤浸润淋巴细胞在结直肠癌中的临床病理分析

目的:探讨结直肠癌中肿瘤浸润淋巴细胞(TIL)的临床病理和免疫组织化学特征, 及大量TIL与各病理因素的关系.方法:利用光镜和免疫组织化学法对370例结直肠癌中的肿瘤浸润淋巴细胞进行组织病理学观察, 并分析对比其与各临床病理因素的相关性.结果:81.9%的结直肠癌中可见淋巴细胞散在分布, 数量少, 18.1%却可见大量的淋巴细胞,并有一定的临床病理特征. 大量的TIL部分侵入肿瘤实质而部分位于肿瘤组织周围. 免疫组织化学染色显示, 肿瘤浸润淋巴细胞主要是由CD3+ T细胞、CD20+、CD79α+B细胞、浆细胞和CD56+NK细胞构成, 其中细胞毒性TIA-1均有较高的表达, 并伴有大量淋巴细胞浸润与肿瘤组织的分化程度、浸润深度及淋巴结转移有关(χ2 = 4.954, 11.240及12.768; P = 0.026,0.001及0.000).结论:结直肠癌组织中TIL的病理形态差异较大并与临床病理因素相关. 在结直肠癌中伴有大量肿瘤浸润淋巴细胞存在时有积极的意义.     

肿瘤浸润淋巴细胞治疗胆道癌研究进展

肿瘤浸润淋巴细胞(TIL)是存在于肿瘤实质和间质内的以T淋巴细胞为主的一类异质性淋巴细胞群体。将其从肿瘤组织消化和分离出来,经体外培养活化和扩增后,回输到患者体内可以起到杀伤肿瘤细胞的作用。TIL具有T淋巴细胞抗原受体的高度多样性、优异的浸润肿瘤部位能力以及低毒性等优势,被认为有希望用于治疗恶性实体肿瘤。目前,TIL疗法已在多种实体瘤中作为二线治疗进行临床试验并取得初步疗效。虽然目前尚无TIL应用于胆道癌单一病种的临床队列报道,近期的多癌种临床报道提供了少数接受TIL治疗的胆道癌患者的疗效信息,初步证实了安全性和有效性。但由于胆道癌一般被认为是大多数效应T淋巴细胞被隔离在肿瘤边缘的免疫排斥性肿瘤,TIL在胆道癌中的抗肿瘤作用仍难以预测。尝试与不同抗肿瘤方法的联合治疗以及开发新技术修饰细胞以增强TIL抗肿瘤能力是未来可能突破的发展方向。     

胃癌细胞粒酶B表达与树突状细胞和活化T淋巴细胞浸润程度的关系及临床意义

粒酶B(granzyme B，GrB)是活化的细胞毒T淋巴细胞(CTL)和自然杀伤(NK)细胞发挥细胞毒作用的主要效应分子，也是其特异标志物，本研究采用免疫组化法，观察胃良／恶性上皮细胞是否表达GrB，同时检测组织中浸润S-100^ 树突状细胞(DC)和GrB^ 肿瘤浸润T淋巴细胞(TIL)，探讨GrB表达与胃癌生物学行为及局部免疫状态的相互关系。     

HPV与人结直肠癌的关系

ＨＰＶ与人结直肠癌的关系陈建华，于皆平，沈志祥（湖北医科大学附属一院消化系病研究室湖北４３００６０）人乳头瘤病毒（ｈｕｍａｎｐａｐｉｌｌｉｍａｖｉｒｕｓｅｓ，ＨＰＶｓ）与鳞状上皮细胞癌（如食管鳞癌）的病因关系已被许多研究所证实。近来文献报道，人乳头瘤...     

Bcl-2表达与结直肠癌分化程度的关系

材料和方法１．１材料收集我院１９９２／１９９７手术切除的结直肠癌石蜡标本共７７例,高、中、低分化者分别为４６,１６和１５例．取癌移行区（距癌灶０５ｃｍ～２０ｃｍ）标本共５７例作为对照．１．２方法标本常规切片（５μｍ）后贴于经ＡＰＥＳ处理的载玻片,...     

树突状细胞诱导的肿瘤特异性细胞毒性T淋巴细胞对裸鼠人肝癌转移的预防和治疗

目的探讨肿瘤抗原特异性细胞毒性T淋巴细胞(CTL)对裸鼠人肝癌转移模型LCI-D20的治疗作用。方法从健康人外周血单个核细胞中诱导树突状细胞,用重组人粒细胞-巨噬细胞集落刺激因子和白细胞介素-4刺激活化,经人肝癌细胞株MHCC97-H肿瘤抗原致敏后,诱导肿瘤抗原特异性CTL,经腹腔注射,以自然杀伤样T淋巴细胞(CIK)和磷酸盐缓冲液为对照,研究其对LCI-D20肝癌治疗和预防转移作用。结果肿瘤抗原特异性CTL组、CIK 组和对照组肝癌肿块重量、血清甲胎蛋白含量、肝癌肝内转移率和存活期依次为(1．11±0．63)g、(1．12±0．36)g 和(2．68±0．53)g;(52．1±9．7)μg／L、(48．6±5．2)μg／L和(82．2±7．2)μg/L;16．7％、16．7％和58．3％; (79．0±5．0)d、(73．3±7．0)d和(52．3±5．2)d。对照组与前两组比较差异均有统计学意义(P值均<0．01)。结论肿瘤抗原特异性CTL可以预防LCI-D20模型肝癌发生转移,延长动物存活时间。     

老年人大肠癌组织胃泌素表达及其与血清胃泌素水平的关系

目的探讨老年人大肠癌组织中胃泌素表达的临床病理意义及其与血清胃泌素水平的关系。方法对４６例老年人大肠癌、３２例非老年人大肠癌组织胃泌素表达进行免疫组化观察,并用放免法测定其血清胃泌素水平。结果癌组织中胃泌素表达阳性率,老年组４７．８％（２２例）,非老年组１８．８％（６例）（Ｐ＜０．０１）;老年组胃泌素的表达与肿瘤分化程度、ＴＮＭ分期、淋巴结转移有关,非老年组未显示这些关系。老年组和非老年组血清胃泌素水平与健康对照组比较差异均无显著性（Ｐ＞０．０５）,癌组织中胃泌素的表达不影响血清胃泌素水平（Ｐ＞０．０５）。结论胃泌素在癌组织中的表达可作为老年人大肠癌恶性度的一项指标,其表达对血清胃泌素水平无影响。     

Clinical implications of multiple colorectal carcinomas in hereditary nonpolyposis colorectal carcinoma

PURPOSE: An increased incidence of multiple (synchronous and metachronous) colorectal carcinomas has been reported in hereditary nonpolyposis colorectal cancer. This review was undertaken to determine the clinical implications of multiple colorectal carcinomas in hereditary nonpolyposis colorectal cancer. METHODS: A retrospective review of the records of patients in the hereditary nonpolyposis colorectal cancer registry at Roswell Park Cancer Institute who had either synchronous or metachronous colorectal carcinomas was conducted. RESULTS: Twenty-five of 93 patients with documented pathology were found to have multiple colorectal carcinomas. The mean age at diagnosis of the index colorectal carcinoma was 46.7 (range, 28–65) years. There were 7 (7.5 percent) patients with synchronous colorectal carcinomas and 20 (21.5 percent) patients with metachronous colorectal carcinomas. Two of the seven (28.6 percent) patients with synchronous colorectal carcinomas developed a metachronous colorectal carcinoma. In the patients with metachronous colorectal carcinomas, 29 metachronous events were noted: colon (23) and rectum (6). The mean and median time interval for metachronous colorectal carcinomas were 10.9 and 11.8 (range, 1.5–43.8) years, respectively. The mean times to first, second, and third events were 11.7 (range, 1.5–43.5), 7.9 (range, 2.7–18.7), and 12.3 (range, 11.8–12.7) years, respectively. The majority of patients with metachronous colorectal carcinomas did not have stage progression at the diagnosis of the metachronous colorectal carcinomas: 13 patients had lower or same stage at first event, 4 had lower or same stage at second event, and 2 patients had lower stage at third event. Three of 20 patients with metachronous colorectal carcinomas died of their disease. CONCLUSION: Multiple colorectal cancers are common in hereditary nonpolyposis colorectal cancer. Even though stage progression may not be evident at diagnosis of metachronous colorectal cancer, some of these patients will nevertheless die of their disease.Presented at the annual meeting of the Southeastern Surgical Congress, Atlanta, Georgia, February 2 to 4, 1998.     

Relationship between expression of laminin and pathological features in human colorectal carcinoma

ＲｅｌａｔｉｏｎｓｈｉｐｂｅｔｗｅｅｎｅｘｐｒｅｓｓｉｏｎｏｆｌａｍｉｎｉｎａｎｄｐａｔｈｏｌｏｇｉｃａｌｆｅａｔｕｒｅｓｉｎｈｕｍａｎｃｏｌｏｒｅｃｔａｌｃａｒｃｉｎｏｍａＦＥＮＧＳｈｕ１,ＷＡＮＧＹｕＹｉｎｇ１ａｎｄＳＯＮＧＪｉｎＤａｎ２Ｓ...     

Immunohistochemical study on endocrine-like tumor cells in colorectal carcinomas

ＩｍｍｕｎｏｈｉｓｔｏｃｈｅｍｉｃａｌｓｔｕｄｙｏｎｅｎｄｏｃｒｉｎｅｌｉｋｅｔｕｍｏｒｃｅｌｓｉｎｃｏｌｏｒｅｃｔａｌｃａｒｃｉｎｏｍａｓＷＡＮＧＤａｏＣｕｎ，ＷＡＮＧＬｉＤｏｎｇ，ＪＩＡＹｕｎＹｉｎｇ，ＬＩＵＹｉＱｉｎｇ，ＦＥＮＧＣｈ...     

幽门螺杆菌感染与胃癌部位组织类型的关系

目的探讨幽门螺杆菌（Ｈｐ）感染与胃癌部位及组织类型的关系．方法胃镜及病理证实的胃癌７３例，男女之比为２０４∶１，平均年龄为５６０岁．其他肿瘤患者７３例（食管癌２２例；结直肠癌１９例；肺癌２１例；乳腺癌１１例），男女之比为１７０∶１，平均年龄为５５６岁，进行１∶１病例一对照研究，采用间接ＥＬＩＳＡ法检测血清抗ＨｐＩｇＧ抗体水平，将Ｈｐ抗体分为３个等级．结果胃癌组Ｈｐ感染率为５８９％，平均抗体水平为２２９±０８５（ｘ±ｓ），显著高于对照组的感染率４２５％（Ｐ＜００５）和平均抗体水平１８４±０６５（Ｐ＜００１）．Ｈｐ感染率在对照组的分布情况为食管癌４０９％，结直肠癌４７４％，肺癌３８１％，乳腺癌４５５％．胃癌组与对照组相比，机会比值呈线性趋势（Ｐ＝０００５４６０）．Ｈｐ阳性率在非贲门部胃腺癌为７４４％，明显高于贲门部腺癌４０７％（Ｐ＜００５）．结论Ｈｐ感染与胃癌有关，特别与非贲门部腺癌关系密切．胃癌的危险性随抗ＨｐＩｇＧ抗体滴度升高而升高．     

血清胃泌素诊断结直肠肿瘤的价值

目的研究结直肠肿瘤患者血清胃泌素水平与病情的相关性．方法经纤维结肠镜下活组织病理检查和／或术后病理确诊的结直肠腺瘤２８例和结直肠癌患者４６例，在排除有可能影响血清胃泌素水平的其它情况后，用ＲＩＡ法检测空腹血清胃泌素及ＣＥＡ含量．结果以胃泌素≥１００ｎｇ／Ｌ作为结直肠腺瘤的诊断指标，其敏感性、特异性和诊断效率分别为７５％，８１％和７８９％，以胃泌素≥１３０ｎｇ／Ｌ作为结直肠癌的诊断指标，其敏感性、特异性和诊断效率分别为７００％，９１９％和７９３％；而ＣＥＡ≥１５μｇ／Ｌ，则分别为３２０％，９４４％和４８５％．以胃泌素≥１３０ｎｇ／Ｌ作为癌肿与腺瘤的鉴别诊断指标，其敏感性、特异性和诊断效率都是７００％；而ＣＥＡ≥１５μｇ／Ｌ，则分别为３００％，９００％和４８６％．在早期结直肠癌患者，胃泌素≥１００ｎｇ／Ｌ者占７７８％，明显高于便血率（４５５％）．结论血清胃泌素对结直肠肿瘤的诊断和鉴别诊断优于ＣＥＡ，可作为结直肠癌的普查手段．     

大肠癌P53蛋白PCNA和CEA的表达与淋巴结转移的关系

目的研究大肠癌Ｐ５３蛋白、增殖细胞核抗原（ＰＣＮＡ）和ＣＥＡ的表达与淋巴结转移的关系．方法应用链霉菌素生物素（ＳＰ）免疫组化法，观察４４例大肠癌Ｐ５３，ＰＣＮＡ的阳性率和ＣＥＡ的表达型式．结果大肠癌Ｐ５３阳性率为５２３％；大肠癌Ｐ５３阳性表达与性别、年龄及肿瘤的部位、分化程度和浸润深度无关（Ｐ＞００５）；大肠癌Ｐ５３阳性者其淋巴结转移率较阴性者高（１４／２３，６０９％ｖｓ６／２１，２８６％，Ｐ＜００５）；Ｐ５３阳性表达及有淋巴结转移者其细胞增殖活性分别较Ｐ５３阴性表达及无淋巴结转移者高（５５９±１７ｖｓ３７９±１４，Ｐ＜００５；５６２±１５ｖｓ３９６±１７，Ｐ＜００５）；Ｐ５３阳性表达及有淋巴结转移者其ＣＥＡ表型均以胞质型和间质型为主（２１／２３，９１３％ｖｓ１３／２１，６１９％，Ｐ＜００５；１９／２０，９５０％ｖｓ１５／２４，６２５％，Ｐ＜００５）．结论检测Ｐ５３和ＰＣＮＡ表达及ＣＥＡ表型对判断大肠癌的恶性程度，预测其淋巴结转移趋势和预后及指导临床治疗有重要价值．     

Relationship between loss of heterozygosity of deleted in colorectal carcinoma gene microsatellites and prognosis of colorectal adenocarcinoma

AIM: To investigate the relationship between the loss of heterozygosity (LOH) of microsatellites on the deleted in colorectal carcinoma (DCC) gene and prognosis of colorectal adenocarcinoma.METHODS: A retrospective study of 58 colorectal adenocarcinoma cases with follow-up data and paired control normal mucosal tissues from 1983 to 1985 from files from the West China University of Medical Sciences Department of Pathology was carried out by PCR microsatellite analysis. Sixteen, 35, and seven cases had well-, moderately, and poorly differentiated tumors, respectively; 11, 30, and 17 cases were staged as Dukes’ A, B, and C, respectively.RESULTS: LOH of DCC microsatellites was detected in 18 cases (31.0%). The 5-year survival rate between LOH-positive and LOH-negative patients was 44.4% and 77.5%, respectively (P < 0.05). The results suggest that LOH of DCC microsatellites correlate with prognosis but not with differentiation (P > 0.05) and Dukes’ stage (P > 0.05) in colorectal adenocarcinoma.CONCLUSION: LOH of DCC microsatellites may be a marker of malignancy. Combined with the traditional prognostic indicators, LOH can predict prognosis of colorectal adenocarcinoma.     

结直肠癌线粒体脱氧核糖核酸拷贝数与患者预后的关系

目的 探讨结直肠癌(CRC)线粒体DNA(mtDNA)拷贝数异常与患者预后的关系.方法 选取60份CRC及相应癌旁组织标本,分别提取基因组DNA.对线粒体ND1基因进行荧光定量PCR,计算mtDNA拷贝数,采用t检验进行统计分析.Kaplan-Meier生存分析判断患者的预后.结果 CRC组织的mtDNA平均拷贝数/细胞数为108.60±20.11,而相应的癌旁组织为153.68±25.72,前者显著低于后者(t=10.69,P＜0.01).淋巴结转移阳性者mtDNA低拷贝率高于阴性者(x2=4.022,P＜0.05),但与性别、年龄、病理分型、TNM分期无明显相关性.mtDNA高拷贝组生存率高于低拷贝组,但差异无统计学意义(P＞0.05).结论 CRC的mtDNA拷贝数明显低于癌旁组织,但拷贝数的改变与患者的预后无关.