新辅助化疗后乳腺癌组织中survivin表达及其与Ki-57、AI的相关性研究

目的探讨采用CTF方案新辅助化疗后乳腺癌组织中凋亡抑制蛋白survivin的表达及其与肿瘤细胞凋亡、增殖的相互关系和临床意义。方法采用免疫组化SABC法,检测60例行新辅助化疗和60例未行新辅助化疗的乳腺癌组织中survivin和Ki-67的表达,并采用原位细胞末端转移标记法（TUNEL法）测定细胞凋亡指数（AI）。结果新辅助化疗组survivin阳性表达率为36．7％（22／60）,明显低于对照组（71．7％,43／60）（X^2=14．821,P〈0．001）。新辅助化疗组Ki-67阳性表达率（38．3％,23／60）明显低于对照组（61．7％,37／60,0=6．533,P〈0．05）。新辅助化疗组AI均数为（9．34±3．12）％,对照组AI均数为（5．27±3．16）％,两组比较差异有统计学意义（y=1．998,P〈0．05）。新辅助化疗组survivin表达与AI呈负相关（γ=-0．36,P〈0．05）,而与Ki-67表达呈正相关（γ=0．47,P〈0．05）。新辅助化疗组化疗总有效率为73．3％（44／60）,化疗后部分缓解（Ⅱ级）病例survivin表达水平（18．2％,8／44）明显低于无效（Ⅲ级）病例（81．3％,13／16）（X^2=20．514,P〈0．001）。结论应用CTF方案新辅助化疗,缓解率高,近期疗效明显。Sur-vivin表达水平可作为预测乳腺癌新辅助化疗疗效的指标。     

激素受体和HER-2及Ki-67预NSL腺癌新辅助化疗疗效价值的分析

目的：探讨乳腺癌组织中雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER-2）及Ki-67的表达状态对新辅助化疗反应的预测作用以及化疗前后其表达差异对疗效的影响。方法：免疫组织化学方法检测新辅助化疗前后118例乳腺癌组织的ER、PR、HER-2及Ki-67的表达情况,并分析其与新辅助化疗疗效的关系。结果：118例新辅助化疗乳腺癌病例中,ER-和PR-组pCR分别为26．1％和27．1％,明显高于ER＋组11．1％和PR＋组6．8％,P-0．003。HER-2和Ki-67的表达对新辅助化疗疗效无显著影响。新辅助化疗前ER、PR与Ki-67的表达呈明显负相关,P〈0．001;新辅助化疗后Ki-67的高表达病例数显著减少,P-0．001。结论：ER-／PR-的患者对新辅助化疗更为敏感,Ki-67在化疗后发生了显著下调,提示新辅助化疗能降低肿瘤的增殖活性。ER、PR及Ki-67可以作为新辅助化疗疗效的预测指标。     

Ki-67抗原在宫颈鳞癌新辅助化疗中的意义

[目的]探讨Ki-67在宫颈鳞癌新辅助化疗（NACT）前后表达的意义。[方法]在新辅助化疗前后用免疫组化方法检测32例宫颈鳞癌组织Ki-67的表达。[结果]化疗前后Ki-67阳性表达率分别为96．9％（31／32）和84．4％（26／32），差异有统计学意R（P=0．045）；不同年龄段，临床期别和病理分级患者，化疗前后Ki-67阳性表达率无统计学差异。新辅助化疗总有效率为100％（32／32）．完全缓解率40．6％（13／32），部分缓解率59．4％（19／32）。化疗前Ki-67的表达程度不同，完全缓解率明显不同，Ki-67（-）和（＋）组CR率为1／9，与（＋＋）和（＋＋＋）组的CR率52．2％（12／23）比较有统计学差异（P=0．033）。[结论]宫颈鳞癌新辅助化疗前晒-67阳性表达强度和化疗后阳性表达率下降程度可能与化疗敏感性密切相关，但Ki-67是否能作为判断宫颈鳞癌新辅助化疗敏感性的指标尚不能确定。     

乳腺癌穿刺活检对HR和HER-2及Ki-67评价可靠性以及化疗对其影响研究

目的：研究乳腺癌空芯针穿刺活检（coreneedle biopsy,CNB）对激素受体（hormone receptor,HR）、HER-2及Ki-67表达状况评价的可靠性,探讨新辅助化疗（neoadjuvantchemotherapy,NAC）对乳腺癌分子生物学信息表达的影响,分析上述生物学指标对NAC疗效的预测价值。方法：选择2012-03-01-2013-01～31山东省肿瘤医院外科收治的乳腺癌患者177例,其中行NAc者95例作为NAC组,未行NAC者82例作为对照组。免疫组织化学SP法检测两组患者CNB和治疗性手术切除标本中ER、PR、HER-2及Kb67的表达状况,依据Miller-Payne分级系统评价化疗后病理反应,依据实体瘤反应评价标准（response evaluation criteria in solid tumors,RECIST）进行新辅助化疗的疗效评价。结果：对照组患者cNB和手术切除标本ER表达一致率为97．6％（80／82）,PR为95．1％（78／82）,HER-2为97．6％（80／82）,Ki-67为92．7％（76／82）,Spearman等级相关系数均〉0．8,P均〈0．05。NAC组和对照组CNB和手术切除标本比较,ER表达状况改变率分别为12．4％（10／79）和3．9％（2／82）,差异有统计学意义,P=0．014;PR表达状况改变率分别为24．0％（19／79）和2．4％（4／82）,差异有统计学意义,P=0．001;HER-2表达状况改变率分别为5．1％（4／79）和2．4％（2／82）,差异无统计学意义,P=0．379;Ki=67表达状况改变率分别为38．0％（30／79）和7．3％（6／82）,差异有统计学意义,Pd0．001。NAC前后ER阳性率分别为64。6％和53．2％,差异无统计学意义,P=0．146;PR阳性率分别为63．3％和45．6o／,差异有统计学意义,P=0．025;Ki-67高表达率分别为45．6％和15．2％,差异有统计学意义,P=0．017。化疗反应分级与ER、PR、HER-2表达变化无相关性,P均〉0．05;与Ki-67表达变化明显相关,P=0．008。ER和PR表达状况与NAC疗效无相关性,P均〉0．05;HER-2阳性的乳腺癌患者NAC有效率为81．8％,阴性者有效率为50．7％,差异有统计学意义,P=0．010;Ki-67高表达乳腺癌患者NAC有效率为70．2％,低表达者有效率为45．5％,差异有统计学意义,P=0．029。结论：cNB与手术切除标本在判断HR、HER-2和Ki-67表达状况上有很好的一致性;NAC能改变乳腺癌患者HR和Ki-67的表达状况,NAc使PR的阳性率降低,Ki-67的表达下降,ER阳性率有降低趋势,NAc对HER-2的表达无显著影响;HER-2阳性和Ki-67高表达的患者对化疗更敏感。     

MCM7和Ki-67在乳腺癌中的表达及其与新辅助化疗关系的研究

目的探讨乳腺癌新辅助化疗前后MCM7和Ki-67蛋白的表达状况,分析其与化疗疗效的关系。方法采用免疫组化方法检测55例乳腺癌新辅助化疗前后标本中MCM7和Ki-67的表达。结果新辅助化疗有效率为76.4%。化疗前MCM7和Ki-67蛋白阳性表达均显著高于化疗后（P〈0.01）;化疗前MCM7蛋白阳性表达显著高于Ki-67（P〈0.01）。化疗有效组（42例）MCM7蛋白阳性表达显著高于无效组（13例）（P〈0.01）,而Ki-67蛋白表达差异无统计学意义（P〉0.05）。化疗前MCM7、Ki-67表达呈正相关（r=0.58,P〈0.01）。结论ET方案新辅助化疗有较好的疗效,可能通过抑制MCM7、Ki-67蛋白的表达阻止乳腺癌细胞的增殖。MCM7蛋白高表达者化疗更敏感,MCM7可作为临床指导乳腺癌化疗并预测化疗敏感性的分子生物学指标之一。     

新辅助化疗对Ⅲ期非小细胞肺癌细胞凋亡和增殖的影响

目的：探讨新辅助化疗对非小细胞肺癌肿瘤细胞凋亡及对肿瘤细胞增殖的影响。方法：选取Ⅲ期非小细胞肺癌患者56例行新辅助化疗后并手术．并选取同期50例直接手术患者作为对照组。两组患者的手术标本．分别采用末端转移酶介导的dUTP切口末端标记法（TUNEL）行细胞凋亡检测，采用免疫组化标记链菌亲和素生物素法（LSAB），检测细胞增殖抗原Ki－67的表达。结果：新辅助化疗组肿瘤细胞凋亡指数（AI）均数为9．34％，对照组肿瘤细胞凋亡指数均数为5．27％．两组比较有显著差异（P〈0，001）。新辅助化疗组肿瘤细胞增殖抗原Ki－67阳性表达率均数为35．68％．对照组Ki－67阳性表达率均数为59.35％，两组比较差异显著（P〈0．001）。新辅助化疗组及对照组中，肿瘤细胞凋亡指数AI与增殖指数Ki-67的阳性表达均成负相关。结论：新辅助化疗能诱导Ⅲ期非小细胞肺癌肿瘤细胞的凋亡．并能抑制其增殖。     

MCM5及Ki-67蛋白表达与乳腺癌新辅助化疗近期疗效关系的研究

目的:探讨人乳腺癌新辅助化疗前后MCM5和Ki-67蛋白的表达状况,分析其与化疗疗效关系的意义.方法:采用免疫组化法检测40例乳腺癌新辅助化疗前后标本中MCM5和Ki-67的表达.结果:新辅助化疗有效率为77.5%.化疗前MCM5和Ki-67蛋白阳性表达显著高于化疗后(P＜0.01);化疗前MCM5蛋白阳性表达显著高于Ki-67(P＜0.01).化疗有效组(31例)MCM5蛋白阳性表达显著高于无效组(9例)(P＜0.01);化疗有效组Ki-67蛋白阳性表达高于无效组,但差异无显著性(P＞0.05).化疗前MCM5、Ki-67表达呈正相关(r=0.601,P＜0.01).结论:ET方案新辅助化疗有较好的疗效,可能通过抑制MCM5、Ki-67蛋白的表达来阻止乳腺癌细胞的增殖.MCM5蛋白高表达者化疗更为敏感,MCM5可作为临床指导乳腺癌化疗并预测化疗敏感性的分子生物学指标之一.     

Ki-67表达与Ⅱ/Ⅲ期乳腺癌新辅助化疗疗效及预后的关系

目的:探讨乳腺癌组织中Ki-67 抗原（简称 Ki-67）表达与新辅助化疗(neoadjuvant chemotherapy,NAC)疗效的关系。寻找新辅助化疗有效的预测因子。方法:选取我院2012年6月至2017年6月收治的112例接受NAC治疗的Ⅱ/Ⅲ期乳腺癌患者作为研究对象。使用免疫组化方法检测NAC治疗前乳腺癌患者的Ki-67表达情况，化疗2~4周期后评估临床疗效。分析乳腺癌中Ki-67的表达与临床病理学特征的关系以及Ki-67的表达与NAC疗效的关系。结果:原发性乳腺癌组织中Ki-67的高表达率为65.18%，Ki-67的高表达与病理组织学分级（P=0.017）有关。Ki-67高表达的患者新辅助化疗后获得临床完全缓解（cCR）+临床部分缓解（cPR）的比率（89.0%）明显高于Ki-67低表达的患者新辅助化疗后获得cCR+cPR的比率（61.5%）（P=0.001）。中位随访时间 37个月，Ki-67高表达患者的无病生存时间（DFS）低于Ki-67低表达的患者（P=0.023），Ki-67高表达患者的总生存时间（OS）低于Ki-67低表达的患者（P=0.040）。结论:Ki-67的高表达与乳腺癌恶性程度密切相关，并可作为预测乳腺癌新辅助化疗敏感度及预后的独立指标。     

乳腺癌组织p53和Ki-67表达及其与新辅助化疗关系的研究

目的:对照观察乳腺癌患者新辅助化疗前后p53和Ki-67的表达及其变化,分析与化疗疗效的关系,并探讨其发生机制.方法:对70例经ET方案(表柔比星,紫杉醇)新辅助化疗的可手术乳腺癌患者,采用IHC法分别测定化疗前后p53和Ki-67的表达情况,与化疗疗效相对照.结果:本组患者新辅助化疗后,有效率为87.1%(61/70);p53化疗前后的表达分别为40%(28/70)和39.7%(25/63),Ki-67化疗前后的表达率分别为67.1%(47/70)和23.8%(15/63);p53阳性表达,化疗有效率明显低于阴性表达,P=0.013; Ki-67阳性表达者,化疗效果明显优于阴性表达者,P=0.021; Ki-67阳性表达率经新辅助化疗后明显降低(P=0.000),p53无明显变化.结论:ET方案新辅助化疗有较好的疗效;p53和Ki-67的表达无明显相关性;新辅助化疗后Ki-67阳性表达呈下降趋势,p53无明显变化;p53阴性,Ki-67阳性表达者显示出较好的疗效;经新辅助化疗后Ki-67下降者疗效好.     

Ki-67与分子亚型预测乳腺癌新辅助化疗敏感性的研究

目的:探讨Ki-67表达与乳腺癌不同分子亚型预测乳腺癌新辅助化疗的敏感性.方法:收集广东省妇幼保健院乳腺中心2007-01-2011-05接受新辅助化疗的55例局部晚期乳腺癌患者的临床资料,分析Ki-67表达、乳腺癌分子亚型与新辅助化疗临床有效率及病理完全缓解之间的关系.结果:55例患者新辅助化疗后总有效率(RR)为78.2％(43/55),其中有20.0％(11/55)病例达临床完全缓解(CR),9.1％(5/55)的病例达病理完全缓解(pCR),58.2％(32/55)病例达临床部分缓解(PR),21.8％(12/55)的病例为病情稳定(SD),无患者获得疾病进展(PD).Ki-67高表达组(Ki-67≥14％)新辅助化疗临床有效率优于Ki-67低表达组(Ki-67＜14％),x2=7.004,P=0.018;但两组的肿瘤原发灶的病理完全缓解(pCR)差异无统计学意义,x2=0.008,P=1.000.在Ki-67低表达组内,不同分子亚型的乳腺癌新辅助化疗疗效,差异有统计学意义,x2 =8.306,P=0.040;三阴型乳腺癌的有效率优于Luminal A型,x2=10.617,P=0.009;三阴型、Luminal B型与HER-2过表达型的新辅助化疗有效率,差异无统计学意义,x2=5.091,P=0.078;Luminal A型、Luminal B型与HER-2过表达型的新辅助化疗有效率,差异无统计学意义,x2=0.417,P=0.812.在Ki-67高表达组内,不同分子亚型的乳腺癌新辅助化疗疗效,差异无统计学意义,x2 =2.921,P=0.404.不同分子亚型的乳腺癌新辅助化疗临床疗效,差异有统计学意义,x2=14.068,P=0.003;三阴型、Luminal B型和HER-2过表达型乳腺癌新辅助化疗的临床疗效优于Luminal A型;三阴型、Luminal B型与HER-2过表达型的新辅助化疗临床疗效差异无统计学意义,x2 =2.074,P=0.354.而这4型乳腺癌新辅助化疗的病理完全缓解(pCR)差异无统计学意义,x2=7.335,P=0.062.结论:Ki-67表达和乳腺癌分子亚型可预测新辅助化疗的疗效,Ki-67高表达和三阴型乳腺癌的患者从新辅助化疗中获益更多.     

Schwannomas of Head and Neck and Review of Literature

Benign nerve cell tumours have been given various names like schwannoma, neurilemmoma, neurinoma, neurofibroma, spindle cell tumours etc. Extra cranial head and neck schwannomas usually present as solitary and well-demarcated lesions. The lesion can cause secondary symptoms, such as nasal obstruction, dysphasia, and hoarseness, depending upon the location of the lesion. Fine needle aspiration cytology, CT scans, and MRI may be of limited help in the diagnosis of schwannomas. The treatment is complete surgical excision of the benign tumour and postoperative histopathological examination establishes the final diagnosis.     

A comparative study of knowledge and awareness of colorectal and breast cancerA comparative study of knowledge and awareness of colorectal and breast cancer

Aims: To assess and compare knowledge and awareness of colorectal cancer and breast cancer in a sample of the general population. Methods: Eleven hundred visitors to six different outpatient clinics, in a University Hospital, were given a study-specific questionnaire, based on educational material from the British Association of Cancer United Patients (CancerBACUP). The questionnaire consisted of 12 statements on the incidence, presentation, detection, treatment and prognosis of colorectal and breast cancer. Results: One thousand and sixty-eight individuals returned the questionnaire. One thousand and four completed questionnaires were analysed. The mean age (SD) of respondents was 50.1 (17.2) years, and the male to female ratio was 2:3. Respondents had read more about breast than about colorectal cancer (60.3%vs 32.4%,P <0.0001, McNemar's test). The proportion of correct answers for each statement on breast cancer was higher than for answers to corresponding items on colorectal cancer. Mean overall scores (95% CI) for breast and colorectal cancer were 88.1 (86.9, 89.2) and 64.4 (62.5, 66.3) respectively, the mean difference (95% CI) being 23.7 (22.0, 25.5). Scores were higher for breast cancer irrespective of age or gender. Conclusion: There is a low level of understanding of colorectal cancer in the general population when compared to breast cancer. This highlights the importance of public education in this common cancer.     

Quality of life and care in leukemia,myeloma and non-malignant disease. Opinions of patients and relatives,and effects of geography and time

In a questionnaire study 140 subjects answered 4200 questions in 1980 and 1986. They consisted of patients with myeloma, acute leukemia, lung carcinoma, and non-malignant disease and their relatives. In 22 additional cases the questionnaire was not answered. The results show that myeloma patients are less content with the general care than leukemia patients (P < 0.05). Similarly, relatives of deceased myeloma patients are less satisfied with the information given to them than relatives of deceased leukemia patients (P < 0.001). The information has improved with time, however, since the patients were more satisfied in 1986 than in 1980 (P < 0.001) and relatives of myeloma patients still alive were more satisfied than relatives of patients who had died earlier (P < 0.001).     

miRNA与肿瘤侵袭转移

目前,microRNA (miRNA)已成为肿瘤研究中最基本的参与者,主要通过与靶标基因3 'UTR(非翻译区)的完全或不完全配对,降解靶标基因mRNA或抑制其翻译,从而参与调控个体发育、细胞凋亡、增殖及分化等生命活动.miRNA作为调控基因表达的重要分子在肿瘤侵袭转移中的作用越来越受到重视,表明miRNA在肿瘤侵袭和转移中的作用机制具有重要的理论意义,同时也可为肿瘤的诊断和治疗提供新方法.本文就miRNA通过调控上皮间质转化及肿瘤干细胞导致肿瘤侵袭转移的最新研究进展作一综述.     

芦荟大黄素及芦荟提取物的诱变性和抗诱变性

目的:用L5178Y小鼠淋巴瘤细胞体外微核试验评价芦荟大黄素和芦荟提取物的诱变和抗诱变作用,为其安全性评价提供依据。方法:设溶剂对照、阳性对照和抗诱变对照,芦荟大黄素和芦荟提取物诱变和抗诱变试验各设4个剂量组,处理L5178Y细胞12 h后按常规方法进行体外微核试验分析。结果:较高浓度(6.67μg/ml)的芦荟大黄素可致微核细胞率增加,与对照组比较,差异有统计学意义(P0.05);而芦荟提取物未见此效应。在一定剂量范围内,芦荟大黄素(0.22～6μg/ml)和芦荟提取物(20～180μg/ml)对甲磺酸甲酯(MMS)所致微核细胞率均有一定程度的拮抗作用,与对照组比较,差异有统计学意义(P0.01)。结论:芦荟大黄素具有一定的诱变作用,而在本实验剂量范围内的芦荟提取物未见遗传毒性。两种受试物在一定范围内均能较好地拮抗MMS所致的染色体损伤。     

甲状腺手术的技巧及副损伤的预防和处置

鉴于甲状腺手术是普外科的常见手术，为求其日渐完美，以有益于病人，现根据作者的体会，并结合阅读相关文献，就其手术操作、喉返神经处理、甲状旁腺处理进行扼要阐述。     

甲胎蛋白与自噬在肝癌发生发展中的作用及其相互关系

甲胎蛋白（AFP）作为临床诊断肝癌最常用的肿瘤标志物,有抑制免疫、促进细胞生长、抑制癌细胞凋亡的作用。自噬是一种维持细胞生存的重要途径之一,其与肝癌的发生发展及治疗有着密切联系,对肝癌既有抑制又有促进作用。PI3K/AKT作为两者共有的信号通路,它们是否有着相互关系来促进肝癌的发展尚需进一步研究。     

Comparison of the Efficacy and Safety of Ceftibuten and Cefaclor in the Treatment of Pneumonia and Bronchiectasis

Summary

In a multicentre, international study of 187 adult patients with bacterial pneumonia or bronchiectasis, the safety and efficacy of a regimen of 200 mg ceftibuten administered twice-daily was compared with cefaclor given in a dosage of 500 mg three times a day. Of the 94 evaluable patients, 66 received ceftibuten and 28 received cefaclor. The overall bacteriological response was similar in the two treatment groups with elimination of the original pathogen in 91% and 89% of the patients receiving ceftibuten and cefaclor, respectively. The overall clinical response mirrored the bacteriological results with a successful clinical outcome in 92% of ceftibuten-treated patients compared with 93% in patients receiving cefaclor. Adverse experiences were, in general, few and mild, being reported in 8% and 17% of patients receiving ceftibuten and cefaclor, respectively.     

Erythrocyte levels of cadmium and lead and risk of B-cell non-Hodgkin lymphoma and multiple myeloma

Cadmium and lead are persistent environmental toxins that are known or probable carcinogens, based on evidence for causality for nonhematologic cancers. Associations of these metals with risk of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) are unknown but biologically plausible. To examine the associations of circulating levels of lead and cadmium exposure with risk of B-cell NHL (B-NHL) and multiple myeloma, we conducted a nested case-control study among 299 incident B-cell NHLs and 76 MM cases within the Cancer Prevention Study-II Nutrition Cohort (CPS-II NC). Each case was incidence-density matched to two eligible controls on age, race, sex and blood draw date. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (CI) for lymphoid malignancies overall and stratified by subtype. We observed a significant positive association between high erythrocyte lead concentration and risk of lymphoid malignancies overall (RR = 1.16, 95% CI: 1.02-1.33 per 17.6 μg/L (1 standard deviation [SD])) and follicular lymphoma in particular (RR = 1.80, 95% CI: 1.15-2.80 per SD). In contrast, there was no association between erythrocyte cadmium and risk of B-NHL (RR = 0.89, 95% CI: 0.75-1.06 per 0.37 μg/L [1 SD]), or any B-NHL subtypes; but a strong inverse association with MM risk (RR = 0.59, 95% CI: 0.38-0.89, per SD). Results from our study suggest a positive association between erythrocyte lead level and risk of lymphoid malignancies and a possible inverse association between cadmium and myeloma. Additional research is needed to confirm and further explore these findings.