Expression of p63 and Cyclooxygenase-2 and Their Correlation in Skin Tumors

To study the expression of p63 and cyclooxygenase-2 (cox-2) in skin tumors and evalu- ate the correlation between p63 and cox-2, the expressions of cox-2 and p63 were measured by streptavidin-peroxidase complex immunohistochemical technique in 17 cases of skin squamous cell carcinoma(SCC), 19 cases of Bowen's disease(Bowen), 11 cases of actinic keratosis(AK), 12 cases of seborreic keratosis(SK) and 13 specimens of normal skin. Our results showed that the expression of p63 in skin squamous cell carcinoma, Bowen's disease and actinic keratosis were significantly higher than that in seborreic keratosis, while the expression of p63 in seborreic keratosis was sig- nificantly higher than that in normal skin. The expression of cox-2 in skin squamous cell carcinoma, Bowen's disease and actinic keratosis were significantly higher than that in seborreic keratosis, while no statistical difference was noted in the expression of cox-2 between seborreic keratosis and normal skin. Cox-2 expression was positively correlated with the high p63 expression in malignant skin tu- mors. The increased expression of cox-2 and p63 may play an important role in the development of skin tumors and work synergetically in malignant skin tumors.     

THE EXPRESSION OF C-erbB-1 AND C-erbB-2 ONCOGENES IN BASAL CELL CARCINOMA AND SQUAMOUS CELL CARCINOMA OF SKIN

The expression of c-erbB-1 and c-erbB-2 oncogenes were investigated by immunohistochemistry using monoclonal antibodies to c-erbB-1 and c-erbB-2 protein in 43 cases of basal cell carcinoma (BCC) and 26 cases of squamous cell carcinoma (SCC). We found that the expression of c-erbB-1 oncogene in all BCC increased by different degrees and the expression of c-erbB-2 oncogene in BCC was significantly reduced or lost when compared to that in normal epidermal cells.Furthermore,apparent negative and positive relationships were observed respectively between the tumor differentiation and the expression of c-erbB-1 and c-erbB-2 oncogenes in SCC.It is suggested that the abnormal expression of c-erbB-1 and c-erbB-2 oncogenes in BCC and SCC may play a role in the development of skin tumors.The pattern of the c-erbB-1 and c-erbB-2 oncogenes expression in SCC may assist in distinguishing the biological behavior and prognosis of SCC.     

The expression of P63 protein in some keratinocyte original tissues and cells

Objective： To examine the expression patterns of p63 in tissues of particular keratinocyte original hyperproliferate diseases and variety cell types for determining if P63 is the marker of proliferative potential keratinocytes. Methods： P63 protein was detected and analyzed by immunoreactivity method and Western blot in biopsy specimens of keratinocyte original disorders including squamous cell carcinomas SCC, basal cell carcinomas BCC, Bowen＇ s disease and other tissues or cells, such as psoriasis vulgaris, normal skin tissues, primary cultured keratinocytes, immortal HaCaT cells, and epidermoid carcinoma cells A431. Results： P63 protein was expressed in the nuclei of basal and suprabasal layer of the epidermis, germinative cells of sebaceous glands in normal epidermal. P63 was strongly and diffusely detected in the majority of tumor cells in BCC and poorly-differentiated SCC. In Bowen＇ s disease, p63 expresses are remarkable in all cell layers. In the psoriasis plaque epidermal, p63 expressed mainly in basal cells and part of spinous cells. P63 expressed more strongly in primary cultured keratinocytes than in A431 cells or HaCaT cells. Conclusion： P63 is a nuclei marker of undifferentiated keratinocytes with the proliferative potential and may disrupt the terminal differentiation. The overexpression of p63 reflects immaturity of the tumor cells. The immunohistochemical staining of p63 may be useful for investigating the origin and differentiation of tumor cells.[第一段]     

Tumours of the Scalp： A Review of Ten Cases

Background： The scalp is a common site for the development of tumours. Most of these tumours are benign; among the malignant ones, squamous cell carcinoma （SCC）） and basal cell carcinoma （BCC） predominate. In Ghana patients with scalp turnouts do not report to hospital unless they are symptomatic. Data on the condition is therefore scanty. Patients and Methods： The objective of the study was to document the hospital prevalence and the management outcome of patients with scalp tumours. Patients with turnouts of the scalp reporting at the Reconstructive Plastic Surgery and Burns Unit （RPSBU） at Komfo Anokye Teaching Hospital （KATH） who were managed by the author between June 2003 and June 2009 were entered into the study. The patients were examined clinically and the diagnosis confirmed by biopsy. The scalp tumours were excised and the defect closed directly, skin grafted, or repaired with a flap as appropriate. Results： Ten patients with eleven scalp tumours were managed during the study period from June 2003 to June 2009, made up of four males and six females. Their ages ranged from 16 to 70 years, with a mean age of 41.7 years. Two benign scalp turnouts, a sebaceous cyst and a sebeceoma were located in the frontal region; five cases of SCC and one case of basosquamous cell carcinoma （BSC） in the parietal region, two cases of SCC in the temporal region, and one case of SCC in the occipital region of the scalp. Eight of the tumours developed de novo from the scalp; one developed from a chronic burn scar （Marjolin＇s ulcer）; two tumours developed from the scalp of a patient with xeroderma pigmentosum. Two patients had excision and direct closure of the defect; six had excision and skin grafting; two had excision and flap repair. One patient had block dissection of the left cervical lymph nodes, and two patients had adjuvant radiotherapy. Conclusions： Most tumours of the scalp presenting at the RPSBU at KATH are SCC which developed de novo. Chronic burn scars and xeroderma pigmentosum were some of the aetiological factors identified. Early lesions can be cured by excision and skin grafting.     

Clinical course and cause of death in elderly patients with idiopathic Parkins on’s disease

Objective To improve the therapeutic and preventive measure for elderly patients (75 years and over) with idiopathic Parkinson’s disease (OEIPD). Methods Fifteen OEIPD patients were observed prospectively over a long period of time. Their diagnosis was confirmed by autopsy. Based on clinical and pathological data, the causes of death were analyzed.Results The mean clinical course in OEIPD patients was 6.2±3.6 years. The majority of the 15 patients were the akinetic type and the akinetic type with tremor (80.0%). In the late stages of disease (4.8±3.5 year), choking occurred in 12 OEIPD patients who received nasal feeding for an average of 4 months after the occurrence of choking. The most common complication in 12 patients was repeated pulmonary infections with an average rate of 2.9±1.9. The causes of death were bronchial pneumonia and shock induced by pulmonary infection (11 cases, accounted for 73.3%), acute myocardial infarction (2 cases), one case with cardiac rupture and one case with rupture of aortic aneurysm. Conclusions The clinical course was shorter in OEIPD patients. Levodopa therapy should be started early in OEIPD patients. Bronchial pneumonia and infectious shock constitute the major cause of death and choking was one of the main causes of aspiration pneumonia. Nasal feeding should be started as early as possible after the appearance of choking. Silent aspiration can be reduced by teaching the patient to protect the airway by ’supraglottic swallowing’.     

High intensity focused ultrasound in combination with chemotherapy by the regime of PFC：a clinical study for advanced gastric carcinoma

Objective： To evaluate the recent curative efficacy and security of High intensity focused ultrasound （HIFU） in combination with chemotherapy（PFC） in patients with advanced gastric carcinoma. Method： Sixty patients with measurable advanced gastric carcinoma, proved pathologically, were divided into Group A and Group B. Group A： Patients were treated by HIFU（FEP-BY01） in combination with chemotherapy（PFC, paclitaxel, cisplatin and 5-fluorouracil）. Group B： Patients were treated with the single regime of PFC. Results： All cases could be evaluated, ha group A, 5 patients achieved complete response, 17 patients achieved partial response,and a response rate was 73.3%. The stable disease（SD） and the inefficiency all were 13.3% （4/30） respectively, and msurvival time（MST） was 13.9 months. In group B, 2 patients achieved complete response, 14 patients achieved partial response, and a response rate was 53.3%. The stable disease（SD） was 23.3%（7/30）. The inefficiency all were 23.3%（7/30） respectively, and median survival time was 9.6 months. There was significant difference between two groups MST（ P 〈 0.05）. Major toxicities included bone marrow depression, nausea, vomiting and alopecia, without significant differences between two groups（ P 〉 0.05）. Conclusion： This study shows that HIFU in combination with chemotherapy（PFC） was a new efficent and secure therapy for the patients with advanced gastric carcinoma. It was observed that the MST was prolonged. Prospective trials should be warranted to determine the result.     

Expression of glycoprotein non-metastatic melanoma protein B in cutaneous malignant and benign lesions: a tissue microarray study

Background  Glycoprotein non-metastatic melanoma protein B (GPNMB) plays an important role in the pathogenesis of inflammatory and malignant diseases. We investigated the expression of GPNMB in benign and malignant skin diseases.

Methods  Tissue microarray was performed in the skin tissues of 102 cases including malignant melanoma (MM), squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and benign dermatosis. The expression of GPNMB in the tissues was detected by immunohistochemistry. Twenty cases of normal skin and adjacent neoplastic normal skin tissues were selected as controls.

Results  GPNMB was positively stained in skin malignancies (38/50, 76%), which was significantly higher than that in the control and the benign skin tissues (P=0.001 and <0.001 respectively). GPNMB was positively stained in MM (13/15, 87%) and SCC (16/20, 80%) (P <0.001). Significant higher expression of GPNMB was observed in patients aged ≥65 years than those less than 65 years (n=11 and n=9 respectively, P=0.027). No significant difference of the expression rates was observed between normal control and BCC; however, stronger intensity was detected in the latter. Negative or weak expression was observed in the controls.

Conclusion  Over-expression of GPNMB correlated strongly and might play an important role in the pathogenesis of MM and SCC.

     

Occult cervical lymph node metastases in 100 consecutive patients with cN0 tongue cancer

Background Squamous cell carcinoma （SCC） of the tongue maxillofacial region. To provide clinical evidence for selective analyzing the characteristics and correlation of factors of occult with SCC of the tongue. is one of the most common cancers in the oral and neck dissection in management of cN0 patients by cervical lymph node metastases （OCLNM） in patients Methods From 2002 to 2006, 100 consecutive patients with SCC of the tongue were reviewed by analyzing the characteristics of OCLNM, diameter of the tumor, T classifications, depth of invasion, forms of growth, pathological grade and degree of differentiation. Results The rate of OCLNM in 100 patients with SCC of the tongue was 22%. The most common region with OCLNM was level Ⅱ in the ipsilateral neck, followed by levels Ⅰ and Ⅲ. There were 51.61% （16/31） of OCLNM in level Ⅱ and 87.10% （27/31） of OCLNM in levels Ⅰ-Ⅲ. There was no significant correlation between the diameter of tumor and OCLNM （P 〉0.05）. OCLNM was statistically significantly correlated with the depth of invasion, forms of growth, pathological grade and degree of differentiation （P 〈0.05）. The rate of occult metastases increased with the increased pathological grade, the decreased degree of differentiation and the increased depth of invasion. Conclusions The most common regions with OCLNM in cN0 patients with SCC of the tongue were levels Ⅰ-Ⅲ in the ipsilateral neck. Supraomohyoid neck dissection should be the elective treatment to the neck in patients with cN0 SCC of the tongue by consideration of the clinical and pathological factors for the depth of invasion, forms of growth, pathological grade, and degree of differentiation.     

Surgical management for carcinoma of the gallbladder: a single-institution experience in 25 years

Background Gallbladder carcinoma is rare and associated with dismal outcomes. Radical surgery is the only curative treatment, and options for adjuvant therapy remain limited. This study aimed to determine the factors influencing outcome of treatment in patients with gallbladder carcinoma, and to identify the patients who might benefit from radical surgery and adjuvant therapy. Methods Medical records and follow-up histories of 150 patients with gallbladder carcinoma who had undergone surgery between April 1980 and December 2005 were retrospectively reviewed. The factors predictive for the survival of the patients were identified using multivariate analysis. Results Surgery for gallbladder cancer was associated with an overall 5-year survival rate of 26.2%. After curative resection （40% of the patients）, the 5-year survival rate was 60.3%. The patients who underwent R0 resection had a significantly longer median survival （97.3 months） than those who had R1/R2 resection （8.3 months） or only laparotomy （3.7 months） （P 〈0.0001）. Univariate analysis showed that resectability, American Joint Committee on Cancer staging, tumor grade, adjuvant therapy, jaundice at presentation, depth of tumor invasion, lymph node involvement, distant metastasis, and carcinoembryonic antigen level were statistically significant predictors for survival. Multivariate analysis revealed American Joint Committee on Cancer staging and resectability were independent prognostic factors for survival. The patients who underwent noncurative resection might benefit from adjuvant therapy （median survival, 12.4 months vs 7.2 months, P=-0.006）. Conclusions Favorable survival rate can be achieved after curative resection, even for selected patients with advanced disease. Adjuvant therapy may improve the survival of patients with gallbladder carcinoma.     

Blastomycosis in China: a case report and literature review

Blastomycosis is a fungal disease that is endemic in parts of North America. It is very rare in China and also commonly misdiagnosed, often as cancer or other infectious diseases. The clinical profile of a case of disseminated blastomycosis with pulmonary changes and skin ulcers was described. He had been misdiagnosed with tuberculosis, after adequate therapy with a lipid formulation of amphotericin B, followed by itraconazole, the lung and skin lesions improved. Then the five cases reported in China and literatures were reviewed. The aim of this report was to improve the knowledge regarding blastomycosis for physicians in China to avoid delaying adequate therapy.

     

δ-氨基酮戊酸光动力疗法治疗皮肤癌的评估

目的 :探讨和评估δ 氨基酮戊酸光动力疗法 (ALA PDT)治疗皮肤癌的疗效。方法 :88例患者首次接受ALA PDT治疗 ,其中包含 34例基底细胞癌 (BCC) ,32例鳞状细胞癌 (SCC) ,2例基底 鳞状细胞癌 (BSCC) ,1例疣状癌 ,9例Bowen病 ,2例乳房Paget病和 8例乳房外Paget病。随访 1～ 3年。结果 :经过 1～ 4次ALA光动力治疗后 ,所有BCC病例 ,包括 1例浅表型和 2 9例实体型病变 ,都获得完全反应 (CR)。除 1例腺样SCC(Ⅲ级 )外 ,全部SCC病例 (Ⅰ、Ⅱ级 )经过 3～ 6次治疗后CR。 9例Bowen病经 1～ 4次治疗后都获得CR。对于Paget病 ,单纯ALA PDT不能使之治愈 ,但可以控制其症状。随访 1～ 3年 ,BCC的复发率为 11% (4 34) ,SCC为 2 2 % (7 2 2 ) ,再次治疗有效。结论 :ALA PDT是一种疗效好、无痛苦、无创伤、无副作用的治疗方法 ,尤其适用于年迈体弱以及肿瘤部位特殊的患者。     

δ-氨基酮戊酸光动力学疗法治疗皮肤癌前病变和皮肤原位癌的疗效评价

目的探讨δ-氨基酮戊酸光动力疗法（ALA—PDT）治疗皮肤癌前病变和皮肤原位癌的疗效。方法局部ALA—PDT治疗32例基底细胞癌、9例Bowen病、8例日光性角化病和2例女性外阴白斑患者。结果经3-6次治疗,除BCC完全缓解率为93．75％外,其余患者的皮损均可达完全缓解,完全缓解率为100％;经过3～11个月随访,除3例BCC及1例Bowen病患者外,其余患者均未见复发,其复发率分别为9．4％和11％。结论ALA—PDT是一种疗效好、无明显痛苦、无瘢痕形成、复发率低、美容效果好的治疗皮肤癌前病变和皮肤原位癌的新疗法;特别适合于头面部及外生殖器部位的多发性、较大面积皮损。     

COX-2、p53和c-myc在皮肤肿瘤中的表达及意义

目的利用组织芯片检测Cox-2、p53和c-myc在皮肤鳞状细胞癌、基底细胞癌和Bowen病中的表达,探讨它们在上述皮肤肿瘤发病中的意义。方法手工制作组织芯片,用免疫组织化学技术检测30例皮肤SCC,21例BCC,20例BD的石蜡包埋组织及10例正常皮肤组织中COX-2、p53和c-myc的表达。结果 COX-2蛋白在皮肤肿瘤组织中阳性率明显高于正常皮肤对照组,两者差异有统计学意义（P〈0.01）;p53蛋白在皮肤肿瘤组织中阳性率高于正常皮肤对照组,两者差异有统计学意义（P〈0.05）;c-myc蛋白在皮肤肿瘤组织中阳性率高于正常皮肤对照组,两者差异有统计学意义（P〈0.05）;COX-2、p53和c-myc相互之间在所检测皮肤肿瘤中的表达无相关性（P均〉0.05）。结论组织芯片适合于样本量较大的研究。COX-2在皮肤SCC、BCC、BD中呈高表达,其与皮肤SCC、BCC、BD的发生关系密切。p53在皮肤SCC、BCC、BD中呈高表达,其与皮肤SCC、BCC、BD的发生关系密切。c-myc在皮肤SCC、BCC中呈高表达,与皮肤BD的发生无明显关系。三者均可作为判定上皮源性皮肤肿瘤恶性程度的一种标志。COX-2、p53和c-myc相互之间在所检测皮肤肿瘤中的表达水平无相关性,具体机制尚不清楚。     

眼睑基底细胞癌的光动力治疗

目的探讨和评估艾拉光动力疗法（ALA-PDT）治疗眼睑基底细胞癌的临床疗效。方法共有11例患者于2009年12月-2011年12月就诊于我科门诊并经过组织病理学检查结果确定为基底细胞癌,在我院首次接受ALA-PDT治疗。使用新鲜配制质量分数20%δ-氨基酮戊酸霜涂于病变及其周围0.5cm皮肤黏膜,塑料薄膜封包3-4h,然后用XO-635AB型光动力激光仪照射,观察患者治疗后的效果。结果 11例患者中有1例治疗1次后放弃治疗,其余经过3-5次治疗后经病理检查未见癌细胞,未见瘢痕形成。结论 ALA-PDT对于眼睑基底细胞癌患者来说,是一种具有良好的靶向性、安全可靠、治疗后无瘢痕、可重复使用、对正常皮肤无损害的治疗手段,患者有很好的耐受性,尤其适用于对其它疗法不能耐受、年龄太大和体弱的患者,是治疗眼睑基底细胞癌的一种新的替代疗法。     

5-氨基酮戊酸光动力疗法治疗头面部基底细胞癌的疗效观察

目的 探讨5-氨基酮戊酸光动力疗法(5-aminolevulinic acid mediated photodynamic therapy,ALA-PDT)治疗头面部基底细胞癌的临床疗效。方法 对25例头面部基底细胞癌患者进行ALA-PDT治疗,每周1次,共治疗5次。3个月内,每2周随访1次;3个月后,每个月随访1次。结果 经过5次ALA-PDT治疗后,25例患者中,18例完全缓解,4例部分缓解,3例无效果。浅表型基底细胞癌治疗效果最好,完全缓解率达90%。随访6~19个月,18例完全缓解患者中2例复发,复发率11.1%。结论 ALA-PDT是一种临床疗效好,复发率低,无创伤性的治疗头面部基底细胞癌的有效方法。     

手术联合5-氨基酮戊酸光动力疗法治疗鳞状细胞癌和日光性角化病临床疗效分析

目的：分析手术联合5-氨基酮戊酸光动力疗法(ALA-PDT)治疗鳞状细胞癌(SCC)和日光性角化病(AK)的疗效。方法对34例患者皮损采取手术切除,于术后第2d开始ALA-PDT,每周1次,共3-7次,随访15-36月。结果所有患者治疗结束后均为完全反应(完全反应率100%),随访仅1例SCC患者复发(复发率5.26%),AK患者无复发。结论手术联合ALA-PDT治疗SCC和AK有效、安全。     

早幼粒细胞白血病蛋白在Bowen病、皮肤鳞状细胞癌及皮肤基底细胞癌组织中的表达

目的作为肿瘤抑制因子,早幼粒细胞白血病（PML）蛋白在Bowen病(BD)、皮肤鳞状细胞癌（SCC）及皮肤基底细胞癌
(BCC)组织中的表达关系、以及PML 蛋白与他们的临床预后关系不明,本研究旨在探讨PML蛋白在其中的作用机制。方法用
免疫组化方法检测正常皮肤组织、BD、SCC及BCC皮损组织中PML蛋白的表达。结果正常人皮肤组织中,PML蛋白不表达
（阴性）;BCC皮损中,全层几乎无PML蛋白的表达(细胞核阳性率为8.69%,细胞质阳性率为4.35%);Bowen病及Ⅰ~Ⅱ级SCC
皮损中,细胞核及细胞质均明显表达PML 蛋白,且细胞核中的表达显著高于Ⅲ~Ⅳ级SCC。结论PML蛋白的过度表达在鳞状
细胞癌发病的早期阶段起关键作用,可能与SCC的发生和转移有关。
     

5-氨基酮戊酸光动力疗法(ALA-PDT)治疗Bowen病的临床分析

目的分析5-氨基酮戊酸(ALA)光动力学疗法(PDT)治疗Bowen病的临床近期效果。方法选择经病理组织学检查确诊为Bowen病患者23例,随机分为治疗组12例和对照组11例。治疗组皮损处局部外用20%ALA霜,3 h后行红光照射,剂量为(100～120)J/cm2,照射时间约20～30 min,4周内每周照射1次。对照组每日外用5-氟尿嘧啶软膏(5-FU软膏)2次,用药4周。比较两组患者的临床疗效。结果治疗组完全有效率91.67%,总有效率100%;对照组完全有效率27.27%,总有效率90.91%。治疗组的完全有效率明显优于对照组,两组间差异有统计学意义(P<0.01)。结论 ALA-PDT治疗Bowen病简单有效、耐受性好,且无严重副作用,值得临床推广。     

P^53,Bcl—2在皮肤鳞状细胞癌、基底细胞癌脂溢性角化病中联合表达的意义

目的：探讨P^53蛋白,Bcl-2蛋白在皮肤鳞状细胞癌（SCC）,基底细胞癌（BCC）及脂溢性角化病（SK）中的表达及意义。方法：采用S－P法分别对12例SCC,BCC,SK进行免疫组化P^53蛋白,Bcl－2蛋白检测。结果：12例SCC,BCC中分别有9例,11例P^53蛋白表达阳性有10例,11例Bcl-2蛋白表达阳性,12例SK中有1例P^53表达阳性,11例Bcl-2表达阳性,P^53蛋白在SCC,BCC中表达显著高于SK（P＜0．01）。结论：P53蛋白基因突变和Bcl-2蛋白的过度表达（即细胞凋亡机制）在皮肤恶性肿瘤的发生,发展中起重要促进作用。     

明胶酶在皮肤基底细胞癌和鳞状细胞癌组织中的表达及意义

目的:探讨明胶酶在皮肤基底细胞癌(basal cell carcinoma,BCC)、鳞状细胞癌(squamous cell carcinoma,SCC)和正常皮肤组织中的表达和意义.方法:应用SP法检测10例正常皮肤组织、10例BCC、30例SCC组织石蜡标本中明胶酶的表达水平进行对比研究.结果:明胶酶的表达在SCC...