CD44v6和p16蛋白表达与肾癌转移的关系

目的:探讨评估肾细胞癌预后因素的指标。方法:应用免疫组化方法对60例肾癌组织进行CD44v6和p16蛋白检测。结果:在肾癌细胞中CD44v6和p16蛋白表达阳性率分别为66.7%和51.7%。肾细胞癌分级、分期和淋巴结转移与CD44v6高表达和p16低表达相关(P<0.05);CD44v6表达与p16表达呈负相关(r=-0.43,P<0.01)。结论:CD44v6高表达和p16低表达,对判断肾细胞癌恶性程度、预测淋巴结转移有一定的参考价值。     

胆囊癌组织中c-erbB-2,nm23H_1癌基因产物的表达及意义

目的　探讨癌基因c erbB 2和肿瘤转移抑制基因nm2 3H1的产物在胆囊癌组织中的表达与其生物学意义。方法　采用免疫组织化学方法检测胆囊癌标本中c erbB 2和nm2 3H1蛋白的表达 ,分析其与临床病理间关系。结果　c erbB 2和nm2 3H1蛋白的阳性表达率分别为 43 75 % (2 8/ 6 4)和 5 4 6 9% (35 / 6 4)。Ⅳ期胆囊癌中c erbB 2蛋白阳性率 (80 % )明显高于其他期胆囊癌 (P <0 0 1) ,c erbB 2阳性组平均生存期差于阴性组 (P <0 0 5 )。而nm2 3H1蛋白的表达与肿瘤的分化、分期和预后无关。结论　在胆囊癌中 ,c erbB 2和nm2 3H1参与肿瘤发生发展过程 ,c erbB 2的表达与肿瘤的转移和预后有着密切关系。     

原发性胆囊癌CD44v6和bcl-2的表达及其与临床病理的关系

目的　探讨CD44v6和bcl 2蛋白在原发性胆囊癌组织中的表达及其与癌组织类型、病理分级和转移状况的关系 ,以及CD44v6表达与bcl 2表达的相关性。方法　应用免疫组织化学方法检测 50例原发性胆囊癌、2 0例胆囊腺瘤和 1 0例慢性胆囊炎组织中CD44v6和bcl 2蛋白的表达。结果　胆囊癌组织中CD44v6和bcl 2表达阳性率分别为82 .0 %和 60 .0 % ,均明显高于胆囊腺瘤 (分别为 45 .0 %和 30 .0 % ,P<0 .0 5) ,并随着胆囊癌细胞分化程度的减低、病理分级的增高和转移而明显增高 (P<0 .0 5)。同时 ,CD44v6的表达与bcl 2表达呈正相关 (r =0 .36 ,P<0 .0 5)。结论　CD44v6和bcl 2均是胆囊癌高度恶性和预后不良的重要指标。胆囊癌CD44v6表达与bcl 2蛋白表达可能具有相互协同作用。     

变异型CD_(44)v6和Rasp21在胰腺癌及其转移灶中的表达

目的:胰腺癌细胞株的研究证明变异型CD_(44)v6和p21蛋白的表达与胰腺癌细胞的转移特性有关。我们用针对CD_(44)v6变异体的鼠抗人单克隆抗体和p21蛋白单克隆抗体,对46例胰腺癌原发灶,18例胰腺癌淋巴结转移灶,5例肝转移灶和8例胃窦十二指肠转移灶进行免疫组化染色。结果表明:胰腺癌转移灶CD_(44)v6和p21蛋白的阳性染色率显著高于原发灶;有转移的胰腺癌组织CD_(44)v6和p21的表达均高于无转移的病例,前者有显著差异,后者则无。说明CD_(44)v6或p21表达阳性的胰腺癌组织较易发生转移。另外,胰腺癌淋巴结转移灶的CD_(44)v6表达高于其它转移灶,提示CD_(44)v6可能在介导胰腺癌淋巴结转移中起作用较大。相关性检验显示CD_(44)v6阳性组和p21阳性组间有显著的相关性,这与文献提出p21蛋白通过引起变异型CD_(44)(CD_(44)v)表达升高来促进转移的结论一致。     

前列腺癌CD44及nm23-H1基因表达

目的　探讨在前列腺癌中CD44和nm2 3 H1基因表达的意义。　方法　应用免疫组织化学、银染单链长度构相多态性半定量逆转录聚合酶链式反应及免疫印迹杂交法分别检测 32例前列腺癌石蜡标本及 15例新鲜标本中CD44、nm2 3 H1基因的突变、表达情况。　结果　前列腺癌组织中nm2 3 H1蛋白及mRNA高水平表达 ,转移组nm2 3 H1蛋白表达强度高于非转移组。前列腺癌组织中存在nm2 3 H1基因突变 ,突变检出率为 13 3% (2 / 15 )。前列腺癌转移组中 ,CD44s蛋白表达水平下降。CD44smRNA在癌及非癌对照组织中全部表达 ,但 86 7% (13/ 15 )的癌组织中同时表达CD44v。　结论　nm2 3 H1基因的高表达和CD44v/CD44s基因的表达失衡可能在前列腺癌的恶性进展中共同发挥作用。     

胃癌中CD44v6、P53和nm23H1基因蛋白表达及其意义

目的　探讨CD4 4v6、P5 3和nm2 3H1基因蛋白表达与胃癌临床病理学行为和患者预后的关系。方法　应用免疫组化技术检测 12 0例胃癌组织中CD4 4v6、P5 3和nm2 3H1基因蛋白表达 ,并结合肿瘤的病理学行为和临床随访资料分析。结果　在胃癌组织中 ,CD4 4v6、P5 3和nm2 3H1表达阳性率分别为 81 7%、6 8 3%和 4 8 3%。CD4 4v6和P5 3高表达和nm2 3H1低表达均与胃癌浆膜浸润、淋巴结转移和患者预后呈正相关 (P <0 .0 5 )。结论　CD4 4v6、P5 3和nm2 3H1表达与胃癌转移和患者生存期密切相关 ,检测CD4 4v6、P5 3和nm2 3H1基因蛋白表达可作为判断胃癌预后的参考指标     

乳腺癌组织CD44v6和nm23H1的mRNA表达及意义

目的 探讨CD44v6和nm23H1的mRNA表达与乳腺癌临床病理参数及预后的关系及相关性。方法 应用原位杂交和CSA免疫组化方法,对94例乳腺癌组织进行CD44v6和nm23H1的mRNA检测。结果 CD44v6mRNA阳性表达及nm23H1mRNA阴性表达均与乳腺癌的组织学分级、临床分期、淋巴结转移、复发和预后呈正相关。乳腺癌中CD44v6mRNA表达与nm23H1mRNA表达呈负相关。CD44v6 mRNA阳性表达及nm23H1 mRNA阴性表达患者淋巴结转移率高、生存率低。结论 CD44v6mRNA表达与nm23H1 mRNA表达具有负调节的协同作用。联合检测两种基因,能更准确地判断乳腺癌的转移、预后状态。     

大肠癌虚证实证与CD44v6、PCNA表达的相关性研究

目的:通过检测细胞粘附分子(CD44v6)及增殖细胞核抗原(PCNA)在大肠癌不同中医证型中的表达,探讨CD44v6、PCNA与虚实证型的关系。方法:采用前瞻性组间对照的研究方法,筛选符合标准的大肠癌患者51例和大肠息肉患者17例,术前认真辨证,术后标本免疫组化检测各种证型组织中CD44v6及PCNA的表达。结果:息肉组织中CD44v6无表达或呈弱表达,大肠癌组织中CD44v6表达明显增强。大肠癌虚证与实证中有淋巴结转移或全身多处转移的患者,CD44v6的表达有显著差异性(P<0.05),实证占85.7%,虚证占46.2%,而PCNA的表达无差异性(P>0.05)。结论:CD44v6、PCNA在大肠癌中的表达具有较高的特异性。CD44v6作为细胞黏附蛋白分子,同肠癌的发生与发展可能有关,对大肠癌预后的判断具有重要的参考价值。PCNA在大肠癌进展期表达具有特征性意义。大肠癌实证中有淋巴结转移或全身多处转移的患者CD44v6的表达明显高于虚证中的表达,提示CD44v6及转移倾向与邪气的盛衰相关。     

早期肾癌保肾手术切除范围的探讨

目的　探讨直径 4cm以下肾癌保肾手术的安全切除范围。　方法　直径≤ 4cm肾癌根治术标本 82例 ,标本分层切开 ,确定多中心病灶 ,假包膜外 15mm范围连续取材确定假包膜完整性及可能存在的假包膜外癌性浸润灶 ,并测量包膜外癌灶与原发灶的最大距离。采用免疫组织化学技术检测 41例直径≤ 4cm肾癌的增值细胞核抗原 (PCNA)蛋白表达 ,其中假包膜外癌灶阳性组 8例 ,阴性组 3 3例。　结果　 82例肾癌平均直径 (3 4± 0 8)cm (1 5～ 4 0cm)。其中 3 1 7% (2 6/82 )缺乏完整假包膜 ,17 1% (14/82 )存在 1种以上假包膜外癌灶 ,其中肾实质浸润 8例 ,小静脉癌栓 2例 ,多中心病灶 4例。假包膜外癌灶与原发灶距离平均 (0 5± 1 3 )mm ,95 %可信区间 (0 11,0 94)。取单侧百分位数P95为 4 9mm ,P97 5、P10 0 均为 5 0mm。 41例肾癌平均PCNA指数为 (2 9 5± 17 6) % (5 5 %～85 6% ) ,其中阳性组为 (49 6± 2 1 5 ) % ,明显高于阴性组 (2 4 6± 12 7) % (t=3 162 ,P =0 0 13 )。阳性组 8例中 ,PCNA高表达 5例 ,而阴性组 3 3例中 ,高表达率仅 18 2 % (6/3 3 ) ,(χ2 =6 44 2 ,P =0 0 11)。结论　直径≤ 4cm肾癌保肾手术安全切缘须包括假包膜外 5mm以上的正常肾实质。单纯肿瘤剜除术易造成肿瘤残留及局部复发     

胆囊癌中CD44v6和Ezrin的表达及临床意义

目的：检测胆囊癌和胆囊良性病变中Ezrin和CD44v6蛋白表达水平,探讨Ezrin和CD44v6蛋白表达与胆囊癌发生、发展的关系;并结合临床病理特点,研究Ezrin和CD44v6蛋白表达与胆囊癌侵袭转移等生物学行为的关系。方法：采用免疫组织化学法检测31例胆囊癌组织和10例慢性胆囊炎组织石蜡切片标本中Ezrin和CD44v6蛋白的表达水平,对Ezrin和CD44v6蛋白表达情况进行统计学分析,并对Ezrin和CD44v6蛋白的表达与胆管癌临床病理资料进行讨论。结果：1）CD44v6和Ezrin阳性表达率在胆囊癌组明显高于慢性胆囊炎组（P〈0.05）;2）CD44v6和Ezrin蛋白在胆囊癌中有淋巴结转移和无淋巴结转移2组间差异有统计学意义（P〈0.01）;3）在胆囊癌病理类型中Ezrin和CD44v6蛋白在高分化、中分化、低分化组中差异均无统计学意义（P〉0.05）;4）Ezrin和CD44v6蛋白在Nevin分期的Ⅰ＋Ⅱ、Ⅲ＋Ⅳ、Ⅴ组中的表达差异有统计学意义（P〈0.01）;5）Ezrin和CD44v6与肿瘤标志物CEA、CA199间有显著相关性（P〈0.01）;6）胆囊癌中Ezrin、CD44v6蛋白的表达与患者年龄、性别无关。7）CD44v6与Ezrin在胆囊癌中的表达无相关性（P〉0.05）。结论：1）胆囊癌组织中Ezrin与CD44v6蛋白表达水平显著高于慢性胆囊炎组织,说明二者与胆囊癌的发展有密切联系。2）Ezrin与CD44v6蛋白表达水平与胆囊癌的浸润转移有密切联系,可以作为反映胆囊癌浸润转移的生物学指标。3）Ezrin与CD44v6蛋白在胆囊癌中的表达无相关性。     

肾细胞癌多中心病灶的研究

目的：探讨肾细胞癌多中心病灶的发病率及相关因素。方法：102例肾癌根治术标本，间隔3mm分层切开检查切面；假包膜外20mm范围及肾门组织连续切片检查包膜完整性及镜下多中心灶。统计分析，计数资料比较采用χ^2检验，相关检验采用多元Logistic回归分析。结果：多中心灶发生率为15．7％，原发灶直径≤4cm组为4．9％，＞4cm组为23．0％，差别有显著性意义（P＝0．014）。血管浸润和包膜完整性为多中心灶的显著相关因素（P＝0．017，0．006）。结论：对侧肾正常时保肾手术应限于直径＜4cm的肾癌，绝对指征的病例可放宽至7cm。血管浸润及假包膜不完整者，多中心灶发生率增高，术后须密切随访。     

Optimal margin in nephron-sparing surgery for renal cell carcinoma 4 cm or less

OBJECTIVE: Renal cell carcinoma (RCC) of 4 cm or less is with a low incidence of multicentricity and metastasis and is usually considered suitable for nephron-sparing surgery (NSS). This study was designed to investigate the distance between extra-pseudocapsule cancer lesions and primary tumors, and to suggest the optimal margin of normal parenchyma in NSS for RCC 4 cm or less.METHODS: We prospectively studied 82 kidneys in which RCCs of 4 cm or less were resected by radical nephrectomy. According to UICC TNM classification (1997), all tumors were staged as T1 and classified as conventional RCC in 76 cases and papillary RCC in 6 cases. The kidney samples were first step sectioned at 3mm intervals and examined for multicentricity. Then, on each layer of tissue sectioned, parenchyma margins of 15 mm beyond pseudocapsule were continuously sectioned and examined microscopically to investigate completeness of pseudocapsule and possible presence of extra-pseudocapsule cancer lesions. The greatest distance between extra-pseudocapsule lesions and primary tumors was measured.RESULTS: The diameter of 82 primary tumors was 3.4+/-0.7 mm (range 1.5-4.0 cm). Of them, 31.7% (26/82) were found without intact pseudocapsule. Of the 82 cases, 19.5% (16/82) were with positive cancer lesions beyond pseudocapsule, with invasion into normal parenchyma in 12.2% (10/82), into venule in 2.4% (2/82) and satellite tumors in 4.9%(4/82). The average distance between extra-pseudocapsule cancer lesions and primary tumors was 0.5+/-1.3mm (range 0-5.0mm), with a 95% confidential interval (CI) (0.11, 0.94). No significant difference was found in the incidence of extra-pseudocapsule cancer lesions between the tumors 2.5 cm or less and that greater than 2.5 cm.CONCLUSIONS: These data suggest that when partial nephrectomy is performed in RCC 4 cm or less, a 10mm margin may be too large and go against renal function maintaining. Enucleation alone was associated with a significant risk of incomplete excision, and therefore liable for local recurrence. Thorough inspection of the whole kidney before and during operation may help to avoid leaving over large and distant multifocal lesions.     

VEGF、EGFR、CD44V6、Cath-D及nm23-H_1在结直肠癌组织中的表达及意义

目的 探讨血管内皮生长因子(VEGF)、表皮生长因子受体(EGFR)、CD44V6、Cath-D、nm23-H1在结直肠癌组织中的表达及临床意义.方法 选择2000年1月至2001年12月行根治性手术的131例结直肠癌病例,应用免疫组化SP法检测肿瘤组织中VEGF、EGFR、CD44V6、Cath-D及nm23-H1的表达情况,分析其与术后复发转移的关系.结果 全组术后复发转移率为31.3%(41/131),VEGF、EGFR、CD44V6、Cath-D、nm23-H1阳性率分别为62.6%(82/131)、58.0%(76/131)、52.7%(69/131)、55.0%(72/131)、72.5%(95/131),VEGF阳性组、EGFR阳性组、CD44V6阳性组、Cath-D阳性组、nm23-H1阴性组术后复发转移率较高(P值均<0.05).根据VEGF、EGFR、CD44V6、Cath-D、nm23-H1的表达情况对患者进行评分再分成3组,3组间的术后复发转移率两两间存在统计学差异(P值均<0.05).结论 VEGF、EGFR、CD44V6、Cath-D、nm23-H1 与结直肠癌术后复发转移有关,合并这些不良预后因素越多,患者的预后越差.     

CD44v和nm23-H1产物在复发性膀胱癌表达的意义

目的探讨ＣＤ４４ｖ和ｎｍ２３－Ｈ１产物对诊断膀胱癌恶性程度和复发的意义。方法应用流式免疫法对４５例膀胱癌标本的ＣＤ４４ｖ和ｎｍ２３－Ｈ１基因产物的表达进行研究。结果ＣＤ４４ｖ产物的高表达和ｎｍ２３－Ｈ１产物的低表达与膀胱癌的浸润程度和复发均有关（Ｐ＜０．０５）。在膀胱癌中ＣＤ４４ｖ和ｎｍ２３－Ｈ１基因产物表达呈负相关（ｒ＝－０．２８７６）,在复发性膀胱癌中两者表达亦呈负相关（ｒ＝－０．４２３８）。结论ＣＤ４４ｖ和ｎｍ２３－Ｈ１表达在膀胱癌发生发展和预后中起协同作用,同时检测ＣＤ４４ｖ和ｎｍ２３－Ｈ１基因产物的表达能为判断膀胱癌的恶性程度和复发提供依据     

大肠癌中CD44V6、CD44s表达与nm23-H1表达相关性及临床意义

目的　了解CD4 4V6 、CD4 4s、nm2 3-H1 在结直肠癌组织、移行粘膜及正常粘膜间的表达 ,探讨它们与结直肠癌侵袭与转移的关系。方法　运用免疫组化SABC法测定CD4 4V6 、CD4 4s、nm2 3-H1 在癌组织、癌远端 3cm处的移行组织及正常结直肠组织中的表达 ,同时记录有关的临床病理指标。结果　CD4 4V6 、、CD4 4s、nm2 3-H1 阳性表达率分别在癌组织中为 70 .18%、4 2 .11%及 5 4 .39%与移行组织中 12 .0 2 %、89.4 7%、91.2 %及正常结直肠组织中 0、10 0 %、94 .74 % ,其差别有显著性 (P <0 .0 5 )。CD4 4V6 表达与肿瘤侵袭深度、Dukes分期及淋巴结转移正相关 ,nm2 3-H1 表达与Dukes分期、淋巴结转移呈负相关 (P <0 .0 5 )。CD4 4s在移行粘膜与正常组织表达有显著差别 (P <0 .0 5 )。结论　结直肠癌组织CD4 4V6 表达增多 ,CD4 4s及nm2 3-H1 表达降低。CD4 4V6 及nm2 3-H1 与结直肠癌的侵袭与转移有关 ,CD4 4V6 变化较nm2 3-H1 在前。直肠癌手术时癌远端至少应切除 3cm长的肠管     

Expression of bcl-2, p53 oncoprotein, and proliferating cell nuclear antigen in renal cell carcinoma

OBJECTIVES: This study was designed to examine the immunohistochemical expression of bcl-2, p53, and proliferating cell nuclear antigen (PCNA) and the relation of this expression to clinicopathological characteristics and prognosis in renal cell carcinoma (RCC). METHODS: The expression of bcl-2, p53 protein, and PCNA was studied by immunohistochemical methods in paraffin-embedded nephrectomy specimens from 53 patients whose clinicopathological data had already become clear. RESULTS: The expression of the bcl-2 protein was recognized in 34 cases (64%); the expression of the p53 protein, however, was seen in only 1 case. Bcl-2 positivity was not associated with any pathological parameters or prognosis. If the percentage of PCNA-positive cancer cells as compared to the total amount of cancer cells was defined as a labeling index (LI), a high PCNA LI number correlated significantly with a high T category, high grade, venous invasion, and shortened survival. Among the conventional pathological parameters, the T category, nuclear grade, and venous invasion had the most significant effect on prognosis. A multivariate analysis in the parameters of PCNA, T category, nuclear grade, and venous invasion demonstrated that only nuclear grade had a significant effect on prognosis. CONCLUSIONS: The inhibitory effect of the bcl-2 gene on apoptosis related to tumor development is not clear, and the expression of the p53 protein is uncommon in RCC. PCNA seems to be a good objective and quantitative marker of the biological malignant potential in RCC, although the assessment of malignant potential in combination with conventional pathological parameters is indispensable.     

肾细胞癌中bcl-2、p53、增殖细胞核抗原表达与细胞增殖和凋亡

目的 探讨肾细胞癌(RCC)中bcl—2、p53、增殖细胞核抗原(PCNA)表达与细胞增殖、凋亡及病理参数之间的关系。方法 应用链霉亲和素辣根过氧化物酶(SABC)法分析34例RCC标本中bcl—2、p53和PCNA蛋白的表达，应用末端脱氧核苷酸转移酶介导的脱氧三磷酸尿苷苦(dUTP)缺口末端标记(TUNEL)法检测细胞凋亡。结果 34例RCC标本中，15(44．1％)例bcl-2阳性表达，表达阳性率与增殖指数(PI)、凋亡指数(AI）及RCC病理学参数无关；仅有3例p53表达阳性；PI为6．0％--24．0％(平均为12．3％)，AI为2．0％--8．0％(平均为5．4％)；PI与肿瘤分级、分期密切关系，AI与肿瘤分级有明显关系。结论 明显增高的PI和AI与肿瘤恶性表型有关，提示在RCC中肿瘤细胞过度增殖伴有频繁的凋亡发生。     

Diffuse large B-cell lymphoma of bone: an analysis of differentiation-associated antigens with clinical correlation

Twenty-nine patients with diffuse large B-cell lymphomas presenting with bone involvement, including 18 localized primary bone lymphomas (group 1), 2 multifocal primary bone lymphomas (group 2), and 9 patients with extraskeletal disease at diagnosis (group 3), were studied. The tumors were subclassified according to the criteria of the WHO classification and evaluated by immunohistochemistry for expression of antigens associated with germinal center (GC) and non-GC stages of B-cell differentiation (bcl-6, CD10, MUM-1, VS38c, CD138, bcl-2, and CD44). The presence of a BCL-2/IgH gene rearrangement was investigated by polymerase chain reaction. All cases were characterized by similar clinicopathologic and morphologic features and had similarly good overall outcome. The patients (23 males, 6 females, median age 44 years) had tumors in long bones (14), axial skeleton (8), limb girdles (3), and multiple sites (4). Most tumors (24) were centroblastic, with multilobated cells in 12 cases. Almost half of the tumors (14 of 29, 48%) were bcl-6+CD10+ (GC-like), 9 of 29 cases (31%) were bcl-6+CD10- (indeterminate phenotype), and 6 of 29 cases (21%) were CD10-bcl-6- (post-GC like). The indeterminate phenotype was seen only in primary bone lymphoma. MUM-1 was frequently expressed in GC-like and non-GC-like categories. We found no evidence of plasmacytic differentiation by CD138, and VS38c immunoreactivity was distinctly rare (2 of 29 cases). CD44 was detected in 6 tumors, all CD10-. Bcl-2 was expressed by 70% of the tumors, but only 1 of 23 cases tested had a Bcl-2/JH rearrangement by polymerase chain reaction. A survival analysis showed that GC-like tumors had a longer overall survival duration compared with non-GC-like tumors (P = 0.0046). In conclusion, a GC-like immunophenotype characterizes roughly half of large B-cell lymphomas of bone and is associated with an improved survival.