胃癌组织中微血管计数与肝转移的相关性研究

目的 :应用第Ⅷ因子相关性抗原 ,行SABC免疫组化染色 ,研究胃癌组织中微血管计数及分布方式与肝转移的相关性。方法 :全组 75例胃癌标本 ,制成石蜡切片 ,SABC免疫组化染色后 ,2 0 0倍显微镜下计数 5个血管密度最高区中微血管数及微血管在癌组织内的分布方式。结果 :全部病例癌组织中微血管 (MVC)均值为 16 .70 7± 10 .718,MVC≥ 16者 ,肝转移发生率较MVC <16者明显增加 (P <0 .0 5 )。MVC分布为肿瘤内型者以分化型癌为多 ,较间质型更易发生肝转移。高血管组比低血管组预后差。结论 :胃癌组织中MVC的高低是胃癌预后的一个有用的预测指标。     

幽门螺杆菌L型感染及血管生成素的表达与胃癌血管生成的关系（摘要）

目的探讨幽门螺杆菌L型（Hp-L）感染和血管生成素（Ang）在胃癌中的表达及与肿瘤血管生成的关系。方法采用革兰染色和免疫组化方法检测84例胃癌和30例癌旁正常组织Hp-L型感染,应用免疫组化方法检测Ang-1、Ang-2蛋白表达水平,计数微血管密度（MVD）,     

胃癌中血管内皮生长因子的表达及其意义

目的探讨胃癌组织中血管内皮生长因子（Vascular endothelial growth factor,VEGF）的表达及其与临床病理学之间的关系。方法应用免疫组织化学方法检测55例胃癌组织、12例癌旁胃组织和正常胃组织中的VEGF蛋白的表达及微血管密度（MVD）。结果胃癌组织的VEGF阳性表达率为78．2％,主要集中于肿瘤细胞胞质内;胃癌组织中微血管分布不均,血管密集区主要集中在癌灶边缘。VEGF蛋白表达及MVD在胃癌组织中均显著高于癌旁胃组织及正常胃组织（P〈0．05）;胃癌中VEGF表达与浸润深度、淋巴结转移、病理分期、肿瘤分化程度密切相关（P〈0．05）,而与患者的性别、年龄、肿瘤直径无关（P〉0．05）。结论VEGF在胃癌的发生、发展中起重要作用,有望作为胃癌抗血管治疗的靶标。     

胃癌组织淋巴管和血管生成与增殖细胞关系的研究

目的探讨胃癌组织中淋巴管和血管生成与增殖细胞的关系。方法对67例胃癌标本分别于癌中心区和癌周边区进行免疫组织化学染色,采用D2—40、VEGFR—C及受体VEGFR-3检测微淋巴管密度（MLD）,CD34和CD31检测微血管密度（MVD）,Ki-67标记观察细胞的增殖情况。结果胃癌中心区有较少闭锁的条索状淋巴管;癌周边区淋巴管增多,且管腔多呈扩张状态,中心多有癌栓形成。胃癌中心区的淋巴管密度（33．6±13．9）与癌周边区（61．7±21．4）比较显著性减少（P〈0．01）。胃癌组织中微血管分布和数量的差异与微淋巴管类似。胃癌中心区有灶性少量分布的Ki-67阳性肿瘤细胞,癌周边区有密集分布的大量Ki-67阳性肿瘤细胞,尤其是癌周1个低倍视野（10倍）内细胞增生显著。胃癌中心区的Ki-67阳性细胞数（49．2％）与癌周边区（73．5％）比较显著性减少（P〈0．05）。结论胃癌组织中存在新生淋巴管,血管、以及大量Ki-67阳性细胞,三者的分布主要是癌组织的前缘,即胃癌周边区的1个低倍视野（10倍）内。检测胃癌组织中MLD、MYD、Ki-67阳性细胞是判断胃癌预后的重要参考指标。胃癌周边区扩张的微淋巴管、微血管和Ki-67阳性细胞增多,其预后差,反之预后好。     

胃癌淋巴管生成与淋巴组织增生关系及其与预后的研究

目的探讨胃癌组织中新生血管和淋巴管以及淋巴组织增生的分布特点与预后关系。方法采用免疫组化方法，对82例胃癌组进行D2-40、VEGFR—C及受体VEGFR-3检测微淋巴管密度（MLD）；CD3、CD20、CD57、S-100检测T、B淋巴细胞，自然杀伤（NK）细胞，树突状细胞（DC）的浸润。结果胃癌中心区有较少闭锁的条索状淋巴管；癌周边区淋巴管增多，并且管腔多呈扩张状态。胃癌中心区的淋巴管密度（32．1&#177;13．6）与癌周边区（54．4&#177;23．8）比较显著性减弱（P〈0．01）。胃癌中心区有散在或小灶性分布的少量淋巴细胞浸润，DC-NK细胞偶见；癌周边区有密集分布的大量淋巴细胞浸润，尤其是癌周1个低倍视野（10倍）内淋巴组织增生显著，DC—NK细胞数量多，多呈大片决和条索状分布，且多围绕肿瘤细胞巢。癌中心区淋巴细胞浸润的数量与癌周边区的比较，显著性减弱（P〈0．01）。胃癌组织中微血管分布和数量的差异与微淋巴管类似。结论胃癌组织中新生淋巴管、血管、淋巴细胞三者的分布主要是癌组织的前缘；胃癌周边区扩张的微淋巴管和微血管增多，而淋巴组织增生减少，包括DC-NK细胞显著减少，其预后差；反之预后好。     

缺氧诱导因子-1α、VEGF表达与胃癌肝转移及肿瘤血管生成的关系

[目的]探讨缺氧诱导因子-1α（HIF-1α）和血管内皮生长因子（VEGF）在胃癌组织中的表达及其意义。[方法]采用免疫组化法检测91例胃癌组织（其中32例伴有肝转移）和20例非肿瘤胃黏膜组织中HIF-1α与VEGF的表达。[结果]HIF-1α在伴有和不伴有肝转移胃癌组织中阳性表达率分别为84.4%和50.8%（P=0.002）;VEGF在伴有和不伴有肝转移胃癌组织中阳性表达率分别为81.3%和54.2%（P=0.01）。HIF-1α阳性组微血管密度（MVD）显著高于HIF-1α阴性组（P=0.0001）;VEGF阳性表达与HIF-1α阳性表达呈正相关（P=0.001）。[结论]在伴有肝转移胃癌组织HIF-1α高表达,其可能通过调节其下游基因VEGF表达参与胃癌的血管形成、浸润和肝脏等远处转移。     

胃癌微血管计数及其分布方式与肝转移相关性研究

胃癌肝转移是影响胃癌治愈性切除术后长期生存率的一个重要因素。目前的研究已经注意到了胃癌组织中微血管数量与肝转移的关系,但其中仍有许多亟待解决的关键问题。     

CD34在胃癌中的表达及微血管密度的临床病理意义

目的　用CD3 4标记胃癌微血管内皮细胞 ,测定肿瘤微血管密度 (MVD) ,探讨其与胃癌各临床病理因素的关系。方法　采用免疫组织化学S P法检测 5 2例胃癌、10例癌旁组织和 16例正常胃黏膜组织CD3 4抗原的表达 ,对CD3 4单克隆抗体标记的血管计数MVD。结果　CD3 4染色胃癌微血管具有高度的特异性、敏感性及清晰的背景 ,易于计数。胃癌组织MVD明显高于正常胃黏膜组织(P <0 .0 1)和癌旁组织 (P <0 .0 5 ) ;MVD与肿瘤大小、浸润深度、是否发生远处器官转移、TNM分期明显相关 (P均 <0 .0 5 )。结论　CD3 4是良好的血管内皮细胞标记物 ;胃癌血管生成与肿瘤的生长、浸润、转移及疾病进展密切相关 ;MVD可作为判断胃癌生物学行为 ,预测胃癌发生发展的指标。     

胸苷磷酸化酶在癌组织中表达的研究

目的　研究胸苷磷酸化酶 (TP)在不同种类癌组织中的表达 ,探讨TP与癌组织血管生成的关系。方法　采用免疫组织化学方法检测 2 5 1例癌组织和相对应的 92例正常组织TP和微血管密度 (MVD)的表达。癌组织包括 :胃癌 4 8例 ,大肠癌 5 3例 ,乳腺癌 4 7例 ,宫颈癌 5 6例 ,肺癌 4 7例 ;正常组织包括 :胃 2 5例 ,大肠 2 5例 ,宫颈 17例 ,肺 2 5例。分析癌组织和正常组织TP表达差异 ,及癌组织TP表达与癌组织MVD的关系。结果　胃癌、大肠癌、乳腺癌、宫颈癌和肺癌的TP表达阳性率分别为6 4 .6 %、6 7.9%、80 .9%、82 .1%和 6 3.8%。癌组织的TP表达阳性率显著高于正常组织 (P =0 .0 0 0 0 )。癌组织TP表达与胃癌、大肠癌、乳腺癌、宫颈癌的MVD值关系密切 (P <0 .0 0 1)。结论　TP在胃癌、大肠癌、乳腺癌、宫颈癌和肺癌组织中过度表达 ,并对胃癌、大肠癌、乳腺癌和宫颈癌的血管生成有明显促进作用。     

人结肠癌组织中Raf 1的表达及其临床意义

目的: 研究Raf-1在人结肠癌组织中的表达与肿瘤血管生成的关系，并探讨它们的临床意义。方法：应用组织芯片技术和免疫组化法检测来自西京医院病理科2005－2006年间的87例结肠癌病例癌区、癌旁区及切缘区组织标本中Raf-1的表达，应用CD34标记的免疫组化法检测微血管密度（micr     

Prognostic significance of laminin in adenocarcinoma of the lung

The distribution of laminin in tumor-associated basement membrane was immunohistochemically investigated in 115 cases of adenocarcinoma of the lung. The distribution of laminin was classified into continuous and discontinuous staining patterns. The incidence of the discontinuous pattern was less in early-stage disease than that in advanced stages (P less than 0.01). In patients with stage I, the incidence of discontinuous patterns was greater in short-term survivors than in long-term survivors (P less than 0.05). By contrast, in patients with stage III, the discontinuous pattern of laminin was frequently seen in both long-term survivors and short-term survivors, with no difference between the two groups. These data suggest that the discontinuous pattern of laminin in tumor-associated basement membrane reflects the spread and dissemination of tumor, hence a close relationship to the prognosis.     

Surgical practice patterns in endometrial cancer: results of the Korean Gynecologic Oncology Group survey

Objective

This study was undertaken to document current practice patterns for the surgical treatment of endometrial cancer in Korea.

Methods

Questionnaires were distributed to 131 Korean gynecologic oncologists, all members of the Korean Gynecologic Oncology Group. Questions addressed extent of hysterectomy procedure, pelvic (PEN) or paraaortic (PAN) lymph node dissection, ovarian preservation, and omentectomy.

Results

Completed questionnaires were returned by 64.1% (84/131) of the oncologists at 50 institutes. Extrafascial hysterectomy (EH) was used by 32% of respondents and modified radical hysterectomy (MRH) or radical hysterectomy (RH) by 17%. Hysterectomy procedures were selectively employed based on tumor-related factors by 51% of the respondents. Laparoscopic hysterectomy was routinely utilized by 49% and was more commonly used by younger surgeons with 10 years of experience or less. PEN dissection was routinely utilized by 67% and was used selectively based on tumor-related factors by 33%. PAN dissection/biopsy was used either routinely (43%) or selectively based on tumor-related factors (43%). PAN dissection/biopsy had never been employed by 12% of the respondents. Sixty-nine percent of respondents stated that grossly normal looking ovaries can be preserved during surgery in young aged patients with early stage disease, and 29% stated that bilateral oophorectomy should be performed irrespective of age or stage. Omentectomy was routinely performed by 11% of respondents, and was selectively performed when extrauterine spread was present by 41%.

Conclusion

Surgical procedures for the treatment of endometrial cancer are still not standardized among Korean gynecologic surgeons. Clinical trials to determine the benefits of the different surgical procedures should be developed.     

Power deposition patterns in magnetically-induced hyperthermia: a two-dimensional low-frequency numerical analysis

The electric fields and power deposition patterns generated in two-dimensional inhomogenous models exposed to the axially directed uniform magnetic fields of an infinitely long solenoid are calculated numerically. The fields are calculated using the method of moments (Galerkin procedure) with linear basis and weighting functions. This low-frequency analysis is useful for studying the power deposition patterns attributable to solenoidal inductive applicators operated at frequencies up to 13.56 MHz. For the models we have studied, the ratio of power per volume deposited into the tumor to power per volume deposited into the immediately surrounding tissue is largest for tumors in the lung, although the power per volume deposited into the outermost layer is still much larger than the power per volume deposited into the tumor; it may be possible, however, to cool this region adequately from the body surface. When the complex permittivity of the tumor model is similar to that of the region in which it is embedded, the currents in the torso and tumor circulate primarily around the center of the body, as has been previously calculated for concentric cylinders. When the complex permittivity of the tumor is much greater than the region in which it is embedded, the currents in the tumor circulate primarily around the center of the tumor.     

Recurrence pattern after [(18)F]Fluoroethyltyrosine-Positron Emission Tomography-guided radiotherapy for high-grade glioma: A prospective study

Purpose

To assess the failure pattern observed after ¹⁸F fluoroethyltyrosine (FET) planning after chemo- and radiotherapy (RT) for high-grade glioma.

Methods

All patients underwent prospectively RT planning using morphological gross tumour volumes (GTVs) and biological tumour volumes (BTVs). The post-treatment recurrence tumour volumes (RTVs) of 10 patients were transferred on their CT planning. First, failure patterns were defined in terms of percentage of RTV located outside the GTV and BTV. Second, the location of the RTV with respect to the delivered dose distribution was assessed using the RTV’s DVHs. Recurrences with >95% of their volume within 95% isodose line were considered as central recurrences. Finally, the relationship between survival and GTV/BTV mismatches was assessed.

Results

The median percentages of RTV outside the GTV and BTV were 41.8% (range, 10.5-92.4) and 62.8% (range, 34.2-81.1), respectively. The majority of recurrences (90%) were centrally located. Using a composite target volume planning formalism, the degree of GTV and BTV mismatch did not correlate with survivorship.

Conclusions

The observed failure pattern after FET-PET planning and chemo-RT is primarily central. The target mismatch-survival data suggest that using FET-PET planning may counteract the possibility of BTV-related progression, which may have a detrimental effect on survival.     

骨肉瘤肺转移存在诊断治疗不足——中国骨肉瘤肺转移多学科诊疗现况调查

背景与目的 骨肉瘤是最常见的骨原发恶性肿瘤,好发于青少年.尽管多学科框架下骨肉瘤的治疗已经取得瞩目成就,然而影响骨肉瘤远期生存的重要因素是肺转移.约有1/2以上患者在其病程的不同时期会发生肺转移,其中10％～15％为同时性肺转移.毋庸置疑,治疗肺转移瘤的首选方法为外科切除,但因骨肉瘤肺转移的诊疗涉及多学科多专业,而由于各学科之间的理念存在差异,因此尚未形成标准化的诊疗模式.本研究通过问卷调查方式旨在了解当前我国骨肉瘤大型医疗中心在此领域中的诊疗模式现况.方法 2015年9月-2015年11月期间,一项关于骨肉瘤肺转移的诊疗现况问卷在全国骨肉瘤大型诊疗中心范围内开展.根据调查对象所在单位、工作年限、年均收治病例数及医学专业不同,进一步行分层分析.结果 调查共发放问卷150份,回收有效问卷105份,总应答率为70％.首先,关于骨肉瘤肺转移治疗的核心问题,41.0％的调查对象认同骨肿瘤外科专业在骨肉瘤肺转移多学科诊疗实践中的主导地位;首选肺转移瘤切除术作为转移灶局部控制措施的比例约64％; 78.1％的调查对象会推荐患者行肺转移瘤切除术;骨科及胸外科医师较之其他专业更加积极(同骨科专业相比,OR其他专业=0.02; 95％CI:0.00-0.22; P=0.001);胸外科医师更倾向根据经验决定肺转移瘤切除术的指证,而非受限于病灶具体数目(OR胸外科专业=20.93; 95％CI:2.05-213.64; P=0.001).其次,关于骨肉瘤肺转移影像学诊断方法,约83％首选胸部计算机断层扫描(computed tomography,CT);约70％的调查对象推荐原发灶切除术后3个月行胸部CT随诊;约68％认为CT诊断准确度90％水平;约92％同时推荐行肺外影像学评估.最后,关于术后生存获益的定义问题,约46％认为肺转移瘤术后生存期超过6个月即为生存获益.结论 本次问卷调查提供了我国骨肉瘤肺转移诊疗模式的现况信息,其反映出缺少统一规范诊疗模式的不足.调查结果为今后研究方向及国际性临床指南提供了基线数据.     

Radiological–pathological correlation: Alveolar pattern

This review summarizes important pathological lesions of the lung that typically present radiographically with an ‘alveolar pattern’. For each entity, the latest findings as to its pathogenesis, aetiology and pathology are reviewed in the introductory remarks. We then present the typical radiological appearances alongside macroscopic and microscopic pathological photographs. It is hoped that the parallel presentation of radiological image with the pathology will enhance the understanding of the diverse range of diseases the aevolar pattern comprises.     

乳腺癌细胞的计算机自动识别—QMSOC的应用研究

应用半自动图像分析仪测量26例乳腺癌(CA组)、5例乳腺纤维腺瘤(FA组)、5例急慢性乳腺炎(IN组)细针针吸穿刺涂片.细胞作几何特征参数,用分步判别法挑选其中7个对识别贡献较大的参数,做计算机自动判别分析:先以18O个随机抽取的细胞作为学习集,推出判别函数组,最后以此函数组对18O个细胞作回代识别,结果显示CA组的专家计算机识到符合率最高,达85%.