基质金属蛋白酶-9及基质金属蛋白酶组织抑制物-1表达失衡与宫颈癌局部肿瘤血管生成的关系

目的 :探讨基质金属蛋白酶 - 9(MMP 9)和基质金属蛋白酶组织抑制物 - 1(TIMP 1)在宫颈癌局部肿瘤血管生成中的作用。方法 :采用免疫组织化学SP法检测 75例早期宫颈癌 (ICC)、18例宫颈上皮内瘤样病变 (CIN)和 15例癌旁正常宫颈上皮 (NCE)中MMP 9和TIMP 1的表达情况 ,并检测其中微血管密度 (MVD ,CD3 4 标记 )。结果 :从NCE组到CIN组再到ICC组 ,MMP 9的阳性表达率显著升高 (P <0 0 5 )而TIMP 1未见升高 (P >0 0 5 ) ,并且TIMP 1在ICC组的阳性表达率显著低于MMP 9(P <0 0 1)。MMP 9在ICC组中表达与MVD显著正相关 (r =0 2 87,P <0 0 5 ) ,而TIMP 1与MVD无显著相关性 (r=0 195 ,P >0 0 5 )。宫颈癌中MMP 9表达高于TIMP 1者 ,其MVD显著高于MMP 9表达低于TIMP 1者 (P <0 0 5 )。结论 :MMP 9和TIMP 1表达失衡可能在宫颈癌局部肿瘤血管生成中起重要作用 ,MMP 9表达增强而TIMP 1表达降低 ,其血管生成能力可能显著增强 ,但并非唯一决定因素。检测宫颈癌中MMP 9和TIMP 1表达对进一步了解宫颈癌局部血管生成情况有一定的应用价值。     

上皮性卵巢癌血管内皮生长因子的表达与肿瘤内微血管密度的相关性研究

目的 :探讨上皮性卵巢癌组织中血管内皮生长因子 (VEGF)是否与肿瘤内微血管密度 (MVD)、淋巴转移等临床病理学因素存在相关性。方法 :以多克隆抗VEGF抗体和单克隆抗CD34抗体分别标记 4 5例FIGOⅠ～Ⅳ期上皮性卵巢癌术后标本的VEGF和MVD。用彩色图像病理分析系统测定VEGF的相对含量 ,MVD采用人工计数。分析VEGF与MVD、肿瘤期别、组织学类型、腹水量以及淋巴转移的关系。结果 :(1)VEGF的平均吸光度为 0 .178± 0 .14 9(中位数 0 .16 7)。MVD值平均为 72 .2 6± 5 8.5 2 /mm2 (中位数 6 8.4 7/mm2 ) ;(2 )VEGF表达水平与MVD之间存在显著相关性 (r =0 .92 6 ,P <0 .0 1) ;(3)盆腔淋巴转移(n =12 )VEGF平均吸光度 (0 .193± 0 .15 3)显著高于无盆腔淋巴转移组 (n =32 )的 0 .138± 0 .0 90 ,(P <0 .0 5 )。不同期别 ,组织学类型和腹水量之间的VEGF表达强度无显著差异(P >0 .0 5 )。结论 :VEGF表达与上皮性卵巢癌血管生成的增强密切相关     

宫颈癌中血管内皮生长因子、环氧合酶-2的表达及意义

目的　探讨环氧合酶 - 2 (COX - 2 )在宫颈癌中的表达 ,及其与血管内皮生长因子 (VEGF)表达和肿瘤微血管密度 (MVD)的关系。方法　应用免疫组化法检测 5 4例宫颈癌中COX - 2、VEGF的表达和MVD值 ,并以 1 0例宫颈CIN和 1 0例正常宫颈上皮为对照组。结果　宫颈癌中COX - 2阳性表达率分别为Ⅰ期5 6 7%、Ⅱ期为 6 6 7%、Ⅲ期 77 8%。VEGF在宫颈癌中阳性表达率分别为Ⅰ期 76 7%、Ⅱ期 80 0 % ,Ⅲ期88 9%。COX - 2在宫颈癌Ⅰ、Ⅱ、Ⅲ期间差异无显著性 (P >0 0 5 )。VEGF宫颈癌Ⅰ、Ⅱ期间差异无显著性 (P>0 0 5 ) ,Ⅰ期与Ⅲ期之间差异有显著性 (P <0 0 5 )。COX - 2、VEGF与MVD的表达呈正相关 ,而与不同的病理分级无明显相关性 (P >0 0 5 )。结论　VEGF、COX - 2、MVD在宫颈癌的发生、发展过程中起着重要作用 ,VEGF、COX - 2、MVD值可作为检测指标 ,为宫颈癌的诊断、临床分期及治疗起指导作用     

分化抑制因子-1在宫颈癌组织中表达及其与微血管密度的关系

目的探讨分化抑制因子-1(Id-1)在宫颈癌组织中的表达及其与肿瘤发生、发展以及血管生成的关系。方法 2009年2月至2010年6月在吉林大学第二临床医院采用免疫组化法检测35例宫颈浸润癌(ICC)组织及20例正常宫颈上皮组织(NCE)中Id-1和微血管密度(MVD)的表达。结果 Id-1蛋白在宫颈癌组织中阳性表达率为71.43%,正常宫颈上皮组织中阳性表达率为0,两组比较有统计学意义(P<0.01),ICC组Id-1高表达与组织分化程度、间质浸润深度和盆腔淋巴结转移相关(P﹤0.05),而与FIGO分期无关(P﹥0.05);MVD计数在宫颈癌组织中表达为46.57±10.291,在正常宫颈上皮组织中为12.40±3.761,两组比较有统计学意义(P<0.05),MVD的表达在ICC组内与盆腔淋巴结转移、组织分化程度有关(P﹤0.05),而与FIGO分期、间质浸润深度无关(P﹥0.05);ICC组中Id-1表达强度与MVD呈正相关(r=0.648,P﹤0.01)。结论 Id-1因子通过促进肿瘤血管生成,从而参与宫颈癌的发生发展;子宫颈癌组织中的MVD值随着Id-1因子表达强度的增加而增高。阻断Id-1因子在子宫颈癌中的表达,有望成为治疗宫颈癌的途径之一。     

MACC1、c-Met蛋白在宫颈癌中的表达及与盆腔淋巴结转移的关系研究

目的:探讨结肠癌转移相关基因1(MACC1)、肝细胞生长因子受体(c—Met)蛋白在宫颈癌中的表达及与盆腔淋巴结转移的关系。方法:采用免疫组织化学检测10例正常宫颈组织、17例中~重度宫颈上皮内瘤变组织(CINⅡ~Ⅲ)和91例宫颈癌组织中MACC1、c—Met蛋白的表达情况,分析两者在宫颈癌组织中表达的相关性及与宫颈癌盆腔淋巴结转移的关系。结果:MACC1、c—Met蛋白在宫颈癌组织、CINⅡ~Ⅲ组织中的阳性表达率分别依次为83.5%、76.5%,80.2%、70.6%,均显著高于正常宫颈组织(P0.05)。宫颈癌中MACC1蛋白的表达与c—Met蛋白的表达呈正相关(r=0.672,P0.05)。将宫颈癌盆腔淋巴结转移组与无转移组进行单因素比较分析,MACC1蛋白表达、c-Met蛋白表达、组织学分化程度、脉管浸润、肌层浸润深度与宫颈癌盆腔淋巴结转移有关(P0.05),进一步Logistic回归分析表明,MACC1蛋白表达、肌层浸润深度是宫颈癌盆腔淋巴结转移的独立危险因素(P0.05)。结论:MACC1、c-Met蛋白异常表达可能协同参与宫颈癌的恶性进展,MACC1蛋白高表达是宫颈癌盆腔淋巴结转移的独立危险因素。     

VEGF、MMP2、MVD与卵巢癌临床病理关系的研究

目的 :研究卵巢癌中VEGF、MMP2的表达和MVD与临床病理参数和预后的关系并探讨其临床价值。方法 :采用免疫组化技术检测 5 3例卵巢癌和 10例卵巢交界性肿瘤中VEGF、MMP2的表达水平 ,用CD34标记新生血管内皮细胞 ,在显微镜下观察血管密度。结果 :卵巢癌中MVD与年龄呈正相关 (P =0 .0 16 ) ,粘液性囊腺癌中MVD高于其它组织学类型 (P <0 .0 1)。卵巢癌中VEGF的表达与FIGO手术分期呈正相关 (P =0 .0 0 1) ,VEGF表达还与腹水量呈正相关 (P =0 .0 0 2 )。MVD与VEGF、MMP2表达呈正相关 (P值分别为 0 .0 2 1和 0 .0 31) ,VEGF表达与MMP2表达呈正相关 (P =0 .0 0 2 )。VEGF、MMP2强阳性表达和MVD较高 (≥ 10 /HP)的患者预后差 (P值分别为 0 .0 2 6 ,0 .0 36和 0 .0 38)。结论 :VEGF是重要的血管生成因子 ,MMP2不仅在肿瘤的浸润和转移中意义重大 ,而且在肿瘤的血管生成中发挥作用。卵巢癌的FIGO手术分期、MVD及VEGF、MMP2表达与预后相关 ,特别是MMP2在肿瘤的浸润、转移和血管生成中有双重作用 ,既有助于判断患者对传统治疗的敏感性 ,而且对开发针对肿瘤的生物特异性治疗具有启发作用。     

血管内皮生长因子在卵巢癌细胞浸润转移中的作用

目的 :探讨血管内皮生长因子 (VEGF)在卵巢癌浸润转移中的作用。方法 :阳离子脂质体介导VEGF165质粒转染 2株卵巢癌细胞CaOV 3、COC1,并经逆转录聚合酶链式反应 (RT PCR)、Western免疫印迹检测转染VEGF165质粒前后癌细胞VEGFmRNA及其蛋白表达水平 ;用Boyden小室体外侵袭实验比较VEGF165质粒转染前后以及单克隆抗体作用后 2株癌细胞通过人工重组基底膜的能力强弱变化。结果 :VEGF165质粒转染后 ,2株细胞mRNA和蛋白表达水平均较转染前明显增强 (P <0 .0 5 )。VEGF165质粒转染的癌细胞CaOV 3、COC1穿过人工重组基底膜的相对百分率分别为 4 2 .5± 4 .1、2 6 .8± 2 .4 ,明显高于对照组穿膜细胞相对百分率 (2 4 .7± 1.9、8.6± 1.1) (P <0 .0 5 ) ;而在VEGF单克隆抗体存在时 ,2株癌细胞穿膜细胞相对百分率 (10 .2± 0 .7、5 .4± 0 .3)较处理前均有不同程度的下降 (P <0 .0 5 )。结论 :VEGF参与了卵巢癌转移的侵袭、浸润阶段 ,应用VEGF单克隆抗体可针对性地抑制VEGF介导的卵巢癌侵袭、浸润。     

宫颈癌组织中环氧合酶-2和诱生型一氧化氮合酶的表达及其意义

目的 :研究环氧合酶 2 (COX 2 )和诱生型一氧化氮合酶(iNOS)在宫颈癌发生发展中的作用。方法 :用免疫组化方法检测 80例宫颈癌患者COX 2和iNOS的表达水平 ,并以 3 1例宫颈上皮内瘤样病变(CIN)、3 0例慢性宫颈炎症患者和 3 0例正常宫颈上皮为对照组。结果 :(1 )宫颈癌患者COX 2和iNOS表达阳性率分别为 5 8.75 %和 86.2 5 % ,高于CIN、慢性宫颈炎症患者和正常宫颈上皮组 ;(2 )宫颈癌患者COX 2和iNOS的表达水平与临床分期、组织学分型及细胞分化程度无关 (P >0 .0 5 ) ;(3 )伴淋巴结转移的宫颈癌患者COX 2的表达水平略高于不伴淋巴结转移者 ,但差异无显著性 (P >0 .0 5 ) ,而iNOS的表达水平明显高于不伴淋巴结转移者 (P <0 .0 5 ) ;(4 )肿瘤直径≥ 5cm的宫颈癌患者COX 2的阳性表达率明显高于肿瘤直径 <5cm者 (P <0 .0 5 ) ,而iNOS的阳性表达率高于肿瘤直径 <5cm者 ,但差异无显著性 (P >0 .0 5 ) ;(5 )伴宫旁浸润或脉管浸润的宫颈癌患者COX 2和iNOS表达水平明显高于不伴宫旁浸润或脉管浸润者 (P <0 .0 1 ) ;(6)宫颈癌患者COX 2和iNOS的表达之间无相关性 ,而慢性宫颈炎症患者COX 2和iNOS的表达之间有相关性。结论 :宫颈癌患者COX 2和iNOS的表达水平明显上调 ,其表达与宫颈癌的发生发展有关     

子宫颈鳞状细胞癌中TGF-β1表达与血管生成的关系

目的　研究转化生长因子 (transforminggrowthfactor - β1 ,TGF - β1 )在子宫颈鳞状细胞癌中的表达 ,及其与血管内皮生长因子 (VEGF)表达和肿瘤内微血管密度 (MVD)的关系。　方法　应用免疫组织化学方法检测 4 3例子宫颈鳞状细胞癌中TGF - β1、VEGF的表达和MVD值。 结果　子宫颈鳞状细胞癌中TGF - β1和VEGF阳性表达率分别为 34 9%和 6 2 8% ,MVD值为 1 7 2～ 1 1 4 6 ,平均值为 5 7 4 2± 2 3 1 5。TGF - β1的表达与肿瘤的淋巴结转移和临床分期密切相关 (P <0 0 5 ) ,而与肿瘤的病理分级无关 (P >0 0 5 ) ,TGF - β1表达与VEGF的表达呈正相关 (P <0 0 5 ) ,而与肿瘤的MVD无明显相关性 (P >0 0 5 )。结论　TGF - β1可能通过上调VEGF的表达间接刺激血管生成而促进子宫颈鳞状细胞癌的进展     

宫颈鳞癌中膜突蛋白及CD105的表达及其临床意义

目的:研究膜突蛋白(Moesin)及CD105在各级宫颈病变中的表达水平,探讨其与宫颈鳞癌的发展及浸润的关系。方法:采用免疫组化SP法检测31例正常宫颈组织(NCE)、48例宫颈上皮内瘤样变(CIN)及66例宫颈鳞癌组织(SCC)中Moesin及CD105的表达。结果:从NCE到CIN到SCC组,Moesin的表达水平显著升高。在CIN组Moesin的表达随病变程度加重而升高;SCC组中与FIGO分期、浸润深度、盆腔淋巴转移有关,与组织分化程度及年龄无关。从NCE到CIN到SCC组,CD105表达的微血管密度(MVD)值显著升高,在SCC组中与淋巴转移及浸润深度有关,且与Moesin蛋白具有较高关联性。结论:Moesin蛋白及CD105可能在宫颈鳞癌的发展及转移过程中起重要作用,二者结合可能成为判断宫颈病变生物学行为的重要指标。     

Contraceptive knowledge and behavior of conventionalists, careerists, idealists, bouncers, desperadoes, and outsiders

The aim of the survey was to determine the contraceptive behavior and knowledge on contraceptive methods of adolescents. We defined six clusters according to personality, leisure activities, and sociodemographic characteristics: conventionalists, careerists, idealists, bouncers, desperadoes, and outsiders. 1010 Austrian adolescents aged 14–24 years participated in the survey. 96%–100% indicated that they were familiar with the condom and the contraceptive pill. The two most popular contraceptive methods cited were the condom (39%) and OC (34%). Whereas 40% of conventionalists reported that OC were their preferred method of contraception, 53% of idealists indicated that they preferred the condom. 66% of the desperadoes indicated that they considered the pill expensive. 85% of conventionalists and careerists believe that OC offer the best protection against pregnancy. Clusters with higher self-esteem and those with a higher educational level were more likely to believe that this method is unreliable. The results obtained indicate that outsiders, desperatoes, and bouncers show deficits in sex education; only careerists and idealists appeared to be better informed. Research on adolescent contraceptive behavior should drop the traditional stratifying criteria and appreciate the diversity of adolescent populations in order to be better able to classify adolescents according to their contraceptive attitudes. Received: 22 March 1999 / Accepted: 24 March 1999     

Prevention of pertussis, tetanus, and diphtheria among pregnant, postpartum women, and infants

Pertussis disease in the United States has been increasing since 1976 and many states are reporting epidemics. Pertussis is more severe in infants less than 3 months of age and is characterized by high hospital admission rates, apnea of the infant. The CDC recommends that Tdap be administered to all pregnant women after the 20th week of gestation to provide pertussis antibodies to the fetus which will offer protection against pertussis disease. Tdap is highly immunogenetic in the pregnant women and has an excellent safety profile. Tdap given to the postpartum patient and her cocoon family is an alternative strategy.     

Rate,type, and cost of pelvic organ prolapse surgery in Germany,France, and England

Objective

To estimate the rate, type and costs of surgical interventions for pelvic organ prolapse (POP) in Germany, France, and England.

Study design

We identified the number, rate, and type of hospital admissions for pelvic floor surgery in 2005 from national hospital activity databases in each country: the German Hospital Episode, the French Medical Care Program Information System, and the National Health Service England Hospital Episode Statistics. Costs to the payer were estimated using the Diagnosis-Related Group reimbursement rates for each country.

Results

In 2005, the number (rate) of admissions for POP surgery was 36,854 (0.87 per 1000 women) in Germany, 36,679 (1.14 per 1000 women) in France, and 28,959 (1.13 per 1000 women) in England. Admissions for POP surgery constituted 10.4%, 16.7% and 16.9% of all admissions for female genital tract therapeutic interventions in Germany, France and England, respectively. At least 20% of hysterectomies were performed for the primary indication of POP. 57.4%, 45.0%, and 40.1% of all admissions for POP surgery included a hysterectomy. The costs to payers were €144,236,557, €83,067,825, and €81,030,907 in Germany, France, and England, respectively.

Conclusion

Burden and costs associated with POP surgery are substantial in the three countries studied. Thus, programs aimed at reducing the burden of this disease are desirable.     

A follow-up study of methods of contraception, sexual activity, and rates of trichomoniasis, candidiasis, and bacterial vaginosis

A randomized, clinical trial was conducted to evaluate the spermicidal agent nonoxynol 9 as prophylaxis for sexually transmitted diseases. Eight hundred eighteen women using birth control who attended a sexually transmitted disease clinic were evaluated monthly for trichomoniasis, candidiasis, and bacterial vaginosis for 6 months. Women using the active spermicide experienced a somewhat lower incidence rate of trichomoniasis (relative rate 0.83; 95% confidence interval 0.61 to 1.12) and bacterial vaginosis (relative rate 0.86; 95% confidence interval 0.69 to 1.12) as compared with placebo users. The rate of candidiasis was nearly identical for spermicide and placebo users (relative rate 1.02; 95% confidence interval 0.77 to 1.35). The number of sexual partners during the preceding month was related directly to the occurrence of trichomoniasis (p = 0.047) and bacterial vaginosis (p = 0.009) but not candidiasis (p = 0.99). Subjects using oral contraceptives experienced a statistically significant lower rate of trichomoniasis than did women using an intrauterine contraceptive device or who had had a tubal ligation (relative rate 0.56; 95% confidence interval 0.39 to 0.81).