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本实验采用免疫组织化学法 (ＳＰ法 ) ,对 1990～ 1994年在我科行根治性手术的ＤｕｋｅｓＢ期结肠癌病人 84例进行了回顾性研究。1　资料与方法全组男 46例 ,女 38例。中位年龄 6 8岁 (39～ 89岁 )。病理类型 :高分化 30例 ,低分化 2 8例 ,未分化 2 6例。在随访期中位期 30个月 (18～ 36个月 )时有 18例发生复发与转移 ,其中肝转移 8例 ,肺转移 6例 ,骨转移 1例 ,腹腔广泛转移 5例。未复发或转移的病例已随访超过 6 0个月。 84例肿瘤石蜡包埋标本均保存完好。主要试剂 :免疫人第Ⅷ因子相关抗原 (Ｆ8-ＲＡ)抗体(多抗ｚｙｍｅｄ)、免疫人ＶＥ…     

宫颈鳞癌间质内CD34表达的临床意义

目的探讨宫颈鳞癌间质内CD34的表达及其临床意义。方法采用免疫组化S-P法,检测15例正常宫颈组织和50例宫颈鳞癌的间质内微血管计数情况,并分析其在不同的临床分期、不同病理分级的表达。结果在子宫颈鳞癌Ⅰ级和Ⅱ级癌组织中,CD34的表达主要分布在癌巢周围间质内,而癌巢内较少;在子宫颈鳞癌Ⅲ级的癌组织,CD34的表达则呈弥漫分布。临床分期比较：Ⅰ期与Ⅱ期比较、Ⅰ期与Ⅲ期比较,差异显著（P〈0．01）;组织学比较：Ⅰ级与Ⅱ级比较、Ⅰ级与Ⅲ级比较,差异显著（P〈0．01）。结论CD34的表达在临床分期、组织学分级差异显著,反映了微血管增生在子宫颈癌发展过程中起重要作用,是一个有价值的标记物。     

补体末端复合物在瘢痕疙瘩中的表达

近20年来的研究表明，免疫学相关因素在瘢痕疙瘩和增生性瘢痕的发病中具有重要作用。瘢痕疙瘩患血清中免疫球蛋白、补体及其活化产物——可溶性补体末端复合物（SC5b-9）较对照组明显增高，由此表明，患免疫系统状态发生改变。在此基础上，笔对补体末端复合物（C5h-9）及C3、IgG、IgA、IgM在瘢痕疙瘩和正常皮肤组织中的表达进行观察，为研究瘢痕疙瘩组织局部的免疫状态提供依据。     

胃癌组织中Ki-67及CD34的表达及其临床意义

目的：研究Ki-67和CD34在胃癌组织中的表达,探讨其与胃癌临床病理相关因素的关系。方法：采用免疫组织化学SP法检测80例胃癌组织Ki-67的表达,并以CD34抗体标记血管内皮细胞,结果用微血管密度（MVD）表示。结果：Ki-67表达与胃癌分化程度、淋巴结转移、浸润深度以及肿瘤大小密切相关（P〈O．05）,与年龄、性别无关（P〉0．05）。Ki-67与MVD在胃癌组织中呈正相关（P〈0．05）。MVD与胃癌分化程度、淋巴结转移、浸润深度密切相关（P〈0．05）,而与年龄、性别、肿瘤大小无关（P〉0．05）。结论：Ki-67及CD34与胃癌的分化程度、浸润深度、淋巴结转移方面明显相关,而与年龄、性别、肿瘤大小无关。检测胃癌组织中Ki-67及CD34的表达对临床有-定的指导意义。     

组织因子在肝癌血管生成中作用的实验研究

目的探索组织因子(TF)在人肝细胞肝癌(HCC)血管生成中的作用。方法用免疫组织化学EnVisionTM法检测50例HCC及相应的癌旁肝组织标本中TF和CD34的表达。结果HCC中TF表达与患者静脉浸润、肝内外转移、无或包膜不完整有关,MVD与静脉浸润、肝内外转移、肝硬化有关(P0.05);HCC中TF阳性组与阴性组的MVD值之间差异有统计学意义(F=5.487,P=0.023);Cox模型提示TF的表达是影响HCC患者总生存率的独立因素之一。结论TF可能参与HCC微血管生成,TF对评估HCC患者预后有参考价值。     

甲状腺癌的微血管密度及其临床意义

1971年Ｆｏｌｋｍａｎ[1] 提出了“肿瘤的生长有赖于血管的生成”这一假说。至今 ,对肺癌、结直肠癌、乳腺癌以及前列腺癌的研究均证实了该观点[2 4 ] 。本研究采用抗ＣＤ34单克隆抗体检测甲状腺癌患者癌组织中的微血管密度 (ＭＶＤ) ,并探讨其临床意义。1.资料与方法 :48例甲状腺癌标本取自我院普外科 1986年～ 1999年手术切除并经病理证实的患者。其中男 10例 ,女 38例 ;年龄 12～ 73岁 ,平均 42 2岁 ;肿瘤长径 0 5 0～ 7 0 0ｃｍ ,平均 3 6 8ｃｍ ;甲状腺乳头状癌 (ＰＴＣ) 2 7例 ,滤泡状癌 (ＦＴＣ) 9例 ,髓样癌 (ＭＴＣ) 12例。另取…     

瘢痕疙瘩中皮肤附件结构破坏与瘢痕增生的关系

目的　探讨瘢痕疙瘩 (keloid K)形成过程中皮肤附件 (skin appendages,SAs)结构破坏与瘢痕增生的关系。　方法　将来自 17例 K患者的活检标本按浸润生长 (K- I,n=9)、瘢痕增生 (K- P,n=17)、瘢痕萎缩 (K- A,n=10 )和边缘正常皮肤 (K- N,n=6 )进行分组 ,另以非 K患者胸部正常皮肤 (NS,n=6 )为对照 ,采用免疫组织化学方法观察SAs密度与广谱细胞角蛋白 (pan- fytokeratin,CKp)、CK19、腺上皮分泌成分 (secretory component,SC)和增殖细胞核抗原 (proliferating cell nuclearantigen,PCNA) ,以及凋亡相关蛋白 Bcl- 2和 Bax之间的变化规律 ,同时用组织学、解剖显微镜及扫描电镜观察 K胶原纤维和 SAs结构的组织形态学改变。　结果　与 K- N和 NS组相比 ,K组织中 CKp和 SC阳性的 SAs密度迅速减少 ,可见 SAs结构消失后残留 CKp阳性蛋白痕迹 ;多数 SAs上皮细胞 Bax表达增强 ,但 Bcl- 2、PC-NA和 CK19阳性的 SAs则呈现复层 (鳞状 )上皮化和形态结构异常。 K组织形态学大致经历浸润、增殖和成熟的过程 ,SAs也相应地发生增生 ,细胞迁移、炎性反应和血管闭塞等引起的形态结构破坏和几乎被纤维结缔组织完全取代的变化过程。直线相关分析显示 ,K的瘢痕厚度与 SAs密度之间呈显著的负相关 (r=- 0 .341,P<0 .0 1)。　结论     

瘢痕动物模型的研究进展

组织创伤修复包括再生和瘢痕愈合两种形式，其中再生一般只发生在低等生物和胚胎早期的创伤，成人组织创伤修复一般通过瘢痕愈合。瘢痕又包括不高出于正常皮肤的非病理性瘢痕(又称正常瘢痕，Normal scar)和高出正常皮肤的病理性瘢痕(又称异常瘢痕abnormal scar)，其中多数伤口愈合后表现为病理性瘢痕，后者又包括增生性瘢痕和瘢痕疙瘩。不论何种类型的瘢痕增生都可能影响外貌与功能，     

E2F1在病理性瘢痕的表达与CD105标记的微血管密度的关系

目的探讨E2F1和CD105对病理性瘢痕血管生成的作用。方法采用免疫组化的方法,检测E2F1和CD105在40例病理性瘢痕,20例非病理性瘢痕以及20例正常皮肤的表达。通过计数和统计学方法探讨E2F1和CD105标记的微血管密度的关系。结果E2F1和CD105标记的微血管计数在病理性瘢痕和非病理性瘢痕、正常皮肤的表达有显著性差异。在病理性瘢痕中,E2F1的表达和CD105标记的微血管密度呈正相关。结论E2F1可能对病理性瘢痕形成过程中血管的形成起到重要的作用。     

组织因子表达与肝癌微血管生成关系及临床意义

目的 探讨组织因子(tissue factor,TF)在人肝细胞肝癌组织中的表达与肿瘤组织微血管形成过程之间的关系和临床意义.方法 对54例人肝细胞肝癌(hepatocellular carcinoma,HCC)及相应的癌旁肝组织标本,进行了TF和CD34免疫组织化学EnVisionTM法检测.结果 ①肝癌组织中TF阳性表达率为63.00%(34/54),MVD值为53.17±27.04:癌旁肝组织中TF阳性表达率为5.60%(3/54),MVD值为19.15±6.92.肝癌组织中TF的表达和MVD值之间存在正相关性(r=0.662,P<0.01);②肝癌组织中TF的表达与患者Edmondson-steinerⅢ Ⅳ、静脉浸润、肝内外转移、无或包膜不完整、甲胎蛋白(AFP)≤20 ng/ml有关(P<0.05);多因素Logistic回归分析表明:TF表达是肝癌静脉浸润的独立危险因素之一.结论 肝癌组织中异常表达增高的TF与肝癌微血管形成过程及部分侵袭转移指标相关,提示TF可能促进了肝癌的发生与侵袭转移.     

A novel model of humanised keloid scarring in mice

Treatments for keloid scarring are a major challenge to scientists and physicians for their unknown aetiology. Although several models, including monolayer cell culture to tissue‐engineered models, were developed, further research on keloid has more or less been hindered by the lack of appropriate animal models. Because these aberrant scars are specific to humans, we obtained human normal and keloid skin tissues and isolated dermal fibroblasts from them. Cell morphology, growth and immunohistochemical staining of myofibroblastmarker α‐SMA were examined, and the cell medium of 2‐hour culture and 24‐hour culture was implanted on the back of nude mice. The cell medium of 2‐hour culture and 24‐hour culture was also analysed by a protein array for the detection of distinction in inflammatory factors. We showed that keloid fibroblasts had similar morphology and growth compared to normal skin fibroblasts, but the α‐SMA expression was obviously up‐regulated. After 6 weeks, mice of the 2‐hour keloid‐derived culture medium group exhibited keloid‐like hypertrophic nodules macroscopically, while mice of 24‐hour keloid‐derived culture medium group were similar to normal skin. Histological findings confirmed that the reconstituted skin tissues had the typical features of human keloids. The protein array data revealed that RANTES were involved in humanised fibrotic occurrence in mice, also suggesting they were important modulators of this inflammatory event. This novel model might help to understand the key events that result in the formation of these abnormal scars and provide new therapeutic options.     

A comparison of the vascular density of VEGF expression with microvascular density determined with CD34 and CD31 staining and conventional prognostic markers in renal cell carcinoma

Aim The aim of this study was to compare the vascular density of Vascular endothelial growth factor (VEGF) expression with microvascular density determined by CD34 and CD31 with conventional prognostic parameters. Methods The study involved 50 renal cell carcinoma (RCC) cases. VEGF, CD34, and CD31 were stained by immunohistochemistry, and then preparations were evaluated by two pathologists under light microscopy. The whole tumor area was scrutinized in all the sections. In the evaluation of VEGF, due to the lack of homogenous staining within the tumor, two parameters, distribution and intensity of expression, were evaluated semiquantitively. In the evaluation of microvascular density with CD34 and CD31 staining, three hot areas with the highest density were determined. In ×200 magnification of these areas, on a single plane, the quantity of vascular structures with lumens was determined. Results Intensity of VEGF Expression was higher in papillary type carcinoma of kidney parenchyma (P = 0.014) and it was significantly correlated with tumor stage (P = 0.013), survival time (P = 0.01), and tumor size (P = 0.035). Distribution of VEGF expression was also higher in papillary RCC (P = 0.055) and it was significantly correlated with tumor stage (P = 0.043) and tumor size (P = 0.039). Vascular density determined with CD34 staining was higher in conventional RCC (P < 0.05); in addition, it was significantly correlated with distribution and intensity of VEGF expression (P < 0.05) and tumor stage (P < 0.05). Vascular density determined with CD31 staining was not significantly correlated with tumor type, tumor stage, nuclear grade, and survival time. Conclusions Intensity and distribution of VEGF were higher in papillary RCC. Both parameters were significantly correlated with tumor size, stage, and vascular density determined with CD34 staining. Intensity of VEGF was also significantly correlated with capsule invasion. Vascular density determined with CD34 staining, however, was higher in conventional RCC, and it was correlated with tumor size and stage.     

免疫组化法对不同类型瘢痕微血管的定量研究

目的　探讨瘢痕微血管构筑在瘢痕形成、发展及临床防治中的意义。方法　应用免疫组化法显示微血管 ,按瘢痕的周边区和中央区划分 ,进行微血管的定量研究。结果　免疫组化法后血管呈棕黄色 ,切片背景清晰 ,增生性瘢痕周边区血管密度高于中央区血管密度 ;增生性瘢痕血管密度高于萎缩性瘢痕 ,差异有非常显著意义 (P <0 .0 1)。结论　瘢痕交界处为较幼稚瘢痕 ,血管最为丰富 ,能代表整个瘢痕的生物学行为。我们认为 :可把此区作为研究瘢痕发生、发展与转归的重点。     

Delayed reepithelialization and scarring deregulation following drug-induced toxic epidermal necrolysis

A 51-year-old Caucasian woman developed severe drug-induced toxic epidermal necrolysis (TEN) due to allopurinol. The withdrawal of the culprit drug was unfortunately delayed, and dramatic retardation of reepithelialization was observed. At that stage of disease evolution, an inflammatory cell infiltrate was present in the dermis. Coverage of eroded lesions by frozen cultured keratinocyte allografts failed to hasten reepithelialization compared to ungrafted sites. This unusual protracted TEN evolution was followed by the development of extensive hypertrophic and keloid scars. Several biopsies were taken over 6 months. The histologic presentation of the grafted and ungrafted eroded scar tissues looked similar. Both the number and size of the Factor XIIIa-positive dermal dendrocytes, as well as the number of alpha-actin-positive myofibroblasts showed a marked increase between weeks 2 and 12 after grafting. They were reduced after 6 months when the scarring process was stabilized. alpha1 [IV] collagen was never expressed over the eroded scars. Similar to burn patients, delayed reepithelialization might be a risk factor for abnormal scarring in TEN. Cultured keratinocyte allograft apparently offered no improvement in reepithelialization and did not prevent abnormal scarring in this TEN patient.     

增生性瘢痕的金属元素含量变化

目的 从金属元素含量变化的角度探讨增生性瘢痕的机理。方法 采用GGX-5型原子吸收分光光度计分3组测定（1）非瘢痕组（2）扁平瘢痕组（3）增生性瘢痕组的全血、瘢痕组织及其自身正常皮肤的钙、镁、锌、铁、铜含量。结果 3组患者的全血和正常皮肤的5种元素水平差异无显著性意义。增生性瘢痕组较其自身正常皮肤5种元素含量减少。扁平瘢痕组与其自身正常皮肤的元素含量相同。结论 增生性瘢痕组织中微量元素含量较自身正常皮肤的含量减少,这可能与增生性瘢痕的形成有关。     

Clinical application of split skin graft from scar tissue for plastic reconstruction in post-extensive burn patients

We evaluated the use of autologous split-thickness skin taken from scars on the backs of patients with extensive burns, without sufficient normal donor skin. Between 1998 and 2008, a total of 15 patients underwent 47 operations using split-thickness skin grafts from scar tissue. Split-thickness skin was harvested from scars on the patient's back. In each operation, two thirds of donor skin was used at the recipient site and the remaining part was used to cover the donor site. All skin grafts survived. The skin function and appearance at the reconstruction site was improved in all cases, and reconstruction had therapeutic effects similar to those achieved by graft procedures using normal autologous split skin. Moreover, 6 months later, the skin graft procedure could be repeated at the donor site. Therefore, we concluded that split-thickness skin from scars on patients' backs is a valuable source of skin graft material that can be used repeatedly for plastic reconstruction in extensively burned patients.     

乒乓球拍样皮瓣成活过程中基质细胞衍生因子-1、CD34的表达

Objective To detect the expression of stromal cell-derived factor 1 (SDF-1), CD34 in the PingPong Racket flap during the survival process, and investigate the role of SDF-1 in flap neovascularization. Methods The PingPong Racket flap animal model was established. The morphology and survival of the flap were observed. The expression of SDF-1 and CD34 in the distal flap was detected by using immunohistochemistry and enzyme-linked immunosorbent assay at 0, 3, 5, 7, and 14 days after operation respectively. Results (1) In the same group of flaps, with prolongation of time, the expression of SDF-1 and CD34 was increased. The expression of SDF-1 reached the peak at the 5th day (group A; 124. 80 ±4.05, B: 137.85±3.03, C: 166.53±2.98, D: 72. 80 ±2.63, E: 62.79±2.20), and that of CD34 reached the peak at the 7th day (group A: 16. 76 ±0.62, B: 17. 60 ±0.72, C: 18.48 ±0.55, D: 12.70 ±0. 60, E: 11. 51 ±0. 70) ; (2) In the different groups of flaps, when the flap area was increased, the expression of SDF-1 and CD34 was increased, and at the area of 5 cm ×5 cm, the flaps had partial necrosis. Conclusion There was a positive relationship between SDF-1 and CD34 in the survival process of the flap.     

不明原因反复自然流产与绒毛组织血管内皮生长因子、微血管密度的相关性

目的探讨不明原因反复自然流产(URSA)发生的可能机制,为临床治疗提供依据。方法随机选取URSA患者28例作为病例组,同期正常妊娠要求人工流产者20例作为对照组,运用免疫组织化学SP法检测两组绒毛组织中血管内皮生长因子(VEGF)表达、微血管密度(MVD)值。结果URSA组绒毛发育不良,VEGF表达强度、MVD值显著低于对照组;两组绒毛组织VEGF表达与MVD值均呈正相关。结论绒毛组织VEGF表达、MVD值降低及绒毛发育不良与URSA的发生存在相关性。