子宫内膜样癌中SIAH2的表达及临床意义

目的探讨癌旁正常子宫内膜、子宫内膜非典型增生及子宫内膜样癌组织中SIAH2的表达及其与子宫内膜样癌临床病理特征的关系。方法采用免疫组化SP法检测癌旁正常子宫内膜、子宫内膜非典型增生及子宫内膜样癌组织中SIAH2的表达;采用qRT-PCR和Western blot法检测新鲜子宫内膜组织中SIAH2 mRNA和蛋白的表达。利用Kaplan-Meier法绘制生存曲线,Log-rank法分析SIAH2表达与子宫内膜样癌患者预后的关系。Cox比例风险回归模型筛选子宫内膜样癌患者预后的独立预测因素。结果免疫组化结果表明,在癌旁正常子宫内膜、子宫内膜非典型增生和子宫内膜样癌中,SIAH2的阳性率逐渐升高,分别为7.50%、42.00%和74.14%,差异有统计学意义(P0.05)。SIAH2与子宫内膜样癌FIGO分期、肌层浸润深度和淋巴结转移相关(P均0.05)。qRT-PCR和Western blot结果均显示,子宫内膜样癌组织中SIAH2 mRNA和蛋白的相对表达量与癌旁正常子宫内膜相比,均明显升高,差异有统计学意义(P均0.05)。生存分析发现,SIAH2阳性子宫内膜样癌患者的生存时间明显短于阴性患者(P0.05)。Cox多因素回归分析表明,SIAH2高表达是子宫内膜样癌患者总生存期的独立预测因子。结论 SIAH2在子宫内膜样癌发生、发展中异常表达,SIAH2阳性的子宫内膜样癌更易发生淋巴结转移,并且与患者的不良预后有关,SIAH2有望成为子宫内膜样癌靶向治疗和预后评估的一项指标。     

术前诊断为子宫内膜不典型增生的子宫内膜癌患者的处理

目的分析和总结术前诊断为子宫内膜不典型增生的子宫内膜癌患者的临床特点及治疗方法。方法 2005年1月至2010年12月北京协和医院妇产科行全子宫切除术后病理诊断为子宫内膜样癌的患者共计404例,其中44例术前子宫内膜活检病理提示子宫内膜不典型增生(AEH),回顾性分析这些患者的临床特点,采用SPSS 13.0统计学软件进行分析。结果 44例术前诊断为AEH的患者中,39例(89%)患者未行子宫内膜癌分期术,子宫切除术后病理均为高分化子宫内膜样癌(100%),14例(32%)年轻患者保留了双侧卵巢,9例(20%)患者给予辅助放疗。中位随诊时间52个月,无复发病例。和绝经后患者相比,绝经前患者术后深肌层浸润(1/22及4/22)及淋巴血管间隙浸润(0/22及3/22)更少,但无统计学差异。比较AEH组和术前诊断为子宫内膜样癌的患者(EC组),AEH组高分化子宫内膜样癌的比例明显高于EC组(P=0.000);辅助化疗率和复发率明显低于EC组(P=0.003和0.019)。结论术前诊刮为AEH的子宫内膜癌患者预后好,年轻患者充分评估后可以考虑保留卵巢,绝经后患者AEH伴发子宫内膜样癌的风险增高,且更容易合并深肌层浸润、淋巴血管间隙受累等高危因素。     

Ⅱ型子宫内膜癌的前驱病变及其发生模式

子宫内膜癌可分两型,Ⅰ型以子宫内膜样癌为代表,Ⅱ型以子宫浆液性乳头状癌为代表。本文旨在阐述Ⅱ型子宫内膜癌的前驱病变及其可能的发生发展模式。子宫浆液性乳头状癌又称子宫内膜浆液性癌,是一种侵袭性子宫内膜癌,预后不良。由于病因不清,人们一直努力试图找出该病的前驱病变,以便通过早期发现来改善其治疗效果。     

子宫内膜黏液性上皮病变中KRAS基因突变分析北大核心CSCD

目的通过对子宫内膜黏液性上皮病变中的KRAS突变情况进行分析,探讨KRAS突变与子宫内膜黏液癌的相关性。方法收集2015年7月至2017年10月首都医科大学附属北京妇产医院病理科诊断的子宫内膜黏液性上皮病变43例,不典型性子宫内膜增生症10例．子宫内膜样癌12例。从中性甲醛固定石蜡包埋组织中提取基因组DNA,聚合酶链反应（PCR）扩增KRAS第2、3号外显子,并进行毛细管电泳分析突变情况。应用Fisher确切概率法对各组中KRAS突变差异情况进行比较。结果43例子宫内膜黏液性上皮病变患者年龄33-77岁,平均年龄（55．12±9．34）岁,中位年龄55岁。8例具有黏液分化的不伴细胞不典型性的子宫内膜增生症均未检出KRAS突变。不典型性子宫内膜增生症、子宫内膜样癌、不典型性子宫内膜增生症伴黏液分化、子宫内膜样癌伴黏液分化与黏液癌中存在KRAS突变,检出比例分别为1／10、1／12、4／11、6／15和8／9。黏液癌与子宫内膜样癌组（P〈0．01）、子宫内膜样癌伴黏液分化组（P〈0．05）相比,KRAS突变分布差异具有统计学意义。结论不典型性子宫内膜增生症伴黏液分化、子宫内膜样癌伴黏液分化和黏液癌中存在KRAS高频突变．提示KRAS突变激活与子宫内膜黏液癌的发病机制密切相关。     

端粒酶逆转录酶和c-myc基因在子宫内膜样癌及子宫内膜增生中的表达

目的　探讨端粒酶逆转录酶 (hTERT)及c myc基因在子宫内膜增生及癌变过程中的作用、意义及二者相关性。方法　所用标本包括 14例子宫内膜单纯增生 ,8例复合增生 ,10例不典型增生 ,42例内膜样癌 ,用原位杂交法检测hTERT和c mycmRNA表达。结果　 (1)hTERT在子宫内膜单纯、复合、不典型增生病变和内膜样癌中阳性结果分别 2 / 14、4/ 8、8/ 10和 92 9% (3 9/ 42 ) ,前两组均为弱阳性表达 ,后两组多为中度和强阳性 ,统计分析表明不典型增生病变和内膜样癌中hTERT表达高于单纯和复合增生 (P <0 0 5)。c myc在子宫内膜单纯、复合、不典型增生病变和内膜样癌中阳性结果分别 3 / 14、1/ 8、5/ 10和 54 8% (2 3 / 42 ) ,后两组c myc阳性率显著高于前两组 (P <0 0 5) ;不典型增生病变的c myc阳性水平高于单纯及复合增生 (P <0 0 5)。(2 )hTERT阳性水平与内膜样癌分化相关(P <0 15) ;c myc阳性率随内膜样癌浸润深度增加而递增 (P <0 0 5)。 (3 )子宫内膜增生和内膜样癌各组中hTERT与c myc表达均不相关 (P >0 0 5)。结论　hTERT及c myc基因过表达与子宫内膜不典型增生及恶性转化相关 ,并与内膜样癌演进以及不良预后有关 ,但其两者表达之间无相关性     

40岁以下妇女子宫内膜癌刮宫活检的病理诊断问题

目的 探讨40岁以下妇女子宫内膜癌刮宫活检的病理诊断。方法对20例40岁以下子宫内膜癌患者的临床病理资料进行回顾性分析。结果子宫内膜样腺癌18例,腺鳞癌(腺癌伴鳞状上皮分化)1例,浆液性乳头状癌并透明细胞癌1例。子宫内膜样腺癌的组织学特点是子宫内膜腺体失去极性,细胞核变大、变圆、核仁突出,染色质粗或呈空泡状,同时子宫内膜间质消失,代之为肉芽组织或纤维组织,常有炎性反应。子宫内膜样腺癌多数仅累及浅肌层,皆无转移。1例子宫内膜腺鳞癌呈双侧卵巢转移;1例浆液性乳头状癌有盆腔淋巴结转移。结论40岁以下妇女的子宫内膜癌多数为高分化子宫内膜样腺癌,应注意与子宫内膜不典型增生及不典型息肉状腺肌瘤鉴别。     

子宫内膜去分化癌/未分化癌17例临床病理及预后分析

目的 探讨子宫内膜去分化癌(dedifferentiated endom-etrial carcinoma,DEC)和子宫内膜未分化癌(undifferentiated endometrial carcinoma,UEC)的临床病理特征,BRG-1/INI-1在DEC/UEC和子宫内膜样癌FIGO 3级中的表达及与预后...     

以脑胶质瘤为首发表现MLH1基因突变Lynch综合征1例并文献复习

目的探讨脑胶质瘤、子宫内膜样癌及升结肠腺癌中MLH1基因突变相关Lynch综合征患者的临床病理学特征。方法随访1例Lynch综合征患者,分析8年间该患者发生脑胶质瘤、子宫内膜样癌、升结肠腺癌的临床及病理资料,并复习相关文献。结果患者女性,36岁时发生脑胶质瘤,43岁时同时发生子宫内膜样癌及升结肠腺癌。错配修复蛋白免疫组化结果显示MLH1和PMS2蛋白阴性,MSH2和MSH6蛋白阳性;基因检测结果显示MLH1基因错义突变。结论以脑胶质瘤为首发肿瘤表现的MLH1基因突变Lynch综合征临床罕见,该类患者同时或异时多部位肿瘤发病率高,发病年龄更早,需密切监测肠道及肠外情况。     

血清CA125及CA19-9水平诊断子宫内膜癌的价值

ＣＡ１２５是卵巢上皮性癌的相关抗原,作为卵巢癌的肿瘤标志物已被广泛应用于临床诊断、化疗疗效观察和疾病复发的监测〔１〕,尤其对尚缺乏理想肿瘤标志物的子宫内膜癌可协助诊断。为此,我们检测了子宫内膜癌患者血清ＣＡ２５及ＣＡ１９９的含量,以探讨子宫内膜癌评估和监测的价值与临床预后因素的关系。１材料和方法１．１材料１９９４０１～１９９８０５,经手术和病理确诊为子宫内膜癌的患者１４９例,其中浆液性乳突状囊腺癌４８例,粘液性囊腺癌２７例,交界性浆液性囊腺癌６例,子宫内膜样癌１７例,库肯勃氏肿瘤７例,腺鳞癌８例,透明细胞癌…     

子宫内膜癌组织内分泌分化及其机制的探讨

目的:探讨子宫内膜癌组织的内分泌分化及其机制。方法:采用免疫组织化学及双重免疫组织化学技术, 观察50例子宫内膜样腺癌及20例正常子宫内膜组织的嗜铬素A(CgA)及CgA/细胞角蛋白(CK)表达。结果:(1)子宫内膜样腺癌组的癌组织中CgA阳性率为44.0%, 明显高于正常子宫内膜组(15.0%, P＜0.05)。正常子宫内膜组织仅见极少量的内分泌细胞, 子宫内膜样腺癌组织中内分泌细胞的数量及染色强度均高于正常子宫内膜组。(2)子宫内膜样腺癌组织中可见同时表达CgA与CK的细胞。结论:子宫内膜样腺癌的内分泌分化是肿瘤异质性的表现。子宫内膜样腺癌组织中存在可向上皮细胞或内分泌细胞分化的"多向分化细胞", 提示子宫内膜样腺癌组织的内分泌分化是肿瘤细胞多向分化的结果。     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Intestinal helminthiasis in school children in Haiti in 2002

A survey on intestinal helminths in school children was conducted in Haiti in 2002. This first nationwide study involving the entire country was stratified by department according to urban and rural zones using the cluster method. Focusing on elementary school children (n=5792; age range 3 to 20 years), it involved 26 urban and 49 rural schools randomly selected. Stools were preserved in formalin and examined by the Ritchie technique. Thirty-four per cent of stools (1981/5792) tested positive for intestinal helminths with the following parasites identified: Ascaris lumbricoides (27.3%), Trichuris trichiura (7.3%), Necator americanus (3.8%), Hymenolepsis nana (2%), Taenia sp. (0.3%) and Strongyloides stercoralis (0.2%). The helminth prevalence was higher in rural (38.4%) compared to urban areas (30%). There was no significant difference in prevalence by sex and age. The importance of geohelminths changed from one department to another with the highest prevalence found in the Southern department of Grande Anse (73.7%) and the lowest prevalence in the Center department (20.6%). Five out of the country's nine departments had a similar prevalence varying from 25.5% to 28.2%. Intestinal helminthic polyparasitism was observed in a percentage of infested school children comprise between 3.4% and 28.6% according in relation to the geographical area. A program to fight against geohelminths in school children should be initiated as a public health priority. Albendazole is the drug of choice. Frequency of drug distribution should be based on the prevalence of geohelminths in each department.     

Experience in adult population in dengue outbreak in Delhi

A dengue outbreak has recently hit the Indian capital. We studied the clinical profile of adult patients. Five hundred and sixty patients of dengue infection were admitted in a specially created ward according to the criteria laid down by WHO. Haematemesis (28.28%), epistaxis (26.78%) and malena (14.28%) were some of the common presentations. Similarly lymphadenopathy, especially cervical (30.89%), palatal rashes (26.96%) and hepatomegaly (23.75%) were the most commonly encountered findings on physical examination. Most of the cases were of dengue fever with haemorrhage and only 2.5% cases were classified under dengue haemorrhagic fever or dengue shock syndrome. The average hospital stay was 3.4 days but only 9.8 hours in the eleven patients who died, suggesting their late arrival in preterminal situation giving little time for resuscitation. Thrombocytopenia was not a feature and only 12.85% patients had platelet count less than 70,000/cmm. Most of the patients who were admitted with thrombocytopenia, showed normalization in their platelet counts in next few days. Serological examination demonstrated evidence of recent dengue infection in 41.17% patients. Few patients required blood or platelet concentrate transfusion. Eleven patients died, three due to DIC, one of intracranial haemorrhage and seven due to massive gastric haemorrhage. Rest of the patients recovered completely. Thus we can conclude that recent outbreak in Delhi was of dengue fever with haemorrhage and mortality was very low in patients who came early to the hospital.     

Changes in the hypothalamic nuclei in in experimental allergy

Summary In rabbits subjected to prolonged sensitization and in which the Arthus phenomenon was induced there was a marked reaction of the hypothalamic nuclei. Staining by Gomori's method indicated a cellular swelling, loss of granules, and protoplasmic vacuolization in the supraoptic nucleus. There was a considerable increase in the size of the cross-sectional area of the cells. The same effects were much less well shown in the paraventricular nucleus. These results show that marked signs of increased neurosecretion developed in the animals at the height of the Arthus phenomenon.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten Éksperimental'noi biologii i Meditsiny, Vol. 55, No. 4, pp. 110–113, April, 1963.     

Development in in vitro toxicology

There are three principal pressures driving the development of in vitro toxicology: (1) the need for more efficient testing systems to cope with the large number of xenobiotics currently being developed; (2) public pressure to reduce animal experimentation; and (3) a need for a better understanding of the mechanisms of toxicity. Within this, in vitro toxicology is focused on local, systemic, and target-organ toxicity. It is becoming increasingly apparent that a step or decision-tree approach using input of a variety of experimental data (physicochemical properties, biokinetics, cytotoxicity) provides the most efficient system for predicting toxicity. Examples of the use of in vitro toxicity systems for prediction of systemic toxicity and target-organ (liver) toxicity are presented.Originally presented at ECCP 93.