头颈部鳞癌及癌旁组织端粒酶活性检测

目的：研究原发头颈部鳞癌及相关癌旁组织中端粒酶活性表达，探讨春作为头颈部鳞癌分子生物学标志物的可能性。方法：采用ＴＲＡＰ－ＰＣＲ－ＥＬＩＳＡ，对３２例原发头颈部鳞癌及１５例癌旁组织进行端粒酶活性检测。结果：３２例原发头颈部鳞癌中，２７例端粒酶活化，阳性率为８４．４％；１５例癌旁组织中５例端粒酶活化，阳性率为３３．３％。有淋巴结累及者端粒酶阳性率（８６．７％）高于无淋巴结累及者（８２．４％），低分化     

喉癌和癌旁组织的端粒酶活性检测

目的：探索端粒酶活性与喉癌发生发展的关系。方法：采用重复序列扩增法（TRAP－PCR）检测56例手术切除的喉癌组织和癌旁粘膜组织的端粒酶活性。喉癌组织均经病理证实,喉癌旁粘膜组织中有正常喉粘膜41例,轻度不典型增生15例。结果：喉癌组织端粒酶活性阳性率为91．07％（51／56）,正常喉粘膜和轻度不典型增生喉粘膜的阳性率分别为9．76％（4／41）和33．33％（5／15）,喉癌组织和癌旁粘膜组织中端粒酶活性阳性率有显著差异（P<0．01）。癌旁上皮端粒酶活性阳性的9例患者其喉癌组织端粒酶活性皆为阳性。结论：端粒酶激活与喉癌的发生发展有密切关系,并可作为喉癌分子诊断的肿瘤标记物。     

喉癌标本端粒酶活性的检测

目的：探讨端粒酶生在喉癌发生过程中的作用。方法：采用ＴＲＡＰ方法检测３４例头颈肿瘤组织标本中的端粒酶活性。结果：在２７例喉癌患者中有２３例同端粒是笥，阳性率８５．２％，２７例相应癌旁组织有７例检出端粒酶阳性，阳性率２５．９％，７例喉乳头瘤瘤患者中有３例检出，阳性率４２．９％，结论：端粒酶活化并非只发生在喉癌进展的晚期阶段，在肿瘤形成的早期也有一定程度的端粒酶激活。端粒酶活性可能民癌的恶性程度有关。     

声门上型喉癌中端粒酶活性的检测及其意义

目的：探讨端粒酶活性在声门上型喉癌中的表达及其意义。方法：采用端粒重复序列扩增法检测了ＨＥＰ－２喉癌细胞系,２６例声门上型喉癌组织和１５例癌旁组织。结果：ＨＥＰ－２喉癌细胞系呈端粒酶阳性,癌组织的端粒酶阳性率为８４．６％,明显高于癌旁组织的阳性率４０％（Ｐ〈０．０１）,喉癌组织端粒酶活性的表达与临床分期和有无颈淋巴结转移未出现出相关性（Ｐ〉０．０５）。结论：端粒酶活化是喉癌发生的重要遗传学改变,但     

癌旁非典型增生组织端粒酶活性的间接定量检测

目的对头颈部癌旁非典型增生组织中端粒酶活性进行间接定量测定;探讨该定量分析对预测癌旁非典型增生组织恶性变的价值.方法用定量方法检测取自10位头颈肿瘤病人的组织标本30份,其中原发癌组织、癌旁非典型增生组织及正常组织标本各10份.端粒酶活性检测采用端粒重复序列液体闪烁计数法并由此推断端粒酶活性.结果癌旁非典型增生组织中端粒酶活性(645±262) rcpm明显低于相应的癌组织(1618±329) rcpm,有统计学意义(P<0.01);高于相应的正常组织(506±209) rcpm,但差异无统计学意义(P>0.05).结论①端粒酶活性的液闪间接定量分析,对癌旁组织恶性变的预测可能有一定的参考价值,可用于肿瘤切缘的研究;②癌旁组织端粒酶活性升高进一步提示头颈部鳞癌发生、发展的多阶段演进过程.     

头颈部非鳞癌组织端粒酶活性的定量检测

研究表明 ,端粒酶在人类恶性肿瘤组织中呈高度表达 ,而在正常细胞呈低表达或无表达 ,提示端粒酶表达在恶性肿瘤的发生过程中起着重要的作用。已有报道显示 ,头颈部鳞癌中端粒酶呈普遍表达〔1～ 3〕。然而 ,除少数有关端粒酶在甲状腺腺癌中表达的报道外〔4～6〕,罕见其在头颈部非鳞癌恶性肿瘤组织中表达的报道。本研究用液体闪烁计数法〔3〕,旨在了解端粒酶在头颈部非鳞癌恶性肿瘤组织中的活性 ,探讨端粒酶活性定量检测的临床价值。1　材料与方法　　共检测 1 4例头颈部非鳞癌恶性肿瘤患者的组织样本 2 5份 (其中 1 1份取自恶性肿瘤患者的相…     

端粒酶hTRT mRNA在口腔癌前病变中的表达

目的探讨端粒酶hTRT mRNA在口腔癌前病变中的表达相关性。方法采用原位杂交方法检测病变组织中hTRT mRNA的表达水平。其中非典型增生18例、单纯性增生5例、肿瘤周围邻近组织5例、正常口腔黏膜2例，共30例口腔病理标本。结果55．6％非典型增生（10／18）、20％单纯性增生（1／5）、20％肿瘤周围邻近组织（1／5）、0％正常口腔黏膜（0／2）端粒酶hTRT mRNA显示阳性表达。其中重度非典型增生与轻度及中度非典型增生之间端粒酶hTRT mRNA表达差异有显著性意义（P〈0．05）。结论端粒酶hTRT mRNA在口腔癌前病变中有表达。端粒酶活性的激活可能发生在口腔癌前病变晚期。其活性的激活是口腔癌前病变恶变及恶性肿瘤形成的重要因素。     

端粒酶RNA组分和端粒酶活性与喉癌的相关性研究

目的：进一步了解端粒酶活性和端粒酶ＲＮＡ组分（ｈＴＲ）与喉癌发生、发展的关系，并建立喉癌的早期诊断标准。方法：采用端粒酶重复扩增法和原位杂交法对正常组织、声带息肉、癌前病变和喉癌进行ｈＴＲ和端粒酶活性分析。结果①所有组织均表达不同水平的ｈＴＲ，ｈＴＲ阳性率随着喉癌的临床分期逐渐增加，但无统计学差异。②３９例（７８％）的喉癌组织表达端粒酶活性，声带息肉仅１例（８．３％）表达，不同分化的喉癌组织端粒酶     

喉癌标本端粒酶活性的检测

目的 :探讨端粒酶活性在喉癌发生过程中的作用。方法 :采用 TRAP方法检测 34例头颈肿瘤组织标本中的端粒酶活性。结果 :在 2 7例喉癌患者中有 2 3例检出端粒酶阳性 ,阳性率 85.2 % ,2 7例相应癌旁组织有 7例检出端粒酶阳性 ,阳性率 2 5.9% ,7例喉乳头状瘤患者中有 3例检出 ,阳性率4 2 .9%。结论 :端粒酶活化并非只发生在喉癌进展的晚期阶段 ,在肿瘤形成的早期也有一定程度的端粒酶激活。端粒酶活性可能与喉癌的恶性程度有关     

头颈部鳞癌端粒酶活性的定量检测

目的：了解头颈部鳞癌及其颈淋巴结转移癌端粒酶的表达情况,探讨粒酶活性定量分析在头颈鳞癌诊断中的价值。方法：采用端粒重复序列液体闪烁计数法检测端粒酶活性。共检测取自２５例头颈部鳞癌患者的组织样本５５份,其中７例患者同时取有原发癌及其颈淋巴结转移癌两份样本,以２３份正常组织为对照。结果：①３２份原发鳞癌组织中端粒酶活性（ｃｐｍ值）在１０００以上的２８份,除２份外,均明显高于正常组织;２３份正常组织的端     

Quantitative assay of telomerase activity in head and neck squamous cell carcinoma and other tissues

OBJECTIVES: To confirm the applicability and use of a new technique to detect and quantify telomerase activity of specimens from head and neck malignant neoplasms and to explore whether the levels of telomerase activity can be a useful marker for cancer risk assessment in head and neck malignant neoplasms. DESIGN: Ninety-six specimens from 39 patients with head and neck malignant neoplasms were obtained. The specimens included 39 from patients with primary tumors (25 with head and neck squamous cell carcinoma and 14 with others), 10 from patients with neck metastases, 10 from patients with dysplasias, and 37 from patients with normal tissue. HeLa cell lines were used as positive control samples. MAIN OUTCOME MEASURE: The levels of telomerase activity were determined using a liquid scintillation counter. RESULTS: The new method has a high rate of outcome reproducibility. The intrabatch and extrabatch variations were 15.6% and 16.4%, respectively. The linear relationship was good between the telomerase activity and the value within 700 radioactive cpm (rcpm) to approximately 7000 rcpm. The levels of telomerase activity determined by radioactive count were more than 1000 rcpm in 42 of the 49 malignant specimens and much more than that in the normal tissues, with the exception of 3 specimens. The levels of telomerase activity in normal tissues were less than 1000 rcpm in every sample and less than that in the malignant neoplasm samples, with the exception of 1 specimen (P < .000). Higher levels of telomerase activity in 2 of 10 tissues from patients who had dysplasias were detected (2 specimens from patients who had severe dysplasia). The differences in the levels of telomerase activity between the head and neck squamous cell carcinomas and the other tumors were not statistically significant (P > .05). CONCLUSIONS: Detection of telomerase activity in head and neck malignant neoplasms can be a useful marker for the assessment of cancer. Telomerase reactivation may play an important role in tumorigenesis in head and neck squamous cell carcinoma. The quantification of telomerase activity may have clinical diagnostic value for head and neck malignant neoplasms.     

Expression of the extra domain B of fibronectin,a marker of angiogenesis,in head and neck tumors

OBJECTIVES/HYPOTHESIS: The extra domain B (ED-B) of fibronectin, a naturally occurring marker of tissue remodeling and angiogenesis, is expressed in the majority of aggressive solid human tumors, whereas it is not detectable in normal vessels and tissues. STUDY DESIGN: In view of the diagnostic and therapeutic clinical applications of the L19 antibody, which is specific for the ED-B domain of fibronectin, a prospective immunohistochemical analysis of different head and neck tumors was performed. METHODS: In all, 82 head and neck tissue biopsy specimens were immunohistochemically analyzed using the L19 antibody. They consisted of 53 different malignant tumors, 8 benign tumors, 10 nontumoral lesions, and 11 normal control tissues. RESULTS: A strong positive staining with the L19 antibody could be observed in 87% of the investigated malignant tumors, in only 38% of the benign tumors, and in 20% of the nontumoral lesions (P <.0001). The extra domain B was completely absent in the normal control tissue samples. CONCLUSIONS: The results show that ED-B is abundantly expressed around the neovasculature and in the stroma of the majority of malignant tumors of the head and neck but is undetectable in normal tissues. The ED-B domain of fibronectin is a good-quality tumor-stroma-associated antigen that warrants clinical trials with antibody-based pharmaceuticals, including immunoscintigraphic investigations and radioimmunoguided surgery with the radiolabeled L19 antibody.     

Reactivation of telomerase in squamous epithelial carcinomas in the area of the head and neck

BACKGROUND: Head and neck cancer development involves the accumulation of multiple cellular alterations over a long period of time. Selection and expansion of altered cell clones can lead to the evolution of a malignant phenotype. The theory of carcinogenesis suggests that unlimited cell proliferation is required for development of malignant disease and cancer must attain immortality for progression to malignant states. One step in the immortalization process may be the reactivation of telomerase. This enzyme complex can prevent the continuous shortening of telomeres which is observed at each cell cycle. RESULTS: Telomerase activity was detected in 68% of squamous cell carcinomas of pharynx and larynx and 58% of histologically tumor-free resection margins. Recurrences occurred with a higher rate in cases with telomerase positive primary tumor. The importance of telomerase activity in histologically negative resection margins needs further investigations. Telomerase activity was found in 90% of corresponding lymph nodes without any correlation to metastasis in the lymph node. CONCLUSIONS: The reactivation of telomerase seems to be an important step in carcinogenesis of head and neck cancers. Further studies are necessary in order to understand the role of the enzyme as a possible marker for tumor progression and clinical outcome.     

原发于头颈以外恶性肿瘤的颈淋巴转移临床分析

目的探讨原发于头颈以外的恶性肿瘤的颈淋巴转移规律，以期对此类疾病进一步认识，为诊断提供依据。方法回顾性分析自1989年1月至2004年6月在北京协和医院住院治疗的466例发生颈淋巴转移的恶性肿瘤患者之中的77例原发灶位于头颈以外的病例，均经病理证实为恶性肿瘤颈淋巴转移。分析其发病特点，并按照颈淋巴结LEVEL分区探讨颈淋巴转移区域的特点。结果77例原发于头颈以外的恶性肿瘤病例，原发部位包括肺、胃、食管、乳腺、结肠、纵隔、卵巢、子宫、胰腺、肝脏、肠系膜、肾上腺、直肠。81．8％（63／77）的患者发生LEVELⅤ区颈淋巴转移，其中50例为左侧LEVELⅤ区转移；11．7％（9／77）发生LEVELⅣ区转移；5．2％（4／77）发生LEVELⅢ区转移；1．3％（1／77）发生LEVELⅠ区转移。原发灶位于头颈部以外的病例占各区域全部病例的比例分别为LEVELⅠ区2．1％，LEVELⅢ区3．7％，LEVELⅣ区14．3％，LEVELⅤ区70．8％。发生颈淋巴转移的头颈外恶性肿瘤中，低分化腺癌占51．9％，中分化腺癌占15．6％，低分化鳞癌占11．7％，中分化鳞癌占10．4％，其他组织学类型占10．4％。结论头颈部以外的多个器官的恶性肿瘤均可见颈淋巴转移，其中以肺癌最为常见，胃、食管、乳腺也是常见的原发灶。头颈部以外的恶性肿瘤发生颈淋巴转移的区域集中在LEVELⅤ区，尤其是左侧LEVELⅤ区。且发生于LEVELⅤ区的肿瘤转移病例，原发肿瘤位于头颈部以外的情况多于头颈部肿瘤。发生颈淋巴转移的头颈外恶性肿瘤，分化程度以中．低分化为主。     

Malignant fibrous histiocytoma of the head and neck. A report of 12 cases

The clinical and pathologic features of 12 cases of malignant fibrous histiocytoma of the head and neck were studied. These tumors occurred in seven men and five women ranging in age from 21 to 75 years (average, 55 years). The sinonasal tract was the most common site (four cases), followed by the parotid area (two cases), oral cavity (two cases), soft tissues of the neck (two cases), mandible (one case), and larynx (one case). Pathologically, 11 of the tumors were subclassified as storiform-pleomorphic and one as inflammatory. All were treated initially with surgery with or without postoperative irradiation. Five (42%) of the patients experienced local recurrences, three (25%) developed distant metastases (especially to the lungs), and five (42%) died of their disease, all of the latter occurring within two years of diagnosis. No patient developed bona fide cervical lymph node metastasis, although one did have a positive paraparotid node as a result of direct extension from an adjacent tumor.     

乙酰肝素酶在头颈部鳞状细胞癌的表达及其临床意义

目的探讨乙酰肝素酶（heparanase，HPSE）在头颈部鳞癌的表达与临床病理特征及预后的关系。方法对62例头颈肿瘤手术切除标本进行检测，采用免疫组化技术检测HPSE在原发肿瘤组织及其淋巴转移灶中的表达，分析HPSE的表达同患者的年龄、临床分期、病理分级、有无淋巴转移及与预后的关系。结果HPSE在癌旁黏膜组织中不表达或少表达，在大多数头颈肿瘤组织中呈阳性表达，阳性表达率为69．3％（43／62），主要为胞质表达。HPSE的表达在患者的年龄、肿瘤的病理分级方面比较，差异无统计学意义（Х^2=0．05，Х^2=3．84，P值均〉0．05）；而在有无淋巴转移以及肿瘤的临床分期方面差异有统计学意义（Х^2=3．98，Х^2=8．06，P值均〈0．05）；HPSE在原发灶及其淋巴转移灶中的表达之间呈明显正相关（r=0．9162，P=0．001）；Kaplan—Meier法计算，HPSE阳性组的3年累积生存率为25．9％，HPSE阴性组的3年累积生存率为72．7％，二者差异有统计学意义（Х^2=11．607，P=0．001）。HPSE的表达和肿瘤的TNM临床分期分别为影响预后的独立因素，二者分别与患者的预后显著相关（Х^2值分别为16．86和19．73，P值均〈0．05）。结论HPSE在头颈鳞癌中表达显著增高。HPSE的表达与有无淋巴转移、肿瘤的临床分期密切相关。HPSE的表达、肿瘤的临床分期是影响患者预后的独立因素。     

Solitary fibrous tumors of the head and neck: a clinicopathologic and radiologic review

OBJECTIVE: To describe the clinicopathologic and radiologic features of solitary fibrous tumors of the head and neck. DESIGN: Retrospective analysis. SETTING: Tertiary referral center that performs head and neck surgical oncology. PATIENTS: Twelve patients with solitary fibrous tumors of the head and neck identified from the pathology and soft tissue tumor databases at Memorial Sloan-Kettering Cancer Center, New York, NY, from 1990 to 2004. All cases were reviewed by 3 experienced pathologists, 1 of whom is an experienced soft tissue tumor pathologist. The diagnosis was confirmed by microscopic features on hematoxylin-eosin staining and by positive staining for CD34 and Bcl2 on immunohistochemical analysis. Tumors were scored for mitotic activity, cellularity, nuclear pleomorphism, necrosis, and the presence of a malignant component. Details on patient characteristics, tumor characteristics, previous treatment and surgery, adjuvant treatment, and outcome were recorded from clinical records. RESULTS: Solitary fibrous tumors occurred in patients over a wide age range (27-78 years; median age, 52 years). Seven patients (58%) were women, and 5 (42%) were men. Most tumors presented as a slow-growing painless mass with a duration ranging from 2 months to 5 years. The tumors ranged from 1 x 1 cm to 6 x 5 cm. Patients presented with a subcutaneous mass of the scalp or face in 4 cases, intraoral mass in 4, sinonasal mass in 3, and paraspinal mass in 1. Computed tomographic and/or magnetic resonance imaging scans of 7 of the 12 patients showed well-circumscribed tumors that enhanced strongly with contrast. Treatment for all of the patients was surgical resection. Pathologic findings showed that 9 tumors were benign and 3 were malignant. Three patients had a positive surgical resection margin. All patients were alive at a median follow-up of 8 months (range, 1-76 months). Local recurrence occurred in 1 patient who had positive surgical margins 3 years after the initial surgery. CONCLUSIONS: Solitary fibrous tumors of the head and neck region are rare and most commonly benign. The diagnosis depends on microscopic and immunohistochemical features, although imaging may help. Patients with these tumors can be safely treated with local excision, but tumors with positive margins require close follow-up over several years owing to the potential for late local recurrence.