C-erbB-2、p53、ER和PR受体在乳腺癌组织中的表达及意义

目的分析研究C—erbB-2、p53、ER、PR在乳腺癌中的表达与分期、转移关系及临床意义。方法用免疫组化法测定83例原发性乳腺癌C—erbB．2、p53、ER、PR的表达情况,进行对照比较。结果C—erbB-2、p53、ER、PR阳性表达者分别为30例（36．1％）、31例（37．3％）、45例（54．2％）、53例（63．9％）。C—erbB-2的表达与p53呈正相关（P〈0．05）,与ER、PR呈负相关（P〈0．05）。C—erbB-2和p53的表达率随着临床分期增加和淋巴结转移而增加,差异有显著性（P〈0．05）。ER、PR阳性表达率随着临床分期的递增和淋巴结转移的减少而降低,差异无显著性（P〉0．05）。ER、PR阳性表达率与C．erbB-2、p53表达呈负相关,差异无显著性（P〉0．05）。结论C—erbB-2、p53是判断乳腺癌预后的有效指标,ER、PR与临床分期及腋窝淋巴结转移有一定关系,联合检测C-erbB-2、p53、ER、PR可指导临床综合治疗。     

C—erbB2、PCNA、ER、PR在126例乳腺癌中的表达及临床意义

目的：研究C—erbB2、PCNA、ER、PR在乳腺癌中的表达及其与乳腺癌临床、病理因素之间的关系。方法：采用免疫组化SP法检测126例乳腺癌组织CerbB2、PCNA、ER、PR蛋白的表达。结果：C—erbB2、pCNA、ER、PR在乳腺癌阳性表达率分别为：36．5％,95．2％,65．1％,54％。C—erbB2、pCNA、ER、PR蛋白阳性表达率和表达强度与乳腺癌患者的年龄、淋巴结转移、肿瘤大小、pTNM分期差异性无统计学意义（P〉0．05）。C—erbB2、PCNA与组织学分级差异具有统计学意义（P〈0．05）。C—erbB2与ER、PR均呈负相关（r=-0．344,P=0．000;r=-0．226,P=0．011）。结论：C—erbB2,PCNA过表达者预后差,可以作为判断乳腺癌患者预后的有效指标。     

ER、PR及C-erbB-2表达与乳腺癌临床病理特征及其预后的关系

目的探讨ER、PR、C—erbB-2表达与乳腺癌临床病理特征及其预后的关系。方法采用免疫组化方法,对1568例乳腺癌患者进行ER、PR、C—erbB-2检测,并分析其与患者年龄、家族史、肿瘤体积、淋巴结转移数目、病理类型、组织学分级及预后患者的关系。结果C—erbB-2表达阳性组患者具有年龄较小（P=0．001）、肿瘤体积较大（P=0．001）、组织学分级较差（P=0．002）、淋巴结转移数目较多（P：0．001）、预后较差（P：0．001）等特点;ER,PR,C—erbB-2表达均阴性的患者预后也较差。结论激素受体及C—erbB-2表达水平可作为制定乳腺癌治疗方案的重要参考指标。     

乳腺癌雌、孕激素受体与cerbB—2基因表达及相关分析

目的：观察乳腺癌组织中雌、孕激素受体（ER、PR）与cerbB-2基因表达及相互关系，乳腺癌淋巴结转移，病理组织分型，临床分期与癌基因表达的关系。方法：应用免疫组织化学法对210例原发性乳腺癌进行了ER、PR与cerbB-2检测。结果：ER的阳性表达率59．05％，PR的阳性表达率47．62％，cerbB-2的阳性表达率33．81％，cerbB-2的阳性表达与ER、PR的阳性表达，与临床分期、病理组织分型有显相关性（P＜0．01），与腋淋巴结转移无相关性（P＞0．05）。结论：ER、PR与cerbB-2在乳腺癌组织中有一定的内在联系，其检测结果对于临床治疗，辅助判断患的预后有重要意义。     

乳腺癌组织中ER、PR、cerbB-2、Ki-67表达及其意义

目的探讨乳腺癌组织中雌激素受体（ER）、孕激素受体（PR）、cerbB-2和Ki-67基因的表达及其临床意义。方法采用S-P免疫组化方法,检测107例乳腺癌组织中ER、PR、cerbB-2、Ki-67的表达水平,并结合其患者的相关临床资料进行分析。结果乳腺癌组织中ER、PR、cerbB-2、Ki-67阳性表达率分别为56.1%、82.2%、71.0%、67.3%。ER、PR、cerbB-2、Ki-67阳性表达与乳腺癌腋窝淋巴结转移和临床分期显著相关（P〈0.05）。而与患者年龄、肿瘤大小无相关性（P〉0.05）。相关分析结果显示ER与PR表达呈正相关（P=0.000）,与Ki-67表达呈负相关（P=0.000）;PR与cerbB-2、Ki-67表达呈负相关（P=0.012、0.006）。结论 ER、PR和cerbB-2、Ki-67与乳腺癌的发生、发展有关,联合检测ER、PR、cerbB-2和Ki-67,有助于客观评估乳腺癌的生物学行为,从而指导临床治疗和预后判断。     

定量分析乳腺癌术后化疗前外周血多药耐药基因及其临床意义的研究

目的探讨乳腺癌肿瘤组织多药耐药基因产物P170与外周血多药耐药基因MDR1mRNA的表达及乳腺癌组织ER、PR、癌基因、Her-2之间的相关性及其临床意义。方法应用荧光定量RT-PCR及免疫组化法对32例乳腺癌组织标本P170蛋白表达阳性的病人（试验组）和11例乳腺癌组织标本P170蛋白表达阴性的病人（对照组）进行化疗前的外周血液MDR1mRNA及ER、PR、Her-2检测。结果乳腺癌组织中多药耐药基因产物P170表达阳性的病人中，外周血MDR1mRNA表达阳性者14例（43．75％），阴性18例（56．25％）；乳腺癌组织中多药耐药基因产物P170表达阴性的11例病人中，外周血MDR1mRNA表达阳性者6例（54．55％），阴性5例（45．45％）；P170阳性组外周血MDR1mRNA阳性表达率43．75％与P170阴性组外周血MDR1mRNA阳性表达率54．55％之间差异无相关性（Χ^2=0．383，P〉0．05）。P170阳性组Her-2阳性表达12例（37．50％），阴性20例（62．50％）；P170阴性组Her-2阳性表达2例（18．18％），阴性9例（81．82％）；P170阳性组Her-2阳性表达率37．50％与P170阴性组Her-2阳性表达率18．18％之间差异无显著性（Χ^2=1．391，P〉0．05）。P170阳性组ER表达阳性者13例（40．63％），阴性19例（59．37％）；P170阴性组ER阳性表达者7例（63．64％），阴性4例（36．36％）；P170阳性组ER阳性表达率40．63％与P170阴性组ER阳性表达率63．64％之间差异无相关性（Χ^2=1．742，P〉0．05）。P170阳性组PR阳性表达者20例（62．50％），阴性12例（37．50％）；P170阴性组PR阳性表达者4例（36．36％），阴性7例（63．64％）；P170阳性组PR阳性表达率62．50％与P170阴性组PR阳性表达36．36％之间差异无相关性（Χ^2=2．267，P〉0．05）。P170阳性组淋巴结转移者9例（28．12％），无淋巴结转移23例（71．88％）；P170阴性组淋巴结转移者5例（45．45％），无淋巴结转移6?     

肿瘤转移抑制基因KAI1/ CD82 和雌孕激素受体在子宫内膜癌组织中的表达及其临床意义

 目的 探讨转移抑制基因KAI1／CD82和雌孕激素受体（ER、PR）在子宫内膜癌组织中的表达及与淋巴结转移的关系，并分析其临床意义。方法 应用SP法对76例子宫内膜癌组织中KAI1、PR、ER的蛋白表达情况进行观察。结果 子宫内膜癌组织中KAI1和PR的阳性表达与手术病理分期、组织学分级、肌层浸润深度呈负相关（ P _{KA H}=0．0089、0．0103、0．0356，P_PR=0．0026、0．000、0．0053）；伴有盆腔淋巴结转移、宫旁或附件受累及的组织KAI1、PR、ER的阳性表达均明显低于无转移的组织（PKAII=0．0091、0．0073，PR=0．0006、0．0074，P _ER=0．0129、0．0073）；ER的阳性表达与FIGO分期呈负相关（P=0．0226）；不同的病理类型中，只有PR表达差异有统计学意义（P=0．0446）；而三者的表达与患者年龄及宫颈是否受累均无关。KAI1、PR、ER表达阴性和阳性的生存率差异均有统计学意义（ P _{KA H}=0．0043，P_PR=0．0010，P _ER=0．0124）。Logistic回归模型分析结果提示：KAI1、PR、ER三个变量中只有KAI1与淋巴结转移有关（P=0．0400，OR=0．245）。COX比例风险回归模型分析结果显示：KAI1、PR、ER表达均不是子宫内膜癌的独立预后因素。结论 KAI1表达与子宫内膜癌的淋巴结转移具有相关性，其可作为临床预测子宫内膜癌患者发生淋巴结转移和评估预后的综合指标之一。KAI1在子宫内膜癌发展中所起的作用可能与PR有关，KAI1、PR、ER的缺失表达与子宫内膜癌的发展、治疗及预后密切相关。     

MDR、C-erbB-2和ER、PR在乳腺癌中的表达

目的 探讨乳腺癌中多药耐药基因产物P170糖蛋白、癌基因c-erbB-2和雌激素受体(ER)、孕激素受体(PR)的表达情况及临床意义。方法采用S-P免疫组化方法对40例乳腺癌组织进行P170、C-erbB-2和ER、．PR表达的联合检测。结果乳腺癌组织中P170、c-erbB一2和ER、PR阳性表达率分别为32．5％、35%、62．5％、30％。P170的表达与术前化疗史及腋窝淋巴结转移呈正相关，与ER、PR的表达无显著相关性。C-erbB-2表达与与腋窝淋巴结转移呈正相关，与ER、PR的表达呈负相关。ER的表达与组织学分级和腋窝淋巴结转移呈负相关，随着年龄增大表达率有升高趋势。结论P170、C-erbB-2和ER、PR与乳腺癌的发生发展有关。耐药基因P170的检测有利于指导乳腺癌的化疗和判断预后。C-erbB-2可作为判断乳腺癌预后的重要指标。ER、PR测定可判断预后，有利于选择乳腺癌内分泌治疗。     

乳腺癌组织HR与HER-2和SATB1表达相关性研究

目的：检测乳腺癌组织中激素受体（hormonereceptor,HR）、人表皮生长因子受体2（humanepidermalgrowthfactOrreceptor2,HER-2）和特异性核基质结合蛋白（specialATrichsequencebindingprotein1,SATB1）的表达,探讨HR与HER-2、SATB1及临床病理参数的关系。方法：应用免疫组织化学方法检测乳腺癌患者雌激素受体（estrogenre-ceptor,ER）、孕激素受体（progesteronereceptor,PR）、HER-2及SATB1蛋白的表达,荧光原位杂交方法检测HER-2基因扩增状态,统计学方法分析HR（包括ER及PR）的表达与HER-2、SATB1及临床病理参数之间的相关性。结果：乳腺癌组织ER及PR的表达均与患者年龄正相关（r=0．286,P=0．010;r=0．249,P=0．026）,ER的表达与肿瘤分级负相关（r=-0．306,P=0．006）;ER及PR的表达与肿瘤大小、组织学类型、淋巴转移情况及TNM分期均无明显相关性,P值均〉0．05。HR的表达与SATB1、HER-2及SATB1／HER2双阳性表达均呈负相关关系（r=-0．248,P=0．027;r=-0．392,P〈0．001;r=-0．150,P〈0．001）。结论：HR阳性患者治疗及预后相对较好;乳腺癌组织HR的表达与HER-2和SATB1呈负相关关系,三者之间可能存在相互联系的信号通路。     

乳腺浸润性导管癌组织激素受体和Cyclin D1及Bcl-2表达的研究

目的：研究生物标志ER、PR、Cyclin D1、Bcb2和Bax在乳腺浸润性导管癌组织中的表达及其与乳腺癌患者无瘤生存时间和总体生存时间的关系,探寻这些生物标志对化疗患者预后的提示作用。方法：用HE及SP免疫组化染色法对100例乳腺浸润性导管癌作回顾性分析。结果：各生物标志的阳性率分别为ER60％,PR58％,Cyclin D1 55％,Bcl-2 50％,Bax 34％。其中ER的阳性率与患者的绝经与否有关,ER、PR和Bcb2的表达均与组织学分级负相关。Cyclin D1阴性的患者总体生存时间要短于Cyclin D1阳性的患者,X^2=7.77,P=0.0053。ER、PR阳性者与阴性者无瘤生存时间差异有统计学意义（X^2=4．59,PER=0.0322;X^2=6.19,PPR=0.0129）,ER、PR阳性者无瘤生存时间更长。Bcl-2阳性者平均无瘤生存时和平均总体生存时间均长于Bcl-2阴性者。ER为阳性表达者,化疗后平均无瘤生存时间（55.4个月）长于ER阴性者（35.8个月）,X^2=6.10,P=0.0135;Bcl-2为阳性表达者,化疗后平均无瘤生存时问（54．8个月）长于Bcl-2阴性者（41、6个月）,X^2=10．11,P=0．0015。结论：ER、PR和Bcl-2的表达与患者的无瘤生存时间相关,Bcl-2和Cyclin D1的表达和患者的总体生存时间相关。ER和Bcl-2阳性表达患者化疗后无瘤生存时间较长。     

Excretion of nitrates with saliva and urine and nitrite excretion with saliva in patients with chronic gastritis and duodenal ulcer

The study assessed excretion of nitrates in urine and saliva and that of nitrites with saliva of patients suffering gastric and duodenal ulcer. In both study groups, a positive correlation was established between nitrate concentration in saliva, on the one hand, and that in urine, and nitrite level in urine, on the other. The groups failed to show a difference in nitrate concentrations in either urine or saliva. Since retention of nitrates in the body of chronic gastritis patients held as precancer of the stomach proved no higher than that in patients with duodenal ulcer, the authors cast doubt on endogenous nitroso compounds as a cause of gastric cancer in cases of chronic gastritis.     

Pathologic states associated with activation of eosinophils and with eosinophilia

Eosinophils are involved in cytotoxicity against helminths and tumor cells and effect both tissue damage and tissue protection in hypersensitivity reactions. Their migratory patterns and oxidative mechanisms are most similar to those of neutrophils, but their tissue longevity and functional variation are more similar to those of monocytes and macrophages. Their enzyme components and behaviors are only now beginning to be defined, and their biologic functions in pathologic states remain a topic of considerable discussion.     

Characteristics and survival of patients with non-Hodgkin's lymphoma with and without acquired immunodeficiency syndrome

Our objective was to determine the characteristics and survival of patients with non-Hodgkin's lymphoma (NHL) with and without acquired immunodeficiency syndrome (AIDS). A cancer registry and AIDS registry linkage for San Diego County was performed in October 1998 as part of a national multicentre study. We performed Kaplan-Meier analysis to compare survival in NHL patients with and without AIDS, after matching for age, sex, and race/ethnicity. We performed logistic regression to determine which patient and tumour characteristics were significantly associated with 1-year survival. Of the 4361 cases of NHL, 324 (7%) had AIDS and 4037 (93%) were not known to have AIDS. Patients with AIDS were more likely to have extranodal, high-grade, and disseminated NHL diagnosed by non-histologic means and were less likely to have received chemotherapy. Patients with AIDS and NHL who survived at least 1 year had less advanced disease stage and received chemotherapy. The median survival in patients with AIDS was 4 months (95% confidence interval (CI): 4-5) and 95 months (95% CI: 58-157) in patients without AIDS (P<0.001). Although these patients with AIDS-related NHL were unlikely to survive, the highly active antiretroviral agents currently used may improve outcomes in future patients.     

Outcomes of patients with stage III nonsmall cell lung cancer treated with chemotherapy and radiation with and without surgery

BACKGROUND:

The objective of this study was to identify the factors associated with improved outcome after treatment for stage III nonsmall cell lung cancer (NSCLC).

METHODS:

A retrospective review of stage III NSCLC patients treated at who were treated at the Dana‐Farber Cancer Institute/Brigham and Women's Cancer Center was done with institutional review board approval. Patients were followed for toxicity, local and distant failure, and overall survival. Multivariate Cox logistic regression analysis was used to determine the factors associated with treatment outcome.

RESULTS:

Between August 2000 and November 2006, 144 patients received concurrent chemoradiation (CRT) for stage III NSCLC. Eighty of 144 patients were men (56%), and the median age was 61 years (range, 33‐81 years). Sixty‐two patients (43%) had stage IIIA NSCLC, and 82 patients (57%) had stage IIIB NSCLC. Radiotherapy (RT) was given concurrently with chemotherapy to all patients; 100 patients (69%) received CRT without surgery, and 44 patients (31%) received with neoadjuvant CRT followed by surgical resection. The median RT dose was 60 grays (Gy) (range, 46‐70 Gy). The median follow‐up was 15 months (range, 3‐64 months), the median potential follow‐up was 37 months (range, 12‐84 months), and the median overall survival was 22 months (95% confidence interval, 15‐28 months). The 1‐year and 2‐year survival rates were 68% and 47%, respectively. Among the 44 patients who underwent resection, the median survival was 61 months, and the 2‐year survival rate was 73%. On multivariate analysis, stage at the time of treatment (stage IIIA vs stage IIIB) and use of surgery were the only factors associated with improved outcome (P = .01 and P = .001, respectively).

CONCLUSIONS:

In this retrospective series, those patients who were able to undergo resection appeared to have improved outcome after induction CRT. Cancer 2009. © 2009 American Cancer Society.     

VEGF and EMMPRIN expression correlates with survival of patients with osteosarcoma

Aim

To investigate the clinicopathologic characteristics of Vascular Endothelial Growth Factor (VEGF) and Extracellular Matrix Metalloproteinase Inducer (EMMPRIN) expression in osteosarcoma, and to evaluate the clinical significance of these two markers in the survival of osteosarcoma.

Methods

VEGF and EMMPRIN expression in paraffin-embedded specimens gathered from 65 patients with primary osteosarcoma were detected by the method of immunohistochemistry using antibodies against VEGF and EMMPRIN. The correlation of VEGF and EMMPRIN expression with the clinicopathologic features and with the survival of osteosarcoma was subsequently assessed.

Results

The expression of VEGF and EMMPRIN was detected in 47/65 (72.31%) and 45/65 (69.23%) of patients with osteosarcoma, respectively. Positive expression of VEGF and EMMPRIN was significantly correlated with surgical stage and percentage of dead cells of osteosarcoma. A significant correlation was found between the expression of VEGF and EMMPRIN in osteosarcoma (r = 0.89, p = 0.01). Additionally, surgical stage, percentage of dead cells, VEGF and EMMPRIN expression showed significant influence on overall survival (OS) and disease-free survival (DFS) in univariate analysis. In multivariate analysis, surgical stage (IIA versus IIB/III) and percentage of dead cells (≤90% versus >90%) were significant for DFS and OS. Those patients with VEGF+/EMMPRIN+ co-expression showed significantly shorter OS and DFS compared with VEGF−/EMMPRIN− expression.

Conclusion

According to our study, the overexpression of VEGF or EMMPRIN may be an important feature of osteosarcoma. A combined detection of VEGF/EMMPRIN co-expression may benefit us in prediction of a poor survival of osteosarcoma.     

免疫细胞及肿瘤标志物与高危型HPV感染宫颈癌患者HPV水平的相关性及与预后的关系

目的探讨免疫细胞及肿瘤标志物与有高危型人乳头瘤病毒(HPV)感染的宫颈癌患者HPV水平的相关性及与预后的关系。方法选取有HPV感染的72例宫颈癌患者(宫颈癌组)、83例宫颈上皮内瘤变(CIN)患者(CIN组)和50例慢性宫颈炎患者(慢性宫颈炎组)。比较不同宫颈疾病患者外周血免疫细胞(CD4^+、CD8^+、CD4^+/CD8^+、CD56^+、Treg)水平和肿瘤标志物(K-ras、Ki-67)的阳性表达情况,高危型HPV宫颈癌患者HPV水平与免疫细胞及肿瘤标志物的相关性,以及有无淋巴结转移的高危型HPV感染宫颈癌患者的免疫细胞水平及肿瘤标志物阳性表达情况,宫颈癌死亡患者与生存患者的免疫细胞水平及肿瘤标志物阳性表达情况。结果宫颈癌组患者的CD4^+、CD56^+、CD4^+/CD8^+水平均低于CIN组患者和慢性宫颈炎组患者(P﹤0.05),CD8^+、Treg的水平均高于CIN组患者和慢性宫颈炎组患者(P﹤0.05);3组患者的K-ras、Ki-67的阳性表达率比较,差异均有统计学意义(P﹤0.05);宫颈癌组患者的CD8^+、Treg水平及K-ras、Ki-67阳性表达情况与HPV-DNA水平呈正相关(r=0.546、0.402、0.645、0.713,P﹤0.05),而CD4^+、CD56^+水平与HPV-DNA水平呈负相关(r=-0.478、-0.463,P﹤0.05);宫颈癌组有淋巴结转移的患者CD4^+、CD56^+、CD4^+/CD8^+水平均明显低于无淋巴结转移的患者(P﹤0.01),而CD8^+、Treg的水平及K-ras(+++)、Ki-67(+++)的比例均高于无淋巴结转移的患者(P﹤0.05);宫颈癌组死亡患者的CD4^+、CD4^+/CD8^+、CD56^+水平均明显低于生存患者(P﹤0.01),而CD8^+、Treg的水平及K-ras(+++)、Ki-67(+++)的比例均明显高于生存患者(P﹤0.01)。结论与有高危型HPV感染的CIN患者和慢性宫颈炎患者比较,有高危型HPV感染的宫颈癌患者的免疫功能降低,而其肿瘤标志物K-ras、Ki-67表达升高,免疫细胞和肿瘤标志物的检测有助于高危型HPV感染宫颈癌患者的早期预防、诊断及预后评估。     

Assessment of guilt and shame in patients with non-small-cell lung cancer compared with patients with breast and prostate cancer

PURPOSE: Patients with lung cancer might feel more guilt and shame resulting from previous smoking. This study was designed to determine the levels of guilt and shame among patients with non-small-cell lung cancer (NSCLC) compared with breast and prostate cancer. PATIENTS AND METHODS: Surveys were sent to participants 3 times (at enrollment, 2 months, and 6 months). Patients were eligible if they had stage IV NSCLC, breast cancer, or prostate cancer. The survey included tests of generalized guilt, shame, depression, and anxiety as well as guilt, shame, and embarrassment related to one's cancer. RESULTS: One hundred seventy-two participants completed >or= 1 questionnaire: 96 patients with NSCLC, 30 patients with breast cancer, and 46 patients with prostate cancer. Of the patients with NSCLC, 91.7% were current or former smokers versus 67.1% of the comparison patients. A composite score of embarrassment related to one's cancer (perceived cancer-related stigma; PCRS) was higher in patients with NSCLC (P < .01). Mean baseline generalized guilt and shame scores were not different among groups and did not change over time. A history of smoking correlated with increased levels of guilt and shame, regardless of tumor type. A personal identification of past behaviors as contributing to cancer correlated with higher levels of guilt, shame, anxiety, and depression. Of the patients with NSCLC, 29.5% felt that their behaviors contributed to their cancer compared with 10.5% of the comparison patients. CONCLUSION: Patients with NSCLC had higher levels of PCRS than patients with prostate cancer or breast cancer but not higher baseline levels of shame and guilt. Smoking is correlated with higher levels of guilt and shame. A belief that one caused one's own cancer is correlated with higher levels of guilt, shame, anxiety, and depression. These findings could be translated into an increased need for open communication among patients and their providers surrounding issues of cancer causation, guilt, shame, depression, and anxiety.