大肠癌免疫组化表达与临床病理的关系

目的:探讨大肠癌CEA、P53、nm23、Ki-67、MRP免疫组化表达特点和相互关系,及其与临床病理的关系．方法:回顾性分析2003-01／2006-07我院收治的73例大肠癌患者的临床病理及随访资料,并对其石蜡标本采用免疫组化SP染色法检测CEA、P53、nm23、Ki-67、MRP,分析其免疫组化特点及其与临床病理之间的关系．结果:CEA、P53、nm23、Ki-67、MRP在大肠癌中的阳性表达率依次为82．2％、68．5％、75.3％、84．9％和64．4％．CEA、MRP与大肠癌患者的各因素无统计学差异．P53、Ki-67和nm23与肿瘤的Dukes分期和淋巴结转移有关, P53、Ki-67在Dukes C、D期的阳性表达率(依次为82．8％和100％1明显高于Dukes A、B期者(59．1％和75．0％)(P<0．05),而nm23在Dukes C、D期的阳性表达率(58．6％)明显低于Dukes A、B期者(86．4％)(P<0．05)．CEA与nm23的表达呈明显的负相关(r=-0．296,P=0．011),而P53和Ki-67表达之间呈现明显的正相关(r= 0．308,P=0．008),其他各指标间的表达无相关性．nm23、P53和Ki-67与预后因素关系明显,nm23在生存期≥3 a患者的阳性表达率(92．9%)高于生存期<3 a者(71．2％)(P<0．05),而P53和Ki-67在生存期≥3 a患者的阳性表达率(依次为42．9％和64.3％)明显低于生存期<3 a者(74．6％和89．8％)(P<0．05)．结论:P53、Ki-67和nm23的表达与大肠癌的侵袭转移和预后密切相关．CEA可能是大肠癌的侵袭转移的促进因素．MRP所引起的耐药机制是一个相对独立的机制．CEA、P53、nm23、Ki-67可作为判断大肠癌恶性程度、侵袭转移以及预后的指标．     

胆囊癌组织中Ki-67、p53的表达及意义

目的检测胆囊癌组织中Ki-67、p53蛋白的表达,并探讨其临床意义。方法采用免疫组化SP法检测42例胆囊癌组织中的Ki-67、p53。结果42例胆囊癌中Ki-67、p53的总阳性表达率分别为59．5％、38．1％。二者表达与胆囊癌的临床分期、淋巴结转移密切相关（P均〈0．05）。结论Ki-67、p53蛋白的表达与胆囊癌临床分期和淋巴结转移情况有相关性,可作为判定胆囊癌预后的独立指标。     

p53、Ki-67、Pgp在胃癌组织中的表达及意义

采用免疫组化SP法检测52份胃癌组织石蜡切片中p53、Ki-67和PgP的表达,并分析其与胃癌临床病理特征的关系.结果 p53、Ki-67和PgP阳性表达率分别为59.6%、舳.8%、51.9%,三者阳性表达均与淋巴结转移有关(P＜0.05),Pgp阳性表达与胃癌组织浸润深度有关(P＜0.05),Pgp与p53、Ki-67联合异常表达多见于伴有淋巴结转移的进展期胃癌.认为检测p53、Ki-67和Pgp对判断胃癌淋巴结转移和选择合理的术式具有重要临床价值.     

结直肠癌P27表达与Ki-67、P170、MLH1、MSH2、MSH6的关系及意义

目的:探讨P27表达与结直肠癌侵袭转移、多药耐药及预后的关系,并初步分析其机制.方法:随机选取北京大学肿瘤医院结直肠外科2008-03/2012-03收治的散发性结直肠癌患者263例,所有病例均经组织学证实,全部肿瘤病例术前均未行放化疗.应用免疫组织化学SP法检测大肠癌组织中P27、Ki-67、P170、MLH1、MSH2和MSH6的表达;并结合其临床病理特征进行回顾性分析.结果:P27、Ki-67、P170、MLH1、MSH2和MSH6在结直肠癌组织中的阳性表达率依次为71.1%、81.4%、82.5%、86.7%、87.8%和71.1%.P27蛋白表达与患者性别、年龄、肿瘤的大体形态无关;而其表达缺失与肿瘤的大小、部位、分化类型、侵袭深度、脉管癌栓和淋巴结转移密切相关.P27表达与Ki-67(r=-0.315,P=0.00)、P170(r=-0.163,P=0.01)呈明显的负相关.而P27与MLH1(r=0.129,P=0.03)、MSH2(r=0.136,P=0.03)、MSH6(r=0.159,P=0.01)的表达均呈明显的正相关.结论:P27蛋白与结直肠癌发生发展、侵袭转移密切相关,其状态与结直肠癌MSI状态密切相关.P27蛋白的检测可以作为一个反映结直肠癌疾病进展的重要指标,并对临床化疗用药和预防多药耐药具有一定的指导意义.     

C-erbB-2、p53、Ki-67及VEGF在乳腺癌组织中的表达及临床意义

目的进一步探讨乳腺癌的发生、发展机制。方法采用免疫组化SP法检测39份乳腺癌组织中人表皮生长因子受体2（C-erbB-2）、突变型p53蛋白（p53）、增殖细胞核抗原（Ki-67）及血管内皮生长因子（VEGF）表达情况;Spearman等级相关分析法分析四者间及与乳腺癌临床病理特征的关系。结果乳腺癌患者C-erbB-2、p53、Ki-67及VEGF的阳性表达率分别为46.15%、46.15%、71.79%5、8.97%;C-erbB-2表达与淋巴结转移、雌激素受体、孕激素受体相关,p53与淋巴结转移相关,Ki-67及VEGF与肿瘤直径、淋巴结转移相关;四指标之间均呈正相关（除p53与VEGF无相关性外）。结论 C-erbB-2、p53、Ki-67及VEGF检测对提示乳腺癌预后有重要意义。     

大肠癌组织中Cyclin E、p27kipl和Ki-67的表达及意义

目的 采用免疫组化PowerVision两步法检测137例大肠癌及其邻近正常黏膜组织中细胞周期素E(Cyclin E)、抑制因子p27kipl和核抗原-67(Ki-67).结果 :大肠癌组织中Cyclin E表达水平显著高于邻近正常黏膜组织,并与原发肿瘤浸润深度、区域淋巴结转移及TNM分期显著正相关(r分别为0.213、0.367、0.348,P均＜0.05).大肠癌组织中p27kipl表达水平显著低于邻近正常黏膜组织,并与原发肿瘤浸润深度、区域淋巴结转移及TNM分期显著负相关(r分别为-0.345、-0.269、-0.348,P均＜0.01).大肠癌组织中Ki-67表达水平显著高于邻近正常黏膜组织,并与区域淋巴结转移及TNM分期呈显著的正相关(r分别为0.218、0.172,P＜0.05).大肠癌组织中Cyclin E与p27kipl表达水平显著负相关(r=-0.235,P＜0.01);Cydin E和Ki-67表达水平显著正相关(r=0.243,P＜0.01);大肠癌组织中p27kipl与Ki-67表达水平呈显著负相关(r=-0.172,P＜0.01).认为Cyclin E和p27kipl是大肠癌发生及侵袭转移的正、负性因子,联合检测Cyclin E、p27kipl和Ki-67有助于判断大肠癌的生物学行为及预后判断.     

大肠癌组织中Cyelin E、p27kipl和Ki-67的表达及意义

目的采用免疫组化PowerVision两步法检测137例大肠癌及其邻近正常黏膜组织中细胞周期素E（Cyclin E）、抑制因子p27kipl和核抗原-67（Ki-67）。结果：大肠癌组织中Cyclin E表达水平显著高于邻近正常黏膜组织，并与原发肿瘤浸润深度、区域淋巴结转移及TNM分期显著正相关（r分别为0．213、0．367、0．348，P均〈0．05）。大肠癌组织中p27kipl表达水平显著低于邻近正常黏膜组织，并与原发肿瘤浸润深度、区域淋巴结转移及TNM分期显著负相关（r分别为-0．345、-0.269、-0.348，P均〈0.01）。大肠癌组织中Ki-67表达水平显著高于邻近正常黏膜组织，并与区域淋巴结转移及TNM分期呈显著的正相关（r分别为0．218、0．172，P〈0．05）。大肠癌组织中Cyclin E与p27kipl表达水平显著负相关（r=-0．235，P〈0．01）；CycHn E和Ki-67表达水平显著正相关（r=0．243，P〈0．01）；大肠癌组织中p27kipl与Ki-67表达水平呈显著负相关（r=-0．172，P〈0．01）。认为Cyclin E和p27kipl是大肠癌发生及侵袭转移的正、负性因子，联合检测Cyclin E、p27kipl和Ki-67有助于判断大肠癌的生物学行为及预后判断。     

p53、 c-erbB-2、nm23在胃癌组织和转移淋巴结中的表达

目的 探讨p53、c-erbB-2、nm23在胃癌组织和转移淋巴结中的表达及三者之间的协同作用.方法 应用免疫组织化学SABC法检测p53、c-erbB-2、nm23在35例非癌症胃黏膜和45例胃癌组织和转移淋巴结中的表达情况.结果 p53、c-erbB-2、nm23均在胃癌组织内表达,阳性表达积分光密度值(IOD)分别为55.32±14.47、25.74±3.75、59.37±12.48;与非癌症胃黏膜比较有显著差异(P<0.05).患者转移淋巴结中p53、c-erbB-2蛋白IOD呈高表达,与原位癌组织IOD比较有显著差异(P<0.05).转移淋巴结中nm23 IOD呈低表达,与原位癌组织nm23 IOD比较有显著差异(P<0.05).结论 p53、c-erbB-2、nm23在胃癌组织表达与淋巴结转移具有相关性,可作为胃癌的诊断和患者预后的评估指标.     

p53、bcl-2、nm23蛋白在肺癌中的表达及与预后的关系

目的探讨p53、bcl-2及nm23的表达与肺癌临床病理因素及预后的关系。方法应用免疫组织化学方法检测129例肺癌患者标本中p53、bel-2及nm23的表达,并术后随访5a以上。结果r,53、bcl-2及mn23在肺癌中的阳性表达率分别为51．9％、26．3％及55．0％。bcl-2在淋巴结癌转移阳性组中的表达率显著高于淋巴结癌转移阴性组（P〈0．05）;而p53、nm23的表达与淋巴结癌转移无明显相关性。三种蛋白均阳性表达者的预后显著差于三种全阴性表达者（P〈0．01）。结论p53、bcl-2及nm23的表达与肺癌的生物学行为密切相关,可作为评价肺癌预后的有效指标。     

胃癌组织中p57kip2和Ki-67的表达及意义

目的探讨胃癌组织中p57kip2和Ki-67的表达及二者相关性。方法采用免疫组化Envision二步法检测40例胃癌组织的p57kip2和Ki-67。结果p57kip2和Ki-67在胃癌组织中的阳性表达率分别为35%（14/40）和87.5%（35/40）,均与胃癌组织的病理组织学分级、临床分期、淋巴结转移有关（P〈0.05）,而与组织学类型无关（P〉0.05）。p57kip2和Ki-67表达强度呈负相关（r=-0.326,P〈0.01）。结论胃癌组织中p57kip2表达下调,Ki-67表达上调,在胃癌的发生发展过程中发挥着重要的作用。     

Correlations between lipid levels and age, gender, glycemia, obesity, diabetes, and smoking

A low level of high-density lipoprotein cholesterol (HDL-C) is an important cardiovascular risk factor. Dietary measures and pharmacological agents are often not sufficient to reach the HDL-C target level of 40 mg/dl in patients with low baseline HDL-C. This study assesses the association between lipid levels and age, gender, body mass index (BMI), glycemia, diabetes and smoking and focuses on the parameters influencing HDL-C. In the town of Lede (Belgium) all patients aged between 45 and 64 years were invited during 1999 for a free of charge health check-up and blood test. Blood pressure, weight, length and smoking habits were recorded. Serum levels for glycemia and lipoproteins were determined. In total, 629 subjects attended for the check-up. In a logistic regression analysis age above 50 years was correlated with low HDL-C (OR = 2.27 CI = 1.10-4.68). Male gender was correlated with low HDL-C (OR = 3.85 CI = 1.77-8.43) and with high triglycerides (TG) (OR = 1.94 CI = 1.14-3.30). From the level of 90 mg/dl glycemia was correlated with low HDL-C (OR = 2.56 CI = 1.02-6.39) and high TG (OR = 2.12 CI = 1.16-4.06). Obesity was correlated with low HDL-C (OR = 2.36 CI = 1.18-4.71) and high TG (OR = 2.17 CI = 1.88-5.23). This study provides some evidence to sharpen the target levels for glycemia and BMI among patients with low HDL-C and high TG. For these patients, the target glycemia should be around 90 mg/dl and BMI around 25 kg/m2. Physical activity and diet are also important in the achievement of these target levels.     

Lipoxins,Resolvins, Protectins,Maresins, and Nitrolipids: Connecting Lipids,Inflammation, and Cardiovascular Disease Risk

Essential fatty acids and their metabolites (γ-linolenic acid [GLA], dihomo-GLA, arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid; prostaglandin E₁; prostacyclin [PGI₂]; PGI₃; lipoxins; resolvins; protectins; maresins; and nitrolipids) prevent platelet aggregation, produce vascular relaxation, inhibit neutrophil degranulation and superoxide formation, inhibit platelet activation, possess peroxisome proliferator-activated receptor-γ ligand activity, and release nitric oxide. Thus, they lower blood pressure, are anti-arrhythmic and anti-inflammatory in nature, reduce low-density lipoprotein cholesterol, ameliorate the adverse actions of homocysteine, activate telomerase, and have cytoprotective properties—actions that prevent atherosclerosis and cardiovascular disease. Because coronary heart disease (CHD) and atherosclerosis are low-grade systemic inflammatory conditions, it is likely that reduced formation of lipoxins, resolvins, protectins, maresins, and nitrolipids plays a significant role in the pathogenesis of CHD. Hence, development of stable synthetic analogues of lipoxins, resolvins, protectins, and maresins may form a new therapeutic approach to CHD and other low-grade systemic inflammatory conditions.     

Cardiovascular,diabetes, and cancer strips: evidences,mechanisms, and classifications

Objectives

To report and name firstly that there are cardiovascular disease (CVD), diabetes mellitus (DM) and cancers (CDC) strips; and disclose their mechanisms, classifications, and clinical significances.

Study design

Narrative and systematic review study and interpretive analysis.

Methods

Data sources and study selection: to collect and present related evidences on CDC strips from evidence-based, open-access, both Chinese- and English-language literatures in recent 10 years on clinical trials from PubMed according to keywords “CVD, DM and cancers” as well as authors’ extensive clinical experience with the treatment of more than fifty thousands of patients with CVD, diabetes and cancers over the past decades, and analyze their related mechanisms and categories which based on authors’ previous works. Data extraction: data were mainly extracted from 48 articles which are listed in the reference section of this review. Qualitative, quantitative and mixed data were included, narratively and systematically reviewed.

Results

With several conceptual and technical breakthrough, authors present related evidences on CDC strips, these are, CVD and DM, DM and cancers, cancers and CVD linked, respectively; And “Bad SEED” +/– “bad soil” theory or doctrine may explain this phenomenon due to “internal environmental injure, abnormal or unbalance” in human body resulting from the role of risk factors (RFs) related multi-pathways and multi-targets, which including organ & tissue (e.g., vascular-specific), cell and gene-based mechanisms. Their classifications include main strips/type B, and Branches/type A as showed by tables and figures in this article.

Conclusions

There are CDC strips and related mechanisms and classifications. CDC strips may help us to understand, prevent, and control related common non-communicable diseases (NCDs) as well as these high risk strips.