宫颈癌和食管癌组织中人乳头状瘤病毒基因型的检测

[目的]探讨宫颈癌及食管癌组织中人乳头状瘤病毒（HPV）感染及其基因型分布的相关性。 [方法]采用基因芯片方法分别检测200例宫颈癌和140例食管癌的HPV基因型,计算HPV感染率,分析HPV基因型与癌肿类型的关系。 [结果]200例宫颈癌的HPV阳性率为94．00％（188／200）,共检测到9种HPV基因型,其中主要基因型为HPV16（74．00％）和HPV18（16．00％）,HPV双重感染的阳性率达12．00％（24／2001。169例宫颈鳞癌的HPV阳性率为95．86％,显著高于腺癌的80．00％（x2=9．73,P〈0．01）,但HPV16、18和HPV双重感染在鳞、腺癌中的阳性率无显著性差异。在140例食管癌组织中,未检测到任何基因型别的HPV。 [结论]宫颈癌组织的HPV感染型别多样,HPV16、18为最常见类型,HPV感染更常见于宫颈鳞癌。但HPV各型别的分布与癌肿类型无关．HPV似乎与食管癌的发生无关。     

358例宫颈病变患者人乳头状瘤病毒感染及基因型分析

[目的]探讨高危型人乳头瘤状病毒(human papillomavirus,HPV)与宫颈鳞癌及痛前病变的关系,了解新疆乌鲁木齐地区宫颈疾患妇女中HPV感染率及高危型HPV基因型别的主要分布.[方法]采用导流杂交技术对358例宫颈液基细胞学标本进行21种HPV基因型检测,并与病理细胞学诊断结果对比,病理细胞学诊断按TBS分为:未见癌细胞或癌前病变细胞(WNL)、非典型鳞状细胞(ASC)、低级别鳞状上皮内病变(LSIL)、高级别鳞状上皮内病变(HSIL)、鳞状细胞癌(SCC),判断不同级别病理细胞学诊断中HPV感染率及其型别分布.[结果] 358例标本中共有HPV阳性148例,总感染率为41.3%.wNL、ASC、LSIL、HSIL、SCC组中HPV感染率分别为:31.1%(82/264)、51.9%(28/54)、90.9%(20/22)、100.0%(14/14)、100.0%(4/4),差异有统计学意义(χ2=30.9,P=0.00).感染频度前6位依次为HPV16、58、52、39、18、31型;感染率分别为35.1%、13.5%、12.2%、12.2%、9.5%、6.8%.WNL组中HPV感染染维吾尔族患者为45.7%(16/35),汉族为28.8%(66/229),两者差异有统计学意义(χ2=4.04,P=0.04).[结论]高危型HPV感染与宫颈鳞癌及癌前病变密切相关,HPV型别分布具有地域差异,WNL组中HPV的感染率要高于其他地区正常人群.     

P16INK4A在宫颈上皮内瘤变中的表达及与HPV感染的关系

目的 探讨抑癌基因P16INK4A在宫颈上皮内瘤变中的表达情况及其与HPV感染的相关性.方法 采用免疫组化染色法,对59例宫颈上皮瘤变(CIN)标本、30例病理检查为正常宫颈组织的标本进行检测.结果 CIN Ⅰ级组织中ILK表达阳性率62.50％、CIN Ⅱ～Ⅲ级为65.71％,均显著高于正常宫颈组织(23.33％),且差异均具有统计学意义(x2=8.472,P=0.004＜0.05;x2=11.675,P=0.001 ＜0.05);CIN Ⅰ级组织中ILK表达阳性率与CIN Ⅱ～Ⅲ级比较差异无统计学意义(x2=0.064,P =0.800 ＞0.05).P16INK4A在HPV16、HPV18 2种高危型宫颈HPV感染中的表达显著高于其他高危型或者低危型(HPV53、HPV58、HPV6).结论 P16INK4A在宫颈上皮内瘤变(CIN)中显著高表达,同时P16INK4A高表达可能与HPV16、HPV18的阳性表达具有协同作用.     

应用核酸杂交技术检测宫颈组织中HPV16DNA序列

应用[α—~(32)P]—HPV16 DNA探针和Southern blo核酸杂交技术检测了154份宫颈活检组织标本。在低限制性条件和高限制性条件下;宫颈癌组织HPV16 DNA杂交的阳性率分别为50.86％(59/116)和37.07％(43/116),且鳞癌与腺癌之间无显著性差异(P>0.90);正常宫颈组织的阳性率则分别为5.56％(2/36)和0.00%(0/36)。宫颈癌组织HPV16 DNA杂交的阳性率均显著地高于正常宫颈组织(P<0.001)。另外,在2例宫颈间变组织中检出1例HPV16 DNA阳性杂交结果。上述给果提示:HPV16及其相关型感染与宫颈癌之间可能存在病因学联系。     

基因芯片技术在德州市女性宫颈HPV感染中的应用研究

目的：了解德州市女性人乳头瘤病毒（human papilloma virus,HPV）感染状况及HPV病毒基因型分布,为宫颈癌筛查提供科学依据。方法使用导流杂交基因芯片技术,对2008年10月至2013年7月期间送检的德州市人民医院3006例宫颈分泌物标本进行HPV基因分型,对各型检出率、年龄分布及多重感染率进行统计分析。结果 HPV总检出率为17．80％（535/3006）,高危型中以 HPV-16、HPV-52、HPV-68检出率最高,分别为3．20％、1．30％、1．26％;低危型中以HPV-6、HPV-11多见,检出率分别为1．50％、1．13％。多重感染共79例,占总感染的14．77％（79/535）,其中二重感染60例（11．21％）、三重感染14例（2．61％）、四重感染5例（0．93％）。HPV感染在16～25岁、26～35岁、36～45岁、46～55岁、56～65岁年龄组中,阳性率分别为16．20％、16．70％、18．20％、16．90％、38．40％,HPV阳性率在56～65岁组达到高峰。结论高危型HPV-16、HPV-52、HPV-68及低危型HPV-6、HPV-11是德州女性宫颈HPV感染的主要基因型别,多重感染较常见,感染人群集中于老年组。导流杂交基因芯片技术一次可检测21种HPV基因型别,特异性强,敏感性高,可应用于宫颈细胞标本HPV感染的检测。     

宫颈高级别病变与HPV感染型别分析

目的探讨HPV在宫颈高级别病变中的感染率及感染型别。方法采用导流杂交法分别检测CINII～Ⅲ30例和宫颈癌患者160例HPV基因型别,比较HPV感染与宫颈病变的关系。结果CINⅡ～III和宫颈癌患者HPV感染率均为90％,且以单型别感染为主,分别为70．37％（19／27）、81．94％（118／144）;在CIN II～Ⅲ中HPV58型、52型感染居多,宫颈癌则以HPV16型、18型感染最常见;无论宫颈鳞癌还是宫颈腺癌,以HPV16型检出率最高。结论HPV16型、18型是宫颈癌的主要致病型,不同病理类型并无HPV型别上的差异;宫颈上皮高级别内瘤变则以HPV58型、52型感染为主;对HPV58型、52型感染者应重视随访。     

萧山区妇女HPV感染现状及与宫颈病变的关系

[目的]探讨人乳头状瘤病毒(HPV)感染与宫颈病变的关系.[方法]对2010年1月至2012年12月就诊的2 423例病例进行液基细胞学检查和HPV检测,对细胞学诊断≥ASCUS及HPV检测为高危阳性的病例进行阴道镜下宫颈组织活检.[结果]在2 423例病例中,HPV阳性率为36.11％(875/2 423).在ASCUS、LSIL、HSIL、SCC中HPV阳性率分别为54.13％、71.67％、93.85％和100.00％.组织学诊断CIN Ⅰ、CINⅡ、CINⅢ、SCC病变中HPV阳性率分别为76.74％、85.0％、90.91％和100.00％.HPV16的检出率在不同宫颈病变中均居首位,且随宫颈病变的级别升高而感染率升高.[结论] HPV16是最常见的高危型.HPV检测并联合液基细胞学和组织学检查能更有效地筛查宫颈病变,为预防宫颈癌提供可靠的科学依据.     

子宫颈腺癌石蜡包埋组织中人类乳头状瘤病毒型别分布及其与患者年龄的关系

 【摘要】　目的　探讨子宫颈腺癌中人类乳头状瘤病毒（HPV）的分布情况及HPV感染与患者年龄的关系。方法　采用描述流行病学研究设计,纳入32例来自一项多中心临床研究的经病理确诊的子宫颈腺癌患者的标本。采用三明治技术进行石蜡包埋组织的切片,SPF10-PCR技术进行DNA扩增,使用反向杂交线型探针检测技术（LiPA）进行HPV分型;对所有切片进行病理阅片和诊断,分析确诊为子宫颈腺癌标本的HPV分布情况,并行统计学分析。结果　32例腺癌患者中,HPV阳性率为53.1 %（17／32）。HPV-18为最主要HPV型别,占HPV阳性患者的47.4 %（8／17）,其次为HPV-16,占HPV阳性患者的26.3 %（5／17）。检测到的其他型别为HPV-39、HPV-45和HPV-66;多重感染者1例（HPV-18和HPV-66）。HPV-16与HPV-18相比,其阳性的腺癌患者平均年龄分别为48.6和40.6岁,差异有统计学意义（P＝0.048）。采用<50岁以及≥50岁作为年龄分组,HPV任意型别阳性率在两个年龄组中的差异无统计学意义（P＝0.074）。HPV-18在两个年龄组的腺癌患者和HPV阳性腺癌患者中的分布均差异有统计学意义（P＝0.003、P＝0.029）。HPV-16在两个年龄组腺癌患者中和在HPV阳性的腺癌患者中的分布差异无统计学意义（P＝1、P＝0.6）。HPV-16和（或）HPV-18感染在两个年龄组HPV阳性腺癌患者中的阳性率差异无统计学意义（P＝0.052）,但在全部腺癌患者两个年龄组中阳性率差异有统计学意义（P＝0.005）。结论　HPV-18和HPV-16是子宫颈腺癌中最主要分布的两种HPV型别。HPV阳性尤其HPV-18阳性在年轻的腺癌患者中更为常见。HPV-16阳性较HPV-18阳性在年龄较大的妇女中更为常见。     

人乳头瘤病毒的基因分型与宫颈腺癌的预后相关性研究

目的 探讨人乳头瘤病毒不同的基因分型在宫颈腺癌中的表达情况及其对宫颈腺癌预后的影响.方法 采用导流杂交的方法检测32例宫颈腺癌中HPV分型情况,分析不同的HPV基因分型与宫颈腺癌预后的关系.结果 宫颈腺癌中HPV阳性率为71.9％,其中HPV18阳性10例(43.5％),HPV16阳性8例(34.8％),其他型感染5例(21.7％),HPV感染与年龄相关,与其他临床病理因素无相关性,单因素分析显示宫颈腺癌的预后与FIGO分期、病理分级、淋巴结是否转移及HPV分型有关,多因素分析显示HPV分型是宫颈腺癌单独的预后因素.结论 HPV基因分型是宫颈腺癌单独的预后因素,HPV18型感染者比HPV16型感染者预后差.     

中国口腔癌中高危型HPV感染率的Meta分析

目的 高危型人乳头瘤病毒(human papillomavirus,HPV)感染可能与口腔癌的发病有关.迄今为止,中国人群中仍缺少大样本量的研究分析中国口腔癌中的HPV感染率及口腔感染HPV的致癌风险.本研究对中国口腔癌中高危型HPV的感染率以及感染高危型HPV的口腔癌致癌风险进行荟萃分析.方法 检索CNKI、VIP、CBM和万方等中文数据库以及PubMed、Embase等外文数据库,检索时间均从建库至2014-10-24.纳入符合条件的文献,采用Stata11.0软件进行荟萃分析口腔癌患者中HPV(未分型)、HPV-16、HPV-18和HPV-16/18重叠感染率,并根据检测方法、标本类型和研究时间进行HPV-16感染率的亚组分析.纳入病例-对照研究,进行高危型HPV-16、HPV-18感染与口腔癌的发病风险的荟萃分析.结果 共44篇文献纳入中国口腔癌中HPV感染率的荟萃分析,中国口腔癌中HPV的总感染率、HPV-16感染率、HPV-18感染率、HPV-16/18的重叠感染率分别为52％(95％CI:41％～63％)、42％(95％CI:33％～51％)、22％(95％CI:13％～30％)和11％(95％CI:7％～16％);口腔鳞癌中HPV-16感染率为42％(95％CI:32％～52％).亚组比较显示,2000年以后发表的论文中HPV感染率更高,P=0.020;PCR和非PCR检测方法的感染率差异无统计学意义,P=0.500;新鲜冷冻组织组和石蜡保存标本相比,虽然HPV感染率较高,但是差异无统计学意义,P=0.229.共15篇文献纳入口腔癌HPV-16感染风险效应的荟萃分析,OR为5.95(95％CI:3.97～8.93),差异有统计学意义,P＜0.001;共5篇文献纳入口腔癌中HPV-18感染风险效应的荟萃分析,OR=1.55(95％CI:0.77～3.13),差异无统计学意义,P=0.221.结论 中国口腔癌患者中HPV感染率保持在较高的水平,其感染以HPV-16为主,并且有随时间增高的趋势.感染HPV 16明显增加了中国口腔癌发生的危险性.     

E-钙粘蛋白及PTEN基因编码蛋白与胃癌浸润转移

目的:观察抑癌基因PTEN蛋白和ECD在胃癌组织中的表达,探讨其与胃癌生物学行为及预后的关系。方法:以兔抗人PTEN多克隆抗体、鼠抗人ECD单克隆抗体,采用SABC免疫组化法,检测100例胃癌手术切除标本中拟测指标的表达。以χ2和Logrank检验对结果做统计学分析。结果:ECD、PTEN蛋白在非癌胃粘膜中均见表达;在胃癌组织中表达下调或缺失。ECD异常表达率为42.0%;弥漫型胃癌异常表达率(48.57%),明显高于肠型胃癌(26.67%),(P<0.05);ECD异常表达与浸润深度有关(P<0.05)。胃癌组织中PTEN蛋白缺失率为59%;弥漫型胃癌缺失率(65.71%)明显高于肠型胃癌(43.33%),(P<0.05);伴淋巴结转移的胃癌缺失率(64.47%)明显高于无淋巴结转移者(41.67%),(P<0.05);PTEN蛋白缺失的患者比阳性表达者预后差(P=0.0066)。65.85%PTEN阳性表达者同时伴ECD正常表达。结论:两种标志物与胃癌浸润转移有关,PTEN表达与胃癌患者预后密切相关。将两种指标联合检测,可作为正确判断胃癌患者预后,指导临床治疗的分子生物学指标。     

Cytologic classification of precancer and cancer of the endometrium and esophagus and of malignant lymphomas

The paper discusses cytological classifications of precancer and cancer of the endometrium, esophagus and malignant lymphomas presented by cytologists from five Soviet research institutes of oncology. The classifications were based on the data of 4400 cases in conformity with WHO histologic classifications.     

世界卫生组织骨质疏松症防治工作报告和防治建议

引 言 作为对第51号综合处理非传染性疾病预防与控制的世界卫生组织决议的反应,1998年7月WHO成立了致力于不断完善对骨质疏松预防和治疗策略的工作小组。小组成员来自世界各国致力于骨质疏松研究的知名专家。Harry K.Genant为本届主席。这一项世界范围内的骨质疏松教育计划旨在通过世界范围的研究,不断改善对骨质疏松的诊断水平和发展并完善对骨质疏松病人的合理治疗。其重点将以发展中国家为主。并为各国政府及其卫生部门和病人群体提供世界性有关骨质疏松症的总体的、完整的指导性资料。该项研究、教育计划的实施将由世界各国的骨质疏松症研究和治疗机构共同完成,并经权威学术机构、政府和非政府组织进行有针对性的回顾研究,最终由WHO审议通过。     

Schwannomas of Head and Neck and Review of Literature

Benign nerve cell tumours have been given various names like schwannoma, neurilemmoma, neurinoma, neurofibroma, spindle cell tumours etc. Extra cranial head and neck schwannomas usually present as solitary and well-demarcated lesions. The lesion can cause secondary symptoms, such as nasal obstruction, dysphasia, and hoarseness, depending upon the location of the lesion. Fine needle aspiration cytology, CT scans, and MRI may be of limited help in the diagnosis of schwannomas. The treatment is complete surgical excision of the benign tumour and postoperative histopathological examination establishes the final diagnosis.     

Quality of life and care in leukemia,myeloma and non-malignant disease. Opinions of patients and relatives,and effects of geography and time

In a questionnaire study 140 subjects answered 4200 questions in 1980 and 1986. They consisted of patients with myeloma, acute leukemia, lung carcinoma, and non-malignant disease and their relatives. In 22 additional cases the questionnaire was not answered. The results show that myeloma patients are less content with the general care than leukemia patients (P < 0.05). Similarly, relatives of deceased myeloma patients are less satisfied with the information given to them than relatives of deceased leukemia patients (P < 0.001). The information has improved with time, however, since the patients were more satisfied in 1986 than in 1980 (P < 0.001) and relatives of myeloma patients still alive were more satisfied than relatives of patients who had died earlier (P < 0.001).     

A comparative study of knowledge and awareness of colorectal and breast cancerA comparative study of knowledge and awareness of colorectal and breast cancer

Aims: To assess and compare knowledge and awareness of colorectal cancer and breast cancer in a sample of the general population. Methods: Eleven hundred visitors to six different outpatient clinics, in a University Hospital, were given a study-specific questionnaire, based on educational material from the British Association of Cancer United Patients (CancerBACUP). The questionnaire consisted of 12 statements on the incidence, presentation, detection, treatment and prognosis of colorectal and breast cancer. Results: One thousand and sixty-eight individuals returned the questionnaire. One thousand and four completed questionnaires were analysed. The mean age (SD) of respondents was 50.1 (17.2) years, and the male to female ratio was 2:3. Respondents had read more about breast than about colorectal cancer (60.3%vs 32.4%,P <0.0001, McNemar's test). The proportion of correct answers for each statement on breast cancer was higher than for answers to corresponding items on colorectal cancer. Mean overall scores (95% CI) for breast and colorectal cancer were 88.1 (86.9, 89.2) and 64.4 (62.5, 66.3) respectively, the mean difference (95% CI) being 23.7 (22.0, 25.5). Scores were higher for breast cancer irrespective of age or gender. Conclusion: There is a low level of understanding of colorectal cancer in the general population when compared to breast cancer. This highlights the importance of public education in this common cancer.     

Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers

BACKGROUND: Frequent consumption of fruit and vegetables has been associated with a reduced risk of colorectal cancer in many observational studies. METHODS: We prospectively investigated the association between fruit and vegetable consumption and the incidence of colon and rectal cancers in two large cohorts: the Nurses' Health Study (88 764 women) and the Health Professionals' Follow-up Study (47 325 men). Diet was assessed and cumulatively updated in 1980, 1984, 1986, and 1990 among women and in 1986 and 1990 among men. The incidence of cancer of the colon and rectum was ascertained up to June or January of 1996, respectively. Relative risk (RR) estimates were calculated with the use of pooled logistic regression models accounting for various potential confounders. All statistical tests were two-sided. RESULTS: With a follow-up including 1 743 645 person-years and 937 cases of colon cancer, we found little association of colon cancer incidence with fruit and vegetable consumption. For women and men combined, a difference in fruit and vegetable consumption of one additional serving per day was associated with a covariate-adjusted RR of 1.02 (95% confidence interval [CI] = 0.98-1.05). A difference in vegetable consumption of one additional serving per day was associated with an RR of 1.03 (95% CI = 0.97-1.09). Similar results were obtained for women and men considered separately. A difference in fruit consumption of one additional serving per day was associated with a covariate-adjusted RR for colon cancer of 0.96 (95% CI = 0.89-1.03) among women and 1. 08 (95% CI = 1.00-1.16) among men. For rectal cancer (total, 244 cases), a difference in fruit and vegetable consumption of one additional serving per day was associated with an RR of 1.02 (95% CI = 0.95-1.09) in men and women combined. None of these associations was modified by vitamin supplement use or smoking habits. CONCLUSIONS: Although fruits and vegetables may confer protection against some chronic diseases, their frequent consumption does not appear to confer protection from colon or rectal cancer.