癌瘤患者骨髓细胞c—erbB和c—erbA绵基因异常

本文在大系列研究造血系统的恶性肿瘤－白血病前期的癌上，对３１例恶性肿瘤患者骨髓进行血液学，细胞和分子遗传学研究。发现恶性肿瘤患乾骨髓有与白血病前期骨髓相似的病态造血（Ｍｙｅｌｏｄｙｓｐｌａｓｉａ）和相关基因异常即ｃ－ｅｒｂＢ基因重排，扩增和ｃ－３４ｂＡ缺失。它们不仅同骨髓红系病态造血相关，也同巨核系病态造血相关。骨髓巨核系病态造血及其相关基因异常可能代表急性淋巴细胞白血病等多种恶性肿瘤的早期病变     

胃癌c－erbB－2蛋白高表达及其与c－erbB－2基因扩增的关系

胃癌ｃ－ｅｒｂＢ－２蛋白高表达及其与ｃ－ｅｒｂＢ－２基因扩增的关系黄焰，宋廷惠，蒋彦永，陆应麟，陈立军关键词胃癌，ｃ－ｅｒｂＢ－２，高表达，扩增中国图书分类号Ｒ７３５．２生长因子受体类癌基因ｃ－ｅｒｂＢ－２扩增或高表达已发现与部分胃癌的恶性发展密切相...     

C—erbB—2基因在宫颈癌中扩增和重排的研究

应用斑点杂交及ＤＮＡ印迹杂交，对Ｃ－ｅｒｂＢ－２基因在宫颈癌中扩增和重排进行了研究。结果表明，在１５例宫颈癌中有１１例具有基因扩增，占７３％，圹增倍数为３～１６倍，ＤＮＡ杂交发现６例宫颈癌中有５例具有基因重排伴扩增，而相应癌旁组织则无扩增或重排，首次发现了Ｃ－ｅｒｂＢ－２基因在宫颈癌中有扩增和重排。     

乳腺癌雌、孕激素受体和c－erbB－2癌基因检测研究

乳腺癌雌、孕激素受体和ｃ－ｅｒｂＢ－２癌基因检测研究刘志林，毛学正，马玉龙，赵志敏关键词乳腺癌，雌激素，孕激素，受体，ｃ－ｅｒｂＢ－２中国图书分类号Ｒ７３７．９应用免疫组化ＳＰ法，观察了两组乳腺癌组织中雌、孕激素状态与癌基因蛋白（ｃ－ｅｒｂＢ－２）产...     

乳腺癌中c-erbB2基因扩增及p53基因缺失的研究

随着分子生物学技术的广泛应用，人们发现肿瘤的发生、发展及预后与某些相关基因改变有关，其中包括：ｃ－ｅｒｂＢ２扩增和ｐ５３缺失［１，２］。我们分别应用差异ＰＣＲ（ｄＰＣＲ）及Ｓｏｕｔｈｅｒｎ杂交方法，检测５８例人乳腺癌中ｃ－ｅｒｂＢ２基因扩增及ｐ５３基...     

原癌基因产物Ras及c—erbB2在着床前小鼠胚胎中的 …

目的 观察小鼠着床前的胚胎细胞中原癌基因ｒａｓ编码的蛋白产物ｐ２１Ｒａｓ、ｃ０ｅｒｂＢ２的表达，并了解其对着床前的胎发育的可能作用。方法 采用免疫组织化学丰床前小鼠胚胎中ｐ２１Ｒａｓ、ｃ－ｅｒｂＢ２蛋白的表达。结果 小鼠着床前的胚胚ｐ２１Ｒａｓ的免疫反应呈阳性，阳性物质分布于胞质中，胚胎外透明带呈阴性反应；而在各期着床关的胚胎中均未检测到ｃ－ｅｒｂＢ２蛋白的表达。结论 小鼠着床前的胚胎中匀未到ｃ－     

c—erbB—2和p53基因表达与胃癌浸润转移的关系

目的：探讨胃癌组织中c-erbB-2和p53基因的表达与胃癌发生和浸润转移的关系。方法：应用荧光原位杂交技术对55例胃癌的常规石蜡标本进行检测,结果：c-erbB-2和p53基因表达的阳性率分别为36．6％和45．45％,其中在肠型和弥漫型胃癌中,c-erbB-2和p53阳性率分别为51．615和16．67％,p53阳性率分别为25．81％和70．83％,两种基因在两型间的差异有显著性意义（P＜0．05）,c-erbB-2和p53基因表达与胃的组织分级有关（分别为P＜0．05及P＜0．01）c-erbB-2和p53基因表达与胃癌的浸润深度有相关性（分别为P＜0．01及＜0．05）,c-erbB-2;基因表达与胃癌的淋巴结内转移有显著性意义（P＜0．05）,结论：c-rebB-2和p53基因有助于确定胃癌的生物学行为。     

乳腺癌中胎盘型谷胱甘肽S－转移酶基因的扩增与异常表达

在国内首次制备并用光敏生物素方法标记胎盘型谷胱甘肽Ｓ－转移酶（ＧＳＴ－π）ｃＤＮＡ探针，应用斑点杂交技术检测２４例乳腺癌ＧＳＴ－π基因ＤＮＡ扩增与ｍＲＮＡ异常表达。结果发现，２４例乳腺癌中，３例（１２．５％）存在ＤＮＡ扩增，７例（２９．２％）存在ｍＲＮＡ异常表达，ＤＮＡ扩增和ｍＲＮＡ表达之间存在正相关性，二者均与患者年龄、肿瘤大小、淋巴结转移无明显相关，但ｍＲＮＡ异常表达与乳腺癌ＥＲ表达呈现负相关性。结果证实人乳腺癌中既存在ＧＳＴ－π基因ＤＮＡ扩增，又存在ｍＲＮＡ异常表达，提示ＧＳＴ－π与乳腺癌有密切关系。     

力学应变对大鼠骨髓间充质干细胞增殖和成骨分化能力的影响

探讨周期性双轴力学应变对大鼠骨髓间充质干细胞(M esenchym a l stem ce lls,M SC s)增殖和成骨分化能力的影响。选用9月龄健康SD雌性大鼠,分离股骨、胫骨提取骨髓,采用密度梯度离心法分离M SC s。体外培养M SC s传至第3代,以1×105细胞浓度接种于双轴力学应变系统,选取4 000μstra in,频率为1hz的力学应变对M SC s加载。每天加载3次,每次2 h,间隔2 h。观察力学应变作用后1 d、3 d,M SC s增殖和成骨分化能力的变化,并与相应未加力学应变对照组比较。结果表明:(1)力学应变可增高M SC s的碱性磷酸酶(ALP)和骨桥蛋白(OPN)表达量;力学应变作用3 d后M SC s的ALP和OPN表达量明显高于力学应变作用1 d。I型胶原(COL I)仅在力学应变作用3 d增高;骨钙素(OCN)在各组无明显变化。(2)力学应变可促进M SC s增殖,但力学应变作用1 d和3 d对M SC s增殖的作用无明显差异。上述结果提示:力学应变可以促进M SC s的增殖和成骨分化能力。     

Analysis of Immunoglobulin and T Cell Receptor Gene Rearrangement in the Bone Marrow of Lymphoid Neoplasia Using BIOMED-2 Multiplex Polymerase Chain Reaction

The evaluation of bone marrow (BM) involvement is important for diagnosis and staging in patients with lymphoid neoplasia. We evaluated of immunoglobulin (Ig) and/or T-cell receptor (TCR) gene rearrangements in the BM using the standardized BIOMED-2 multiplex PCR clonality assays and compared the results with microscopic findings such as histology and CD10, CD20, CD79a, CD3 and CD5 immunohistochemistry. A total of 151 samples were enrolled; 119 B cell neoplasia, 29 T cell neoplasia, and 3 Hodgkin''s lymphoma. The molecular clonality assay and microscopic diagnosis were concordant in 66.9% (n=101) and discordant in 33.1 % (n=50). Ig/TCR gene clonality assay detected 43 cases of BM involvement which was not presented in the morphology. Two cases among them turned into microscopic BM involvement during a close follow up. Clonal TCR gene rearrangements were detected in 12.6% of B cell neoplasia and Ig gene rearrangement were found in 3.4% of T cell neoplasia. This molecular clonality assay is valuable particularly in diagnosing BM involvement of lymphoid neoplasia if it is morphologically uncertain. But it should be carefully interpreted because molecular clonality may be present in the reactive lymphoproliferation. Therefore, comprehensive analysis with morphologic analysis should be important to reach a final diagnosis.     

全身骨显像、肿瘤标志物及碱性磷酸酶在乳腺癌患者骨转移中的临床应用

目的 探讨全身骨显像、肿瘤标志物及碱性磷酸酶对乳腺癌骨转移的诊断及疗效评估的临床价值.方法 回顾性分析本院2011年1月至2014年1月100例临床确诊为乳腺癌患者,单光子发射型计算机辅助断层(single-photon emission computed tomography,SPECT)全身骨显像、CT扫描及肿瘤标志物[糖链抗原153(CA15-3)、癌胚抗原(CEA)及碱性磷酸酶(ALP)]检测结果,分析各项检查诊断骨转移的灵敏度、特异度和准确度,其中22例骨转移患者治疗前后均行各项检查,分析治疗前后的变化.结果 100例乳腺癌患者中62例发生骨转移,骨显像诊断骨转移的灵敏度为88.71％,特异度为78.95％,准确度为85.00％;CT诊断骨转移的灵敏度为72.58％,特异度为92.11％,准确度为80.00％.乳腺癌骨转移组血清CA15-3、CEA、ALP水平较未发生骨转移患者组浓度升高,差异有统计学意义(P＜0.05).随着乳腺癌骨转移分级的增高,血清CA15-3、CEA及ALP含量升高,呈正相关(P值均＜0.05,r值分别为0.65、0.40、0.63).治疗有效组骨转移患者血清CA15-3、CEA及ALP水平均下降,差异有统计学意义(均P＜0.05).结论 全身骨显像诊断的乳腺癌骨转移灵敏度、特异度及准确度较高;血清CA15-3、CEA及ALP检测可协助诊断骨转移并评价疗效.     

胸腔积液中肿瘤坏死因子和腺苷脱氨酶含量对结核性胸膜炎的诊断意义

目的：探讨肿瘤坏死因子（TNF）和腺苷脱氨酶（ADA）对结核性胸膜炎的诊断价值．方法：ADA采用比色法、TNF采用ELISA法对27例恶性胸腔积液、52例结核性胸腔积液进行检测．结果：结核性胸腔积液ADA和TNF水平都明显高于恶性胸腔积液,差别具有显著性（P＜0.01）．结论：应用TNF和ADA可能有助于结核性胸膜炎的鉴别诊断．     

G-CSF-Mobilized Blood and Bone Marrow Grafts as the Source of Stem Cells for HLA-Identical Sibling Transplantation in Patients with Thalassemia Major

As an inherited anemia, thalassemia major (TM) is currently only curable with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Here we report an allo-HSCT protocol for patients with TM who received a combination of granulocyte colony-stimulating factor-primed bone marrow and peripheral blood stem cells (G-BM & PBSCs) from a matched sibling donor (MSD). The conditioning regimen consisted of i.v. busulfan, cyclophosphamide, fludarabine, and antithymocyte globulin. Chimerism analysis was performed for all patients. Immunosuppressive treatment was terminated if rejection was suspected, and donor lymphocyte infusion was administered once no response was observed. A total of 184 patients with TM were enrolled in the study between July 2007 and July 2018. The cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) was 13.1%, and that of moderate or severe chronic GVHD was 5.7%. The cumulative incidence of graft rejection was .6%. In the total cohort, the 3-year overall survival, thalassemia-free survival, and GVHD-free, relapse-free survival were 97.8%, 97.3%, and 89.5%, respectively. Collectively, our results indicate that G-BM & PBSCs from an MSD is be a good stem cell source for patients with TM undergoing allo-HSCT.     

Diagnostic Accuracy and Prognostic Relevance of Immunoglobulin Heavy Chain Rearrangement and 18F-FDG-PET/CT Compared With Unilateral Bone Marrow Trephination for Detecting Bone Marrow Involvement in Patients With Diffuse Large B-Cell Lymphoma

BackgroundIn diffuse large B-cell lymphoma (DLBCL), bone marrow involvement (BMI) has an important clinical implication as a component of staging and International Prognostic Index. This study aimed to determine whether molecular analysis of immunoglobulin heavy chain (IgH) genes and positron emission tomography-computed tomography (PET/CT) could overcome the limitation of defining morphologic BMI by trephination biopsy and could increase the diagnostic accuracy or prognostic prediction.MethodsA total of 94 de novo patients with DLBCL underwent PET/CT, polymerase chain reaction (PCR) test for detection of IgH gene rearrangement, and unilateral bone marrow (BM) trephination at diagnosis.ResultsA total of 9 patients (9.6%) were confirmed to present morphologic BMI (mBMI) based on trephination biopsy. On the other hand, 21 patients (22.3%) were confirmed to have IgH clonality (IgH BMI), while 16 (17.0%) were classified with BMI based on the assessment of PET/CT (PET BMI). Each IgH rearrangement PCR and PET/CT showed the high negative predictive value of detecting the BMI. However, the combined assessment of IgH rearrangement and PET/CT could increase the diagnostic accuracy and specificity with 87.2% and 97.0%, respectively. The survival outcome of patients with double positive PET BMI and IgH BMI was significantly worse than that with either single positive PET BMI or IgH BMI, and even less than patients with neither PET BMI nor IgH BMI (3-year PFS: 50.0% vs. 75.4% vs. 97.9%, P = 0.007, 3-year OS: 50.0% vs. 75.6% vs. 80.1%, P = 0.035, respectively).ConclusionThis study suggests that the combined evaluation of PET/CT and IgH rearrangement could give additional information for predicting therapeutic outcomes in patients with negative morphologic BMI as an important part of the prognosis.     

白血病和MDS患者外周血CA.SCE.CK及超微结构的观察

对11例白血病和10例MDS患者外周血进行CA、SCE、CK及电子显微镜观察。结果表明:白血病及MDS患者染色体畸变率及SCE频率增高,细胞增殖周期延长及白细胞超微结构异常等改变具有一致性。这对白血病及MDS的早期诊断提供实验依据。     

慢性阻塞性肺疾病患者抑郁、焦虑情绪调查

目的：发现慢性阻塞性肺疾病（COPD）病人伴抑郁、焦虑情绪的患病率，并分析其相关的影响因素。方法：对62例COPD患者进行了一般情况及医院焦虑抑郁量表（Hospital Anxiety and Depression Scale，HAD）问卷调查。结果：有抑郁情绪的患者42人（67．7％）。有焦虑情绪的患者的43人（69．3％）。14例Ⅲ级COPD患者中达到抑郁、焦虑症状肯定存在标准的均有13人，高达92．8％。Logistic多因素回归分析，男性比女性病人更易出现抑郁和焦虑症状（OR值分别为1．05，95％CI1．01-2．11，1．12，95％CI1．03-2．23），肺功能差的患者更易出现抑郁和焦虑症状（OR值分别为2．34，95％CI1．98-3．21，2．53，95％CI2．11-4．01）；对病情越了解的病人更易出现抑郁和焦虑症状（OR值分别为1．22，95％CI0．98-1．54，1．25，95％CI1．01-2．31）。结论：COPD患者中存在较高的抑郁及焦虑情绪障碍，肺功能受损程度是其主要影响因素。     

肺癌患者化疗前后SIL-2R和TNF检测的临床意义

目的 :探讨了 4 0例肺癌患者化疗前后血清中SIL - 2R和TNF含量的变化。方法 :应用放免法和酶免法检测 4 0例肺癌患者血清中SIL - 2R和TNF含量并与 35名正常人作比较。结果 :肺癌患者在化疗前血清中SIL - 2R和TNF含量显著地高于正常人组 (p <0 0 1 ) ,化疗后明显下降 (p <0 0 5 )。 结论 :血清中SIL- 2R和TNF水平可作为肺癌患者免疫功能监测指标之一 ,并可作为疗效判断参考