34βE12、CK5/6、p63、SMA在乳腺增生、不典型增生与原位癌鉴别诊断中的价值

目的探讨高分子量细胞角蛋白34βE12、细胞角蛋白CK5/6、肌上皮标记物p63、平滑肌肌动蛋白SMA在乳腺增生、不典型增生与原位癌鉴别诊断中的价值。方法采用免疫组织化学染色法(SP),检测34βE12、CK5/6、p63、SMA在30例乳腺普通型增生(UDH)、30例非典型导管增生(ADH)、20例导管原位癌(DCIS)和20例浸润性导管癌(IDC)中的表达。结果 UDH和ADH组中34βE12均呈阳性表达,DCIS和IDC组中大部分34βE12呈阴性表达,前两组与后两组比较,差异均有统计学意义(P<0.05);UDH组中CK5/6均呈阳性表达,ADH、DCIS及IDC组中CK5/6大部分呈阴性表达,UDH组与其他3组比较差异有显著性(P<0.05);p63表达量依次为UDH组>ADH组>DCIS组,IDC组中其无阳性表达,各组间差异均有统计学意义(P均<0.05);UDH、ADH和DCIS组中SMA均呈阳性表达,IDC组中其大部分呈阴性表达,与前3组比较,差异均有统计学意义(P均<0.05)。结论联合检测34βE12、CK5/6、p63、SMA表达,有助于鉴别乳腺增生、不典型增生与原位癌,为临床提供可靠的诊疗依据。     

乳腺轻、重度乳头状瘤病和导管内癌中p16蛋白表达的比较观察

目的:探讨p16基因蛋白表达与乳腺乳头状瘤病及导管内癌的相关性。方法:应用免疫组化法检测40例导管内癌、40例重度乳头状瘤病、40例轻度乳头状瘤病、25例正常乳腺组织中p16蛋白的表达情况。结果:p16基因蛋白在导管内癌组表达阳性率为40.0%,重度乳头状瘤病组为52.5%,轻度乳头状瘤病组为72.5%,正常乳腺组织为92.0%,四组比较有显著性差异,χ2=21.018,P<0.05;导管内癌组与重度乳头状瘤病组比较无显著性差异,χ2=1.257,P>0.05;导管内癌组与重度乳头状瘤病组合并与轻度乳头状瘤病组比较有显著性差异,χ2=7.424,P<0.05;p16基因蛋白表达强度在四组间比较有显著性差异,χ2=23.474,P<0.05。结论:p16基因蛋白表达异常在乳腺乳头状瘤病及导管内癌的发生中起重要作用,可为乳头状瘤病变的临床治疗提供较有价值的依据。     

乳腺浸润性导管癌组织Ki-67和p53蛋白的表达及其临床意义

目的检测乳腺浸润性导管癌组织中Ki-67和p53的表达,并探讨其表达在乳腺浸润性导管癌中的临床意义。方法免疫组化S-P法检测乳腺浸润性导管癌组织及乳腺良性病变组织中Ki-67和053的表达,统计学分析Ki-67和053表达与乳腺浸润性导管癌患者临床病理特征及预后的关系。结果Ki-67和p53蛋白在乳腺浸润性导管癌中均呈高表达,42例组织中Ki-67阳性表达率78．6％,p53为38．1％,乳腺良性病变中Ki-67无表达,2例053阳性表达,两组存在显著性差异;Ki-67与p53的表达率随浸润性导管癌TNN分期的增高而上升,另外Ki-67表达与浸润性导管癌的大小密切相关。结论Ki-67和p53蛋白与浸润性导管癌TNM分期密切相关,对其进行联合检测可有助于浸润性导管癌的预后判断。     

乳腺导管内乳头状瘤和导管癌中Pten、p16基因蛋白表达研究

 目的　分析抑癌基因Pten及p16蛋白在乳腺导管内乳头状瘤和导管癌组织中的表达 ,以进一步探讨导管内乳头状瘤的生物学特性。方法　应用间接免疫荧光染色流式细胞术对 2 3例乳腺导管内乳头状瘤、2 9例导管癌Pten及p16在蛋白水平上的表达情况进行定量检测。结果　正常乳腺组织、导管内乳头状瘤和导管癌组织中Pten蛋白表达阳性率逐渐下降 ,分别为 10 0 %、4 7.83%及 10 .34% ,三组比较有显著性差异 (P <0 .0 1)。与Pten结果相似 ,在所有的正常乳腺组织中 p16均呈阳性表达 ,而在导管内乳头状瘤和导管癌中p16的表达均有不同程度降低 ,分别为 82 .6 1%及 2 4 .14 % ,两组与正常对照比较有显著性差异 (P <0 .0 1) ,而导管内乳头状瘤与导管癌之间 p16蛋白表达无统计学意义 (P >0 .0 5 )。结论　乳腺导管内乳头状瘤存在Pten和p16蛋白表达异常 ,提示导管内乳头状瘤是一种具有抑癌基因变化的癌前病变。     

P504S、p63、34βE12在前列腺不同病变诊断中的意义

目的 探讨P504S、p63、34βE12在良性前列腺增生、不典型腺瘤样增生、前列腺上皮内瘤变和前列腺腺癌诊断中的意义.方法 收集102例前列腺不同病变的常规石蜡标本,光镜下按WHO标准分类,应用免疫组织化学二步法,观察PS04s、p63、34βE12的表达.结果 良性前列腺增生、不典型腺瘤样增生的腺泡和导管周围34βE12和p63均为(+),而P504S均(-).低级别PIN及高级别PIN的腺泡和导管周围34βE12和p63均为(+),而增生的腺上皮P504S分别为7.7%(2/26)、33.3%(1/3)呈局灶性阳性.前列腺腺癌18例中,34βE12和p63均为(-),P504S有2例呈局灶性阳性(11.1%),15例P504S呈阳性(83.3%).结论 P504S是前列腺腺癌敏感而特异性的标记物,联合检测PS04S、p63、34βE12可提高前列腺腺癌的诊断准确率,对前列腺穿刺标本进行不同病变的鉴别诊断更有帮助.     

E2F-1和Rb基因表达与乳腺乳头状瘤病及导管内癌的相关性

目的　研究细胞周期调控因子E2F 1和Rb与乳腺乳头状瘤病及导管内癌的相关性 ,探讨乳头状瘤病癌变的某些分子机制。方法　采用原位杂交法和免疫组化法对 4 0例乳腺轻度乳头状瘤病、4 0例重度乳头状瘤病和 4 0例导管内癌进行了检测 ,观察E2F 1和Rb基因mRNA和蛋白的表达情况。结果　E2F 1mRNA表达阳性率在乳腺轻度乳头状瘤病、重度乳头状瘤病和导管内癌中分别为17.5 %、4 5 .0 %和 80 .0 % ;蛋白表达阳性率分别为 2 0 .0 %、4 7.5 %和 77.5 %。E2F 1mRNA和蛋白表达三组间差异有显著性 (P <0 .0 1) ,组间两两比较 ,差异也有显著性 (P <0 .0 1)。Rb基因mRNA表达阳性率在乳腺轻度乳头状瘤病、重度乳头状瘤病和导管内癌中分别为 90 .0 %、5 0 .0 %和 2 0 .0 % ;蛋白表达阳性率分别为 85 .0 %、5 2 .5 %和 2 2 .5 %。Rb基因mRNA和蛋白表达三组间差异有显著性 (P <0 .0 1) ,组间两两比较 ,差异也有显著性 (P <0 .0 1)。随着乳腺乳头状瘤病程度的加重最终进展为癌 ,E2F 1mRNA和蛋白表达阳性率呈上升趋势 ;RbmRNA和蛋白表达阳性率呈下降趋势。E2F 1和RbmRNA表达均与蛋白表达呈正相关 ,但这两种调控因子的表达呈负相关。结论　E2F 1和Rb基因mRNA和蛋白表达可作为癌症早期较有价值的参考指标 ,有助于从乳腺乳头状瘤病     

EGFR、p53、Bcl-2表达,Ki-67标记指数与胸腺瘤WHO组织学分型、分期及预后的关系

目的探讨EGFR、p53、Bcl-2表达，Ki-67标记指数（Ki-67Li）与胸腺瘤WHO组织学分型、分期及预后的关系。方法应用免疫组化染色方法检测46例胸腺瘤患者EGFR、p53、Bcl-2的表达和Ki-67标记指数。结果胸腺瘤EGFR、p53、Bcl-2阳性表达率分别为34．8％、56．5％、54．3％，Ki-67标记指数平均值为11．0％。EGFR、p53、Bcl-2蛋白表达与胸腺瘤WH0组织学分型均无明显关系；B2、B3、C型与A、AB、B1型之间Ki-67标记指数表达差异有显著性（P〈0．05）；Bcl-2蛋白表达与胸腺瘤Masaoka分期和预后均无关系（P〉0．05）；EGFR、p53蛋白的过度表达和Ki-67标记指数与胸腺瘤Masaoka分期明显相关（P〈0．05）；Ki-67标记指数与预后有关（P〈0．05）。结论EGFR、p53蛋白的过度表达和Ki-67标记指数与胸腺瘤Masaoka分期明显相关，反应其侵袭性，Ki-67标记指数还与组织学分型相关，并可作为估计胸腺瘤预后的参考指标。     

乳腺囊内乳头状癌临床病理学特征的探讨

目的探讨乳腺囊内乳头状癌(intracystic papllary carcinoma,IPC)的临床病理学特征。方法采用常规苏木精-伊红(HE)染色、光镜观察,并通过Maxvision法对16例乳腺IPC进行免疫组化检查。结果乳腺IPC的细胞为高柱状,与乳头轴心垂直排列。细胞排列紧密,核位于基底,卵圆形,核苍白或深染。在一些病例中,肌上皮细胞消失。还有些病例,尤其是肿瘤较大的病例中,纤维脉管轴心有广泛的玻璃样变性及纤维化。免疫组化显示乳头被覆细胞CK7、p53、Ki-67、E-cadherin均阳性,CD34、actin和SMA乳头纤维血管轴心及周围血管呈阳性表达,而actin、ER、PR、cerbB-2、p63及CK,(34βE12)癌细胞均阴性。结论乳腺IPC好发于老年妇女,即绝经期后的妇女,具有较独特的病理组织学改变和免疫表型,乳腺IPC的预后非常好。     

乳腺增生性病变组织中相关分子标志的表达及意义

目的：探讨c-erbB-2、CyclinD1、p16和Ki-67与乳腺癌发生的关系。方法：通过免疫组化SP法检测20例乳腺单纯性增生、75例非典型增生（轻度20例、中度26例、重度29例）、28例导管原位癌及32例浸润性癌组织中c-erbB-2、CyclinD1、p16和Ki-67的表达情况,并用正常乳腺组织作对照。结果：c-erbB-2的表达在轻度非典型增生与中度、重度非典型增生及导管内癌、浸润性癌比较差异均有统计学意义,Χ^2=19．131,P〈0．001;中度、重度非典型增生与导管内癌、浸润性癌比较差异无统计学意义,Χ^2=5．660,P〉0．05。CyclinD1、p16和Ki-67的表达在中度非典型增生与重度非典型增生、导管内癌、浸润癌比较差异均有统计学意义（Χ^2值分别为23．660、27．726和20．782,P均〈0．001）,与单纯性增生、轻度非典型增生比较差异无统计学意义,P〉0．05。在各组中,CyclinD1、Ki-67与c-erbB-2呈正相关,与p16呈负相关,c-erbB-2与p16呈负相关。结论：c-erbB-2、CyclinD1、p16和Ki-67表达异常发生在乳腺癌发生过程中的早期,其联合检测可作为早期诊断癌前病变和估计预后的有效指标。     

端粒酶基因与凋亡相关基因在乳腺导管非典型增生中表达的相关性研究

背景与目的:近年研究表明端粒酶的激活及凋亡抑制基因的过度表达与多种肿瘤发生有关,本研究观察端粒酶基因(hTR,hTRT)、凋亡相关基因(p53,bcl-2)在乳腺导管非典型增生中的表达及相互关系,旨在探讨端粒酶活性及凋亡相关基因的变化在乳腺导管非典型增生上皮癌变过程中的作用和意义。方法:应用原位杂交方法检测端粒酶基因(hTR,hTRT)和凋亡相关基因(p53,bcl-2)mRNA在44例乳腺导管非典型增生组织中的表达,应用免疫组化方法检测p53蛋白在上述病例中的表达,并与6例良性乳腺增生及26例乳腺癌病例进行了比较。结果:端粒酶基因(hTR,hTRTmRNA)在乳腺导管重度非典型增生组织中表达增强(60.9%,52.1%),其表达与在轻、中度非典型增生(22.2%,11.1%;33.3%,25.0%),乳腺癌(88.5%,80.8%)组织中的表达差异显著(P<0.05)。p53mRNA在乳腺导管非典型增生组织中的表达随着异型性的增加而下降(轻度:55.6%;中度:41.7%;重度:26.1%),而p53蛋白则相应增加(轻度:11.1%;中度:25.0%;重度:34.8%)。bcl-2在乳腺导管非典型增生组织中呈中度表达,其中以在重度非典型增生组织中表达明显。结论:端粒酶基因(hTR,hTRT)的表达与乳腺非典型增生细胞的恶性转化密切相关,同时可检测到p53mRNA的表达缺失、p53蛋白突变及bcl-2mRNA的过表达,且表达水平与端     

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.     

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.     

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).     

miRNA与肿瘤侵袭转移

目前,microRNA (miRNA)已成为肿瘤研究中最基本的参与者,主要通过与靶标基因3 'UTR(非翻译区)的完全或不完全配对,降解靶标基因mRNA或抑制其翻译,从而参与调控个体发育、细胞凋亡、增殖及分化等生命活动.miRNA作为调控基因表达的重要分子在肿瘤侵袭转移中的作用越来越受到重视,表明miRNA在肿瘤侵袭和转移中的作用机制具有重要的理论意义,同时也可为肿瘤的诊断和治疗提供新方法.本文就miRNA通过调控上皮间质转化及肿瘤干细胞导致肿瘤侵袭转移的最新研究进展作一综述.     

芦荟大黄素及芦荟提取物的诱变性和抗诱变性

目的:用L5178Y小鼠淋巴瘤细胞体外微核试验评价芦荟大黄素和芦荟提取物的诱变和抗诱变作用,为其安全性评价提供依据。方法:设溶剂对照、阳性对照和抗诱变对照,芦荟大黄素和芦荟提取物诱变和抗诱变试验各设4个剂量组,处理L5178Y细胞12 h后按常规方法进行体外微核试验分析。结果:较高浓度(6.67μg/ml)的芦荟大黄素可致微核细胞率增加,与对照组比较,差异有统计学意义(P0.05);而芦荟提取物未见此效应。在一定剂量范围内,芦荟大黄素(0.22～6μg/ml)和芦荟提取物(20～180μg/ml)对甲磺酸甲酯(MMS)所致微核细胞率均有一定程度的拮抗作用,与对照组比较,差异有统计学意义(P0.01)。结论:芦荟大黄素具有一定的诱变作用,而在本实验剂量范围内的芦荟提取物未见遗传毒性。两种受试物在一定范围内均能较好地拮抗MMS所致的染色体损伤。     

甲状腺手术的技巧及副损伤的预防和处置

鉴于甲状腺手术是普外科的常见手术，为求其日渐完美，以有益于病人，现根据作者的体会，并结合阅读相关文献，就其手术操作、喉返神经处理、甲状旁腺处理进行扼要阐述。     

甲胎蛋白与自噬在肝癌发生发展中的作用及其相互关系

甲胎蛋白（AFP）作为临床诊断肝癌最常用的肿瘤标志物,有抑制免疫、促进细胞生长、抑制癌细胞凋亡的作用。自噬是一种维持细胞生存的重要途径之一,其与肝癌的发生发展及治疗有着密切联系,对肝癌既有抑制又有促进作用。PI3K/AKT作为两者共有的信号通路,它们是否有着相互关系来促进肝癌的发展尚需进一步研究。     

Erythrocyte levels of cadmium and lead and risk of B-cell non-Hodgkin lymphoma and multiple myeloma

Cadmium and lead are persistent environmental toxins that are known or probable carcinogens, based on evidence for causality for nonhematologic cancers. Associations of these metals with risk of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) are unknown but biologically plausible. To examine the associations of circulating levels of lead and cadmium exposure with risk of B-cell NHL (B-NHL) and multiple myeloma, we conducted a nested case-control study among 299 incident B-cell NHLs and 76 MM cases within the Cancer Prevention Study-II Nutrition Cohort (CPS-II NC). Each case was incidence-density matched to two eligible controls on age, race, sex and blood draw date. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (CI) for lymphoid malignancies overall and stratified by subtype. We observed a significant positive association between high erythrocyte lead concentration and risk of lymphoid malignancies overall (RR = 1.16, 95% CI: 1.02-1.33 per 17.6 μg/L (1 standard deviation [SD])) and follicular lymphoma in particular (RR = 1.80, 95% CI: 1.15-2.80 per SD). In contrast, there was no association between erythrocyte cadmium and risk of B-NHL (RR = 0.89, 95% CI: 0.75-1.06 per 0.37 μg/L [1 SD]), or any B-NHL subtypes; but a strong inverse association with MM risk (RR = 0.59, 95% CI: 0.38-0.89, per SD). Results from our study suggest a positive association between erythrocyte lead level and risk of lymphoid malignancies and a possible inverse association between cadmium and myeloma. Additional research is needed to confirm and further explore these findings.     

Comparison of the Efficacy and Safety of Ceftibuten and Cefaclor in the Treatment of Pneumonia and Bronchiectasis

Summary

In a multicentre, international study of 187 adult patients with bacterial pneumonia or bronchiectasis, the safety and efficacy of a regimen of 200 mg ceftibuten administered twice-daily was compared with cefaclor given in a dosage of 500 mg three times a day. Of the 94 evaluable patients, 66 received ceftibuten and 28 received cefaclor. The overall bacteriological response was similar in the two treatment groups with elimination of the original pathogen in 91% and 89% of the patients receiving ceftibuten and cefaclor, respectively. The overall clinical response mirrored the bacteriological results with a successful clinical outcome in 92% of ceftibuten-treated patients compared with 93% in patients receiving cefaclor. Adverse experiences were, in general, few and mild, being reported in 8% and 17% of patients receiving ceftibuten and cefaclor, respectively.