乳腺癌微血管数与转移和预后的关系

目的探讨浸润性乳腺癌中微血管数（ＭＶＱ）与转移、预后的关系,ＭＶＱ与增殖细胞核抗原（ＰＣＮＡ）、ｃ－ｅｒｂＢ－２、ｎｍ２３－Ｈ１、组织蛋白酶Ｄ的关系。方法应用免疫组织化学ＬＳＡＢ法检测浸润性乳腺癌中ＭＶＱ与ＰＣＮＡ、ｃ－ｅｒｂＢ－２、ｎｍ２３－Ｈ１、组织蛋白酶Ｄ的表达。结果ＭＶＱ在７６例浸润性乳腺癌中的均数是５７．８２±２２．２２。ＭＶＱ与淋巴结转移、ｃ－ｅｒｂＢ－２、组织蛋白酶Ｄ（癌细胞）的表达无关;ＭＶＱ与远处转移（１０年内）、ＰＣＮＡ、组织蛋白酶Ｄ（间质细胞）表达呈正相关（Ｐ值均小于０．０１）;而与ｎｍ２３－Ｈ１、５年生存期呈负相关（Ｐ＜０．０１）。结论浸润性乳腺癌中ＭＶＱ与肿瘤的远处转移和生存期关系密切,可以作为一项独立的预后指标。     

Expression of metastasis suppressor gene product, nm23 protein, is not inversely correlated with the tumour progression in human malignant melanomas

An inverse correlation between the nm23 RNA level and tumour progression of melanocytes has been reported. To elucidate whether the expression of nm23 gene product in malignant melanoma is also inversely correlated with metastatic potential, conventional prognostic parameters or the tumour suppressor protein p53, immunohistochemical studies using a monoclonal antibody against nm23-H1 protein were performed on 138 benign and malignant melanocytic tumours. The expression of nm23 protein was compared with that of p53 protein and conventional clinicopathological prognostic factors. The nm23 protein level in benign melanocytes and metastatic melanoma cells was also studied by Western blot analysis. No significant difference regarding the protein was observed between naevi and melanomas, either at histological or protein levels. The expression correlated with local recurrence within 1 year after surgery, level of invasion and tumour thickness, but no parallels were observed between the nm23 and p53 proteins, suggesting that gene is regulated by independent mechanisms, although located on the same chromosome. There was no inverse correlation between the nm23 protein and melanoma metastasis which suggested that the nm23 protein does not appear to be lost during melanoma metastasis.     

Expression of c-myc, erbB-2, p53 and nm23-H1 gene product in benign and malignant breast lesions: coexpression and correlation with clinicopathologic parameters

The aims of this study were to assess the expression of protein products of c-myc, erbB-2, p53 and nm23-H1 gene in benign and malignant breast lesions, to estimate their possible coexpression and to correlate the results of immunohistochemical analysis with various clinicopathologic parameters. The method used was the immunohistochemical detection of the corresponding protein. Expression of c-myc protein was high in both malignant and benign lesions (95% and 100%). Expression of erbB-2 and mutated p53 proteins in malignant lesions was 27% and 34%. These proteins were present in benign lesions as well: 7.8% of benign lesions were positive for erbB-2 protein and 19.6% for p53 protein. The expression of nm23-H1 protein was similar in benign and malignant lesions: 47% and 54%. The coexpression of nm23-H1 and mutated p53 protein was found in 14 carcinomas (16.5%). We found a tendency of negative correlation between the expression of these two proteins. We also found a negative correlation between the size of breast carcinomas and the expression of nm23-H1, a higher proportion of nm23-H1-positive carcinomas in the group of erbB-2-negative, p53-negative carcinomas and a higher proportion of nm23-H1-positive carcinomas in the group of malignant lesions with negative axillary lymph nodes. Our results support the hypothesis that in women with breast cancer the expression of nm23-H1 gene may contribute to more favorable phenotype. We also showed that some changes found in malignant breast tumors such as the presence of mutated p53 protein and the expression of erbB-2 protein may be found in benign lesions as well.     

nm23—H1与p21、p53蛋白在人卵巢癌中表达的相关性研究

目的：研究人卵巢癌组织中肿瘤转移抑制基因nm23-H1、抑癌基因p21^WAFI及p53蛋白的表达,探讨它们在卵巢癌发生、发展中的作用。方法：采用免疫印迹技术,对74例卵巢癌组织及21例卵巢非癌组织中nm23-H1p21^WAFI及p53蛋白进行检测。结果：在卵巢癌中nm23-H1、p53蛋白的表达高于卵巢非癌组织,p21^WAFI蛋白的表达呈下调;肿瘤发生转移时卵巢癌组织中nm23-H1和p21WAF蛋白表达显著低于未发生肿瘤转移的癌组织。p53蛋白表达与肿瘤转移无关。nm23-H1 \p21^WAFI 蛋白与卵巢癌组织类型无关,但与卵巢癌的临床分期相关。p53蛋白的表达与卵巢癌组织类型及卵巢癌的临床分期无关。nm23-H1与p53、p21^WAFI蛋白间表达在卵巢癌中呈相关性。结论：nm23-H1、p53、p21^WAFI 基因在卵巢癌发生、发展中起一定的作用,nm23-H1与p53、p21^WAFI基因在卵巢癌发生、发展中可能起协同作用。     

Comparison of p53 gene mutations in paired primary and metastatic gastric tumor tissues.

Our previous study revealed that mutations of the p53 gene were detected by cDNA sequencing in one of four (25%) primary gastric tumors and in five of six (83%) gastric cancer cell lines. It was of interest that all five cell lines established from metastatic lesions had p53 gene mutations, while the single cell line established from a primary tumor lacked an abnormality. Thus, the current study was initiated to determine the frequency of p53 mutations in 10 pairs of samples from primary gastric carcinomas and their lymph node metastases, in addition to morphologically normal gastric mucosa. In addition, we correlated the findings with other relevant molecular markers including the metastasis associated nm23-H1 gene and loss of heterozygosity (LOH) using multiple polymorphic markers for chromosome 17p and sequencing the entire open reading frame (ORF) of the p53 gene. Five of ten (50%) patients were constitutionally heterozygous for one or more 17p and/or p53 probes (pYNZ 22, BamHI RFLP; pMct35.1, Mspl RFLP; php53cl, Bg/II RFLP), while none had LOH at the 17p and/or p53. A Bg/II RFLP for analysis of possible nm23-H1 somatic allelic deletion revealed no LOH out of four informative cases. One paired sample demonstrated the substitution of valine for isoleucine at codon 41 (GTT to ATT) in both primary gastric tumor and metastasis. Another metastatic sample demonstrated the substitution of proline for threonine at codon 278 (CCT to C/ACT) in addition to a non-mutated codon, while only the wild-type p53 sequence was present in the paired primary gastric tumor tissue.(ABSTRACT TRUNCATED AT 250 WORDS)     

Reduced nm 23-H1 messenger RNA expression in metastatic lymph nodes from patients with papillary carcinoma of the thyroid.

The nm 23 gene product, which possesses nucleoside diphosphate kinase activity, is a possible mediator of cancer cell invasion and metastasis. It has been divided into two distinct gene products, nm23-H1 and nm23-H2. We have developed a method for detecting nm 23-H1 and nm 23-H2 RNA using the polymerase chain reaction, based on the amplification of complementary DNA copies of nm 23-H1 and nm 23-H2 RNA. Using this method, the nm 23-H1 and nm 23-H2 messenger (m)RNA levels in 35 thyroid papillary carcinomas, 11 metastatic lymph nodes from patients with thyroid papillary carcinomas, five thyroid follicular adenomas, and three normal thyroid tissue samples were studied. Both nm 23-H1 and nm 23-H2 mRNA were expressed ubiquitously in normal and malignant thyroid tissues. However, in metastatic lymph nodes no (3 of 11) or weak expression (8 of 11) of nm 23-H1 mRNA was observed, the extent of which was inversely proportional to the degree of cancer cell occupancy, whereas nm 23-H2 mRNA was expressed and the levels were similar to those in other tissue tested. These results show that nm 23-H1 only may play a role in cancer cell invasion and metastasis although the exact mechanisms involved have yet to be elucidated.     

甲状腺滤泡癌和乳头状癌细胞黏附分子与转移抑制基因nm23-H1蛋白表达的关系

目的 探讨黏附分子CD44、上皮性钙黏附蛋白（E-cad )和转移抑制基因nm23-H1与甲状腺滤泡源性癌分化、浸润转移的关系。方法 采用免疫组织化学SP法和EnVision法检测42例滤泡癌和54例乳头状癌中CD44、E-cad和nm23-h1的表达。结果 CD44主要表达于癌细胞及浸润淋巴细胞膜,低分化滤泡癌和有转移乳头状癌CD44表达分别高于高分化滤泡癌和无转移乳头状癌,E-cad阳性物质和nm23-H1阳性率高于滤泡癌,转移癌的阳性率和表达强度低于原发灶。甲状腺滤泡原性癌CD44检测阳性率高于E-cad和nm23-H1。在滤泡癌中E-cad与nm23-H1的表达之间呈正相关关系,而在乳头状癌中呈正相关趋势。CD44与E-cad的表达、CD44与nm23-H1的表达之间在滤泡癌和乳头状癌均呈负相关趋势。结论 综合检测CD44、E-cad和nm23对甲状腺滤泡源性癌的诊断、预后评估具有一定参考价值。     

p53和nm23联合表达对食管鳞癌淋巴结转移的影响

目的：探讨ｐ５３ 和ｎｍ２３ 表达作为食管鳞癌转移标志物的实用价值。方法：采用免疫组化方法检测８５ 例原发性食管鳞癌中ｐ５３ 和ｎｍ２３ 蛋白表达。结果：６３－５３ ％ （５４／８５） 肿瘤呈ｐ５３ 阳性表达,ｐ５３ 阳性表达与肿瘤淋巴结转移和ＴＮＭ 分期有关（Ｐ值均为０－００１）。４０ ％（３４／８５） 肿瘤为ｎｍ２３ 低表达。ｎｍ２３ 低表达与肿瘤浸润深度、淋巴结转移、ＴＮＭ 分期有关（ Ｐ值分别为０－０３２、０－００１、０－００１） 。单因素分析显示：ｐ５３ 和ｎｍ２３ 表达为影响淋巴结转移的主要因素（ ＯＲ值分别为６－９８４ 和０－０８７,Ｐ＜０－００１）。多因素分析显示：ｎｍ２３ 表达是影响淋巴结转移的一个独立因素（珘ｂ＝ － ０－８４８１ , ＯＲ＝ ０－１８１, Ｐ＝ ０－０００１） 。ｐ５３阳性肿瘤具有高度淋巴结转移的倾向（珘ｂ＝ ０－３１５０, ＯＲ＝２－２８４,Ｐ＝ ０－０５６５）,其它临床病理学参数与淋巴结转移之间未见明显关系（Ｐ＞ ０－０５） 。ｐ５３ 和ｎｍ２３ 异常表达之间呈负相关（ｒｓ＝ － ０－３８４９ ,Ｐ＝ ０－０００３）,在促进肿瘤的进展和转移过程中起联合作用。结论：ｐ５３ 和ｎｍ２３ 联合表达对判断食管鳞癌患者     

nm23-H1 protein expression and gene mutation in 150 patients with non-Hodgkin's lymphomas

The metastasis-suppressing role of the nm23 gene in the metastatic spread of malignant tumor is still debated. We examined the nm23-H1 protein expression and gene mutation in non-Hodgkin's lymphomas to compare with the clinicopathologic parameters. The expression of nm23-H1 protein was immunohistochemically examined in 150 cases of non-Hodgkin's lymphomas; 85 diffuse large B cell lymphomas (DL-BCL), 18 marginal zone B cell lymphomas (MZL), 3 mantle cell lymphomas, 25 peripheral T cell lymphomas, not otherwise specified (TCLNOS), and 19 NK/T cell lymphomas (NK/T). Eighty-one cases (58 DLBCL, 6 MZL, 4 TCLNOS, and 13 NK/T) were studied for nm23-H1 gene mutation in exon 1 to 5. The high expression of nm23-H1 protein was associated with the high IPI score (p=0.019) and the low survival rate of the patients (p=0.0039). The gene mutation of nm23-H1 was detected in 10.3% of DLBCL and 30.7% of NK/T; but none in MZL and TCLNOS. The mutation was found in exon 1 in 5 cases, exon 2 in two cases, exon 4 in one case and both exon 1 and 2 in two cases. Our results suggest that the expression of nm23-H1 protein can be used as a poor prognostic marker in non-Hodgkin's lymphomas, and the mutational change of gene may operate in the lymphomagenesis.     

Role of the nm23-H1 gene in the metastasis of gastric cancer.

The nm23 gene is now generally accepted as one of the suppressor genes for metastasis in many types of human cancer. To investigate the role of the nm23 gene in gastric cancer, we examined the expression of nm23-H1 mRNA, mutations, and loss of heterozygosity (LOH) of the nm23-H1 gene in gastric cancers. The expression of nm23-H1 mRNA was examined by Northern blot analysis in eight paired sets of specimens. The expression was higher in primary cancer specimens and metastatic lymph nodes than their corresponding normal gastric mucosa in all eight sets of specimens examined, while it was similar between primary cancer specimens and metastatic lymph nodes. The mutations of the nm23-H1 gene were examined in an additional 11 sets of specimens, including eight sets of analysed by Northern blotting, by polymerase chain reaction single-strand conformation polymorphism analysis, no mutation being found in any of the 11 sets of specimens tested. LOH of the nm23-H1 gene was also examined in additional 12 sets of specimens, among which seven (58%) specimens were informative for LOH. LOH was identified in one (14%) out of these seven informative sets. These results suggest that nm23 may not be the metastasis suppressor gene and the alteration of this gene not play an important role in the process of metastasis of gastric cancer.     

A case of secondary malignant giant-cell tumor of bone with p53 mutation after long-term follow-up

A 46-year-old man was admitted to the hospital with a recurrent giant-cell tumor of the distal femur. This was his fourth recurrence, and it had occurred 16 years after his last treatment. The resected recurrent tumor was histologically determined to be a conventional giant-cell tumor. However, a single lung metastatic lesion and local recurrence were noticed 6 months after the resection, both of which were surgically excised. The lung lesion was histologically determined to be an implantation of giant-cell tumor, whereas the local recurrent lesion contained a clearly separated fibrosarcomatous area within the conventional giant-cell tumor. Immunohistochemistry showed diffuse and strong p53 expression in the fibrosarcomatous area. Direct sequencing revealed a p53 mutation in the sarcomatous area and a recessive mutant signal in the conventional area. The lung lesion also contained the same p53 mutation. Identification of the p53 mutation may help in diagnosing potential malignant transformation of giant-cell tumor.     

nm23-H1基因对人肺腺癌A549细胞增殖和侵袭的抑制作用

目的:研究转染nm23-H1基因对体外培养A549细胞增殖和侵袭的抑制作用及其机理。方法:构建nm23-H1基因的真核表达载体,转染到体外培养的人肺腺癌细胞A549中,通过G418筛选出稳定表达克隆,RT-PCR及免疫组化检测nm23-H1在细胞内的表达情况。绘制细胞生长曲线检测nm23-H1基因对细胞生长的影响,流式细胞仪检测细胞周期,原子力显微镜观察细胞膜表面伪足的超微结构。结果:转染后的肿瘤细胞能稳定表达nm23-H1基因,抑制了肿瘤细胞的增殖。nm23-H1基因没有诱导细胞凋亡但使G1期细胞增加而S期细胞减少,停滞于G0期。转染nm23-H1基因后细胞边缘的伪足减少。结论:nm23-H1基因能抑制体外培养的A549肿瘤细胞的增殖,可能通过改变细胞表面结构减弱细胞的侵袭能力。     

鼻咽癌转移相关的分泌蛋白质的筛选

目的：筛选鼻咽癌（nasopharyngeal carcinoma, NPC）转移相关的分泌蛋白质,为阐明NPC转移机制以及筛选NPC转移分子标志物提供实验依据。方法：应用二维凝胶电泳（two-dimensional electrophoresis,2-DE）技术分离一对来自同一亲本,具有不同转移潜能的NPC细胞系5-8F和6-10B细胞的分泌蛋白质,图像分析识别差异表达的蛋白质点,基质辅助激光解吸电离飞行时间质谱(MALDI-TOF-MS)和电喷雾-四极杆-串联质谱(ESI-Q-TOF MS/MS)对差异表达的蛋白质点进行鉴定。Western印迹法检测差异分泌蛋白质nm23-H1在两株细胞中的表达水平。结果：建立了5-8F和6-10B分泌蛋白质的2-DE图谱,质谱分析鉴定出14个非冗余的分泌蛋白质,其中Oncoprotein18等蛋白质在高转移潜能NPC细胞系5-8F中的表达水平高于无转移潜能的NPC细胞系,而nm23-H1等蛋白质在5-8F细胞系中的表达水平低于6-10B细胞系。Western印迹分析证实了nm23-H1在5-8F和6-10B细胞分泌蛋白质中的差异表达水平。结论：所鉴定的14个非冗余的差异分泌蛋白质为研究NPC转移机制以及筛选NPC转移分子标志物提供了实验依据。     

Immunohistochemical analysis of the nm23 gene products in testicular seminoma

The nm23 gem, has been ldenwied as a metastasis suppressor gene. To clam the role of nm23 as a metastasis sup pressor gene In testicular seminoma, the expression of the nm23-Hl and -H2 proteins (human nucleoside-dlphosphate kinase-A and -B) was Immunohistochemically examined in 43 patients. Thirty-six (84%) and 21 (49%) of the 43 primary tumors were posithre for the nm23-H1 and -H2 proteins, respecthrely. There was no significant difference in either nmH1 or -H2 expression between the 24 primary non-invashre tumors and the 19 primary invasive tumors, or between the 31 primary tumors without metastasis and the 12 primary tumors with metastasls. In all, and 5 of 6 meta-static tumors, the expression of nm23H1 and -H2 proteins was obsenred, respectively, and the expression was not decreased in the metestetlc tumors, compared to the primary tumors. In conclusion, the lmmunohistochemlcal expression of both the nm23-Hl and -H2 gene products is not associated with the metastatic status or the invasive status of testicular seminoma, and it Is unlikely to be a useful non-metastatic Indicator for testicular seminoma. Further studies are needed to elucidate the biological role of nm23.     

nm23-H1 suppresses invasion of oral squamous cell carcinoma-derived cell lines without modifying matrix metalloproteinase-2 and matrix metalloproteinase-9 expression

nm23-H1 is a candidate gene for the suppression of cancer metastasis. Several studies on human breast, hepatocellular, gastric, ovarian, and colon carcinomas and melanomas have shown that reduced nm23-H1 expression was closely related to metastatic progression with poor prognosis. However, the biochemical mechanism by which nm23-H1 suppresses the metastasis has yet to be elucidated. In this study, we analyzed the correlation between nm23 expression, cell motility, and the invasive abilities of six different oral squamous cell carcinoma cell lines (HSC2, HSC3, HSC4, KB, OSC19, and OSC20). Reduced mRNA/protein expression of the nm23-H1 was observed in three cell lines (HSC2, HSC3, and HSC4). These cell lines exhibited increased cell motility and an invasive character on organotypic raft culture. On the other hand, the cell lines (KB, OSC19, and OSC20) that showed a higher expression of nm23-H1 exhibited a threefold to fivefold reduced motility and also reflected fewer invasions compared to the former three cell lines. Because the HSC3 cells demonstrated the lowest nm23-H1 expression with the highest cell motility and invasive character, we established nm23-H1-transfected HSC3 cell lines to investigate whether exogenous nm23-H1 protein could inhibit cell migration and invasive activity. These transfectants showed a significant reduction in cell motility with exogenous nm23-H1 in a dose-dependent manner, and exhibited a noninvasive character. An immunofluorescence study demonstrated a distinct stress-fiber distribution at peripheral region of these transfectants. However, no significant difference of matrix metalloproteinase (MMP)-2 and MMP-9 expression was observed between mock transfectant and nm23-H1-transfected cells. These findings suggest that nm23-H1 inhibits the invasive activity of oral squamous cell carcinoma by suppression of cell motility without altering the MMP-2 and MMP-9 status.     

Reduced protein expression of metastasis-related genes (nm23, KISS1, KAI1 and p53) in lymph node and liver metastases of gastric cancer

PURPOSE: Metastasis remains an incurable common complication in patients with gastric cancer. A variety of theories have been proposed to explain the inefficiency of the metastatic process. To compare protein expression of metastasis-related genes (nm23, KISS1, KAI1 and p53) between primary tumours and metastatic tumours may be useful in illustrating these theories. METHODS: Metastasis-related tissue microarrays (including normal tissues, primary tumours, nodal metastases and liver metastases) were constructed. The protein expression of nm23, KISS1, KAI1 and p53 in lymph node and liver metastases from advanced gastric cancer specimens was mainly examined by immunohistochemical staining in relation to primary tumours. RESULTS: Immunohistochemical staining showed reduced protein expression of nm23, KISS1 and KAI1 in lymph node and liver metastases compared with primary tumours. Results for p53 were to the contrary. CONCLUSIONS: Our investigations revealed a tendency of reduced protein expression of metastasis suppressor genes nm23, KISS1 and KAI1 in gastric cancer with the progress of metastasis. This means that the progression theory is an important determinant of metastatic efficiency.     

Prognostic implication of nm23-H1 expression in colorectal carcinomas

AIMS: Expression of nm23 has been identified as a potential metastatic suppressor. In this study, nm23-H1 expression, clinicopathological parameters and influences on clinical outcomes were investigated in colorectal carcinoma patients. METHODS: Immunostaining was performed on 185 colorectal carcinomas using a polyclonal anti-nm23-H1 antibody. RESULTS: The nm23-H1 immunoreactivity was weak in 31 (17%), moderate in 48 (26%) and strong in 106 (57%) cases. The well differentiated adenocarcinomas showed significantly strong staining for nm23-H1 compared with the moderately and poorly differentiated adenocarcinomas (chi2 test, P<0.001). Advanced tumour stages were associated with reduced nm23-H1 expression (P<0.001). There was an inverse correlation with angiolymphatic invasion, nodal metastasis and liver metastasis (univariate logistic regression analysis, P<0.001). In univariate analysis, patients with reduced expression of nm23-H1 had significantly shorter overall and disease-free survival than the strong expression group (log-rank test for trend, P=0.002 and P=0.003, respectively). CONCLUSIONS: Our results indicated that reduced nm23-H1 expression showed poor prognosis in colorectal carcinomas. As a result, nm23-H1 expression might be a useful marker to predict outcome while planning treatment.     

Increase in the intracellular free calcium concentration is not an obligatory early event in lipopeptide-induced B-cell activation

We recently showed that synthetic lipopeptides, analogues of the N-terminal region of bacterial lipoprotein, induce DNA synthesis in B lymphocytes in the absence of enhanced phosphatidylinositol 4,5-bisphosphate hydrolysis and protein kinase C translocation. Here we demonstrate that lipopeptides are capable of inducing enhanced expression of MHC class II molecules and early increases in the intracellular free calcium concentration ([Ca2+]i) in B cells. However, they do not effect T cells. The increase in [Ca2+]i seen in B cells is due primarily to Ca2+ release from intracellular stores. Since lipopeptides differ in their capability to induce early increases in [Ca2+]i and since the calcium response does not correlate with the ability of lipopeptides to induce proliferation and expression of MHC class II molecules, we suggest that this biochemical event may not be essential for lipopeptide-mediated B-cell activation.     

Co-expression of endothelial cell and macrophage antigens in Kaposi's sarcoma cells

Mutations in the p53 tumour suppressor gene, with consequent accumulation of the p53 protein, are frequently observed in non-small cell lung cancer (NSCLC). Little is known, however, about the timing of their appearance or their maintenance through cancer progression and metastatic spread. We have examined the normal epithelium and a panel of bronchial lesions, including dysplastic, neoplastic, and metastatic leisons, for p53 immunoreactivity and for expression of proliferating cell nuclear antigen (PCNA). No p53 immunoreactivity was found in normal and hyperplastic epithelium, nor in squamous metaplastic lesions. Twenty out of 30 invasive tumours and 13 out of 17 in situ carcinomas adjacent to an invasive tumour showed p53 immunoreactivity. There was a strict correlation between the level of p53 expression in the non-invasive and the invasive components of the tumours. Five out of eight pairs of primary tumours and matching metastases expressed p53, at identical levels in both compartments. These data indicate that p53 overexpression can occur in the earliest recognized phase of NSCLC and that the alteration is maintained during progression from in situ to invasive carcinoma and metastatic spread. PCNA expression increased from early to advanced phases of NSCLC. High PCNA immunoreactivity was observed in tumours expressing high p53 levels. A significant association was observed for PCNA expression between preinvasive and invasive lesions.     

应用CpG-寡脱氧核苷酸免疫刺激进行慢性淋巴细胞白血病的染色体研究

目的 验证CpG-寡脱氧核苷酸(CpG-oligodeoxynucleotide,CpG-ODN)免疫刺激是否能提高B细胞慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)核型异常检出率.方法 抽取57例B-CLL患者的骨髓或外周血,分别加入CpG-ODN DSP30+白细胞介素-2(interleukin-2,IL-2)、植物血凝素(phytohemagglutinin,PHA)、美洲商陆(pokeweed,PWM)和IL-2后进行培养,5 d后按常规收获并制备染色体,应用R显带技术进行核型分析.应用Cen12、D13S25、Rb1、ATM、P53、MYB和IgH探针对其中19例核型正常的患者进行组合荧光原位杂交(fluorescence in situ hybridization,FISH)检测.抽提骨髓或外周血单个核细胞基因组DNA,应用聚合酶链反应(polymerase chain reaction,PCR)扩增免疫球蛋白重链可变区(immunoglobulin variable heavy chain,IgVH)并进行DNA序列分析.应用流式细胞仪(flow cytometry,FCM)检测白血病细胞的CD38和ZAP70表达.结果 DSP30+IL-2组的异常核型检出率(43.85%)明显高于PHA组(15.09%)、PWM组(17.31%)和IL-2组(3.13%)(P<0.01).DSP30+IL-2组共检出畸变52种.数目异常以+12或+12伴其它异常为最多见(9例);结构异常以易位为最多见(14例),包括平衡易位11例和不平衡易位3例,前者中又以14q32重排为最多见(7例).FISH显示19例正常核型患者中13例(68.42%)显示1种或多种异常,包括12三体和p53缺失各l例,IgH重排和部分缺失各1例,13q14.3缺失11例,其中5例合并RB1缺失,1例合并RB1部分缺失,未见ATM和MYB缺失者.PCR揭示10/18例有IgVH突变(55.55%).FCM检测揭示10/45例CD38+,35/45例CD38-,11/27例ZAP70+,16/27例ZAP70-.同时进行CD38和ZAP70检测的26例中,5例为CD38+ZAP70+,13例为CD38-ZAP70-,2例为CD38+ZAP70-,6例为CD38-ZAP70+.统计学分析揭示复杂核型异常与IgVH无突变之间有相关性,但未发现CD38或ZAP70表达与核型之间有相关性.结论 CpG-ODN可显著提高CLL的核型异常特别是各种平衡和不平衡易位的检出率;FISH是常规核型分析的重要补充,二者结合能提供更全面的遗传学信息.