349例新辅助化疗后乳腺浸润性导管癌嗜神经侵袭与临床病理特征间的关系

摘 要：［目的］ 探讨新辅助化疗后乳腺浸润性导管癌嗜神经侵袭（perineural invasion,PNI）与患者临床病理特征之间的关系。［方法］ 收集甘肃省肿瘤医院349例乳腺浸润性导管癌患者的临床和病理资料,所有患者均接受术前新辅助化疗,分析PNI发生与临床病理特征之间的关系。［结果］ 新辅助化疗后349例患者中PNI阳性91例（35%）,PNI阴性258例（65%）。单因素结果显示,乳腺浸润性导管癌神经侵犯与腋下淋巴结转移、淋巴结转移数目、TNM分期、脉管侵犯、分子分型和组织学分级有关（均P<0.05）,而与年龄、肿瘤直径、Ki-67增殖指数、化疗后反应、ER、 PR及Her-2表达无关（均P>0.05）。多因素Logistic 回归分析显示,分子分型和组织学分级是PNI阳性的危险因素（P<0.05）。［结论］ 新辅助化疗后乳腺浸润性导管癌神经侵犯与腋下淋巴结转移、淋巴结转移数目、TNM分期、脉管侵犯、分子分型和组织学分级有关。     

子宫内膜癌经腹膜后淋巴结切除术后淋巴结转移的危险因素分析

目的 分析子宫内膜癌(EC)经腹膜后淋巴结切除术后淋巴结转移的危险因素。方法 选择88例EC患者均行子宫切除及淋巴结清扫术。收集患者一般资料,统计淋巴结转移发生情况,并依据术后淋巴结转移与否将其分为转移组(n=25)、未转移组(n=63)。采用多因素Logistic回归方法对EC经腹膜后淋巴结切除术后淋巴结转移的危险因素进行分析。结果 88例EC患者术后出现淋巴结转移25例,淋巴结转移率为28.41%(25/88);转移组病理分期Ⅲ+Ⅳ期、病理类型浆液性乳头状癌+透明细胞癌、组织学分级G3、病灶直径≥2 cm、深肌层浸润、脉管浸润患者占比高于未转移组,有统计学差异;两组在年龄、腹腔积液细胞学、附件转移、宫颈浸润方面对比,无统计学差异;Logistic回归分析显示,病理分期、病理类型、组织学分级、病灶直径、肌层浸润、脉管浸润为影响EC经腹膜后淋巴结切除术后淋巴结转移的独立危险因素(P<0.05且OR≥1)。结论 影响EC经腹膜后淋巴结切除术后淋巴结转移的独立危险因素主要为病理分期、病理类型、组织学分级、病灶直径、肌层浸润、脉管浸润,临床应高度重视,以早期发现、早治疗。     

分子分型在乳腺癌术后复发转移中的应用研究

[目的]研究乳腺癌分子分型与术后复发转移的关系。[方法]收集术后复发转移的乳腺癌患者的临床病理资料,明确患者复发转移的部位及时间,分析各分子亚型与临床病理特征以及复发转移部位、时间的关系。[结果]入组299例术后复发转移的乳腺癌患者,其中Luminal A型、Luminal B型、Her-2阳性型和Basal-like型分别为92例、79例、47例和81例。各分子亚型中年龄（P=0.034）、月经状况（P=0.013）、肿瘤组织学分级（P=0.000）、术后淋巴结转移情况（P=0.035）、术后复发转移时间（P=0.000）以及术后复发转移部位（P=0.007）存在显著差异。Cox逐步回归分析显示,组织学分级（P=0.000）和分子分型（P=0.000）是乳腺癌术后复发转移的独立预后因子。[结论]乳腺癌分子分型作为传统TNM分期的重要补充,能够很好地预测乳腺癌术后复发转移部位和时间,有助于临床医师对术后患者进行个体化随访筛查。     

NSCLC外周血循环肿瘤细胞水平检测及其与TNM分期、预后的关系

目的:分析非小细胞肺癌（non-small cell lung cancer,NSCLC）外周血循环肿瘤细胞（circulating tumor cells,CTC）表达特点及其与国际抗癌联盟肿瘤通用分期（tumor node metastasis,TNM）及预后的关系。方法:采集我院胸外科收治的NSCLC患者82例,选取肺良性疾病30例作为良性组及30名正常志愿者作为对照组,入院后均完成外周血CTC检测,比较NSCLC外周血CTC与良性组、对照组之间的差异;比较不同病理类型、TNM分期、不同预后NSCLC患者CTC阳性率,筛选NSCLC预后影响因素。结果:NSCLC组CTC阳性率高于良性组与对照组（P＜0.05）,良性组、对照组组间对比差异无统计学意义（P＞0.05）;不同病理类型NSCLC患者CTC阳性率比较差异无统计学意义（P＞0.05）;不同TNM分期NSCLC患者CTC阳性率比较差异有统计学意义（P＜0.05）,各分期CTC阳性率比较:Ⅲa期＞Ⅱ期＞Ⅰ期;CTC阴性NSCLC患者随访中位无 病生存时间（disease free survival,DFS）长于阳性组,复发、转移率低于阳性组（P＜0.05）;有吸烟史、CTC阳性、高TNM分期、伴淋巴结转移的NSCLC患者中位DFS低于无吸烟史、CTC阴性、低TNM分期、无淋巴结转移的NSCLC患者（P＜0.05）;Cox回归分析显示:TNM分期、CTC、淋巴结转移均为影响NSCLC患者中位DFS的相关因素（P＜0.05）。结论:NSCLC外周血CTC阳性率较高,且与TNM分期、淋巴结转移共同影响患者预后。     

进展期远端胃癌患者行腹腔镜辅助胃癌根治术后复发的影响因素及治疗

目的 探讨进展期远端胃癌患者采用腹腔镜辅助胃癌根治术后复发的影响因素及治疗效果.方法 回顾性分析90例行胃癌根治术进展期胃癌患者的临床病历资料,根据患者1年内是否复发分组为早期复发组(60例)与无复发组(30例),并采用Logistic回归分析患者术后复发影响因素.将60例术后复发患者分组为甲乙丙3组,各20例,分别采用再次手术、姑息治疗及未手术治疗,统计3组患者生存时间.结果 经单因素分析发现,患者早期复发影响因素为瘤体直径和TNM分期、T分期、N分期、术后化疗、新辅助化疗及Borrmann分型、Lauren分型,P＜0.05;经多因素分析,患者术后复发高危因素为N分期与TNM分期,且新辅助化疗为患者术后保护因素,P＜0.05.经再次治疗发现,其中甲组3年生存率明显高于乙、丙组,P＜0.05,而乙组略高于丙组,P＞0.05.结论 进展期胃癌根治术后早期复发高危因素主要为N分期与TNM分期,积极采取新辅助化疗及腹腔镜辅助胃癌根治术治疗,可以减少复发,延长患者生存期.     

乳腺癌患者中医证型、VEGF-C、雌激素受体表达与预后的相关性

目的 分析乳腺癌患者中医证型、血管内皮生长因子C(VEGF-C)、雌激素受体(ER)表达与预后的相关性。方法 回顾性分析手术治疗的84例女性乳腺癌患者的病历资料，按中医证型的不同分为肝郁痰凝型(n=26)、冲任失调型(n=30)、正虚毒炽型(n=28)。以免疫组织化学染色法测定VEGF-C与ER表达；统计分析不同中医证型与患者临床病理特征、VEGF-C、ER的关系；所有患者均于术后进行1年的随访，分析患者临床病理特征、VEGF-C、ER表达与患者复发率的关系。结果 中医证型与乳腺癌患者的肿瘤最大径、淋巴结转移、病理学分级、TNM分期、VEGF-C、ER有关，差异有统计学意义(P<0.05);中医证型与患者年龄无关，差异无统计学意义(P>0.05)。随访1年，共有30例患者复发，复发率为35.71%(30/84);正虚毒炽型患者的复发率高于冲任失调型与肝郁痰凝型患者，VEGF-C阳性表达与ER阴性表达患者的复发率高于VEGF-C阴性表达与ER阳性表达患者，TNMⅢ期、有淋巴结转移、病理学分级Ⅲ级患者的复发率高于TNMⅠ～Ⅱ期、无淋巴结转移、病理学分级Ⅰ～Ⅱ级患者，差异有统计学...     

子宫内膜癌复发的影响因素分析及相应治疗方案

目的 探讨子宫内膜癌复发的影响因素,并制定相应的治疗方案.方法 比较分析135例子宫内膜癌手术治疗后出现复发患者与同期就治但未出现复发的135例子宫内膜癌患者复发的危险因素,并进行Logistic多因素回归分析.结果 病理分级、腹腔积液检测阳性、肌层浸润深度≥1/2、淋巴结转移、肉眼分型和宫旁转移与子宫后内膜癌复发相关(P＜0.05);年龄、病理分期和病理类型与其复发无关(P＞0.05).Logistic回归分析得出病理分级、肌层浸润深度、腹腔积液细胞学和淋巴结转移是影响子宫内膜癌术后复发的高危因素(P＜0.05).术后采取合适的辅助治疗能够提高长期生存率.结论 病理分级、肌层浸润深度、腹腔积液检测阳性和淋巴结转移是影响子宫内膜癌术后复发的高危因素.患者术后可选择适宜的辅助治疗,经常复查,及时处理、减少复发,提高术后生存率和生活质量.     

分化型甲状腺癌患者术后复发转移的临床指标及相关影响因素分析

目的 分析分化型甲状腺癌(DTC)患者术后复发转移的临床指标及相关影响因素。方法 选择122例DTC患者。术后随访2年,收集患者基本资料、病理资料及手术治疗情况;依据随访患者术后复发转移与否将其分为复发转移组与未复发转移组。测定两组甲状腺球蛋白(TG)水平,并进行超声检查。比较两组TG水平及超声检查结果,并采用多因素Logistic回归方法分析DTC患者术后复发转移的相关影响因素。结果 122例DTC患者术后出现复发转移31例,复发转移率为25.41%(31/122);术后复发转移组TG水平高于未复发转移组,复发转移组点状强回声、低回声占比高于未复发转移组,有统计学差异(P<0.05);复发转移组年龄≥50岁、术前淋巴结转移、肿瘤直径≥5 cm、TNM分期Ⅲ期+Ⅳ期患者占比高于未复发转移组,有统计学差异(P<0.05);两组在性别、病理类型、手术方式方面对比,无统计学差异(P>0.05);采用Logistic回归分析显示,术前淋巴结转移、肿瘤直径、TNM分期为影响DTC患者术后复发转移的独立危险因素(P<0.05且OR≥1)。结论 TG及超声检查可作为预测DTC...     

盆腔淋巴结清扫对评估膀胱癌预后的价值

目的：评价规范化盆腔淋巴结清扫对膀胱癌患者预后的影响作用,分析影响淋巴结转移的相关因素及淋巴结肿大与淋巴结转移两者的关系。方法：回顾性分析2008年1 月至2013年7 月天津医科大学肿瘤医院120 例膀胱癌患者临床资料,分为盆腔淋巴结规范化清扫组58例,未规范化清扫组62例。分析淋巴结转移与病理分期、分级及术中触及肿大淋巴结的关系,探讨盆腔淋巴结清扫对预后的影响。结果：120 例膀胱癌患者术后1、3、5 年总生存率分别为84.0% 、69.9% 、57.9% 。规范化盆腔淋巴结清
扫组与未规范化清扫组的3 年生存率分别为78.4% 与46.2%（χ2= 5.487,P = 0.019）。 淋巴结阳性与阴性患者术后3 年生存率分别为50.0% 与86.4% ,（χ2= 9.303,P = 0.002）。 术中触及肿大淋巴结与淋巴结转移具有相关性（P < 0.001）,病理分期、病理类型（尿路上皮癌及非尿路上皮癌）及年龄是患者预后的影响因素（P < 0.05）。 结论：术中触及肿大淋巴结与淋巴结转移相关,可预测淋巴结转移的发生,盆腔淋巴结清扫影响膀胱癌患者预后,阳性淋巴结是膀胱癌患者预后的独立危险因素,规范盆腔淋巴结清扫术可延长患者术后生存时间。     

术后辅助化疗在Ⅰ期子宫内膜样腺癌治疗中的价值

背景与目的:Ⅰ期子宫内膜样腺癌患者的预后较好,但仍有少数患者复发,且复发后治疗困难.本研究旨在探讨Ⅰ期子宫内膜样腺癌患者复发的相关因素及术后辅助化疗在其治疗中的价值.方法:回顾性分析96例Ⅰ期子宫内膜样腺癌患者的临床病理资料,采用Cox回归分析方法探讨与复发相关的预测因素,并分析术后辅助化疗对Ⅰ期子宫内膜样腺癌患者预后的影响.所有患者进行随访,平均随访时间(43.6±24.0)个月. 结果:96例Ⅰ期子宫内膜样腺癌患者中10例复发,复发率为10.4%.平均复发时间为(17.3±8.0)个月;其中盆腔复发3例,远处转移6例,盆腔复发并远处转移1例.复发患者的平均年龄为(61.8±6.4)岁,明显高于未复发患者的(53.6±10.1)岁(P=0.015).复发患者中Ⅰ c及G3比例明显高于其他分期及病理分级者(P=0.011,P=0.000).多因素分析发现:FIGO分期和病理分级是判断复发的重要预测指标(P=0.013,P=0.000).Ⅰ c期患者术后给予辅助化疗者的复发率明显低于未化疗者(P=0.046).结论:FIGO分期/肌层浸润深度和病理分级是判断复发的重要预测指标;术后辅助化疗有助于降低Ⅰ c期子宫内膜样腺癌患者的复发率.     

Comparison between Ki67 labeling index determined using image analysis software with virtual slide system and that determined visually in breast cancer

Background

In recent papers, Ki67 labeling index (LI) has been used to classify breast cancer patients into the low and high Ki67LI groups for comparison studies, which showed significant differences in many prognostic factors. It has not been clarified whether image analysis software can be used for calculating LI in breast cancer. In our study, we examined whether Ki67LI in breast cancer calculated using image analysis software correlates with that measured on the basis of visual.

Methods

Fifty patients were randomly selected among breast cancer patients who underwent surgical operation from March, 2010 to May, 2010 in our hospital without preoperative chemotherapy. In this study, for the virtual slide system (VSS: VS120-L100, Olympus, Tokyo, Japan), the high-resolution VSs of all the 50 patients were prepared as samples. The image analysis software use for calculating LI was Tissuemorph Digital Pathology (Tissuemorph DP: Visiopharm, Hoersholm, Denmark). The calculated LI was extracted from 3 to 5 views containing hot spots. The LI calculated using Tissuemorph DP was designed as LI/image/T. The digital image of 3 to 5 LI/image/T views was printed out, and on the digital photograph, we counted visually the number of Ki67-immunopositive cells in exactly the same area, and the percentage of Ki67-immunopositive cells was designed as LI/direct. Moreover, a pathologist’s assistant (PA) determined the tumor area in the same specimen using VSS and calculated LI using Tissuemorph DP, which was designed as LI/image/PA. The chief pathologist (CP) similarly calculated LI which was designed as LI/image/CP. We evaluated the degree of agreement between different data sets “LI/image/T and LI/direct” and “LI/image/T, LI/image/CP, and LI/image/PA” by using interclass correlation coefficient (ICC).

Results

The average counts of cells were as follows: LI/direct, 3209.7 ± 1970.4 (SD); LI/image/T, 2601.6 ± 1697.1; LI/image/PA, 2886.5 ± 2027.5; LI/image/CP, 18805.5 ± 22293.4. The values of LI/direct and LI/image/T showed almost perfect agreement as showed by an ICC of 0.885 (95 % CI, 0.806–0.933; p < 0.001). The agreement among three investigators was almost perfect. The obtained ICC was 0.825 (95 % CI, 0.739–0.890; p < 0.001) among the data of LI/image/T, LI/image/CP and LI/image/PA. There were five cases that immunopositivity for Ki67 showed a more than 10 % disagreement between LI/direct and LI/image/T.

Conclusion

The merits of calculating Ki67 LI using Tissuemorph DP are as follows. First, the staining intensity of the cells to be counted can be adjusted. Second, the portion of a tumor including “hot spots” for counting can be chosen. Third, many cancer cells can be counted more rapidly using Tissuemorph DP than by visual observation. However, it is important that pathologist should check and carry out the final decision of the data, when Ki67 LI using Tissuemorph DP is calculated.

     

Colonic Epithelial Proliferation Indices Before and After Colon Cancer Removal

Rectal mucosal (epithelial) proliferation labeling indices (LI) have been widely used as a risk marker for colorectal cancer and as an intermediate end-point in chetno-prevention studies. The purpose of this study was to determine whether the presence of cancer preoperatively altered the LI and whether these LI could be used over the long term us a market for colon cancer. We studied 25 patients (18 with colorectal cancer and 7 with benign colonic diseases) who were admitted for colonic resection. Biopsies for thymidine LI were taken before, during, and 4 and 7 months after the operation. The preoperative LI of cancer patients was higher, but not significantly, than that of noncancer patients (5.22 5 3.54 and 4.11 ± 1.34%, respectively, p = 0.28). The intraoperative LI was significantly higher than the preoperative LI (8.08 ± 4.00 and 4.90 ± 3.07%, respectively; p = 0.004). After 4 and 7 months, the LI was not significantly different from the preoperative LI (p= 0.60 and 0.89, respectively). Resection of a colonic segment did not affect the level of proliferation over time. Therefore, it is unlikely that LI can be used as a marker to predict local recurrence after curative resection of colorectal cancer.     

Prognostic significance of lymphocyte infiltration following preoperative chemoradiotherapy and hyperthermia for esophageal cancer

Purpose: Lymphocyte infiltration (LI) around cancerous lesions is an important immune response. The purpose of this study is to evaluate the prognostic significance of LI after preoperative treatment for esophageal cancer.

Methods and Materials: Preoperative chemoradiotherapy (CR therapy), either bleomycin 30 mg or cisplatin 120 mg/m² plus radiation 30 Gy, was performed on 51 cases with esophageal cancer, while hyperthermo-chemoradiotherapy (HCR therapy) was also indicated in 71 cases. Using resected specimens, both the histopathologic effectiveness and degree of LI to cancerous lesions were evaluated.

Results: The incidences of the cases in which preoperative treatment was effective were 56% and 92.3% in LI (−) and LI (++) group (p < 0.05). The presence of LI resulted in favorable prognosis; the 5-year survival rates of LI (++) and LI (+) patients were 75.5% and 46.1%, both of which were significantly better than LI (−) (27.8%, p < 0.05 and p < 0.01, respectively). Especially among cases whose preoperative treatment was moderately effective, a multivariate analysis revealed LI to be a favorable prognostic factor independent of other clinicopathologic factors (p = 0.0171). Regarding the preoperative treatment, the incidence of LI (++) was higher in the HCR group (16.9%) than in the CR group (2.0%, p < 0.01).

Conclusions: LI appears to be a prognostic predictor after preoperative CR therapy while, in addition, simultaneous hyperthermia may stimulate LI in cases with esophageal cancer.     

MDM2 and p53 expression in gliomas: a multivariate survival analysis including proliferation markers and epidermal growth factor receptor.

p53 and the murine double minute 2 (MDM2) oncoprotein expression was evaluated in paraffin-embedded tissue from 61 patients with central nervous system gliomas (53 astrocytomas and eight oligodendrogliomas) and related to proliferation-associated markers [i.e. proliferating cell nuclear antigen (PCNA), Ki-67 and nuclear organizer regions (NORs)] and epidermal growth factor receptor (EGFR). We used the monoclonal antibodies PC-10, MIB-1, DO-1, 1B1O and EGFR 113 and the colloid silver nitrate (AgNOR) technique. MDM2 and p53 were co-expressed in 28% of cases. A p53-positive/MDM2-negative phenotype was observed in 15% and a p53-negative/MDM2-positive phenotype in 20% of cases. There was a positive correlation of p53 and MDM2 expression with grade and proliferation indices. Univariate analysis in the group of diffuse astrocytomas showed that older age, high histological grade, high PCNA labelling index (LI) and high AgNOR score were associated with reduced overall survival (P < 0.05). p53 LI, Ki-67 LI, AgNOR score, tumour location and grade influenced disease-free survival (P < 0.05), whereas the only parameters affecting post-relapse survival were histological grade and Ki-67 LI (P < 0.1). Multivariate analysis revealed that age, radiotherapy, PCNA LI and p53 LI were the independent predictors of overall survival. p53 LI, Ki-67 LI, MDM2 LI, EGFR LI, grade and type of therapy were independent predictors of disease-free survival, and grade was the only independent predictor of post-relapse survival. Our results indicate that p53 LI and MDM2 LI, EGFR expression as well as proliferation markers (PCNA and Ki-67) are useful indicators of overall and disease-free survival in diffuse astrocytoma patients.     

PCNA和Ki-67在脑膜瘤组织中的表达及其意义

目的：探讨增殖细胞抗原（PCNA）和Ki-67核抗原在脑膜瘤中的表达及其与肿瘤良、恶性及复发的关系。方法:采用LSAB法检测80例脑膜瘤组织中PCNA和Ki-67的表达。结果：恶性脑膜瘤PCNA标记指数（PCNALI）和Ki-67标记指数（Ki-67LI)明显高于良性脑膜瘤（P＜0．01）和非典型性脑膜瘤（P＜0．05），复发脑膜瘤PCNA LI显著高于未复发脑膜瘤（P＜0．01），复发脑膜瘤Ki-67LI也显著高于未复发脑膜瘤（P＜0．01），Ki-67表达与PCNA表达呈正相关。结论：脑膜瘤细胞标记指数可作为判断脑膜瘤良；恶性的客观指标之一，标记指数对预测脑膜瘤的复发有一定意义。     

CIN2+患者高危型HPV感染情况及治疗方法分析

目的研究宫颈上皮内瘤变(CIN)2级及以上(CIN2+)患者高危型人乳头瘤病毒(HPV)持续感染的可能因素和治疗方法。方法249例CIN2+合并高危型HPV感染患者接受环形电切术(LEEP)治疗,依据术后1年高危型HPV检测是否转阴分为术后转阴组(n=160)和持续感染组(n=89),依据治疗方式将89例持续感染组患者分为对照组(n=41)和联合组(n=48)。对照组患者接受重组人干扰素α2b阴道泡腾片治疗,联合组患者在此基础上联合保妇康栓治疗。比较术后转阴组和持续感染组患者术前高危型HPV分型及持续感染的相关因素,以及对照组和联合组患者药物治疗后高危型HPV转阴情况。结果持续感染组患者术前多重感染率为24.72%,高于术后转阴组的21.88%,但差异无统计学意义(P﹥0.05)。持续感染组和术后转阴组患者高危型HPV亚型均以HPV16和HPV58为主。持续感染组和术后转阴组CIN2+患者切缘情况、性伴侣人数、避孕方式、人工流产次数和CIN分级情况比较,差异均有统计学意义(P﹤0.01)。治疗后,联合组患者高危型HPV感染转阴率为79.17%,高于对照组患者的58.54%,差异有统计学意义(P﹤0.05)。结论应加强对有不健康性行为史、宫颈锥切术切缘阳性、高级别CIN患者的术后随访,预防高危型HPV的持续感染,发现持续感染应及时行抗病毒治疗。保妇康栓联合重组人干扰素α2b阴道泡腾片可能使接受LEEP手术的CIN2+合并HPV持续感染的患者获益。     

Cell kinetics and hormonal features in relation to pathological stage in breast cancer

Proliferative activity (expressed as³H-thymidine labeling index,³H-TdR LI) was evaluated on a series of 281 primary tumors recruited in two years in 6 different institutions from central Italy.³H-TdR LI proved to be low in intraductal, or well and moderately differentiated, or hormone receptor positive tumors. Conversely, no relation was observed between³H-TdR LI and menopause, tumor size, or lymph node involvement. An inverse relation was observed between³H-TdR LI and hormone receptor content. Specific patterns of³H-TdR LI value and ER content association were observed as a function of menopause, lymph nodal status, and degree of lymph nodal involvement.     

Cell proliferation in childhood acute leukemia. Comparison of Ki-67 and proliferating cell nuclear antigen immunocytochemical and DNA flow cytometric analysis.

The proliferative activity of bone marrow leukemia cells was determined by DNA flow cytometric (FCM) analysis and labeling index (LI) of Ki-67 monoclonal antibodies and proliferating cell nuclear antigen (PCNA) autoantibodies in 73 children with acute leukemia. LI of Ki-67 varied greatly from patient to patient (range, 0.4% to 42.2%; mean, 18.8%) and differed significantly between acute lymphoblastic leukemia (ALL) and acute nonlymphoblastic leukemia (ANLL). In ALL, the Ki-67 LI showed a positive correlation with the S-phase fraction (SPF) determined by DNA FCM analysis, whereas, in ANLL, there was a discrepancy between the Ki-67 LI and SPF. In contrast, LI of PCNA varied less among the patients (range, 57.2% to 100%; mean, 90.3%), and the value was always higher than that of the Ki-67 LI in individual patients. A significant relationship between PCNA LI and the percentage of blast cells was found in peripheral blood leukocytes from patients with leukemia. These results suggest that the Ki-67 LI reflects differences in the proliferative activity depending on the subtype of the disease and that the PCNA LI is useful as a marker of proliferating cells.     

Long-term effect on EMT6 tumors in mice induced by combination of laser immunotherapy and surgery

Laser immunotherapy (LI) has been demonstrated to be a promising modality for cancer treatment. The present study was designed to further investigate the impact of LI combined with surgery. LI consists of a near-infrared laser, a light-absorbing dye (indocyanine green, ICG), and an immunostimulant (glycated chitosan, GC). ICG and GC were intratumorally injected, followed by laser irradiation. Female BALB/c mice bearing EMT6 tumor cells were divided into 4 groups: control, LI, LI followed by immediate surgery resection of residual tumor (LI + S(0wk)), and LI followed by surgical removal of residual tumor after 1 week (LI + S(1wk)). Successfully treated mice from all treatment groups were rechallenged twice with 10(5) and 5 × 10(5) EMT6 cells, respectively. The LI + S(1wk) group had the highest survival rate (72%) after 90 days, whereas the mice survival rates of the LI + S(0wk), LI, and control groups were 50%, 46%, 0%, respectively. The median survival times of control, LI, LI + S(0wk), and LI + S(1wk) groups were 32, 66, 74, and 90 days, respectively. Survival rates of the treated mice after the first and second tumor rechallenges, ranging from 73% to 95%, were not significantly different among the 4 groups (P > .05). The results show that LI is a useful tool for the treatment of tumor-bearing mice. Long-term antitumor effect can be induced by LI. They also indicate that combination of LI with surgery can further improve the therapeutic efficiency of LI.