胃癌细胞株核因子κB组成性激活对细胞增殖的影响

目的探讨胃癌细胞株是否存在核转录因子(NF)-κB组成性激活及对胃癌细胞增殖的影响。方法采用逆转录-聚合酶链反应(RT-PCR法)和蛋白免疫印迹法(Westernblot法)检测4株不同分化程度的胃癌细胞株NF-κB的mRNA和蛋白表达,比较4株胃癌细胞株中NF-κB的转录和蛋白质表达水平的差异,并利用TransAMTMNF-κBP65试剂盒比较不同胃癌细胞株中P65亚基的蛋白活性差异。采用噻唑蓝(MTT)比色法观察NF-κB活性抑制剂PDTC(吡咯烷二硫代氨基甲酸盐)对胃癌细胞增殖的影响。结果4株胃癌细胞株中均存在NF-κB的组成性激活,且存在蛋白表达和活性差异。活化的P65亚基在MKN28、MKN45细胞株中表达较低,在AGS、SGC-7901细胞株中表达较高。经PDTC处理的实验组胃癌细胞的增殖明显受到抑制,对照组呈正常生长。结论胃癌细胞株中存在NF-κB组成性激活及P65蛋白表达差异。抑制NF-κB的活性可明显抑制胃癌细胞的增殖。     

腹腔血流阻断动脉介入化疗对肝脏影响的实验性研究

目的观察腹腔内区域性血流阻断动脉内介入化疗(stop-flow)对肝脏的影响及其可能机制。方法将12只健康雌性幼猪随机分为两组,一组行腹腔血流阻断动脉内介入化疗(SFC组),另一组为单纯腹腔血流阻断(SF组)。应用RT-PCR检测肝脏组织白介素(IL)-8及ICAM-1mRNA表达;Westernblot检测核转录因子(NF)-κBP65亚基在细胞核内表达;测定外周静脉血丙氨酸转氨酶(ALT)及天冬氨酸转氨酶(AST)以及观察肝脏组织形态学改变,以评价阻断前及阻断区域血流循环再通后不同时间段肝脏损伤程度。结果Stop-flow(血流阻断时间为20min)引起阻断区域血流循环再通30min时肝脏组织细胞核内NF-κBP65亚基表达升高,IL-8及ICAM-1mRNA转录活性增强,但于再通后3h、6h逐渐减弱。血清ALT及AST于术后48h内轻度升高,并在升高24h后达到高峰(ALT为89.9U/L及93.2U/L,AST为185.5U/L及217.0U/L),术后1周恢复至术前水平。组织学改变表现为阻断区域血流循环再通后早期肝细胞小泡性脂肪变性伴轻度PMN浸润,肝小叶结构未见明显破坏,上述各种改变在SF组及SFC组之间差异无统计学意义。结论Stop-flow腹腔血流阻断20min引起的肝脏损害是自限且可逆的,不会引起肝脏结构和功能的严重损害。     

原发性胃癌中DCC抑癌基因杂合性丢失的研究

目的：探讨原发性胃癌组织中结直肠癌缺失基因（deleted in colorectal carcinoma.DCC)杂合性丢失（loss of heterozygosity,LOH)的情况及其与胃癌临床病理学间的关系。方法：用多聚酶链反应－单链构相多态性（PCR－SSCP）银染法分析49例原发性胃癌组织中DCC的杂合性丢失。结果：D18S484位点发生LOH的频率为26．6％（12／45），D18S487为23．9％（11／46），DCC发生LOH的频率为36．7％（18／49）。36．8％（7／19）的肠型胃癌发生DCC LOH，24．0％（6／25）的弥漫型胃癌发生DCC LOH，而100％（5／5）的混合型胃癌为DCC LOH（P＜0．05）。在淋巴结有转移的胃癌中，52％（13／25）的原发性胃癌发生DCC LOH，无转移者中为20．8％（5／24）（P＜0．05）；发生远处转移者，原发性胃癌DCC LOH为100％（3／3），而无转移者为32．6％（15／46）（P＜0．05）；在TNM Ⅲ、Ⅳ期中DCC LOH为50．0％（12／24），有高于TNM I、Ⅱ期（24％，6／25）的趋势（P＝0．059）。DCC LOH与病人的性别、年龄、肿瘤发生部位、大小、组织学分级均无统计学意义（P＞0．05）。结论：DCC的杂合性丢失可能在胃癌的发展和转移中起重要作用，是胃癌发展后期的重要分子事件。     

环氧化酶-2表达与胃癌淋巴管生成及淋巴结转移的关系

目的研究环氧化酶-2(COX-2)与血管内皮生长因子C(VEGF-C)在胃癌中的表达及其与胃癌临床病理因素间的关系,并评价上述两指标与肿瘤新生淋巴管和淋巴结转移之间的相关性。方法采用免疫组织化学(免疫组化)染色法,检测63例胃癌原发灶标本COX-2与VEGF-C蛋白的表达情况,并用淋巴管内皮细胞特异性抗体LYVE-1行免疫组化染色,观察肿瘤组织淋巴管生成状况。结果所测63例胃癌组织中,COX-2及VEGF-C的表达阳性率分别为66.7%(42/63)和52.4%(33/63),35例标本(55.6%)中可检测到LYVE-1阳性的肿瘤新生淋巴管。COX-2表达与VEGF-C表达、肿瘤新生淋巴管形成及淋巴结转移等临床病理指标间呈明显相关关系(P<0.05);但与患者性别、肿瘤大小、肿瘤部位、Lauren分型及有无浆膜浸润等无明显相关。结论胃癌组织中,COX-2表达与VEGF-C表达状态、肿瘤淋巴管生成和淋巴结转移均呈明显相关。COX-2可能通过上调VEGF-C表达,促进胃癌淋巴管生成,并顺次导致淋巴结转移的发生。     

胃癌病人之血浆金属蛋白酶和组织抑制物水平及其临床意义

目的:探讨不同分期胃癌病人之血浆MMP-2、MMP-9及TIMP-1水平与病人个体预后之间的关系。方法:运用酶联免疫分析法(ELISA)测定不同分期的胃癌病人、良性胃病病人和健康志愿者血浆中MMPs/TIMP水平,逐例随访胃癌病人。结果:胃癌病人血浆MMP-2、MMP-9及TIMP-l的水平分别为(21.7±6.3)ng/ml(、17.9±9.2)ng/ml和(39.5±13.3)ng/ml;较良性胃病病人和健康志愿者显著升高,差异有显著性意义,尤其是Ⅳ期胃癌病人。胃癌病人血浆中MMP-2水平与肿瘤浸润深度、转移(包括淋巴结和远处)相关,T1MP-1与转移相关,MMP-2水平也与病人生存期相关。结论:血浆MMP-2可以作为预测胃癌病人预后的标志物。     

胃黏液腺癌的临床病理和CT特征

目的:探讨胃黏液腺癌的临床病理和CT特征。方法:回顾性分析507例行根治或姑息性切除术的胃癌病例的临床病理资料(20例黏液腺癌和487例非黏液腺癌)及术前的多层螺旋CT检查结果;对比分析20例黏液腺癌和38例非黏液腺癌的CT征象(CT轴位图像上肿瘤最大径、厚度、大体分型及强化方式)。结果:通过术前电镜活检,仅25.0%(5/20)的胃黏液腺癌得到确诊。20例黏液腺癌均为进展期胃癌,487例非黏液腺癌中早期胃癌占16.8%(82/487),但差异无统计学意义(P=0.056)。与非黏液腺癌相比,黏液腺癌肿瘤较大[(6.9±4.0)cm比(4.4±2.3)cm,P=0.011],淋巴结转移率较高(85.0%比60.6%,P=0.028),且Ⅱ～Ⅳ期病例较多(95.0%比72.3%,P=0.025);二者在CT轴位图像上肿瘤最大径(P=0.008)、厚度(P=0.001)、大体分型(P=0.037)和强化方式(P=0.000)间均存在显著差异。但黏液与非黏液腺癌在年龄、性别、肿瘤位置、远处转移和根治性切除率间均无差异。结论:胃黏液腺癌病例数少且多属进展期,通过内镜活检判断黏液腺癌的敏感度较低,而多层螺旋CT则有助于鉴别黏液和非黏液腺癌。     

前列腺导管腺癌临床病理和诊治特点分析

Objective To discuss the pathological and clinical features, diagnosis and treatment of prostatic duct adenocareinoma. Methods The clinical data of nine cases of prostatic duct adeno-carcinoma were retrospectively analyzed, with the average age of 76 (59-106) years. Six cases were presented with dysuresia and/or nocturia, and two of them had the painless gross hematuria. Two pa-tients presented painless gross hematuria as the first symptom. One case was detected the elevated ser-um PSA in a routine healthy examination. Radical prostatectomy (RP) was performed in 1 case;RP and bilateral orchidectomy and external beam radiotherapy (EBRT) were performed in 1 case;5 cases underwent transurethral resection of the prostate (TURP) combined with photoselective vaporization of the prostate (PVP) by green laser and bilateral orchidectomy;1 case underwent TURP combined with PVP;1 case underwent bilateral orchidectomy combined with EBRT. Eight cases took flutamide for 3-45 months. All patients were followed-up according to the scheduled time. Results The op-erations were successfully performed in all 9 patients. The papillary or cauliflower-like tumors infiltra-ted colli culus seminalis and prostate duct nearby. The glands were coated with tall pseudostratified columnar cells. The nuclei were large, dark stained with more frequent mitoses. The positive rates of immunolabelling antibody PSA, AR, PAP were found to be 89%(8/9), 100%(5/5), 100%(5/5) re-spectively. The distribution of Gleason score was 6-7(3 cases), and≥8(6 cases), and a coexisting acinar carcinoma component was identified in 5 cases of the group. Nine cases had a mean follow up for 20(3-48) months. Five cases have developed biochemical recurrence, of whom 3 died of bone metas-tasis and multiple organ failure, and 1 developed lung and bone metastasis. Three cases remained alive without recurrence. The remaining 1 case survives during the follow-up survey for 6 months until now, without examinations due to the old age. Conclusions Duct adenocarcinoma of the prostate presents the low incidence and lacks of typical symptoms in the early stage. Diagnosis was confirmed mainly on the basis of pathology. The tumors tend to have a more advanced stage and a very short term survival rate. The treatment options and management are similar to that of high-grade adenocar-cinoma of the prostate;meanwhile, close follow-up survey should be performed.     

蛋白质组技术在胃癌相关标志物筛查中的应用

目的 建立胃癌组织和正常胃组织双向凝胶电泳图谱，鉴定差异表达蛋白，从中发现有意义的胃癌相关标志物。方法 采用双向凝胶电泳（2-DE）分离胃癌组织和正常胃组织总蛋白，银染显色，PDQuest软件分析，从中选取差异表达蛋白质点，通过基质辅助激光解析电离飞行时间质谱（MALDI-TOF-MS）或MALDI-TOF-TOF-MS鉴定差异表达的蛋白质。结果 获得重复性和分辨率较好的胃组织双向凝胶电泳图谱；发现23个差异表达蛋白质，其中15个得到鉴定，在肿瘤组织中高表达的有10个，其余5个在肿瘤组织中低表达。结论 建立了胃癌组织和正常胃组织双向凝胶电泳图谱，并应用质谱技术鉴定了15个差异表达蛋白质。     

前列腺导管腺癌临床病理和诊治特点分析

Objective To discuss the pathological and clinical features, diagnosis and treatment of prostatic duct adenocareinoma. Methods The clinical data of nine cases of prostatic duct adeno-carcinoma were retrospectively analyzed, with the average age of 76 (59-106) years. Six cases were presented with dysuresia and/or nocturia, and two of them had the painless gross hematuria. Two pa-tients presented painless gross hematuria as the first symptom. One case was detected the elevated ser-um PSA in a routine healthy examination. Radical prostatectomy (RP) was performed in 1 case;RP and bilateral orchidectomy and external beam radiotherapy (EBRT) were performed in 1 case;5 cases underwent transurethral resection of the prostate (TURP) combined with photoselective vaporization of the prostate (PVP) by green laser and bilateral orchidectomy;1 case underwent TURP combined with PVP;1 case underwent bilateral orchidectomy combined with EBRT. Eight cases took flutamide for 3-45 months. All patients were followed-up according to the scheduled time. Results The op-erations were successfully performed in all 9 patients. The papillary or cauliflower-like tumors infiltra-ted colli culus seminalis and prostate duct nearby. The glands were coated with tall pseudostratified columnar cells. The nuclei were large, dark stained with more frequent mitoses. The positive rates of immunolabelling antibody PSA, AR, PAP were found to be 89%(8/9), 100%(5/5), 100%(5/5) re-spectively. The distribution of Gleason score was 6-7(3 cases), and≥8(6 cases), and a coexisting acinar carcinoma component was identified in 5 cases of the group. Nine cases had a mean follow up for 20(3-48) months. Five cases have developed biochemical recurrence, of whom 3 died of bone metas-tasis and multiple organ failure, and 1 developed lung and bone metastasis. Three cases remained alive without recurrence. The remaining 1 case survives during the follow-up survey for 6 months until now, without examinations due to the old age. Conclusions Duct adenocarcinoma of the prostate presents the low incidence and lacks of typical symptoms in the early stage. Diagnosis was confirmed mainly on the basis of pathology. The tumors tend to have a more advanced stage and a very short term survival rate. The treatment options and management are similar to that of high-grade adenocar-cinoma of the prostate;meanwhile, close follow-up survey should be performed.     

双源CT在主动脉瓣置换术前左心功能评价中的应用

目的:以磁共振成像(MRI)为金标准,用双源CT(DSCT)定量评价左心功能,探讨DSCT在主动脉瓣置换术前左心功能评价中的应用价值.方法:选取临床诊断主动脉瓣病变欲行主动脉瓣置换术的患者21例,全部病例均行DSCT和MRI心功能分析检查.由有经验的2位放射科医生独立进行,结果以均数士标准差表示.两种仪器间测量值应用配对样本t检验及相关分析检验,同一仪器测量值的差异相互关系用组内相关系数描述,P ＜0.05为有统计学意义.结果:DSCT和MRI两种方法测量的心功能指标差异无统计学意义,舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)、左室射血分数(EF)相关性高,r值(EDV)=0.93,r值(ESV)=0.94,r值(SV)=0.89,r值(EF)=0.85.EDV均值:DSCT＞ MRI;ESV均值:DSCT＞ MRI;SV均值:DSCT＞ MRI; EF均值:DSCT＞ MRI.同一仪器三次测量值的差异相互关系(ICC值):MRI测量的EDV、ESV、SV、EF值的ICC值在0.8～1之间;DSCT测量的EDV、ESV、SV、EF值的ICC值在0.6～0.75之间.结论:DSCT在左心室收缩功能定量评价方面准确、可靠,重复性好,并可在不增加放射剂量的前提下,一次DSCT冠状动脉造影检查同时评估冠状动脉狭窄情况和左心室收缩功能,能够为临床主动脉瓣置换术前评估及制订手术方案提供更多重要的参考信息.