The role of EBV and HPV infection in cervical cancer development of Uyghur women

目的:探讨维吾尔族妇女宫颈癌发生过程中EB病毒(Ebstein-Barr virus,EBV)及人乳头瘤病毒(human papillomavirus,HPV)感染的作用及其意义.方法:收集维吾尔族妇女宫颈炎、宫颈内上皮瘤样病变(cervical intraepithelial neoplasia,CIN)Ⅰ/Ⅱ/Ⅲ和宫颈鳞癌患者福尔马林浸泡与石蜡包埋组织标本共178例,提取DNA并采用PCR方法对EBV和HPV DNA进行检测;用免疫组织化学方法检测宫颈癌EBV蛋白表达.结果:病毒DNA检测结果显示,宫颈炎、CIN Ⅰ、CINⅡ～Ⅲ和宫颈癌患者各组HPVDNA检出率依次是2.5％、12.5％、68.0％、96.4％,EBV DNA为0、3.1％、28.0％和69.6％,其中宫颈炎组与CINIⅠ～Ⅲ和宫颈癌组间的差异具有统计学意义(P均＜0.05),但宫颈炎与CINⅠ组间的差异无统计学意义(P＞0.05).宫颈病变病理进程不仅伴随着HPV及EBVDNA阳性检出率梯度上升,而且与HPV和EBV双重感染检出率增高呈正相关(r=0.46,x2=82.50,P＜0.01).对宫颈癌组织进行免疫组织化学分析,发现EBV DNA检测阳性标本中EBV蛋白阳性表达检出率为89.7％(34/39),而阴性标本中蛋白表达阳性率为6％(1/17).结论:维吾尔族妇女宫颈癌的发生与发展可能与HPV和EBV双重感染密切相关.     

维、汉族妇女宫颈病变中抑癌基因DAPK1、MGMT表达及其意义

目的:探讨O6-甲基鸟嘌呤-DNA甲基转移酶(06-methylguanine-DNA methyl-transferase,MGMT)、死亡相关蛋白激酶(death associated protein kinase 1,DAPK1)抑癌基因表达水平与宫颈癌前病变病理进程的关系及其族群差异.方法:收集维吾尔族和汉族妇女宫颈炎、宫颈内上皮瘤样病变(cervical intraepithelial neoplasia,CIN)和宫颈鳞癌患者石蜡包埋组织标本共218例,采用免疫组织化学方法检测MGMT、DAPK1蛋白表达水平.结果:DAPK-1阳性表达率在维、汉族妇女CIN Ⅱ/Ⅲ和宫颈鳞癌中均明显降低,低于宫颈炎/CIN Ⅰ(P(0.05);DAPK-1表达减弱与CIN、宫颈癌发生密切相关.MGMT在维、汉族宫颈病变病理进程中表达水平明显不一致,MGMT在汉族妇女宫颈炎/CIN Ⅰ、CIN Ⅱ/Ⅲ和宫颈鳞癌中的表达无递增或递减趋势;在维吾尔族妇女中阳性表达率随宫颈病变病理进程而升高,差异有统计学意叉(P<0.05).结论:DAPK1、MGMT基因的蛋白质表达水平变化与维、汉族妇女宫颈病变病理进程密切相关,为建立新一代族群和宫颈癌特异性早期诊断指标提供重要依据.     

维吾尔族妇女宫颈癌人乳头状瘤病毒感染与人类白细胞抗原Ⅰ类基因表达缺失的关系及其意义

目的 研究维吾尔族妇女宫颈癌中人乳头状瘤病毒(HPV)感染和人类白细胞抗原Ⅰ类(HLA-Ⅰ)家族基因HLA-A、B和C表达的关系,探讨HPV感染和HLA-Ⅰ类家族基因表达缺失在宫颈癌演进过程中的作用.方法 收集维吾尔族妇女宫颈炎、宫颈上皮内瘤样病变(CIN)Ⅰ/Ⅱ/Ⅲ和宫颈鳞癌患者的新鲜组织标本共78例,提取总RNA,采用半定量RT-PCR方法鉴定HLA-A、B和C基因的mRNA表达水平.提取组织DNA,采用HPV通用引物和HPV分型芯片确定HPV亚型.结果 HLA-A、B和C基因的总体mRNA表达缺失率随着宫颈病变的加重而增加,在宫颈炎组织内为1/12,在CIN及宫颈鳞癌分别占70.0%(14/20)和84.8%(39/46),在恶性程度高的低分化癌组织中高达90.6%(29/32),并与高危型HPV16感染呈正相关(r=0.803,P＜0.01).结论 HLA-Ⅰ类基因的表达缺失是维吾尔族妇女宫颈癌发生的重要标志,而HPV16感染可能是HLA-Ⅰ分子表达缺失的前提条件.     

Analysis of Helicobacter pylori antimicrobial susceptibility and virulence genes in gastric mucosal biopsies in the United Arab Emirates

AIM: To determine the virulence attributes (presence of cagA and vacA genes) of Helicobacter pylori , and presence of clarithromycin resistance genes in gastric mucosal biopsy samples obtained in the United Arab Emirates. METHODS: DNA was extracted from antral gastric biopsy samples from 91 dyspeptic patients. Real-time PCR and melting curve analysis were used to identify patients infected with H. pylori and to further identify strains containing the A(2142/43)G or the A(2142)C mutations that are associated with clarithromycin resistance. PCR was also used to identify cagA - and vacA -positive strains. RESULTS: Real-time PCR analysis detected the presence of H. pylori in 55 (60%) samples. Thirty-six pathogen-positive samples contained at least one of three point mutations associated with clarithromycin resistance. The vacA gene was present in 40 (72.7%) and cagA was present in 41 (74.5%) of the positive samples. Both genes were present in 36 (65%) of the positive samples. The presence of each clarithromycin-inducing mutation was largely independent of the others. Mutation at one position, A(2142/43)G, was strongly associated with the presence of both the vacA gene and the cagA gene. CONCLUSIONS: A high proportion of gastric mucosal biopsies obtained in the UAE is positive for genes associated with clarithromycin resistance. This may have implications for treatment of the infection.     

CYP2E1 polymorphism, cigarette smoking, p53 expression, and survival in non-small cell lung cancer: a long term follow-up study.

The expression of selected gene products involved in cell differentiation and cell growth and genetic polymorphism of detoxifying genes was examined in 105 surgically resected nonsmall cell lung cancer (NSCLC) patients, and the relationship of these factors was correlated with cigarette smoking and patient survival. Genotyping of peripheral blood lymphocytes from 87 patients was performed for CYP2E1, GSTM1, GSTT1, mEH, and MPO detoxifying genes using polymerase chain reaction. Formalin-fixed, paraffin-embedded tissue was immunostained with antibodies to p53, p27, phospho-AKT, and bcl-2 using the avidin-biotin-peroxidase method and tissue microarray technique. Tumors were assigned a positive or negative score based on more than 10% of tumor cells staining positive with the antibody. The subtypes of NSCLC included 48 adenocarcinomas, 47 squamous cell carcinomas, and 10 large cell undifferentiated carcinomas. A total of 54 tumors were pathologic stage I, 23 were stage II, and 26 were stage III. All subjects smoked (range, 10-175 pack-years; mean, 60 pack-years). The mean overall survival was 112 weeks (median, 129 weeks). Patients with p53-positive tumors had significantly fewer pack-years of smoking (52 pack-years vs 72 pack-years; P = 0.021), smoked fewer years (34 years vs 40 years; P = 0.018), and had significantly better survival compared with those with p53-negative tumors (P = 0.045). When smoking history was further analyzed, the authors found that p53 expression was associated with the number of years smoked and not the number of packs smoked per day. Patients with squamous cell carcinoma had smoked longer compared with those with adenocarcinoma (P = 0.011). Significant association was seen between the CYP2E1 wild-type allele and better survival (P = 0.016). Patients with stage I tumors had better survival compared with stages II and III (P = 0.032). No association was found between survival and tumor type; tumor differentiation; expression of phospho-AKT, p27, and bcl-2; and polymorphic metabolizing genes other than CYP2E1. The significant association of long duration of smoking (>40 years) with loss of p53 expression and poor survival suggests inactivation of the protective p53 pathway in those who had a history of more than 40 years of smoking.     

Percutaneous treatment of displaced intra-articular calcaneal fractures

Background The outcome after displaced intra-articular calcaneal fractures is influenced by the condition of the surrounding soft tissues. To avoid secondary soft tissue complications after surgical treatment, several less-invasive procedures for reduction and fixation have been introduced. The percutaneous technique according to Forgon and Zadravecz is suitable for all types of displaced intra-articular calcaneal fractures and was therefore introduced in our clinic. The aim of this study was to evaluate the long-term outcome of percutaneous treatment according to Forgon and Zadravecz in patients with displaced intra-articular calcaneal fractures. Methods A cohort of patients with displaced intra-articular calcaneal fractures treated with percutaneous surgery was retrospectively defined. Clinical outcome was evaluated by standardized physical examination, radiographs, three published outcome scores, and a visual analogue scale of patient satisfaction. Results Fifty patients with 61 calcaneal fractures were included. After a mean follow-up period of 35 months, the mean values of the Maryland foot score, the Creighton-Nebraska score, and the American Orthopaedic Foot and Ankle Society score were 79, 76, and 83 points out of 100, respectively. The average visual analogue scale was 7.2 points out of 10. The average range of motion of the ankle joint was 90% of normal and subtalar joint movements were almost 70% compared with the healthy side or normal values. Superficial wound complications occurred in seven cases (11%) and deep infections in two (3%). A secondary arthrodesis of the subtalar joint was performed in five patients and was scheduled in four patients (15%). Conclusions Compared with the outcome of historic controls from randomized trials and meta-analyses, this study indicates favorable results for the percutaneous technique compared with the open technique. Despite similar rates of postoperative infection and secondary arthrodesis, the total outcome scores and preserved subtalar motion are overall good to excellent.     

Cavernous lymphangioma of the duodenum: Case report and review of the literature

Lymphangiomas of the gastrointestinal tract are extremely rare benign tumors. There have been 39 cases of solitary intestinal lymphangiomas reported, 8 of which were found in the duodenum; only 3 of these were seen radiographically. A case of cavernous lymphangioma of the duodenum is presented, the roentgenographic and pathologic findings are described, and the literature is reviewed.     

Small cell carcinoma of the ovary with hypercalcemia and ectopic parathyroid hormone production

Small cell carcinoma of the ovary is a rare malignant tumor of the ovary. It is the most common undifferentiated ovarian carcinoma in young women. Approximately two thirds of patients with ovarian small cell carcinoma have hypercalcemia. The mechanism of development of hypercalcemia is unclear, although parathyroid hormone-related protein has been found in some of the cases. Parathormone expression in tumor cells, rarely reported, was seen in this case, suggesting that ectopic parathyroid hormone production by the tumor cells may be the cause of hypercalcemia.