Sp1在 NK／T 细胞淋巴瘤细胞株中的表达及其对细胞侵袭的影响

目的：观察转录因子 Sp1在 NK／T 细胞淋巴瘤（NK／TCL）细胞株中的表达及其对细胞侵袭的影响。方法采用实时荧光定量聚合酶链反应（PCR）、免疫荧光和 Western blot 法测定 NK／TCL 细胞株 SNK-1、SNK-6和健康人 NK 细胞中 Sp1的表达;采用 Sp1抑制剂光神霉素 A（MIT）作用于 NK／TCL细胞株后,用实时荧光定量 PCR 和 Western blot 法检测 Sp1、胰岛素样生长因子1受体（IGF-1R）和基质金属蛋白酶2（MMP-2）的表达;采用 Transwell 实验观察 MIT 对细胞侵袭力的影响。结果 NK／TCL 细胞株SNK-1、SNK-6中 Sp1基因和蛋白高表达。其中基因的表达水平分别是健康人 NK 细胞的（9.4±0.3）倍和（10.6±0.3）倍（P＝0.0052,P＝0.0037）,蛋白的表达水平分别是健康人 NK 细胞的（5.4±0.3）倍和（8.6±0.5）倍（P＝0.0083,P＝0.0069）。100 nmol／L MIT 抑制 Sp1后,与二甲基亚砜处理的对照组相比,细胞株中 IGF-1R 的基因表达量分别下降了（83.9±3.7）%和（65.8±4.2）%（P＝0.0082,P＝0.0097）,蛋白表达量分别下降了（51.5±7.1）%和（49.6±9.1）%（P＝0.0178,P＝0.0155）。100 nmol／L MIT 处理细胞后 SNK-1、SNK-6细胞的侵袭率分别下降了（29.6±6.4）%和（37.2±7.6）%（P＝0.0418,P＝0.0372）,MMP-2蛋白表达量分别是对照组蛋白表达量的（52.7±4.7）%、（29.7±5.6）%（P＝0.0286,P＝0.0202）。结论 NK／TCL细胞株高表达 Sp1,其可能通过正调控 IGF-1R 增强 MMP-2的表达,进而提高 NK／TCL 细胞的侵袭力。     

超声和CT在儿童神经母细胞瘤诊断、临床分期和治疗方案制定中的价值分析

目的:对比分析超声和CT对儿童神经母细胞瘤的诊断价值以及二者在该病临床分期和治疗方案制定中的价值。方法:筛选经病理证实的儿童神经母细胞瘤34例（其中术后证实瘤内钙化者26例）,分析其临床及影像资料。结果:本研究的34例患者中,有29例超声显示为大小不等、回声不均匀的实性肿块,其中20例肿块表现为跨中线生长,18例包绕腹部大血管,18例后腹膜淋巴结肿大,且有9例、8例和2例分别为肾脏、肝脏、脾脏受累患者。本研究中有28例患者在术前通过超声进行了确诊,其符合率高达82.4%,特征性瘤内钙化的检出率达88.5%（23/26）;CT示大小不等、密度不均匀的肿块34例,增强可见明显强化,包绕大血管者18例,跨中线生长者20例,侵犯椎管腔者8例,后腹膜淋巴结肿大者15例,肾脏、肝脏、脾脏受累者分别为9例、6例、1例,头颅转移者7例,30例术前做出正确诊断,术前CT诊断符合率为88.2%,瘤内钙化的检出率高达96.2%（25/26）。结论:儿童神经母细胞瘤有其典型的影像学表现,超声和CT对该病的诊断符合率都很高,且各具优势,二者联合应用对儿童神经母细胞瘤的诊断、临床分期和指导治疗有重要价值。     

MALAT-1在肿瘤中的作用及其机制

肺腺癌转移相关转录1（metastasis-associated lung adenocarcinoma,MALAT-1）自首次发现以来,其在肿瘤中作用逐渐成为非编码长链RNA（long non-coding RNA,lncRNA）研究中的热点。MALAT-1主要通过调控可变剪接及直接调控编码蛋白质基因表达,参与肿瘤相关基因的表观遗传调控及相关信号转导通路,影响肿瘤生长、侵袭及转移、抗凋亡、耐药形成。本文就MALAT-1结构、生物学功能特点及其在肿瘤发生、发展中的作用和机制进行简述。     

MRI导丝定位术对仅MRI显示的乳腺病变的诊断价值

目的:初步探索MRI导丝定位术对仅MRI显示的乳腺微小病变的诊断价值。方法:使用Toshiba 1.5T VISART超导MRI仪,八通道相控阵乳腺专用线圈,专用导丝及定位系统,对16例患者19处仅MRI显示、BI-RADS分类为4类及以上的乳腺微小隐匿病灶进行导丝定位术。根据MRI检查可疑病灶的部位,结合专用软件进行测量计算,选择外侧位、内侧位,精准定位进针,观察操作方式及定位准确性,准确划定手术区域位置及范围,定位结束后送病人行外科手术切除,结合手术病理结果进行对比分析。结果:16例患者19个病灶均一次定位成功,病理切片证实病变完全成功切除,成功率为100%。术前MRI综合诊断BI-RADS分类4A类5处,4B类6处,4C类6处,5类2处;病理包括:导管内多发乳头状瘤3处(其中1例伴不典型增生),中度不典型增生2处,重度不典型增生5处,导管内癌4例,导管内癌伴微浸润1例,浸润性乳腺癌1例,大汗腺化生伴导管上皮增生1例,硬化性腺病伴筛状增生1例,微小纤维腺瘤1例,术前MRI诊断结论与术后病理结果对照,诊断符合率为84.21%（16/19）。结论:对X线、超声无法检出,临床触及阴性,仅MRI显示的乳腺微小隐匿性病灶,应用MRI进行初步定性诊断,对BI-RADS分类4A类及以上的病灶进行MRI导丝定位术,是一种早期、安全、准确可靠的方法,弥补了X线、超声诊断的不足及假阴性的发生,提高了早期乳腺癌、导管内癌及不典型增生的精准诊治水平,是对乳腺X线和超声引导乳腺导丝定位术的重要补充。     

化疗周期数对DC/CIK治疗晚期非小细胞肺癌临床效果的影响

目的:研究化疗周期数对树突状细胞（DC）联合细胞因子活化的杀伤细胞（CIK）治疗晚期非小细胞肺癌（NSCLC）临床效果的影响。方法:回顾性分析2012年2至2016年2月内一科收治的124例化疗后接受DC/CIK治疗的晚期NSCLC患者的临床资料。患者按实际化疗周期分为2周期化疗组（43例）、3周期化疗组（40例）、4周期化疗组（41例）。3组患者临床资料及化疗方案相近。所有患者均在化疗后1~3个月内接受免疫细胞治疗。DC/CIK治疗前应用流式细胞仪检测外周血PD-1的表达。免疫细胞治疗完成后4周,参照RECIST标准和NCI-CTCAE 4.0标准评价近期临床疗效和安全性;根据卡氏（Karnofsky）功能状态评分评估患者生活质量（QOL）变化。结果:4周期化疗组PD-1表达水平明显高于2、3周期化疗组［(34.65±3.29)% vs (13.94±2.89)%和(25.88±5.06)%］,差异有统计学意义（P＜0.001）。2周期化疗组治疗的客观反应率（ORR）27.91%显著高于4周期化疗组（9.76%）（P＜0.05）。2周期化疗组疾病控制率(DCR)34.88%显著高于4 周期化疗组（14.63%）,差异有统计学意义（P＜0.05）。2周期化疗组QOL改善率55.81%,显著高于3周期化疗（32.50%）、4周期化疗组（21.95%）（P＜0.05）。三组患者治疗后均未出现Ⅲ-Ⅳ级不良反应。结论:化疗周期数可降低DC/CIK对晚期非小细胞肺癌的临床治疗效果,化疗周期数越多病人取得DC/CIK细胞治疗的近期临床获益越小。     

CA 125 regression after two cycles of neoadjuvant chemotherapy as prognostic factor in patients with advanced ovarian cancer and primary peritoneal serous cancer who underwent interval surgical cytoreduction

OBJECTIVES: The aim of our study was to assess the prognostic role of CA 125 regression during neoadjuvant chemotherapy (NAC) in patients with ovarian cancer (OC) or primary peritoneal serous carcinoma (PPSC) that underwent interval debulking surgery (IOC). MATERIAL AND METHODS: Thirty one patients with advanced OC or PPSC (FIGO stage IIIC and IV) who underwent initial exploratory surgery, followed by NAC containing platinum analogs, have been analyzed, retrospectively. We have used a regression coefficient (RCA 125), which was calculated as following: log10 (CA 125 level measured after two cycles of NAC/baseline CA 125) for statistical analysis. The median value of RCA 125 reached -0.788 and has been used to dichotomize. Optimal IOC has been performed in 67.74% (21/31) patients, suboptimal in 25.81% (8/31) patients and 6.45% (2/31) of patients did not undergo IOC due to the progression of the disease. RESULTS: We have noted significant correspondence between time to progression and RCA 125 in univariate analysis, which we have also confirmed in multivariate analysis (HR 0.27; 95% CI, 0.15-0.96; p = 0.0178). Similarly, we have observed significant relationship between overall survival, RCA 125 and extension IOC in univariate analysis. Multivariate analysis confirmed that RCA 125 was independent prognostic factor, HR-0.18 (95% CI, 0.07-0.56; p = 0.004). In case of patients with high RCA 125, a greater rate of optimal debulking cytoreduction (p = 0.0278, U = 50.0) has been observed. CONCLUSIONS: RCA 125 after two courses of NAC appears to be an important prognostic factor in patients with OC or PPSC, who underwent IOC High RCA 125 during NAC seems to be a good predictive factor in order to achieve optimal IOC.     

Thrombotic thrombocytopenic purpura in pregnancy. A case report

Thrombotic thrombocytopenic purpura (TTP) is characterized by microangiopathic hemolytic anemia and thrombocytopenia, accompanied by microvascular thrombosis that causes variable degrees of tissue ischemia and infarction. About 10-20% of TTP cases are associated with the pregnancy. Preterm delivery and intrauterine fetal death are frequent pregnancy complications of TTP. The following paper presents the case of a 32-year-old woman with TTP relapse at 10 weeks of her second pregnancy. Despite regular fresh frozen plasma transfusions, intrauterine fetal death occurred at 21 weeks of gestation. Current views on TTP management during pregnancy have been presented in the article as well.     

Krukenberg tumor--8 years after surgical treatment of gastric carcinoma

The aim of the study was to discuss the case of Krukenberg tumor in a patient, eight years after the diagnosis and surgical treatment of gastric carcinoma. We have concluded that there was no safe period after which distant metastases may be excluded. In case of gastric carcinoma diagnosed in women, a regular gynecological examination is necessary due to a high propability of metastases into ovaries, even if the clinical stage of gastric carcinoma is low.     

The 3020insC NOD2 gene mutation in patients with ovarian cancer

OBJECTIVE: There is an increasing evidence that genetic factors play a role in the etiology of malignant tumors. Mutations of BRCA1 and BRCA2 genes are responsible for an increased risk of ovarian cancer. The role of mutations in NOD2 gene in this type of neoplasm is still under investigation. THE AIM: The aim of this study was to determine: 1. incidence of NOD 2 3020insC constitutional mutation in a group of consecutive women with ovarian cancer, 2. risk of developing ovarian cancer in patients with NOD2 gene mutation, 3. clinical and pathological features of ovarian cancer in NOD2 gene mutation carriers. PATIENTS AND METHODS: Clinical and pathological data were collected from 257 non-selected patients with primary epithelial ovarian cancer. The researches identified NOD2 3020insC gene mutation. On the basis of patient source documentation we obtained the data concerning the age of patients at diagnosis, histopathological recognition, FIGO stage and morphological grade G. RESULTS: 19 out of 257 women were identified with germ-line 3020insC mutation of NOD2 gene (7.39%). An increased risk of ovarian cancer in NOD2 mutation carriers was not revealed (OR=1.01; p=0.928; 95% Cl=0.61-1.66). The mean age at diagnosis of patients with NOD2 mutation was 54.8 (SD=9.9), while for non-carriers it was 53.2 (SD=10.2). The difference between these frequencies was statistically irrelevant (p=0.550). Clinical and pathological profile of ovarian cancer was made. We assessed the following features: age at disease onset, histopathology, FIGO stage and morphological grade G. For NOD2 mutation carriers no statistically significant features of ovarian cancer were revealed. CONCLUSION: 1. Despite high frequency of constitutional mutations occurrence in NOD2 gene in women with ovarian cancer, genetic testing seem not to be justified in all women diagnosed with this disease. 2. Due to a lack of increased risk of ovarian cancer in NOD2 gene mutation carriers, proceedings for them may not differ from recommendations for general population. 3. It is difficult to determine characteristic clinical and pathological features of ovarian cancer for NOD2 gene mutation carriers.