细胞膜磷脂与肿瘤侵袭、转移及靶向治疗的相关性研究进展

侵袭和转移是肿瘤进展的标志,是肿瘤临床治疗的难题及肿瘤患者死亡的主要原因。磷脂是生物膜的重要物质基础,参与肿瘤细胞增殖、运动、黏附、凋亡、信号转导、细胞周期调节等活动。本文对膜磷脂在肿瘤侵袭、转移、靶向治疗中的作用研究进展进行了综述。细胞膜磷脂成分及分布、磷脂代谢产物、磷脂酶及磷脂结合蛋白在肿瘤细胞膜流动性、黏附、凋亡、增殖、侵袭、转移、血管及淋巴管形成中具有重要作用,以细胞膜磷脂及其代谢产物为靶点治疗恶性肿瘤具有广阔前景。     

乳腺癌淋巴结微转移患者克隆性T细胞TCRα链CDR3谱型分析

目的 分析乳腺癌微转移淋巴结T细胞克隆性增生及TCR α链谱型偏移情况,了解抗肿瘤T细胞克隆的分子特征。方法 利用RT-PCR扩增10例乳腺癌微转移淋巴结T细胞32个TCR可变区（AV）亚家族的基因,基因扫描检测T细胞克隆性及TCR AV亚家族取用情况,对单克隆家族行PCR扩增TCR α链全长序列,构建重组质粒后测序,分析互补决定区（CDR3）序列。结果 乳腺癌淋巴结微转移患者T细胞呈单、寡克隆、寡克隆趋势和多克隆增生,不同患者表达1～4个TCR AV亚家族。克隆性T细胞的CDR3氨基酸序列不同,但是病例4和病例8含有相同的CDR3氨基酸基序：AM和DDKII。结论 乳腺癌TCR AV基因表达具有多样性特点,TCR AV家族的取用可能与乳腺癌肿瘤抗原的多样性和不同个体的免疫应答反应有关。相同CDR3氨基酸基序的发现可能对乳腺癌的T细胞介导免疫治疗提供帮助。     

肾原发性非霍奇金淋巴瘤临床诊治分析

目的:探讨肾原发性非霍奇金淋巴瘤（PRL）的临床特点和诊治方法。方法:回顾性分析2008年3月-2012年10月我院收治的6例PRL患者的临床资料,分析其临床、病理、治疗和预后的特点。结果:6例患者均行根治性肾切除术。术后免疫组化诊断为PRL。5例获得随访,1例失访。随访时间9-64个月,平均28个月。2例分别于术后4个月和6个月局部复发,再次行手术治疗。1例术后4个月出现多发肺转移,3个月后死亡。余2例未见转移和复发。结论:PRL是一种罕见的、恶性程度较高的肿瘤,诊断依赖于免疫组化检查。根治性肾切除术联合放化疗为治疗首选。术后需要密切随访。     

Vimentin在结肠癌中的表达和临床意义

目的:研究Vimentin在结肠癌中的表达及潜在的临床意义。方法:免疫组织化学染色的方法检测Vimentin在150例结肠癌及其相应癌旁组织中的表达,分析Vimentin的表达水平与年龄、性别、组织学类型、TNM分期、淋巴结转移、远处转移等临床参数间的相关性。结果:Vimentin在结肠癌中的表达阳性率为58.0%,远高于相应癌旁组织的18.7%(P＜0.000),Vimentin表达水平在发生淋巴结转移、远处转移的结肠癌中表达明显高于未发生淋巴结转移、远处转移的结肠癌,差异具有统计学意义(P=0.003)。 结论:Vimentin在结肠癌中呈高表达,其表达水平与淋巴结转移、TNM分期、远处转移密切相关,提示Vimentin在结肠癌的转移过程中可能发挥重要作用。     

73例广泛期小细胞肺癌患者的预后因素分析

目的:对广泛期SCLC影响中位生存期的相关因素进行分析。方法:统计73例患者的临床资料,包括性别、年龄、肿瘤位置、PS评分、远处转移部位和治疗方法等。采用电话形式进行随访,Kaplan-Meier曲线进行单因素生存分析,生存率比较采用Log-rank检验。将有统计学意义的变量,带入COX比例风险模型进行多因素生存分析。结果:患者总体中位生存期是10.7个月。单因素分析得出,PS评分、脑转移、肝转移、常规治疗以及全脑预防性照射对患者的中位生存期有影响。多因素分析得出,PS>2分、发生肝转移和未行全脑预防照射是独立危险因素。结论:在广泛期SCLC患者中,PS>2分,发生肝转移以及未行PCI治疗的患者预后较差。在临床诊治中,应结合患者具体情况,给予合适的综合治疗。     

贲门癌前纵隔胸骨旁淋巴结转移—附5例报道

目的:报道5例贲门癌前纵隔胸骨旁淋巴结转移。方法:2009年5月至2013年5月我院就诊的贲门癌根治术后患者5例,4例经CT检查发现有腹腔和纵隔淋巴结转移及胸骨旁淋巴结肿大,1例超声检查发现有胸骨旁淋巴结肿大,全部患者在超声定位引导下行胸骨旁肿大淋巴结穿刺病理活检。结果:穿刺活检组织病理结果全部发现癌组织,提示腺癌。结论:贲门癌发生纵隔淋巴转移时有可能通过隔上淋巴结转移至胸骨旁淋巴结。     

肠内外营养对胃癌根治性切除术患者免疫功能的影响

目的 比较肠内营养支持（enteral nutrition,EN）、肠外营养支持（parenteral nutrition,PN）对胃癌根治性切除术术后患者肠道功能恢复、住院时间和免疫功能的影响。方法 选取2011年1月至2014年5月在我院治疗的80例胃癌根治性切除术患者为研究对象,随机分为EN组和PN组各40例,比较两组患者术后肠道功能恢复的时间、住院时间及免疫功能的指标。结果 EN组患者术后肠道通气时间及平均住院时间均显著短于PN组（P均＜0.05）;EN组患者术后1 d及术后7d IgA、IgG、IgM、CD3⁺的水平及术后7 d CD4⁺的水平均显著高于PN组,差异有统计学意义（P均＜0.05）。两组患者术后1 d及术后 7 d的NK细胞、C反应蛋白（C-reactive protein,CRP）的水平及术后1 d CD4⁺的水平差异均无统计学意义（P均＞0.05）。结论 EN对促进胃癌根治性切除术患者肠道功能恢复及提高免疫功能均优于PN,且住院时间较短,值得临床推广应用。     

Association of miR-1266 with Recurrence/Metastasis Potential in Estrogen Receptor Positive Breast Cancer Patients

The Homeobox B13 (HOXB13):Interleukin 17 Receptor B (IL17BR) index of estrogen receptor (ER)-positivebreast cancer (ER (+) BC) patients may be a potential biomarker of recurrence/ metastasis. However, effects ofmicroRNA (miRNA) binding to the 3’ untranslated region (3´UTR) of HOXB13 and IL17BR and its function onrecurrence/metastasis in ER (+) BC remains elusive. The aims of this study were to determine the expressionof miRNAs that bind to 3´UTR of HOXB13 and IL17BR in ER (+) BC patients and asess the effects of thesemiRNAs on recurrence/metastasis. The expression profiles of HOXB13 and IL17BR were evaluated using RTPCRin tumors and normal tissue samples from 40 ER (+) BC patients. The expression level of 4 miRNAs, whichwere predicted to bind the 3´UTR of HOXB13 and IL17BR using TargetScan, microRNA.org and miRDB onlinedatabases, were further evaluated with RT-PCR. Our findings demonstrated that high miR-1266 levels might besignificant prognostic factor for recurrence/metastasis occurrence (3.05 fold p=0.004) and tamoxifen response(3.90 fold; p=0.2514) in ER (+) BC cases. Although we suggest that modulation of miR-1266 expression may bean important mechanism underlying the chemoresistance of ER (+) BC, advanced studies and validation arerequired.     

Is it Necessary to Submit Grossly Normal Looking Gall Bladder Specimens for Histopathological Examination?

Background: The objectives of the study were to: 1) determine the frequency of incidental malignancy inunsuspected/grossly normal looking gall bladders; 2) determine the frequency of malignancy in suspected/grosslyabnormal looking gall bladders. Materials and Methods: This prospective, cross sectional study was carried outat a tertiary care hospital in Pakistan, during a four year period (Jan 2009-dec2012). All the cholecystectomycases performed for gallstone diseases were examined initially by a surgeon and later on by a pathologist formacroscopic abnormalities and accordingly assigned to one of the three categories i.e. grossly normal, suspicious,abnormal/malignant. Frequency of incidental carcinoma in these categories was observed after receiving the finalhistopathology report. Results: A total of 426 patients underwent cholecystectomy for cholelithiasis, with a 1:4male: female ratio. Mean age of the patients was 45 years with a range of 17-80 years. The frequency of incidentalgallbladder carcinoma was found to be 0.70 %(n=3). All the cases of gallbladder carcinoma were associatedwith some macroscopic abnormality. Not a single case of incidental carcinoma gallbladder was diagnosed in383 ‘macroscopically normal looking’ gallbladders. Conclusions: Incidental finding of gall bladder cancer wasnot observed in any of macroscopically normal looking gall bladders and all the cases reported as carcinomagallbladder had some gross abnormality that made them suspicious. We suggest histopathologic examinationof only those gall bladders with some gross abnormality.