P-GP170、LRP与Ki-67在甲状腺乳头状癌中的表达及临床意义

 目的　检测多药耐药基因蛋白P 糖蛋白 (P GP170 )和肺耐药蛋白 (LRP)与抗核抗体Ki 6 7在甲状腺乳头状癌中的表达及临床意义。方法　采用免疫组化SP法检测P GP170、LRP、Ki 6 7在 6 4例甲状腺乳头状癌和 2 0例甲状腺腺瘤中的表达。结果　 3种抗体在甲状腺乳头状癌中均呈高表达 ,在甲状腺腺瘤中呈低表达。与甲状腺腺瘤相比有显著性差异 (P <0 .0 1)。P GP170、LRP、Ki 6 7三者呈显著相关性 (LRP与Ki 6 7r =0 .4 2 ,LRP与P GP170r =0 .4 2 ,Ki 6 7与P GP170r =0 .6 5 ,P <0 .0 1)。结论甲状腺乳头状癌标记指数高、耐药性强、化疗敏感性低。在化疗中同时给予耐药抑制剂 ,可以提高化疗敏感性和化疗效果。     

Imaging of the symptomatic type II accessory navicular bone

Accessory ossicles of the foot are commonly mistaken for fractures. The accessory navicular is one of the most common accessory ossicles of the foot. There is a higher incidence in women and the finding might be bilateral in 50?90%. This entity is usually asymptomatic, although populations with medial foot pain have a higher prevalence. Three types of accessory navicular bone have been described. The type II accessory navicular is the most commonly symptomatic variant with localized chronic or acute on chronic medial foot pain and tenderness with associated inflammation of overlying soft tissues. Plain radiographic identification of the accessory navicular is insufficient to attribute symptomatology. Ultrasound allows for comparison with the asymptomatic side and localization of pain. Bone scintigraphy has a high sensitivity but positive findings lack specificity. Magnetic resonance imaging is of high diagnostic value for demonstrating both bone marrow and soft tissue oedema.     

P21WAF1, P27KIP1, TP53 and C-MYC analysis in 204 ovarian carcinomas treated with platinum-based regimens.

BACKGROUND: The prognostic and predictive value of cell cycle regulatory proteins in ovarian cancer has not been established. We evaluated the clinical and biological significance of P21(WAF1), P27(KIP1), C-MYC, TP53 and Ki67 expressions in ovarian cancer patients. MATERIALS AND METHODS: Immunohistochemical analysis was performed on 204 ovarian carcinomas of International Federation of Gynecology and Obstetrics (FIGO) stage IIB to IV treated with platinum-based chemotherapy. Multivariate analysis with Cox and logistic regression models was performed in the whole group, and in the TP53-negative and TP53-positive subgroups. RESULTS: High P21(WAF1) labeling index (LI) was an independent positive predictor of platinum-sensitive response (P = 0.02). Overall survival was positively influenced by P21(WAF1) LI (P = 0.02) or by P21(WAF1) plus P27(KIP1) LI (P = 0.004) in the TP53-negative group only. Ki67 LI showed borderline association with disease-free survival (P = 0.05). Growth fraction was negatively associated with P21(WAF1) and P27(KIP1) indices in the TP53-negative group (P = 0.023 and 0.008, respectively), and these associations were borderline or lost in the TP53-positive group. Endometrioid and clear cell carcinomas differed from other carcinomas by having a low incidence of TP53 accumulation, a high incidence of C-MYC overexpression (70%) and a low median Ki67 LI (all with P <0.001). CONCLUSIONS: We have shown an independent predictive value of P21(WAF1) LI in ovarian carcinoma patients. The prognostic value of P21(WAF1) and P21(WAF1) plus P27(KIP1) LI was determined by TP53 status. A high frequency of C-MYC overexpression in endometrioid and clear cell carcinomas may suggest its role in the development of these tumor types.     

An individual patient-based meta-analysis of tamoxifen versus ovarian ablation as first line endocrine therapy for premenopausal women with metastatic breast cancer

Increased dietary fat intake and rate of breastepithelial cell proliferation have each been associated withthe development of breast cancer. The goal ofthis study was to measure the effect ofa low fat, high carbohydrate diet on therate of breast epithelial cell proliferation in womenat high risk for breast cancer. Women wererecruited from the intervention and control groups ofa randomized low fat dietary intervention trial, breastepithelial cells were obtained by fine needle aspiration,and cell proliferation was assessed in these samplesusing immunofluorescent detection of Ki-67 and PCNA. Theeffects of needle size and study group oncell yield and cytologic features of the cellswere also examined. Fifty three women (20 inthe intervention group and 33 in the controlgroup) underwent the biopsy procedure. Slides from 38subjects were stained for Ki-67 and from 14subjects for PCNA. No cell proliferation (fluorescence) wasdetected for either Ki-67 or PCNA in anyof the slides. Epithelial cell yield and numberof stromal fragments were greater with a largerneedle size. Numbers of stromal fragments and bipolarnaked nuclei were greater in the low fatas compared to the control group but nodifferences in epithelial cell yield were observed betweenthe two groups. This study confirms that fineneedle aspiration biopsy is a feasible method ofobtaining epithelial cells from women without discrete breastmasses, but suggests that cell proliferation cannot beassessed using Ki-67 and PCNA in such samples.     

No association between immunohistochemical expression of p53, c-erbB-2, Ki-67, estrogen and progesterone receptors in female papillary thyroid cancer and ionizing radiation

An association has previously been reported between exposure to medical diagnostic ionizing radiation and papillary thyroid cancer in women. To further evaluate potential mechanisms in carcinogenesis, the expression of p53, c-erbB-2, as well as Ki-67, estrogen and progesterone receptors were analyzed by immunohistochemistry in 19 women exposed to X-rays and for comparison in nine women without such reported exposure. They all had papillary thyroid cancer. No difference was found between these groups. The results of this study showed that p53, c-erbB-2, Ki-67, estrogen and progesterone receptors are not involved in papillary thyroid cancer associated with exposure to medical diagnostic ionizing radiation.     

应用组织芯片技术研究bcl-10、TopoⅡα及Ki-67在MALT型淋巴瘤中的表达和意义

目的应用组织芯片技术研究bcl蛳10、TopoⅡα及Ki蛳67在MALT型淋巴瘤中的表达及意义。方法建立包含84例MALT型淋巴瘤、7例弥漫性大B细胞淋巴瘤(DLBCL)、17例其他肿瘤及18例淋巴结反应性增生,共252点阵的组织芯片,应用免疫组织化学技术(S蛳P法)检测bcl蛳10、TopoⅡα及Ki蛳67在MALT型淋巴瘤中的表达。结果Ki蛳67、TopoⅡα的表达在ⅠE期与Ⅱ2E+Ⅲ期之间差异有显著性(P<0.05),并且与临床分期呈正相关(r=0.423,P=0.000;r=0.299,P=0.016)。淋巴结反应性增生中生发中心B细胞胞质大量表达bcl蛳10,边缘区中等量表达,在套区B细胞较少表达;在MALT淋巴瘤中,bcl蛳10核型表达7例(8.33%),胞质型表达27例(32.14%)。bcl蛳10胞质表达在低度和高度恶性MALT型淋巴瘤中差异有显著性(P<0.05);但与临床分期无关。核型表达者与肿瘤细胞浸润有关。结论MALT型淋巴瘤中TopoⅡα与Ki蛳67的作用相似,它们可作为预后评价的指标。bcl蛳10表达广泛地存在于MALT型淋巴瘤中,该基因异常表达可能与肿瘤恶性程度有关,可作为判断预后的指标之一,核表达可能与病情的进展有关,与肿瘤侵袭行为有关。     

神经母细胞瘤血管内皮细胞生长因子、Ki-67抗原表达及微血管密度研究

目的 探讨血管内皮细胞生长因子（VEGF）、瘤内微血管密度（MVD）与神经母细胞瘤（NB）细胞增殖及预后的关系。方法 采用S-P免疫组化法，检测VEGF、CD34和Ki-67抗原在21例NB中的表达及MVD计数。结果 VEGF及Ki-67表达与NB病理分型及核分裂指数有关（P〈0．05或P〈0．01），而与NB分化与否、肿瘤大小及性别无关。MVD值在临床各病理参数间差异无显著意义。VEGF表达与MVD值、VEGF与Ki-67表达呈明显正相关（P〈0．01）。结论 VEGF、Ki-67表达与NB细胞增殖及预后密切相关。     

Proliferation, Vascular Endothelial Growth Factor Expression and Cavernous Sinus Invasion in Growth Hormone Secreting Pituitary Adenomas

Summary  Surgical cure of growth hormone producing pituitary adenomas (GHomas) becomes difficult when they invade the cavernous sinus (CS). Tumour proliferative activity and angiogenesis are thought to be required for tumour growth and invasion, and vascular endothelial growth factor (VEGF) activates neovascularization around tumours. In this study, the mechanism and clinical significance of CS invasion is analysed. In 25 surgically treated GHomas, the extent of CS invasion was classified as high (Knosp's grade 3 and 4), and low (grade 0, 1 and 2) MR grades, and the MR grades were compared with tumour proliferative potential (Ki-67 expression), angiogenetic demand (VEGF expression), volume of adenomas and serum hormone levels.  The Ki-67 index of high MR grade adenomas (1.17±0.62%) was significantly higher than that of low MR grade adenomas (0.55±0.42%, p=0.027), whereas VEGF expression showed no significant correlation with MR grades (p>0.999). Tumour volume also showed a significant correlation with MR grade (p=0.002). VEGF expression was not correlated with serum hormone level and volume, but was correlated with tumour proliferative potential. Proliferative potential and tumour volume were two independent factors related to CS invasion. Although VEGF expression was not a direct factor related to CS invasion, it may indirectly play a role in activation of tumour aggressiveness, which is required in CS invasion.  Our results show that high MR grade adenomas have higher proliferative ability. In order to improve the surgical outcome, pre-operative medical debulking is indicated, particularly, in such adenomas.     

肺气/灌注显像与螺旋CT诊断肺栓塞的对比分析

目的比较肺通气／灌注(Lung perfusion／ventilation scintigraphy．Q／V)显像与螺旋CT肺动脉造影(Computerized tomography pulmonary angiography．CTPA)在肺栓塞(Pulmonary embolism，PE)定性及定位诊断对治疗决策的影响、溶栓及抗凝治疗后的疗效观察等方面的临床价值。方法回顾性分析了23例PE患者的肺Q/V显像(35例次)，并与CTPA(31例次)结果进行对比分析。结果肺Q／V与CTPA定性诊断符合率91．3％；定位诊断符合率53．37％；治疗前肺Q/V提示大面积肺栓塞的4例急性PE患者行溶栓治疗．1例CTPA提示大面积肺栓塞的急性PE患者行溶栓治疗：PE患者溶栓治疗后4例复查肺Q/V及2例复查CTPA、抗凝治疗后3例复查肺Q/V及2例复查CTPA结果显示受累肺段的改善情况与溶栓治疗疗效、与患者症状改善相一致。结论肺Q/V与CTPA定性诊断PE有很好的一致性。但定位方面存在差异．CTPA与肺Q/V存在互补关系。但尚无法取代肺Q/V显像。