血清HS-AFP GGT-Ⅱ对肝癌患者手术预后判断的价值

目的:探讨血清肝癌特异性甲胎蛋白(HS-AFP)和γ-谷氨酰转肽酶同工酶Ⅱ(GGT-Ⅱ)对原发性肝癌患者手术预后判断的临床价值。方法:对40例肝癌患者手术切除前后的血清HS-AFP、GGT-Ⅱ进行动态观察,并与患者的生存期进行对比分析。结果:40例肝癌患者术前HS-AFP﹑GGT-Ⅱ阳性率分别为57.5%和67.5%,联合检测阳性率为80.0%。术后发生复发转移者在HS-AFP和GGT-Ⅱ阳性组分别为90.9%和58.8%,而阴性组仅分别为20.7%和26.1%。术后HS-AFP和GGT-Ⅱ二者均为阳性的患者则均有复发转移。而术后二者均为阴性组患者复发转移率仅为9.5%。单因素分析显示术后HS-AFP和GGT-Ⅱ与患者预后有关。结论:术后血清HS-AFP﹑GGT-Ⅱ对肝癌患者手术后预后判断具有重要价值。     

肝细胞癌在血中微小转移的检测

目的 肝细胞癌患者术后复发常是术前不能检出微转移灶或术中癌细胞释放入血之故。建立早期检出肝细胞癌（HCC）血中微小转移的方法并评价其临床意义。方法 采用巢式RT－PCR检测肝细胞特异白蛋白（ALB）mRNA和甲胎蛋白（AFP）mRNA在HCC患者外周血有核细胞成分及组织标本中的表达情况。并以肝癌细胞系HepG2、SMMC7721,乳腺癌细胞MCF－7作为阳性，阴性对照。结果 在肝组织，无论是癌、癌旁还是正常组织，ALB mRNA的表达均为阳性（8／8），而AFP mRNA在癌组织7／8例表达，癌旁5／8例表达。外周血表达的情况为：同一组标本ALB mRNA的阳性率为75.6%（34／45，P＜0．01），AFPmRNA的阳性率为57．8％（26／45，P＜0．01）。在有肝外转移和无肝转移分组中，ALBmRNA和AFPmRNA的表达分别为100．0％，54．2％和29．2％。结论 在HCC患者外周血有核心细胞成分中检测ALBmRNA和AFPmRNA的表达，是预测转移、复发的简捷手段，若ALB与AFP二者联合使用，应用性会更强。     

The roles and applications of autoantibodies in progression,diagnosis, treatment and prognosis of human malignant tumours

The existence of autoantibodies towards an individual's own proteins or nucleic acids has been established for more than 100 years, and for a long period, these autoantibodies have been believed to be closely associated with autoimmune diseases. However, in recent years, researchers have become more interested in the role and application of autoantibodies in progression, diagnosis, treatment and prognosis of human malignant tumours. Over the past few decades, numerous epidemiological studies have shown that the risk of certain cancers is significantly altered (increased or decreased) in patients with autoimmune diseases, which suggests that autoantibodies may play either promoting or suppressing roles in cancer progression. The idea that autoantibodies are directly involved in tumour progression gains special support by the findings that some antibodies secreted by a variety of cancer cells can promote their proliferation and metastasis. Because the cancer cells generate cell antigenic changes (neoantigens), which trigger the immune system to produce autoantibodies, serum autoantibodies against tumour-associated antigens have been established as a novel type of cancer biomarkers and have been extensively studied in different types of cancer. The autoantibodies as biomarkers in cancer diagnosis are not only more sensitive and specific than antigens, but also could appear before clinical evidences of the tumours, thus disclosing them. The observations that cancer risk is lower in patients with some autoimmune diseases suggest that certain autoantibodies may be protective from certain cancers. Moreover, the presence of autoantibodies in healthy individuals implies that it could be safe to employ autoantibodies to treat cancer. Of note, an autoantibodies derived from lupus murine model received much attention due to their selective cytotoxicity for malignant tumour cell without harming normal ones. These studies showed the therapeutic value of autoantibodies in cancer. In this review, we revisited the pathological or protective role of autoantibodies in cancer progression, summarize the application of autoantibodies in cancer diagnosis and prognosis, and discuss the value of autoantibodies in cancer therapy. The studies established to date suggest that autoantibodies not only regulate cancer progression but also promise to be valuable instruments in oncological diagnosis and therapy.     

Ovarian tumors in children and adolescents: A series of 41 cases

ObjectivePictorial review with a detailed semiological analysis of ovarian tumors in children and adolescents to provide a relevant diagnostic approach.Patients and methodsRetrospective study (2001–2011) of 41 patients under the age of 15 who underwent surgery for an ovarian mass with a definite pathological diagnosis.ResultsSixty-two percent of the lesions were benign, 33% were malignant and 5% were borderline. Germ cell tumors were most frequent (77.5%), followed by sex cord stromal tumors (12.5%) and epithelial tumors (7.5%). Malignant tumors were more frequent in children between 0 and 2 years old. On imaging, calcifications and fat were specific for germ cell tumors; the presence of a mural nodule was predictive of a mature teratoma (P < 0.001). Predictive factors for malignancy were clinical, including abdominal distension (P < 0.01) or a palpable mass (P = 0.05), biological, including increased hCG and/or AFP levels (P < 0.001) and radiological, including tumors larger than 12 cm (P < 0.05), tumoral hypervascularity (P < 0.01) and voluminous ascites (P < 0.01).ConclusionThis semiological analysis confirms the role of imaging in diagnosing the etiology of ovarian lesions in children and adolescents and emphasizes the importance identifying tumoral hypervascularity, which, in addition to classic criteria, is highly predictive of malignancy.     

甲胎蛋白调节肿瘤坏死因子相关凋亡诱导配体受体2表达及其对Bel 7402细胞耐受该配体的影响

目的 研究甲胎蛋白(AFP)对肝癌细胞肿瘤坏死因子相关凋亡诱导配体(TRAIL)受体-2(DR5)表达及其在肝癌细胞耐受TRAIL中的作用.方法 用Western blot法分析全反式维甲酸(ATRA)处理人肝癌细胞株Bel 7402细胞24 h后DR5表达的变化;免疫共沉淀(Co-IP)技术研究AFP与维甲酸受体(RAR)-β相互作用;激光共聚焦显微镜观察AFP与RAR-β的细胞共定位; RNA干扰技术抑制Bel 7402细胞AFP表达,再用ATRA处理24h后检测细胞内DR5表达的变化;用pcDNA3.1质粒和人AFP基因连接构建表达AFP的载体(称为pcDNA3.1-afp),然后转染到不表达AFP的人肝癌细胞株HLE细胞;细胞生长状况用四甲基偶氮唑盐法检测.组间比较用f检验进行统计学分析.结果 Bel 7402和HLE细胞低表达DR5,ATRA(160μmol/L)处理24h后能促进肝癌细胞DR5表达; Co-IP技术研究显示AFP能与RAR-β结合;共聚焦显微镜观察发现AFP与RAR-β共定位于细胞质;干扰AFP表达后,Bel 7402细胞的DR5表达明显提高,抑制AFP表达后,ATRA能显著促进Bel 7402细胞内DR5的表达,并增加Bel 7402细胞对TRAIL的敏感性;转染pcDNA3.1-afp载体后,HLE细胞内的AFP能与RAR-β结合,并发现pcDNA3.1-afp载体能对抗TRAIL诱导HLE细胞凋亡.结论 Bel 7402细胞内表达的AFP具有抑制DR5表达的生物学功能;AFP可能通过抑制RAR-β入核调节DR5的表达;细胞内高表达的AFP是导致Bel 7402细胞耐受TRAIL诱导细胞凋亡的重要原因.     

Alpha-fetoprotein specific CD4 and CD8 T cell responses in patients with hepatocellular carcinoma

The presence of CD8 T cell responses to tumor associated antigens have been reported in patients with different malignancies. However, there is very little information on a comparable CD8 and CD4 T cell response to a tumor antigen in liver cancer patients. Here, we re-examine the kinetic and the pattern of T helper 1 and cytotoxic T lymphocyte responses to alpha-fetoprotein (AFP), a tumor rejection antigen in hepatocellular carcinoma (HCC). Then, we discuss the possibility of using AFP-based immunotherapy in combination with necrotizing treatments in HCC patients.     

甲胎蛋白、癌胚抗原和糖类抗原199联合检测在原发性肝癌诊断中的应用研究

目的探讨血清甲胎蛋白（AFP）、癌胚抗原（CEA）和糖类抗原199（CA199）联合检测在原发性肝癌诊断中的应用价值。方法选取我院2009年1月～2012年6月收治的原发性肝癌患者153例为观察组,经临床病理诊断分为两组,病理诊断为良性患者94例为观察Ⅰ组,病理诊断为恶性患者59例为观察Ⅱ组。选取我院同期健康体检人员70例为对照组。所有人员均行AFP、CEA、CA199检测,比较单项检测与联合检测的应用价值。结果观察Ⅱ组AFP、CEA、CA199均明显高于对照组和观察Ⅰ组,观察Ⅰ组AFP、CEA、CA199均明显高于对照组,肿瘤Ⅱ、Ⅲ期患者AFP、CEA、CA199均明显高于肿瘤Ⅰ期患者,癌细胞转移患者AFP、CEA、CA199均明显高于未转移患者,特异性由高到低依次为AFP、CEA、CA199、联合诊断,敏感性由高到低依次为联合诊断、AFP、CA199、CEA,准确性由高到低依次为联合诊断、AFP、CEA、CA199,差异均有统计学意义（均P〈0．05）。结论AFP、CEA和CA199联合检测可以显著提高原发性肝癌诊断的准确率,具有较高的敏感度,值得临床推广使用。