H3K9Ac在卵巢上皮性肿瘤中的表达及其临床意义

目的 研究组蛋白H3赖氨酸残基9位乙酰化（H3KgAc）在卵巢上皮性肿瘤中的表达及其与卵巢癌组织学分级、临床分期之间的关系。方法 采用免疫组织化学ABC法检测20例良性、16例交界性、40例恶性卵巢上皮性肿瘤中H3K9Ac的表达情况，并分析其与临床病理指标间的关系。结果 ①H3K9Ac在良性、交界性、恶性卵巢上皮性肿瘤中的表达逐渐降低，差异有显著统计学意义（P〈0．01）；②与粘液性囊腺癌相比，H3KgAc在浆液性囊腺癌中表达较低，差异有统计学意义（P〈0．05）；③H3KgAc的表达与卵巢上皮性癌的组织分化程度及临床分期有关，在Ⅲ、Ⅳ期卵巢癌中H3KgAc的表达明显低于Ⅰ、Ⅱ期卵巢癌（P〈0．01）；随着组织分化程度降低，H3KgAc表达也逐渐降低，两两比较差异有统计学意义（P〈0．05）。结论 H3KgAc在良性、交界性、恶性卵巢上皮性肿瘤中的表达差异显著，且随着卵巢上皮性癌恶性程度的增高，表达逐渐降低，H3K9Ac可能为卵巢上皮性肿瘤的良恶性及其预后判断提供一个新的生物学指标。     

抗体蛋白质芯片检测卵巢癌耐药细胞株细胞因子改变的研究

目的： 抗体蛋白质芯片初步筛选常见细胞因子在卵巢癌耐药细胞株中的表达。 方法： 对6株卵巢癌细胞分别进行平行药敏试验及细胞因子抗体蛋白质芯片检测，同时筛选78种细胞因子的表达差异，并进行两两比较。 结果： 不同种类卵巢癌细胞系对于ADM的IC50值从高到低前3位依次为SKOV3，OVCAR5，OVCAR4；CBPDA为IGROV1，SKOV3，OVCAR3；TAXOL为OVCAR4，SKOV3，IGROV1；VP16为OVCAR4，OVCAR5，OVCAR8。在对一线化疗药ADM和 CBPDA耐药性较高的SKOV3细胞中GRO，IL-6，IL-8和TIMP-2均较其余5株相对敏感细胞增高，对二线化疗药TAXOL，VP16耐药性较高细胞株OVCAR4中IL-6，IL-8较之IGROV1，OVCAR3，OVCAR5升高。 结论： 在常见分泌型细胞因子中，GRO，IL-6，IL-8和TIMP-2升高与一线化疗药ADM和CBPDA耐药性相关，IL-6，IL-8与二线化疗药TAXOL，VP16耐药性相关，不同来源的卵巢癌细胞分泌型蛋白作用机制可能存在共同的上述几种蛋白参与的调节体系。     

卵巢癌腹膜后淋巴结转移的特点及其临床意义

目的：研究卵巢上皮性癌淋巴结转移的解剖学和生物学特点及临床合理治疗。方法：40例Ⅰ期卵巢癌根据清除淋巴结与否分成A、B两组；40例Ⅲ-Ⅳ卵巢癌清除淋巴结20例为C组、不清除淋巴结20例为D组，C、D两组减瘤术后残余癌灶均2cm。化疗方法，药物及其剂量基本相同。结果：A组3例腹主动脉旁淋巴结转移者合并盆腔淋巴结转移2例，单纯盆腔淋巴结转移1者，共4例淋巴结转移，转移率20％。A、B两组5年生存率各为95％与80％。C组腹主动脉旁淋巴结转移10例中合并盆腔淋巴结转移9例，单独盆腔淋巴结转移2例，转移率为60％（12／20）。C、D两组5年生存率各为55％与15％。5年生存率A、B两组差异有显著意义（P〈0．05），C、D两组差异有极显著意义（P〈0．001）。结论：卵巢癌淋巴结转移率，随期别而升高，腹主动脉旁与盆腔淋巴结转移率几乎相等，但腹主动脉旁淋巴结转移是主要路线。恰当清除淋巴结可以提高生存率。     

Effect of etoposide on experimental testicular teratoma in 129/SvJ mice

To study the effects of etoposide on experimental testicular teratoma in 129/SvJ mouse we analysed the tumour growth, differentiation, apoptosis and the localisation of mdr₁ P-glycoprotein (mdr₁-Pgp). In this model the implanted gonadal ridges developed into testicular teratomas in 17 out of 56 implanted testes (30%) and in 14 out of 28 mice (50%). The tumour-bearing mice were treated with etoposide on 4 successive days either 4 weeks or 6 weeks after implantation, and killed 7 days after the last dose. The mice in the control groups did not receive etoposide. The teratomas consisted mainly of neural tissue. The etoposide-treated 4-week teratomas, but not the 6-week teratomas, were significantly smaller than those in the corresponding control groups. The density of apoptotic cells and the distribution of the mdr₁-Pgp were not altered by etoposide. The decreased proportion of immature neuroectodermal tissue components was observed in all treated teratomas, converting the histology towards that of a mature teratoma. In addition, a low proportion of immature tissue components was frequently combined with a low density of apoptotic cells. In conclusion, etoposide decreased the immature tissue components of teratomas, while mature tissues remained unaffected. These results may have clinical relevance in man, since they confirm that postchemotherapy mature teratomas cannot be treated with chemotherapy. Despite benign histology, the human residual tumours have a significant malignant potential and require complete surgical excision and close surveillance. Received: 20 August 1999 / Accepted: 20 January 2000     

A Randomized Study of Epithelial Ovarian Cancer: Is Chemotherapy Useful after Complete Remission?

Objective. The aim of this study is to verify whether consolidation chemotherapy with Cisplatin improves disease-free survival and/or overall survival in patients affected by epithelial ovarian cancer.Methods. A multicenter study examined 122 randomized patients in complete remission as judged by laparoscopy or laparotomy following first-line chemotherapy consisting of ACy (Adriamycin + Cyclophosphamide), PCy (Cisplatin + Cyclophosphamide), or Mitoxantrone + Carboplatin. Sixty-one of these patients were treated with 3 cycles of 5-Fluorouracil (FU) 500 mg/m2 for 5 days followed by Cisplatin at 100 mg/m2 on the 6th or 7th day every 28 days; the other 61 received no further treatment (nihil group).Results. Sixty patients in the Cisplatin arm were evaluable. There were 36 relapses in the FU+Cisplatin arm and 30 in the nihil arm. Peritoneal relapses were 25% for Cisplatin treatment vs. 16.4 % for nihil. There were 29 deaths in the Cisplatin arm vs. 27 for nihil. Median overall survival time (95 months with Cisplatin vs. 96 months in the nihil group) and median disease-free survival (66 months with Cisplatin vs. 73 in the nihil group) were similar in both arms (p=0.66 and p=0.41, respectively). There were no significant differences in tumor stage and grade between the two arms. Seven patients presented a second neoplasm during follow-up: six in the nihil arm, but only one patient in the Cisplatin arm. Death in these patients was due to the second neoplasm and not to progression of ovarian cancer.Conclusion. Three courses of additional platinum+FU treatment after five cycles of first-line chemotherapy without FU produced no increase in overall survival or disease-free survival.     

Eutopic endometrium and peritoneal,ovarian and bowel endometriotic tissues express a different profile of matrix metalloproteinases-2, -3 and -11, and of tissue inhibitor metalloproteinases-1 and -2

Endometriosis is subsequent to the ability of endometrial glands to invade normal tissues. Matrix metalloproteinases (MMPs)—enzymes that mediate normal tissue turnover, including endometrial breakdown during menstruation—appear to be involved in this invasive process. Here, we examined the immunohistochemical expression of MMP-2, MMP-3, MMP-11, tissue inhibitor metalloproteinase (TIMP)-1 and TIMP-2 in endometrium from women with (n=9) or without endometriosis (n=18) in comparison with peritoneal (n=20), ovarian (n=20) and colorectal endometriosis (n=20). Women with endometriosis showed decreased endometrial MMP-2 expression compared with women without endometriosis (mean±SD positive cells: 24.3±28.3% and 69.3±12.1%), together with loss of MMP-3 expression (0 versus 17.5%±20.2). MMP-11, TIMP-1 and TIMP-2 expression was similar in the two groups. Endometrial MMP-2, -3 and -11 expression and TIMP-1 and -2 expression were similar in women with endometriosis and in those with peritoneal endometriosis. MMP-2, -3 and -11 expression was higher in colorectal endometriosis than in ovarian and peritoneal endometriosis. TIMP-2 expression was lower in colorectal endometriosis (P=0.0002) and ovarian endometriotic cysts (P=0.003) than in peritoneal endometriosis. TIMP-1 expression did not vary according to the location of endometriotic lesions. These results suggest that MMP-2 and -3 and TIMP-2 may be involved in the pathogenesis of endometriosis. Interestingly, MMP-2 and -3 overexpression was related to the infiltrative nature of endometriotic lesions, with possible sequential expression from peritoneal to colorectal endometriosis.     

卵巢女性化性索间质性肿瘤39例临床病理分析

重新复查我院1960～1980年收治原诊为卵巢女性化性索间质性肿瘤39例的病理切片,可疑者再切片作特殊染色,复查后纠正了11例误诊病例,对确诊的28例的临床表现、病理特征、随访结果及预后等进行了分析。讨论了误诊病例的病理后,建议此类肿瘤中的粒层细胞瘤命名为“恶性粒层细胞瘤”,其恶性度与细胞分级密切相关,预后与卵巢外扩散及治疗是否彻底相关。     

卵巢癌肿瘤标志物研究进展

卵巢癌是妇科三大恶性肿瘤之一,由于疾病早期没有明显的临床症状,发现时多已进展为晚期,且约80%的晚期患者在治疗后3年内复发,因此卵巢癌成为妇科恶性肿瘤中死亡率最高的肿瘤。早期有效的筛查及预后评估机制对卵巢癌的诊断及治疗有重要意义。CA125是监测卵巢癌病程和转归的重要标志物,然而其特异性不足,其他标志物包括HE4、CA199对卵巢癌的诊断和预后也缺乏敏感性和特异性。因此,寻找和鉴定新的分子标志物用于早期筛查和诊断卵巢癌以及评估预后至关重要。本文基于目前卵巢癌生物标志物最新研究进行综述。     

CT在卵巢肿瘤中的应用价值

目的 :评价卵巢肿瘤的CT诊断价值。方法 :搜集经手术和病理证实的 2 0例卵巢肿瘤 ,对其CT表现作回顾性分析。结果 :2 0例卵巢肿瘤中 ,单纯性卵巢囊肿 2例 ,卵巢成熟性畸胎瘤 4例 ,卵巢甲状腺肿 1例 ,卵巢囊腺瘤 3例 ,卵巢无性细胞瘤1例 ,卵巢颗粒细胞瘤 1例 ,卵巢癌 8例。结论 :CT对卵巢肿瘤的定位及定性诊断有重要的价值 ,但对卵巢良、恶性肿瘤的鉴别须结合病史和年龄。     

人卵巢癌SCID小鼠移植瘤模型、细胞系建立及其生物学特性研究

目的建立人卵巢癌SCID小鼠移植瘤模型和相应体外细胞系.方法将病理证实的人卵巢浆液性乳头状腺癌手术切除标本移植于SCID小鼠皮下,成瘤后行鼠间传代,取移植瘤细胞体外分离培养、传代和建系,并应用细胞、分子生物学手段对移植瘤和建系细胞进行一系列生物学特性检测.结果历时14个月传至5代,皮下移植瘤存活率为90%,持续6个月,体外建系(OVA-319)细胞生长稳定.镜下观察组织形态学和超微结构符合原肿瘤组织基本特征;染色体分布在12～46条之间,多为异倍体,显示人类肿瘤异常染色体;流式细胞术和RT-PCR技术分析原代、体内移植瘤和OVA-319细胞结果一致,表现为瘤细胞生长活跃、细胞周期分布相仿,MAGE-2基因在mRNA水平异常表达.结论人卵巢癌SCID小鼠移植瘤模型和OVA-319细胞系为人类肿瘤的研究提供了良好的实验材料.