The value of pretreatment clinical and biochemical parameters in patients with newly diagnosed untreated prostate carcinoma and no indications for bone metastases on the bone scintigram

Between 10% and 25% of patients with newly diagnosed prostate cancer without bone metastases at the time of diagnosis will develop metastases during follow-up. To determine the value of clinical and biochemical parameters for assessment of prognosis at the time of diagnosis, a retrospective study was performed in 124 consecutive patients with newly diagnosed prostate cancer without bone metastases. The mean follow-up was 41 months, during which time 36 patients died and 15 patients developed metastases. Bone scans were classified from 0 (=normal) through 2 (=abnormal, but not typical for metastases) and were correlated with age, alkaline phosphatase (AP), prostate-specific antigen (PSA), tumour grade, T-stage and N-stage. In patients with a class 2 scan, additional roentgenograms and follow-up were used to exclude metastases at initial stage. All parameters, including therapy, were finally correlated with the development of metastases and survival. For survival 38 patients with proven metastases were used as controls. For all parameters tested, no statistically significant differences were found between the three bone scan classifications. The interval between diagnosis and the development of metastases ranged from 12 to 72 months. For the risk of development of metastases only PSA was found to be a significant correlate (P=0.0075). However, when tumour stages were clustered in limited disease (T0–2) and extensive disease (T3–4), the incidence of metastases was significantly higher in patients with extensive disease than in those with limited disease (P=0.0021). Finally, age, PSA and Anderson classification were found to be significant correlates of survival, but in stepwise analysis PSA was selected as the most prognostic variable (P<0.0001). In contrast with a typical pattern of metastases on bone scintigraphy, an abnormal scan (class 1 and 2) at the time of diagnosis is not a poor prognostic parameter of the risk of death. In conclusion, in patients with prostate cancer without bone metastases at the time of diagnosis, pretreatment PSA and tumour stage can be used for the assessment of risk of development of metastases during follow-up and survival. For this purpose, tumour stage should be clustered in limited and extensive disease. Received 14 April and in revised form 9 June 1997     

P糖蛋白和Ki-67抗原表达对肺癌T/NT的影响

目的:研究肺癌放射导向手术中肿瘤及正常组织P糖蛋白(P-gp)、Ki-67抗原表达与放射性核素摄取比(T/NT)的关系.方法:采用免疫组化方法和显微图像分析技术,测定32例接受放射导向手术的肺癌病人P-gp和Ki-67抗原表达,分析P-gp和Ki-67的标记指数(LI)与T/NT之间的相关性.结果:P-gp和Ki-67的LI和肺癌病人T/NT之间均有相关性(r=-0.61,P=0.0002; r=0.75,P=0.0001).结论:Ki-67的LI越高(肿瘤增殖越旺盛),T/NT值越高;P-gp阳性的肿瘤,T/NT值较低.     

Prevalence of elevated serum prostate-specific antigen in rural Nigeria

BACKGROUND: Recent hospital and cancer registry data show increasing prostate cancer incidence in Nigeria, which was previously regarded as a low incidence region. This study investigates the prevalence of prostate cancer risk in a previously unscreened cohort of rural Nigerians. METHODS: Rural Nigerian men, 40 years and older, were screened by serum prostate-specific antigen (PSA) and digital rectal examination (DRE) and those with PSA >/= 4 ng/mL and/or abnormal DRE were referred for prostate biopsy. RESULTS: Of 200 consecutive men invited, 151 (75.5%) presented for screening, the mean age was 56.45 + 15.1 and 95 (61.6%) were >/= 50 years of age. Of the 140 who consented to a blood test, PSA correlated with age (r = 0.3, P < 0.01), 14 (10.0%) had abnormal PSA >/= 4 ng/mL, increasing from 3 (3.6%) in men < 60 years to 4 (50%) in men >/= 80 years. The rate was 13 (15.7%) for men >/= 50 years and there was no evidence of increased incidence of prostatitis in the community. Mean (median) PSA in ng/mL increased from 1.17 (0.60) in the youngest to 13.75 (4.45) in the oldest cohort. Of those who accepted DRE, 38 (29.0%) had an enlarged prostate, including two who had nodular prostate, one-third with symptoms, increasing from 4 (5.4%) in those < 50 years to 6 (75.0%) in men >/= 80 years. The proportion of men with PSA >/= 4 ng/mL among those with enlarged vs normal prostate is 27.0 to 3.4%, P < 0.001, and the pattern was similar for men >/= 60 years and those < 60 years of age. The 40 (32.0%) men referred for prostate biopsy defaulted mainly because they did not fully understand the need for further investigation because they were symptom free or afraid of the possible side-effects of the procedure or diagnosis of cancer. CONCLUSION: The proportion of men with PSA >/= 4 ng/mL is comparable to that of previously unscreened populations with high incidence of prostate cancer such as African-American men. A larger study is required to confirm these findings and intensify efforts to determine the prostate cancer detection rate by biopsy in this population. A prostate cancer awareness and education campaign will be useful in this community.     

前列腺特异抗原和高分子量细胞角蛋白改良免疫组织化学染色法对前列腺癌的诊断作用

目的 探讨前列腺特异抗原(PSA)和高分子量细胞角蛋白(CK34βE12)改良免疫组织化学染色法对前列腺癌鉴别诊断的作用。方法 对52例疑难病例采用改良免疫组织化学染色法检查。即在同一切片的一侧贴附可靠的阳性对照组织，应用微波处理，尽可能保存和修复抗原，在显微镜下严格控制显色等方法以达到最佳染色效果。结果3例前列腺不典型腺瘤样增生(AAH)、37例前列腺上皮内瘤(PIN)高表达PSA与CK34βE12；3例前列腺导管内癌也表达PSA及CK34βE12；9例前列腺腺癌仅表达PSA无CK34βE12表达；10例膀胱移行上皮癌均不表达PSA与CK34βE12。结论 PSA和CK34βE12的改良免疫染色可以作为前列腺癌鉴别诊断的工具之一，对指导临床治疗可发挥重要作用。     

前列腺癌患者外周血中前列腺特异抗原,前列腺特异膜抗原和人腺体激肽释放酶mRNA的表达及临床意义

目的:采用巢式RT-PCR方法,检测前列腺癌合并骨转移的患者外周血中前列腺特异抗原(PSA)、前列腺特异膜抗原(PSMA)和人腺体激肽释放酶mRNA的表达,探讨其临床意义.方法:应用巢式RT-PCR的方法,检测外周血中PSA、PSMA和hK2mRNA表达.结果:巢式PCR能够检测到经淋巴细胞稀释的LNCaP细胞的PSA、PSM和hK2mRNA的灵敏度,稀释浓度分别为10-6、10-6及10-7.检测初发伴骨转移的前列腺癌患者外周血PSA、PSMA和hK2mRNA的阳性率分别为59.45%、51.35%、59.46%,其中三种检测同时阳性的为32.43%;检测接受内分泌治疗后出现骨转移的前列腺癌患者的阳性率分别为57.14%、85.71%、83.33%,其中三种检测同时阳性的为52.48%.局限性前列腺癌患者、健康男性及健康女性的检测结果均为阴性.以β-actin mRNA做为内参照,所有临床标本检测均为阳性.结论:采用巢式RT-PCR检测前列腺癌患者外周血PSMA、hK2和PSA mRNA有助于发现进入循环系统的前列腺癌细胞,提示隐匿性转移的存在.PSMA和hK2较适合用于内分泌治疗后患者的检测.三种指标联合检测有助于提高敏感性.     

The usefulness of CEA as an indicator for early detection and a guide to the treatment of recurrent gastric cancer

The usefulness of carcinoembryonic antigen (CEA) as an indicator for recurrence and a guide to the treatment was evaluated from a retrospective analysis of 88 patients with recurrent gastric cancer. Sixty-two of these patients (70.5 per cent), 25 of whom had a preoperative positive assay, and 37 a negative assay, had elevated levels of CEA after disease progression. Averaged CEA level in patients with liver metastasis was significantly higher (872 ng/ml) than in those with peritoneal metastasis (68 ng/ml), with lymph node metastasis (103 ng/ml) or with local metastasis (93 ng/ml) (p<0.01). An elevation of CEA was found prior to the clinical manifestation of recurrence, and the average lead time was 4 months. In 25 patients with a lead time of more than 4 months, survival time after CEA elevation was 13.3 months, which was longer than the 6.5 months of 28 patients with less than 4 months. Thirty-seven of the 88 patients were treated after recurrence. The average survival period after the detection of recurrence was 9.4 months in patients with surgical treatments followed by chemotherapy, 5.9 months in those with chemotherapy alone and 3.8 months in those with surgery alone. The average survival period of 26 patients with positive CEA assays in recurrence was 5.1 months longer than of patients with negative assays. This fact suggested that early detection of recurrence followed by various treatments, in the elevated CEA group, contributes to favorable results.     

血清TPS浓度在消化道肿瘤中价值的研究

共选择３０例消化道肿瘤病人，其中食管癌，胃癌，大肠癌各１０例，设健康献血者３０例，对两组血清特异型组织多肽抗原浓度进行了检测，结果肿瘤组血清ＴＰＳ浓度明显高于健康人。消化道肿瘤阳性检出经达７０％，其中食管癌８０％，胃癌６０％，大肠癌７０％。消化道肿瘤合并淋巴转移阳性检出率达７６．９％，其中食管癌１００％，胃癌６６．７％，大肠癌７０．０％。随着病程发展，血清ＴＰＳ浓度呈现升高趋势。     

人抗HBsAg噬菌体抗体Fab段基因的序列分析及表达

对已建的噬菌体抗体库分离出来的人抗－ＨＢｓ克隆进行了序列分析和表达研究，发现４个克隆中３个克隆的重链和轻链完全相同，ＤＮＡ序列分析表明ＶＨ分别属于ＶＨ１亚群和Ⅱ亚群，其轻链ＶＬ分别属于ＶλⅡ亚群和ＶλⅠ亚群。构建了可溶性Ｆａｂ段表达载体，显示出在细菌中表达的Ｆａｂ段抗体与ＨＢｓＡｇ特异性结合，这说明所筛选出来的噬菌体抗体具有ＨＢdisplay status     

Ultrastructural localization of blood group antigen A in normal and neoplastic urothelium

The subcellular distribution of the blood group antigen A in the transitional epithelium of the urinary tract and its neoplastic growths was studied using transmission immuno-electronmicroscopy. Sixty-five tissue specimens from 50 blood group A1 patients were processed according to an immunogold procedure which was optimized for preservation of both antigen and ultrastructure. The reactions were stronger in the glycocalyx of the luminal surfaces and at the interdigitating cytoplasmic processes of the cells. In the intracellular compartment the reactions were associated with tubulovesicular membrane-bound structures and with the Golgi complexes. Secretory products, intra- or extra-cellular, were also positive. The greatest variability was noted in the cell surface reactions, which were positive in 88% of normal but only 41% of neoplastic urothelial specimens. An inverse correlation was found between malignant behaviour and cell surface, but not intracellular, reactions. We conclude that, in transitional cell carcinomas, there is a quantitative defect in the processing of substance A which affects predominantly the cell surface component and may involve either the transport-insertion steps, the plasma membrane-associated glycosyltransferases or internalization of blood group antigen A.