高危型人乳头瘤病毒整合在宫颈癌变中的作用机制和临床检测进展

流行病学研究已证实,生殖道人乳头瘤病毒(human papillomavirus,HPV)感染是宫颈癌发生的必要因素。目前对HPV感染型别及数量的检测在宫颈癌筛查中有着重要的应用价值,为宫颈癌的防治提供了重要的依据,而对预测肿瘤的恶性化程度及预后作用不大[1]。高危型HPV的持     

半乳糖凝集素-1在宫颈癌组织中的表达及其与高危型HPV感染的关系

目的探讨半乳糖凝集素-1(Galectin-1,Gal-1)在宫颈癌的发生、发展中作用及与高危型HPV的关系。方法免疫组织化学法检测柳州市人民医院2007年2月至2009年2月54例宫颈癌、35例宫颈上皮内瘤样病变(CIN)和20例宫颈正常组织中Gal-1蛋白的表达;并用HC-Ⅱ法检测高危型人乳头状瘤病毒(HR-HPV)感染情况。结果 Gal-1在正常宫颈、CINⅠ～Ⅱ、CIN Ⅲ和宫颈癌组织中的阳性表达率分别为5.0%、15.0%、53.3%、48.1%;晚期宫颈癌组织中Gal-1的表达率(83.1%)明显高于早期宫颈癌中的表达率(34.2%)。宫颈癌中Gal-1阳性表达与淋巴结转移(P<0.05)、肿瘤低分化(P<0.05)、临床分期(P<0.01)和HR-HPV的感染(P<0.05)有关,但与宫颈癌组织学类型无关。结论 Gal-1可能在宫颈癌的发生、发展中起着重要作用,HR-HPV可能通过诱导宫颈上皮高表达Gal-1而促使宫颈癌发生发展。     

新型上颈椎前路钩状钛板的研制及应用解剖学基础

目的:通过解剖测量C1～3获得形态学参数为研制上颈椎前路钩状钛板提供解剖学依据.方法:采用40套正常成人干燥寰枢椎骨标本及50例正常成人颈椎侧位X线片测量C1～3的相关参数,并进行统计学分析,据此设计上颈椎前路钩状钛板,并在3具成人尸体标本上模拟钩状钛板置入并植骨术.结果:寰椎前弓宽度(AW)为(20.06±1.16)mm、前弓高度(AH)(10.61±1.04)him、前弓厚度(AT)(4.09±0.66)mnl;齿突横径(DW)(9.80±0.83)mm、齿突前后径(DD)(10.13±0.63)mm;寰枢椎体前缘高(VAH)(22.03±1.99)nHn、前缘横径(TD)(16.80±1.26)mm、前后径(AP)(16.14±1.06)mm;寰枢椎前缘总高度(AAOH)(37.44±3.2)mm、C2/3椎间盘前缘高(C2/3IVDHA)(4.55±0.64)mm、C3椎体前缘高(C3BHA)(13.31±1.39)mm.前路钩状钛板由一对钩形钛板和配套螺钉构成,其中钛板分为C1～2和C1～3两种型号.结论:颈椎前路钩状钛板的设计在形态学上具有可行性,各部件参数有一定的选取范围,其能在颈前侧咽后入路下安装,既能够避免进口咽入路的并发症又能重建寰枢关节的稳定性,具有牢靠安全、操作简便的特点.     

Coflex植入术治疗退行性腰椎管狭窄症41例的临床观察

目的探讨腰椎后路棘突间Coflex植入术治疗退行性腰椎管狭窄症（DLSS）的临床疗效。方法 2012年2月至2013年9月期间收治的74例DLSS患者,按愿意分为对照组33例和治疗组41例,其中对照组接受全椎板减压植骨融合内固定术,治疗组接受Coflex植入术。比较两组手术时间、出血量、并发症;日本整形外科学会（JOA）下腰痛评分、疼痛视觉模拟标尺（VAS）评分、美国脊柱损伤协会（ASIA）神经功能分级;X线片测定植入节段椎间隙前后缘的高度、椎弓根间距及Cobb角。结果治疗组与对照组相比,手术时间缩短[（1.02±0.32）h vs（2.13±0.58）h]、术中出血量减少[（145.5±36.0）mL vs（279.3±56.8）mL]、并发症减少（0 vs 9.1%）（P〈0.05）;两组JOA下腰痛评分均较术前明显增高,VAS评分较术前明显降低（P〈0.05）,治疗组术后VAS评分较对照组更低[（2.3±0.3）vs（2.6±0.6）,P〈0.05];术后两组神经功能均有一定程度恢复,但组间比较差异无统计学意义（P〉0.05）;两组患者手术前后植入节段椎间隙前缘高度、椎弓根间距及Cobb角均无明显变化,椎间隙后缘高度均增大[治疗组术前与术后比较[（7.31±1.36）mm vs（8.98±1.56）mm],对照组术前与术后比较[（7.19±1.08）mm vs（8.61±1.41）mm,P均〈0.05],但组间比较差异无统计学意义。结论腰椎后路棘突间Coflex植入术是一种治疗退行性腰椎管狭窄症安全、有效的手术方法。     

Ectopia cordis: A rare congenital anomaly

Ectopia cordis (EC) is a rare congenital anomaly associated with the heart positioned outside of the thoracic cavity either partially or completely. The ectopic heart can be found along a spectrum of anatomical locations, including the cervical, thoracic and abdominal regions and in most cases, it protrudes outside the chest through a split sternum. Although the first case of EC was identified during the early 1600s only 91 cases have been reported since then in the literature. This review will discuss the history and prevalence of EC, its etiology, morphology, presentation and symptoms, complications, diagnosis, treatment and management and prognosis. Clin. Anat. 27:1193–1199, 2014. © 2014 Wiley Periodicals, Inc.     

MMP‐9 expression increases according to the grade of squamous intraepithelial lesion in cervical smears

Studies about cervical carcinogenesis have demonstrated the increased expression of matrix‐metalloproteinase (MMP) according to the grade of cervical intraepithelial lesions. Considering the importance of innovative techniques to introduce noninvasive and rapid diagnoses for patients, this study aimed to perform MMP‐9 immunocytochemistry in cervical smears according to the cytopathological diagnoses, in order to monitor MMP activity in cervical smears. This cross‐sectional study investigated the expression of MMP‐9 in normal cervical smears, inflammatory cervical smears, squamous intraepithelial lesions, and cervical carcinoma. Cervical smears from 630 women were collected for cytopathological diagnoses and immunocytochemistry. Women with squamous intraepithelial lesions showed an increase in MMP‐9 expression, with moderate to intense staining occurring with increasing cervical lesion grade. The prevalence of moderate to intense MMP‐9 staining was 9% in normal cervical smears, 12% in cervical inflammation, 24% in low‐grade squamous intraepithelial lesion (LSIL), 92% in high‐grade squamous intraepithelial lesions (HSIL) and 100% in cervical carcinoma cases. In the specific case of LSIL, we found that association with MMP‐9 is more evident when there is the simultaneous presence of an infectious agent. Thus, the expression of MMP‐9 in cervical smears increases according to the grade of cervical lesion and LSIL in the presence of infectious agents showed higher MMP‐9 expression than women with LSIL without infectious agents. Diagn. Cytopathol. 2014;42:827–833. © 2014 Wiley Periodicals, Inc.     

Clinical significance of HPV DNA cotesting in Korean women with ASCUS or ASC‐H

The purpose of this study was to evaluate the clinical significance of Human papillomavirus (HPV) DNA cotesting in Korean women with abnormal Papanicolaou (Pap) smear results based on colposcopic pathology. A total of 1012 women underwent liquid‐based Pap smears and hybrid capture II HPV DNA tests followed by colposcopy at the Korea University Hospital from January 2007 to May 2012. Of these women, 832 women were included in this retrospective study. The mean patient age was 45.4 ± 13.7 years (range:15–80). The distribution of Pap smear results was normal (4.7%), atypical squamous cells of uncertain significance (ASCUS) (42.1%), low‐grade squamous intraepithelial lesion (26.8%), ASC‐H (7.0%), and high‐grade squamous intraepithelial lesion (HSIL) (19.5%). In women with ASCUS, none of the 87 HPV‐negative had ≥cervical intraepithelial neoplasia (CIN2) (P < 0.001). In women with ASC‐H, only one out of 17 HPV‐negative vs. 14 out of 41 HPV‐positive had ≥CIN2 (P = 0.025). In patients with HSIL, 54.5% of HPV‐negative had ≥CIN2, as compared to 80.8% of HPV‐positive with ≥CIN2 (P = 0.039). Patients were further analyzed by age groups: <30 and ≥30 years. In HPV‐negative women, there was a significant difference in the ratio of ≥CIN2 (30.8% <30 vs. 4.5% ≥30, P = 0.005). When the HPV DNA test was negative in women ≥30, the risk of ≥CIN2 was significantly lower (P < 0.001). HPV DNA cotesting in women with ASCUS and ASC‐H furnish healthcare providers with informative data. There is a lower proportion of ≥CIN2 in HPV‐negative women and a higher proportion of ≥CIN2 in HPV‐positive. When HPV data were further evaluated by age group, the risk of ≥CIN2 was lower in HPV‐negative women, especially in women ≥30. Diagn. Cytopathol. 2014;42:1058–1062. © 2014 Wiley Periodicals, Inc.     

Association of an insertion/deletion polymorphism in IL1A 3′-UTR with risk for cervical carcinoma in Chinese Han Women

Emerging evidence has demonstrated that polymorphisms of interleukin-1 (IL-1) may be involved in human tumorigenesis by regulating the production of this cytokine. Previous studies have investigated the association between two genetic variants (rs3783553 and rs17561) of IL1A and many diseases. The present study was conducted to evaluate whether these two variants are associated with cervical carcinoma (CC). These two polymorphisms were genotyped in 319 CC patients and 424 healthy controls by polymerase chain reaction polyacrylamide gel electrophoresis (PCR-PAGE) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Significantly reduced CC risk was observed to be associated with the insertion allele of rs3783553 (P = 0.014, OR = 0.71, 95% CI = 0.57–0.88). Stratification analysis based on different certain clinical features showed that patients with the heterozygous genotype were associated with a reduced predisposition advancing to clinical stage II-III or developing non-squamous cell carcinoma. Furthermore, patients with the insertion homozygous genotype were also associated with a reduced risk to have a poor tumor differentiation. No significant association was observed between rs17561 and CC. The present study provided evidence that the rs3783553 in IL1A 3′-UTR is inversely associated with CC risk, suggesting an important role IL-1α may play in cervical carcinogenesis.     

Hypoxia promotes the proliferation of cervical carcinoma cells through stimulating the secretion of IL-8

To explore whether hypoxia and interleukin 8 (IL-8) regulate the viability and apoptosis of cervical carcinomas cells and the possible mechanism. We evaluated the expression of hypoxia inducible factor-1α (HIF-1α), IL-8 and its receptors (CXCR1 and CXCR2) in cervical cancer and cervicitis tissues by immunohistochemistry. Then the effects of hypoxia and IL-8 on the viability and apoptosis of HeLa and SiHa cells were detected by the SRB and apoptosis assays. Here we observed that the expression of HIF-1α, IL-8 and CXCR1 in cervical cancer tissues was significantly higher than that in cervicitis tissues. Hypoxic condition stimulated the secretion of IL-8 and the expression of CXCR1 and CXCR2 on HeLa and SiHa cells. Recombinant human IL-8 enhanced the viability and reduced the apoptosis in HeLa and SiHa cells. HeLa and SiHa cells cultured in 1% oxygen showed the increased viability and apoptosis, and the former effect could be partly reversed by anti-human IL-8 neutralizing antibody. This data suggested that IL-8 secreted by cervical carcinomas cells induced by hypoxia can stimulate the viability of cervical carcinomas cells in an autocrine dependent manner, and contribute to the pathogenesis of cervical cancer.     

NF-κB及其调控的miRNA在宫颈癌移植瘤及癌旁组织中的活化和表达

目的分析宫颈癌移植瘤小鼠的癌与癌旁组织中miR-15b和miR-16的表达状况以及NF-κB信号通路在宫颈癌癌旁组织活化情况,为宫颈癌的诊断和治疗提供新思路。方法建立小鼠宫颈癌移植瘤模型,取癌组织与癌旁组织,以及正常的脂肪组织,用实时荧光定量PCR方法检测miR-15b和miR-16的表达,用免疫组化检测NF-κB(P65)蛋白的表达及定位。结果移植瘤造模成功。miR-15b在宫颈癌组织中表达为32.21±3.67,明显高于癌旁组织的25.16±1.86和正常组织的1.00±0.12(P0.05),癌旁组织也显著高于正常组织(P0.05);miR-16在宫颈癌组织中表达为28.63±2.34,明显高于癌旁组织的22.16±1.76和正常组织的1.00±0.12(P0.05),癌旁组织也显著高于正常组织(P0.05)。在正常脂肪组织中,NF-κB(P65)蛋白主要定位于胞质,而在癌组织与癌旁组织中,NF-κB(P65)蛋白主要位于胞核。结论 NF-κB通路及其相关的miR-15b和miR-16可能参与了宫颈癌发生的早期分子事件。