原位PCR和免疫组化检测垂体腺癌P16基因

目的研究人垂体腺瘤P16基因的改变,同时探索原位PCR技术的适宜条件和结果确认,以及用于基因缺失检测的可行性。方法原位PCR和免疫组化技术。结界绝大部分间质细胞为P16蛋白免疫组化阴性,而一部分垂体肿瘤细胞呈P16阳性;针对P16基因的原位PCR信号则可见于垂体肿瘤细胞和间质细胞等各种细胞,即P16组化阴性的细胞同样表明有P16基因存在。结论原位PCR可以是P16基因研究的一种有效手段,提示垂体腺癌的P16基因改变形式可能主要是表达过度而不是基因缺失。     

Mitotic counts in rat adenohypophysial thyrotrophs and somatotrophs: Effects of short-term thyroidectomy,thyroxine, and thyrotropin-releasing hormone

The question of whether thyroxine (T₄) and thyrotropin-releasing hormone (TRH) affect mitoses in pituitary thyrotrophs (Tt) and somatotrophs (St) of hypothyroid rats was investigated. Fifteen day thyroidectomized (Tx) rats were used. Groups of Tx animals received T₄ or TRH or both. Except 6 and 24 h TRH groups, the animals were sacrificed 12 h after injections. Unoperated euthyroid rats served as controls. In Tx group adenohypophysial mitoses were significantly increased. T₄ diminished mitoses in Tx rats. Mitotic counts were decreased in 6 and 24 h Tx groups, but increased in 12 h TRH group. TRH plus T₄ in Tx animals had a synergistic effect on adenohypophysial mitoses. In unoperated controls few mitoses were observed in Tt and more mitoses in St. In Tx rats more mitoses were seen in Tt than in St. T₄ alone failed to reduce mitoses in Tt but increased them in St. We concluded that T₄ affects Tt and St replication. In normal rats mitoses occur mainly in St. In Tx rats mitotic activity increased in Tt. TRH plus T₄ have a synergistic motogenic effect on St. T₄ but not TRH affects St replication. It appears that the presence, of T₄ is necessary for St multiplication.     

Vanishing Psammoma Bodies in the Anterior Pituitary of the Human Newborn: An Immunohistochemical and Histometric Study

Adenohypophyses of human newborns contain characteristic psammoma bodies. Their numbers are maximal within 2 weeks of the neonatal period and diminish thereafter. They are very rare in infant pituitaries, seeming to disappear by shrinkage in that there is a significant direct correlation between their number and size. The bodies were found to contain a high concentration of endogenous peroxidase, thus suggesting that the enzyme may be responsible for their disappearance. A statistical majority of psammoma bodies were located within follicular lumens. By immunohistochemistry, the follicular epithelium surrounding psammoma bodies showed immunoreactivity for various pituitary hormones. Light microscopy demonstrated that adenohypophysial cells surrounding psammoma bodies contain randomly, scattered granules or globules exhibiting peroxidase activity. Extrusion of such granules into follicular lumens may play a role in the genesis of the concretions. The conspicuous lamellar nature of the calcified psammoma bodies suggests that waves of calcium deposition occur during their morphogenesis. Despite histologic similarities, the histochemical characteristics of this type of psammoma body differ from those in other organs as well as from the calcification encountered in prolactin (PRL)-producing pituitary adenomas.     

Immunohistochemical analysis of 61 pituitary adenomas with a monoclonal antibody to the neuron-specific β-tubulin isotype

Pituitary adenomas surgically resected from 61 consecutive patients and 9 normal pituitary glands were studied by immunohistochemistry to determine the localization of the class III-tubulin isotype (neuron-specific) which is recognized by the monoclonal antibody TUJ1. In normal pituitary glands only a few cells were weakly immunopositive for TUJ1, whereas, in 43(73%) of 61 adenomas, more than 5% of tumor cells were immunopositive. The result may indicate that this neuron-specific -tubulin isotype may be either expressed de novo or enhanced under the transformation of pituitary acinar cells to tumors.Research fellow of the Department of Pathology, Kitasato University School of Medicine where the work was conducted     

Pituitary apoplexy: Endocrine,surgical and oncological emergency. Incidence,clinical course and treatment with reference to 799 cases of pituitary adenomas

Summary Authors analised retrospectively the incidence of pituitary apoplexy in a series of 799 pituitary adenomas with respect to the long term follow-up of the patients.Focal vascular abnormalities in histological specimens of tumours, regarded as morphological suggestion of past apoplexy (heamorrhage, ischaemic infarction or necrosis), were established in 113 out of 783 surgical cases (14.4%).Acute clinical onset, justifying the clinical diagnosis of pituitary apoplexy, occurred in 39 patients only (5% of the whole series), 19 of them were subjected to urgent surgical decompression due to severe neurological deficit. The haemorrhagic character of apoplexy was established in most cases requiring immediate surgery.The detailed clinical picture of this condition and its management are discussed with respect to the long term prognosis.On this basis the authors suggest the necessity of surgical treatment in every case of pituitary apoplexy, taking into account not only neurological recovery, but also endocrine and oncological aspects of the disease. The observation that pituitary apoplexy may be a marker of tumour invasiveness (even in small, enclosed adenomas) is highlighted.     

PTEN蛋白和CyclinD1在垂体瘤中的表达和相关性研究

目的:探讨垂体瘤中抑癌基因PTEN和CyclinD1表达的临床意义。方法:应用免疫组织化学技术检测56例垂体肿瘤,5例正常垂体组织中PTEN和CyclinD1蛋白的表达情况。结果:5例正常垂体组织和22例非侵袭垂体瘤中PTEN表达阳性率和强阳性率比34例侵袭性垂体瘤中PTEN的强阳性率和阳性率强度明显增加,有显著性差异(P<0.01)。正常垂体组织和非侵袭性垂体瘤细胞内CyclinD1蛋白表达较弱,甚至不表达,侵袭性垂体瘤细胞内CyclinD1的表达率和强度明显增加(P<0.01),并且发现在PTEN蛋白表达显著减少的病例中伴随CyclinD1蛋白表达增加,经过相关性分析发现两者呈显著性相关关系(P<0.05)。结论:抑癌基因PTEN的失活和CyclinD1蛋白表达增加与垂体瘤的侵袭性有一定的相关性。     

垂体腺瘤nm23-H_1基因表达的临床意义

目的明确nm23-H_1基因在垂体腺瘤中的表达及其临床意义。方法采用免疫组织化学染色（SP）法对62例垂体腺瘤nm23-H_1基因表达进行回顾性研究。结果侵袭型垂体腺瘤nm-H_1基因表达水平显著低于非侵袭型（P＜0.01）;Ⅲ、Ⅳ级垂体腺癌nm23-H_1基因表达水平显著低于Ⅰ、Ⅱ级（P＜0.05）;nm23-H_1基因表达水平下降与垂体腺瘤患者的性别、年龄及肿瘤分泌功能无显著相关性（P＞0.05）。结论nm23-H_1基因可能在会作腺瘤的侵袭过程中起重要作用,其表达改变是反映垂体腺癌侵袭性的敏感指标。     

PTTG mRNA及其蛋白在食管鳞癌中的表达及临床意义

目的:探讨食管鳞癌组织中PTTG mRNA与蛋白的表达及其二者间的相互关系。研究它们的表达与肿瘤临床资料之间的联系。方法:采用原位杂交技术检测30例食管鳞癌及相应的癌旁组织中PTTGmRNA的表达,同时采用免疫组织化学SP法检测相应标本中PTTG蛋白的表达。结果:在食管鳞癌和相应的癌旁组织中PTTG mRNA表达的阳性率分别为66.7%(20/30),10%(3/30)。PTTG蛋白表达的阳性率分别为76.7%(23/30),16%(5/30)。食管鳞癌组远高于癌旁组,有显著性差异(P<0.01)。PTTG mRNA与蛋白在食管鳞癌组织的阳性表达具有一致性(P>0.05),其阳性率高低与性别、年龄、肿瘤大小无关,而与组织学分级、淋巴结转移、TNM分期有关。结论:PTTG基因的异常表达可能对食管鳞癌的发生和发展起重要作用,它可能为食管鳞癌的早期诊断和基因治疗提供新的靶点。     

内窥镜辅助下经单鼻腔蝶窦入路切除垂体腺瘤

目的　探讨局部麻醉下利用内窥镜辅助 ,经单鼻腔蝶窦入路切除垂体腺瘤的可行性、优缺点 ,适应证及注意事项。方法　采用MRI明确诊断 ,使用局部麻醉内窥镜电视监测下经单鼻腔蝶窦入路进行垂体腺瘤切除。结果　 30例病人中 2 5例肿瘤全切除 ,5例次全切除。术后 2～ 4小时病人即可下床活动 ,进食。术后平均 4天出院 ,无死亡、无感染。术后脑脊液鼻漏 1例 ,再次经鼻蝶入路修补后痊愈。随访 6～ 4 8个月 ,视力恢复到 1.0以上10例 ,内分泌功能正常 15例 ,月经恢复正常 10例。结论　内窥镜辅助下经单鼻腔切除垂体瘤使用局部麻醉是安全可行的 ,手术对病人的损伤和影响可以达到最低程度     

Determinants of Short-Term Weight Gain Following Surgical Treatment for Craniopharyngioma in Adults

ObjectiveCraniopharyngiomas (CPs) are associated with hypothalamic damage that causes hypothalamic obesity, however, the mechanisms underlying CP-related postoperative weight gain remain debatable. This study aimed to elucidate whether the major determinant of postoperative weight gain in patients with CP is hypothalamic injury or steroid replacement therapy. MethodsWe included 48 adult patients with CP (age ≥18 years) who underwent transsphenoidal surgery between 2010 and 2018 in a single tertiary center, and whose body weight was measured pre- and postoperatively (<120 days after the surgery). We recruited 144 age- and body mass index-matched patients with non-functioning pituitary adenoma (NFPA) as controls. ResultsPatients with CP experienced greater postoperative weight gain than patients with NFPA (3.0±5.1 vs. 0.1±3.6 kg, p<0.001). The prevalence of postoperative steroid use was significantly higher in patients with CP than in those with NFPA (89.6% vs. 34.0%, p<0.001). Steroid replacement therapy and CP were associated with postoperative weight gain after adjusting for covariates in overall patients (p=0.032 and 0.007, respectively). In subgroup analysis with postoperative steroid users, weight gain was significantly greater in patients with CP (n=43, 0.96±0.25 kg/month) than in patients with NFPA (n=49, 0.26±0.23 kg/month) even after adjusting for the daily steroid dose (p=0.048). ConclusionPatients with CP experience greater postoperative weight gain than those with NFPA. Hypothalamic damage itself as well as steroid replacement may contribute to the postoperative weight gain in patients with CP.