肝癌肝移植患者外周血中AFP mRNA和MXR7 mRNA的表达及其与预后的关系

目的： 探讨甲胎蛋白（ɑ-fetoprotein,AFP）mRNA和米托蒽醌抗性基因（Mitoxantrone-resistant 7，MXR7）mRNA作为游离癌细胞（isolated tumor cells,ITC）的标志物在肝癌肝移植患者外周血中的表达情况及其与术后肿瘤复发和转移的关系。方法: 以2002年4月至2003年12月期间的53例肝癌肝移植患者为对象，通过建立稳定可靠的实时荧光定量RT-PCR检测方法来定量检测肝癌患者外周血全细胞中AFP mRNA和MXR7 mRNA在整个肝移植术围手术期的表达和动态变化情况，并与术后肝癌复发和转移进行相关分析。 结果: 将研究对象分为肝癌移植组（53例）、晚期肝癌组（8例）、良性肝病组（26例）、正常对照组（10例），检测发现在肝移植术前，晚期肝癌组的AFP mRNA和MXR7 mRNA其表达率均达到100％,在肝癌移植组中表达率分别为57.7%和53.6%。2者均明显高于在良性肝病组（表达率为19.2%和0）和正常对照组（表达率均为0）（P<0.05）。同时在2者的阳性结果表达水平上，晚期肝癌组和肝癌组要明显高于良性肝病组和正常对照组(P<0.05)，前2者阳性结果定量水平达到1×10¹²copies/g RNA，是后2者定量水平的100－200倍。围手术期AFP mRNA和MXR7 mRNA的表达无论是表达率还是阳性结果表达水平，均以在术中的检测标本为最高，而术后1周为次之。术后出现2次以上的持续性的AFP mRNA和MXR7 mRNA的表达往往提示肝癌的复发和转移，较之移植术后没表达或一过性升高的病例，其差异有统计学意义（P<0.05），而术前和术中单次的AFP mRNA和MXR7 mRNA的表达与否则对术后肝癌复发和转移无明显影响（P>0.05）。结论: AFP mRNA和MXR7 mRNA可以作为肝癌ITC细胞的标志物，具有较好的特异性。术后血全细胞检测出现2次以上的持续性的AFP mRNA和MXR7 mRNA的表达可以有效预测肝癌肝移植术后肿瘤复发和转移。     

血管紧张素Ⅱ受体在大鼠肝星状细胞上的表达

目的: 了解血管紧张素Ⅱ的I_a亚型受体(AT_1a)在大鼠肝星状细胞中的表达情况。方法: 大鼠肝脏经链霉蛋白酶和Ⅳ型胶原酶循环灌注后, 以11% Nycodenz密度梯度离心, 分离获得肝星状细胞。提取肝星状细胞的总核糖核苷酸(RNA), 以逆转录-聚合酶链式反应(RT-PCR)技术和PCR产物测序方法检测AT_1a表达。结果: 采用RT-PCR技术检测到大鼠肝星状细胞有AT_1a mRNA表达, 且PCR产物的测序结果与GenBank上AT_1a cDNA序列有94%的一致性。结论: AT_1a mRNA在大鼠肝星状细胞上表达, 从而又为探索肝纤维化的发生机制提供了有力的依据。     

Large-cell calcifying Sertoli cell tumor of the testis: a case report with ultrastructural study

Large-cell calcifying Sertoli cell tumor (LCCSCT) is a rare histologic variant of Sertoli cell tumor. Recently we observed a case of LCCSCT of the testis with no associated endocrine abnormality. Our ultrastructural findings of rows of tight junctions, numerous intracytoplasmic filaments, and abundant rough endoplasmic reticulum in whorled formations support the Sertoli cell origin of this neoplasm.     

Mixed Epithelial and Stromal Tumor of the Kidney: Preliminary Immunohistochemical and Electron Microscopic Studies of the Epithelial Component

Mixed epithelial and stromal tumor of the kidney is a rare biphasic tumor composed of cysts and tubules embedded in the spindle cell stroma. Although the histogenesis of this tumor is unknown, it has been proposed that both components of the tumor, i.e., stromal and epithelial, are neoplastic. The authors report preliminary immunohistochemical and electron microscopic studies of the epithelial component from one case of a typical, benign, mixed epithelial, and stromal tumor of the kidney. In this study, some tubules showed positivity for proximal, while others showed positivity for distal, nephron immunomarkers. By electron microscopy, some tubules had features of proximal tubular epithelium, while other tubules had features of the loop of Henle (thin segments). The authors believe that in a benign tumor such morphologic heterogeneity is inconsistent with neoplastic proliferation. Therefore, they postulate that in mixed epithelial and stromal tumor of the kidney the tubules are entrapped rather than neoplastic. Additional studies are needed to address this issue and electron microscopy should play a significant role in this process.     

肺癌患者血清TSGF、CEA、CYFRA21—1和NSE水平的临床价值

目的:探讨血清TSGF、CEA、CYFRA21-1和NSE水平的临床价值。方法:采用放射免疫分析测定了179例肺癌、48例肺良性病变和51例正常对照组的血清TSGF、CEA、CYFRA21-1和NSE的水平。结果:在NSCLC中,37例I～II期鳞癌血清中TSGF、CEA和NSE水平与肺良性病变无明显差异(P均>0.05),32例I～II期腺癌血清中NSE也与肺良性病变无明显差异(P>0.05);其余,NSCLC和SCLC血清中TSGF、CEA、CY-FRA21-1和NSE水平明显增高,均与肺良性病变具有明显差异(P<0.05～0.01),从总体而言,随着病变的严重程度增加,肺癌标志物水平也增高。51例正常对照组血清TSGF、CEA、CYFRA21-1和NSE水平分别为(64.1±14.8)U/ml,(3.51±1.1)ng/ml,(2.6±1.4)ng/ml和(5.1±3.6)ng/ml。结论:肺癌的诊断中,以血清CY-FRA21-1测定为最佳,其次为TSGF和CEA,最差NSE,故肺癌标志物的联检是诊断肺癌的最佳选择。     

参杞合剂对小鼠腹水型肝癌细胞株H22细胞周期及凋亡的影响

目的：观察参杞合剂(SQ)在体内、外对小鼠腹水型肝癌细胞株(HcaF16A3)细胞周期及凋亡的影响。方法：用SQ对荷瘤小鼠连续胃饲治疗10d，观察其NK细胞／Mφ的杀伤活性及细胞周期的改变。用流式细胞仪检测SQ对HcaF16A3细胞增殖的抑制作用与诱导凋亡的作用。结果：SQ的抑瘤率为65．68％。流式细胞仪检测发现，SQ可使肿瘤细胞的细胞周期阻滞到S期，并在体外诱导其凋亡。结论：SQ在体内、外均有抑瘤作用，其机制与细胞周期阻滞继而诱发凋亡有关。     

后颅凹肿瘤术中的脑干听觉诱发电位监测分析

目的:探讨脑干听觉诱发电位技术对后颅凹肿瘤术中监护的临床意义。方法:对16例后颅凹肿瘤患者进行术前检查,术中监护,并对BAEP各波波形、潜伏期进行分析。结果:Ⅰ、Ⅲ、Ⅴ波潜伏期延长10例伴Ⅰ—Ⅲ、Ⅲ—Ⅴ或Ⅰ—Ⅴ波波间期延长;波形分化不良或波幅较低6例;手术操作牵拉可引起BAEP不同程度变化。结论:后颅凹占位病变术中的BAEP监护,对保护听觉和脑干功能及术后功能的评估有重要意义。     

Electron Microscopic Study of Adenoid Cystic Carcinoma

This ultrastructural study is based on nine cases of adenoid cystic carcinoma arising from the salivary glands. Electron microscopically, the tumors consisted of five cell types: relatively differentiated intercalated duct cells, secretory cells, undifferentiated cells, cells of a squamous nature, and myoepithelial cells. Special attention was paid to the characteristic extracellular substances noted by light microscopic examination of these tumors. The hyaline material of the pseudocysts contained not only mucopolysaccharide granules but also fingerprintlike structures formed by replicated basement membrane. Some of these structures had a dense core, probably composed of mucopolysaccharide granules. Cell islands surrounded by elasticlike material also were found. The true lumina were usually filled with membranovesicular structures originating from fragments of the lining cells, mainly those with squamous differentiation. These membranovesicular structures included electron-dense rods, filamentous whorls, and structures displaying periodicity.     

An ultrastructural and immunohistochemical study of microcystic meningioma with emphasis on matrix proteins and connexin 26 type gap junctions

Although the histopathological subtypes of meningioma do not themselves appear to have prognostic significance, they are collectively important for defining the overall histopathological entity of microcystic meningioma (MCM) and allowing a distinction from other intracranial tumors, such as capillary hemangioblastoma, glioma, and metastatic renal cell carcinoma showing similar histology. Four cases of MCM were analyzed by conventional histology, immunohistochemistry, and electron microscopy. The present series of MCM was characterized by spindle- or cobweb-shaped tumor cells, characteristically associated small blood vessels, and a peculiar microcystic pattern. Among the microcystic meningeal tumor tissue, small areas of conventional subtypes were identified. Immunohistochemically, tumor cells showed the mesenchymal features of vimentin positivity and a rich distribution of matrix proteins around tumor cells. They lacked epithelial marker positivity but were faintly EMA positive. Ultrastructurally, primitive cellular junctions, desmosomes, and gap junctions were frequently seen between tumor cells. The gap junctions correlated with connexin 26 immunoreactivity. Although lacking an obvious epithelial nature, these features could be interpreted as showing an abortive differentiation mimicking meningothelial (arachnoidal) cells, which, physiologically, regulate cerebrospinal fluid between blood vessels and brain parenchyma.     

脑肿瘤患者认知功能障碍的初步研究

目的 :探索脑肿瘤患者认知功能障碍的特点。方法 :采用CLB测验对 31例左侧大脑肿瘤患者、34例右侧大脑肿瘤患者及正常对照组进行测验。结果 :(1)左侧大脑脑肿瘤组四项语言—序贯能力测验成绩明显低于对照组 (P <0 .0 5 ) ,四项空间认知能力成绩无明显差别 (P >0 .0 5 ) ,病例组CLQ为正值 ,表明右半球信息加工能力无明显损害 ;(2 )右侧大脑脑肿瘤组四项空间认知能力测验成绩明显低于对照组 (P <0 .0 5 ) ,四项语言—序贯能力测验成绩中系列数字、偏旁组字、类别组词与对照组间无明显差异 (P >0 .0 5 ) ,系列声音测验成绩有明显差异 (P <0 .0 5 ) ,病例组CLQ为负值 ,表明左半球信息加工能力基本正常。结论 :CLB可以对脑肿瘤患者认知功能障碍进行量化 ,是一种评估左右侧大脑肿瘤患者认知功能障碍的有效方法。