TECHNIQUES AND PITFALLS OF ENDOSCOPIC SUBMUCOSAL DISSECTION FOR COLORECTAL TUMORS

Endoscopic submucosal dissection (ESD) for colorectal tumors is steadily being developed. Safety and standardization of ESD for colorectal tumors have not been yet established because of the technical difficulties and the unsuitable anatomical characteristics of the colon and rectum. The authors mainly use a Flex knife for mucosal incision and a Hook knife for submucosal dissection to perform ESD safely. Skillful colonoscopic control, selection of scope, distal attachment tip hood, adequate high‐frequency generator and correct approach strategy should all be considered for safe performance of ESD. However, the incidence of indicative lesions is rare because the majority of colorectal tumors are adenomatous large laterally spreading tumors, which can be cured by intentional endoscopic piecemeal resection. At present, ESD for colorectal tumors should be performed only at central facilities that have expert colonoscopists. With the development of new devices and associated techniques, technical standardization of ESD for colorectal tumors is expected in the near future.     

不同浓度5-溴脱氧尿嘧啶核苷标记山羊骨髓基质干细胞的体外研究

Objective To explore the feasibility of labeling and tracing in vitro goat bone marrow mesenchymal stem cells (BMSCs) by bromodeoxyuridine (BrdU) on the basis of investigation of its optimal concentration, incubating time and cytotoxicity. Methods A healthy goat, aged 10 months old, male, weighing 32 kg, was used in this study. Bone marrow was aspirated. BMSCs were isolated and cultured using the adherence method in vitro. The fourth passage of BMSCs (P4) were incubated with BrdU at 5, 10, 15, 20 μmol/L as 5, 10, 15, 20 μmol/L BMSC groups. Cells were not labeled by BrdU as negative control. The following parameters were measured: induction, differentiation and determination of goat BMSCs; the optimal mass concentration and incubation time of 5-BrdU labeling; cell positive rate at 12, 24, 48 and 72 hours in each group using immunofluoreseenee; the cell survival rate after various concentrations of BrdU ladling by trypan-blue exclusion. Results The morphology of the primary and passage goat BMSCs was fusiform in shape. Goat BMSCs could differentiate into osteoblasts and chondrocytes following induction. BMSC nucleus showed green fluorescence under fluorescence microscope after being labeled by BrdU. The mean labeling rate increased with the increase in the concentration and incubation time of BrdU, and reached to (93.32± 3.25)% after incubation in 15 μmol/L, BrdU for 48 hours. There were no significant differences between 15 μmol/L BrdU for 72 hours, 20 μmol/L BrdU for 48 hours and 72 hours (P > 0.05), or between the other groups or time points (P < 0.05). The labeling rate of the blank control group was 0. The cell survival rate was all above 90% (P > 0.05). Conclusions BrdU can be used as a labeling marker for goat BMSCs. When the concentration is 15 μmol/L and the incubation time is 48 hours, the optimal labeling effect can be achieved. Goat BMSCs labeled with BrdU is of high efficiency and safety.     

肿瘤干细胞与肝癌干细胞

肿瘤起源于干细胞的假说正在各种人类肿瘤中得到证实,肿瘤不单是一种基因病,而且是一种干细胞病,基因突变作用于干细胞,干细胞突变成为肿瘤干细胞,这是肿瘤发生、再生、转移和复发的关键。肝细胞癌是最常见的恶性肿瘤之一,其中是否存在“肝癌干细胞”的问题一直倍受人们关注。该文介绍肿瘤干细胞与肝癌干细胞的研究情况。     

肿瘤转移抑制基因KAI1在喉鳞状细胞癌中表达的研究

目的　探讨肿瘤转移抑制基因KAI1在喉鳞状细胞癌 (简称鳞癌 )中的表达及其与之发生、发展的关系。方法　采用原位杂交方法检测 84例原发性喉鳞癌 (primarylaryngealsquamouscellcarcinoma ,PLSCC)、2 7例喉癌前病变不典型增生 (laryngealprecancerouslesion ,LPL)、10例声带息肉(vocalcordpolyp ,VCP)和 10例正常喉黏膜 (normallaryngealtissues ,NLT)石蜡标本组织细胞中KAI1mRNA的表达。结果　NLT、VCP、LPL和PLSCC 4种组织中KAI1阳性表达的积分吸光度值 ( x±s)分别为 (136 2 0 6 8± 36 6 75 5 )、(1336 74 5± 4 2 85 8 5 )、(90 36 8 8± 2 5 70 1 9)和 (6 7880 6± 2 8189 5 ) ,其中NLT组和VCP组之间差异无显著性 (t=0 14 2 ,P >0 0 5 ) ,NLT组和LPL组之间差异有显著性 (t =4 2 81,P <0 0 1) ;PLSCC组中KAI1表达普遍下调 ,且病理分化G1 2组阳性表达水平高于G3组 ;T1 2病变组高于T3 4组 ;颈淋巴结NO组高于N1及N1以上组 ;临床Ⅰ Ⅱ期组高于临床Ⅲ Ⅳ期组 (P值均 <0 0 1)。KAI1表达与患者性别无关 (P >0 0 5 )。结论　KAI1低表达在喉鳞癌的发生、发展中可能起着重要作用 ,可望作为喉鳞癌早期诊断、评估肿瘤细胞侵袭转移潜能及患者病程发展阶段的指标之一。     

“胰岛素正常”的胰岛素瘤

目的分析胰岛素瘤胰岛素水平正常的原因，以提高其诊断水平。方法对我院1982年6月至2005年10月诊断为胰岛素瘤，且胰岛素水平检测结果在正常范围内的12例进行回顾性分析。结果12例患者均出现空腹或发作性低血糖症状，连续检测血糖，至少1次血糖值〈2．8mmol／L。同期检测外周静脉血中免疫反应性胰岛素（IRI）水平均〈25mU／L。周围静脉血中免疫反应性胰岛素／血糖比值（IGR）：〈0．3者5例，〉0．3者7例。12例中8例进行了血清C-肽检测，6例高于正常。结论少数胰岛素瘤患者的血胰岛素可在正常范围内，血胰岛素水平正常不能排除胰岛素瘤的诊断。     

肝癌患者血清12种肿瘤标志物的变化

目的探讨定量测定肝癌患者血清12种肿瘤标志物的临床意义。方法用蛋白芯片技术定量测定42例正常人、46例肝癌、41例肝炎和23例肝硬化患者血清12种肿瘤标志物的变化并对检测效果进行评价。结果42例正常人CA-199(KU/L)、NSE(g/L)、CEA(g/L)、CA-242(KU/L)、Ferritin(g/L)、β-HCG(g/L)、AFP(g/L)、f-PSA(g/L)、PSA(g/L)、CA-125(KU/L)、HGH(g/L)和CA-153(KU/L)的含量分别为12.42±10.62、2.22±1.43、1.28±1.20、5.72±5.73、91.17±79.43、0.64±0.34、2.96±3.93、0.13±0.11、0.61±1.40、5.46±9.65、1.61±2.40、9.83±9.51;46例肝癌患者血清12种肿瘤标志物含量依次为:35.09±39.50、2.83±4.13、2.98±8.72、8.47±23.42、157.50±129.77、0.72±0.72、87.58±63.27、0.15±0.19、0.58±1.88、56.34±102.02、3.63±4.57、15.65±51.09;41例肝炎患者其含量依次为:76.23±96.57、4.12±4.94、2.06±3.92、4.68±6.99、298.76±326.82、1.00±0.74、63.16±91.76、0.11±0.006、0.27±0.94、18.57±36.60、3.63±4.00、6.13±6.86;23例肝硬化患者其含量依次为:49.85±75.60、5.47±14.97、1.71±1.77、12.44±34.55、278.32±326.82、0.70±0.54、52.89±98.28、0.22±0.21、2.24±4.36、111.50±191.99、2.15±0.99、10.51±15.79。该蛋白芯片测定的敏感性为50.0%,特异性为64.2%,阳性预测值为37.7%,阴性预测值为74.7%。结论采用蛋白芯片技术同时测定患者血清多种肿瘤标志物,对普查肿瘤和临床疗效观察有较好应用价值。     

Ameloblastoma ex calcifying odontogenic cyst (dentinogenic ghost cell tumor)

Calcifying odontogenic cyst (COC) has shown to be of extensive diversity in its clinical and histopathological features, as well as in its biological behavior. In this report, a rare case is described of ameloblastoma ex COC (dentinogenic ghost cell tumor) and the relevant literature is briefly reviewed.     

趋化因子及其受体在肿瘤侵袭转移中的作用

近年来陆续发现了许多新的趋化因子和受体，研究发现趋化因子及其受体参与机体的多种生理和病理过程，并在肿瘤的侵袭转移中通过不同机制发挥着重要作用。本文对其进行简要综述。     

416例甲状腺肿瘤临床病理分析

目的了解本地区甲状腺肿瘤的发病情况，探讨甲状腺肿瘤的诊断与鉴别诊断6方法对416例甲状腺肿瘤病理资料进行回顾性分析。结果甲状腺肿瘤以良性多见，良恶性之比为8．2：1。各类型肿瘤均以女性明显多于男性，男女之比为1：5．4，好发年龄为21～50岁，肿瘤发生于甲状腺右侧多见。结论本组甲状腺肿瘤的发生率、好发年龄、性别差异、良恶之比与文献报道基本一致。乳头状腺瘤与乳头状癌的鉴别有一定难度，对可疑标本要多处取材，连续切片，仔细观察，找出其特征，提高诊断的准确性。