平扫CT值在常见肾上腺肿瘤鉴别诊断中的应用价值

目的:评价平扫CT值在肾上腺常见肿瘤诊断中的应用价值,并结合肿瘤大小优化选择肾上腺腺瘤与非腺瘤的鉴别阈值。方法:回顾性分析经手术及病理证实的肾上腺肿瘤209例(221个病灶),其中腺瘤137个,非腺瘤84个,分别测量肿瘤的大小及平扫CT值并计算不同CT值阚值鉴别腺瘤与非腺瘤的敏感度、特异度、准确度、阳性预测值及阴性预测值。结果:137个腺瘤平扫CT值-12～59(13.19±12.84)HU,直径0.3～7.3cm,其中包括88个无功能性腺瘤,平扫CT值-12～59(15.04±13.01)HU;醛固酮腺瘤43个,平扫CT值-8～42(10.19±12.26)HU;皮质醇腺瘤6个,平扫CT值-4.6～18(7.58±10.16)HU。84个非腺瘤平扫CT值15～69(38.33±10.08)HU,直径1.5～11.6cm,包括:嗜铬细胞瘤43个,平扫CT值15～69(38.67±11.05)HU;节细胞神经瘤5个,平扫CT值18～39(29.60±8.65)HU;皮质癌28个,平扫CT值26～58(38.96±8.84)HU;转移癌8个,平扫CT值28～54(39.75±8.24)HU;腺瘤和非腺瘤的平均平扫CT值差异有显著性意义(t=-15.281,P=0.000)。使用CT值25HU且肿瘤大小≤4cm作为鉴别腺瘤与非腺瘤的阈值时诊断腺瘤的敏感度73.7%,特异度100%,准确度83.7%,阳性预测值100%,阴性预测值70%。结论:平扫CT值在肾上腺腺瘤与非腺瘤的鉴别诊断上有重要价值,以平扫CT值≤25且肿瘤大小≤4cm作为腺瘤的诊断标准是比较合适的,特异度高,敏感度及准确度均较高。但在进一步鉴别腺瘤及非腺瘤的组织类型及具体临床诊断中的作用有限,需结合临床其他检测手段及病理结果做出全面准确的判断。     

细胞株源人前列腺肿瘤干细胞的分选与鉴定

目的:论证人前列腺癌(prostate cancer,PCa)细胞株中是否存在干细胞亚群。方法:分别用免疫表型法和侧群(side population,SP)细胞法从5种人PCa细胞株(Du145、IA8、LNCaP、TSU-PrL和PC-3)中富集类干细胞,再应用软琼脂克隆形成试验初步验证类干细胞亚群的体外生长方式及成瘤能力。选择LNCaP源SP细胞(LNCaP/SP),依次采用免疫细胞化学技术、Transwell、MTT以及裸鼠致瘤试验,分别检测其干细胞标记物的表达情况、鉴定其体外增殖和侵袭能力以及动物体内的致瘤和转移潜能。结果:5种细胞株中均难以分选出免疫表型为CD133+CD44+的细胞亚群。除PC-3外,其余4株细胞可分选出呈现典型克隆性生长特点的SP细胞。体外克隆形成率在IA8、LNCaP和TSU-PrL源SP细胞与非侧群(non-side population,NSP)细胞间有显著性差异(P<0.05)。与LNCaP/NSP相比,LNCaP/SP的体外增殖和侵袭能力显著增强,同时阳性表达整合素α2、Nanog、CD44、OCT4以及ABCG2等5种干细胞标记物。而且,LNCaP/SP的皮下成瘤率、骨转移率及瘤体体积亦显著高于LNCaP/NSP(P<0.01)。结论:SP分选法更适合富集人PCa细胞株中类干细胞,LNCaP/SP细胞是PCa细胞株LNCaP中的肿瘤干细胞(cancer stem cell,CSC)。     

Isolation and identification of cancer stem-like cells from side population of human prostate cancer cells

It has been widely verified by various sorting methods that cancer stem cells (CSCs) exist in different types of tumor cells or tissues.However,due to lack of specific stem cell surface markers,CSCs are very difficult to be separated from some cancer cells,which becomes the key barrier of functional studies of CSCs.The sorting method by side population cells (SP) lays a solid foundation for in-depth and comprehensive study of CSCs.To identify the existence of SP in prostate cancer cell lines,we applied flow cytometry sorting by SP to cultures of prostate cancer cell lines (TSU,LnCap,and PC-3),and the cancer stem-like characteristics of SP were verified through experiments in vitro and in vivo.The proportion of SP in TSU cells was calculated to be 1.60%±0.40% (±s),and that in PC-3 and LnCap cells was calculated to be 0.80%±0.05% and 0.60%±0.20%,respectively.The colony formation assay demonstrated that the colony formation rate of SP to non-SP sorted from TSU via flow cytometry was 0.495±0.038 to 0.177±0.029 in 500 cells,0.505±0.026 to 0.169±0.024 in 250 cells,and 0.088±0.016 to 0.043±0.012 in 125 cells respectively.In the in vivo experiments,tumors were observed in all the mice on the 10th day after injecting 50 000 cells subcutaneously in SP group,whereas when 5×106 cells were injected in non-SP group,tumors were developed in only 4 out of 8 mice until the 3rd week before the end of the experiment.Our results revealed that prostate cancer cells contain a small subset of cells,called SP,possessing much greater capacity of colony formation and tumorigenic potential than non-SP.These suggest that SP in prostate cancer cells may play a key role in the self-renewal and proliferation,and have the characteristics of cancer stem-like cells.Dissecting these features will provide a new understanding of the function of prostate CSCs in tumorigenicity and transformation.     

输尿管坐骨孔疝的诊治进展

输尿管坐骨孔疝是盆底疝的一种罕见类型,该病临床症状缺乏典型性,受累输尿管可继发上尿路梗阻并进一步引起肾盂肾炎、腰腹痛、肾功能不全等。截至目前全世界报道的输尿管坐骨孔疝患者不足40例,临床医师对输尿管坐骨孔疝的诊治水平有待强化。目前输尿管坐骨孔疝常用的治疗方法包括积极监测、手法复位、输尿管支架置入术、外科手术修补,其中腹腔镜下疝修补术的安全性和有效性逐渐得到认可。本文就输尿管坐骨孔疝诊治方法的最新进展进行综述。     

缺氧微环境下缺氧诱导因子-1α对前列腺癌细胞上皮间质转化的影响

目的：探讨缺氧诱导因子-1α在缺氧的条件下对前列腺癌细胞发生上皮间质转化的影响。方法在缺氧的环境中培养前列腺癌细胞 PC3,并应用分子生物学的方法检测其是否是发生上皮间质转化的关键转录因子。结果缺氧微环境可以诱导前列腺癌细胞 PC3发生上皮间质转化,缺氧诱导因子-1α起关键的调节作用,并且可以增强前列腺癌细胞的侵袭能力。缺氧条件下抑制缺氧诱导因子-1α的表达可以阻止前列腺癌细胞发生上皮间质转化。结论缺氧微环境通过缺氧诱导因子-1α诱导前列腺癌细胞 PC3发生上皮间质转化。