肿瘤分子靶向治疗的研究进展

近年来，随着分子生物学技术的提高和对肿瘤发病机制从细胞、分子水平的进一步认识，分子靶向治疗已成为肿瘤医学的发展方向。其中以受体酪氨酸激酶为治疗靶点的分子靶向治疗受到国内外肿瘤界的普遍关注。它的ErbB受体家族通过基因扩增、过度表达和突变导致信号传导的增加与很多肿瘤及其不良预后呈正相关。     

GTP Cyclohydrolase 1 Gene 3'-UTR C+243T Variant Predicts Worsening Outcome in Patients with First-Onset Ischemic Stroke

Tetrahydrobiopterin (BH4) is an essential cofactor for all three nitric oxide synthase (NOS isoforms), which plays an important role in vascular diseases. GTP cyclohydrolase 1 (GCH 1) is the first-step and rate-limiting enzyme for BH4 biosynthesis in its de novo pathway. Common GCH1 gene variant C+243T in the 3'-untranslated region predicts NO excretion. The present study examined the predictive role of GCH 1 gene 3'-UTR C+243T variant in the long-term outcome of ischemic stroke. A total of 142 patients with first-onset ischemic stroke were recruited and detected for genotype of GCH1 3'-UTR C+243T by a TaqMan SNP Genotyping assay. Subsequent vascular events and death were determined over a 5-year follow-up period. The frequency of GCH1 3'-UTR +243 C/T or T/T genotype was significantly increased in patients with endpoint events as compared with those without events (74% vs 57.8%, P=0.06). Cox regression survival analysis indicated that an increased probability of death or new vascular events was found in patients with GCH1 3'-UTR +243 C/T or T/T genotype compared with those with GCH1 3'-UTR C/C genotype (40.6% vs 25.5%), GCH1 3'-UTR +243 C/T or T/T genotype relative to GCH1 3'-UTR C/C genotype was associated with the increased risk of death or vascular events even after adjustment for other risk factors (OR=2.171, 95% CI: 1.066–4.424, P=0.033). It was concluded that GCH1 3'-UTR C+243T variant was an independent predictor of worsening long-term outcomes in patients with first-onset ischemic stroke.     

CYP2J2基因和EPHX2基因多态性与肺癌易感性研究

目的探讨CYP2J2基因启动子区G-50T多态性和EPHX2基因G860A多态性与肺癌发生的关系。方法经病理检查确诊为肺癌患者150例（肺癌组）,300名本院健康体检者作为对照组,检测其CYP2J2基因启动子区G-50T多态性和EPHX2基因G860A多态性,并进行统计学分析。结果肺癌组和对照组比较,CYP2J2启动子区G-50T多态性差异无统计学意义,而肺癌组患者EPHX2 860G等位基因频率显著高于对照组人群（96％比78．3％,P〈0．01）,多元回归分析方法显示,肺癌的发生与EPHX2 G860A多态性显著相关（校正OR值=0．164,95％CI 0．079～0．342,P〈0．001）。结论EPHX2 G860A多态件与肺痛密切相关．可作为肺癌高毹患者的预涮指标．     

GTP cyclohydrolase 1 gene 3′-UTR C+243T variant predicts worsening outcome in patients with first-onset ischemic stroke

Tetrahydrobiopterin (BH4) is an essential cofactor for all three nitric oxide synthase (NOS isoforms), which plays an important role in vascular diseases. GTP cyclohydrolase 1 (GCH 1) is the first-step and rate-limiting enzyme for BH4 biosynthesis in its de novo pathway. Common GCH1 gene variant C+243T in the 3’-untranslated region predicts NO excretion. The present study examined the predictive role of GCH 1 gene 3’-UTR C+243T variant in the long-term outcome of ischemic stroke. A total of 142 patients with first-onset ischemic stroke were recruited and detected for genotype of GCH1 3’-UTR C+243T by a TaqMan SNP Genotyping assay. Subsequent vascular events and death were de- termined over a 5-year follow-up period. The frequency of GCH1 3’-UTR +243 C/T or T/T genotype was significantly increased in patients with endpoint events as compared with those without events (74% vs 57.8%, P=0.06). Cox regression survival analysis indicated that an increased probability of death or new vascular events was found in patients with GCH1 3’-UTR +243 C/T or T/T genotype com- pared with those with GCH1 3’-UTR C/C genotype (40.6% vs 25.5%), GCH1 3’-UTR +243 C/T or T/T genotype relative to GCH1 3’-UTR C/C genotype was associated with the increased risk of death or vascular events even after adjustment for other risk factors (OR=2.171, 95% CI: 1.066-4.424, P=0.033). It was concluded that GCH1 3’-UTR C+243T variant was an independent predictor of worsening long-term outcomes in patients with first-onset ischemic stroke.     

恶性肿瘤相关高钙血症临床特征及预后分析

目的 探讨恶性肿瘤相关高钙血症患者的临床特点及预后.方法 收集华中科技大学同济医学院附属同济医院肿瘤中心2007年1～6月收治的603例恶性肿瘤患者的血清总钙、白蛋白、校正血钙(游离钙)及相关临床资料,分析其中33例合并高钙血症患者的临床特征及生存状况.同时对33例患者进行生存期随访.观察终点为发现高钙血症后的生存时间.随访时间截止至2012年6月1日.结果 恶性肿瘤相关高钙血症的发生率为5.5％ (33/603),高钙血症的发生与年龄(P＜0.05)、临床分期(P＜0.01)、血清总钙(P＜0.01)、血清白蛋白水平(P＜0.01)相关.而与性别、肿瘤类型无关.在转移部位上,肺转移(P＜0.05)和骨转移(P＜0.01)与高钙血症相关.33倒出现高钙血症患者的生存时间为2～1 467天(中位时间96天),至随访截止时间全部死亡.结论 恶性肿瘤相关性高钙血症多见于晚期,生存期短,诊断高钙血症应对血清总钙进行校正,以血清游离钙判断为宜.