胃肠道类癌临床病理与免疫组织化学研究

应用免疫组织化学ＡＢＣ法，对５２例胃肠道类癌进行８种多肽／胺类神经内分泌激素、２ 种上皮细胞性标记物的研究。结果：胃肠原位激素胰多肽、生长抑素、蛙皮素、胃泌素、五羟色胺较多 表达于组织形态分化好的类型。血管活性肽的表达随肿瘤组织形态分化降低而上升显著（１５．０％、 ２５．０％、５８．３％、Ｐ＜０．０５），并与肿瘤的浸润和转移有关（Ｐ＜０．０５）。异位激素降钙素的表达主要分 布于肿瘤组织形态分化较低的类型（２０．０％、５０．０％、６６．７％、Ｐ＜０．０５）。癌胚抗原的表达随肿瘤组 织形态分化的降低呈大幅度上升（１０．０％、５５．０％、８３．３％、Ｐ＜０．００１），且与肿瘤的浸润有关（Ｐ＜ ０．０５）；神经特异性烯醇化酶与角蛋白的表达与组织分化无相关性。提示应用多种抗原标记对胃肠 道类癌的良恶性判断很有帮助。     

Clinical Experience in Application of the Point Zhaohai

Zhaohai (KI 6) is a point on the Kidney Channel of Foot Shaoyin, and it is one of the eight confluent points, connecting with the Yinqiao Channel. It is located in the depression of the lower border of the medial malleolus, indicated for the disorders along the distributing courses of the Foot Shaoyin Channel and Yinqiao Channel. Connecting with the kidney and bladder collaterally, it gives the effect of reinforcing the kidney and strengthening qi, and promoting the function of the bladder.     

Differential Growth of IFN-beta-Engineered Tumor Cells in Nude and IFN Receptor-Null Mice.

The purpose of this study was to investigate the therapeutic potential of interferon-beta (IFN-beta) against tumors that resist its antiproliferative effects. Mouse fibrosarcoma cells (UV-2237m-P) and their counterparts, transfected with either IFN-beta cDNA (UV-2237m-IFN-beta) or its control vector (UV-2237m-neo), were used in the study. UV-2237m-IFN-beta cells, still expressing functional IFN receptors, were resistant to the antiproliferative effects of IFN-beta. UV-2237m-P and UV-2237m-neo cells produced progressive tumors in both nude and IFN receptor-null nude (IFNAR-/-nude) mice. In contrast, growth of UV-2237m-IFN-beta cells was significantly delayed in nude mice. UV-2237m-IFN-beta tumors from nude mice contained fewer microvessels, fewer proliferating cells, and more apoptotic cells than did UV-2237m-P and UV-2237m-neo tumors. They expressed high levels of inducible nitric oxide synthase (iNOS) and were densely infiltrated by macrophages. Incubation with macrophages from nude mice, but not those from IFNAR-/- nude mice or iNOS-null/nude mice, led to more significant killing of UV-2237m-IFN-beta cells than that of control cells, which was blocked by iNOS inhibitor N-methylarginine. Similarly, more UV-2237m-IFN-beta cells were killed when they were incubated with spleen lymphocytes from nude mice. These data indicate that IFN-beta can inhibit growth of IFN-beta-resistant tumors by T cell-independent host-mediated mechanisms, including the role of macrophages, natural killer (NK) cells, and iNOS activity.     

Analysis of missense variation in human BRCA1 in the context of interspecific sequence variation

Introduction: Interpretation of results from mutation screening of tumour suppressor genes known to harbour high risk susceptibility mutations, such as APC, BRCA1, BRCA2, MLH1, MSH2, TP53, and PTEN, is becoming an increasingly important part of clinical practice. Interpretation of truncating mutations, gene rearrangements, and obvious splice junction mutations, is generally straightforward. However, classification of missense variants often presents a difficult problem. From a series of 20 000 full sequence tests of BRCA1 carried out at Myriad Genetic Laboratories, a total of 314 different missense changes and eight in-frame deletions were observed. Before this study, only 21 of these missense changes were classified as deleterious or suspected deleterious and 14 as neutral or of little clinical significance. Methods: We have used a combination of a multiple sequence alignment of orthologous BRCA1 sequences and a measure of the chemical difference between the amino acids present at individual residues in the sequence alignment to classify missense variants and in-frame deletions detected during mutation screening of BRCA1. Results: In the present analysis we were able to classify an additional 50 missense variants and two in-frame deletions as probably deleterious and 92 missense variants as probably neutral. Thus we have tentatively classified about 50% of the unclassified missense variants observed during clinical testing of BRCA1. Discussion: An internal test of the analysis is consistent with our classification of the variants designated probably deleterious; however, we must stress that this classification is tentative and does not have sufficient independent confirmation to serve as a clinically applicable stand alone method.     

人胎儿脊髓神经肽Y样神经元及其纤维的发育和分布的免疫细胞化学研究

人工流产胎儿标本２３例，孕龄１０～４１周，用免疫组织化学ＡＢＣ法，研究人胎儿脊髓神经肽Ｙ样神经元的发育和分布。结果在胎龄第１０周，发现脊髓后角浅层（ＲｅｘｔｄⅠ、Ⅱ层）已有神经肽Ｙ样免疫阳性神经元胞体存在，且阳性神经元总数随胎龄的增加而递增，并向后角深层（ＲｅｘｅｄⅢ～Ⅳ层）扩展神经肽Ｙ样阳性纤维，在胎龄第１０周，不仅出现于脊髓的灰质和白质，而且见于脊髓的被膜。随胎龄的增长，免疫阳性反应纤维相对集中于脊髓的植物性神经中枢的所在部位，揭示在妊娠早期，神经肽Ｙ可能与脊髓植物神经元的发育及其功能的调节有关。     

Immunohistochemical diagnosis in fine-needle aspiration cytology

This paper reports 25 kinds of polyclonal or monoclonal antibodies by ABC immunohistochemical technique used for 253 cell smears by fine-needle aspiration. The results were,1. Immunohistochemical diagnosis were classified into 136 metastatic cancers ( K12 EMA CEA LCA-),92 lymphomas (LCA k12- EMA- CEA-), 4 mesenchymal tumors (Vimentin ), 3 melanomas (S-100 NSE ). 15 reactive proliferations (k λ4 CD CD8 ) and 3 unspecified.2. The origin of 70 metastatic cancers were classified into 36 lung (HLC3-AB ), 4 gastrointestinal tract (MG7 ), 8 thyroid (TGB ), 1 prostate (PSA ), 3 liver (AFP ) and 14 unknown. 3. Immunologic phenotype of 87 lymphomas wereclassified into 66 cases of B-cell, 4 T-cell, 3 hsitocyte, 7 Hodgkin' s diseases and 7 unclear. The above results suggest that immunohistochemlcal method may be used as a new method of diagnosing and differentiating epithelial and non-epithelial tumors, detecting primary focus of metastatic cncer, differentiating between reactive proliferation adn lymphome a     

Don't throw out the customer

Addresses the severe criticism by the Health Service Commissioner of NHS trusts for their handling of patient complaints, particularly the attitude of managers and the new NHS trust culture, which emphasized that patients should be considered as more than just customers. Argues that the word "customer" should not be thrown out because managers are uncomfortable with it; takes the view that while they may have tried to adopt the term, they have failed to appreciate its meaning. Makes a comparison between customer and consumer and presents a case for regarding patients as customers. Concludes that lessons can be learned from private business in developing the provider-customer relationship and that attitude and behaviour changes can be brought about by a long-term cultural change programme.     

Expression of c-erbB-2 and PCNA in cervical adenocarcinoma and its signification

Objective: To investigate the significance of c-erbB-2 and PCNA expression in adenocarcinoma. Methods: Expression of c-erbB-2 and PCNA in 74 cases of adenocarcinoma of the uterine cervix was examined by immunohistochemistry. Results: The expression of c-erbB-2 was detected in 34 cases. The positive staining of c-erbB-2 was associated with increased lymph node metastasis (57.1% Vs 24.0%, P=0.041) and lower 5-year survival rate (32.4% Vs 58.9%, P=0.008). The average PCNA labeling index (PCNA LI) was 40.6% (0.1%–91.4%). High PCNA LI was associated with lymph node metastasis (56.4% Vs 38.5%, P=0.016) and lower 5-year survival rate (28.7% Vs 64.4%, P=0.005). Positive staining of c-erbB-2 were associated with high PCNA LI (44.7% Vs 34.6% P=0.003). Conclusions: c-erbB-2 and PCNA LI were associated with malignant biological behavior and poor prognosis of patients with cervical adenocarcinoma.     

Detection of SYT-SSX fusion transcripts in paraffin-embedded tissues of syno vial sarcoma by reverse transcription-polymerase chain reaction

目的　探讨用逆转录 聚合酶链反应 (RT PCR)技术检测滑膜肉瘤石蜡包埋组织中SYT SSX融合基因的可行性。方法　我们采用RT PCR方法对 37例福尔马林固定、石蜡包埋的滑膜肉瘤组织中SYT SSX融合基因转录本进行了检测。为探讨SYT SSX融合基因对滑膜肉瘤的特异性 ,一系列非滑膜肉瘤的肿瘤标本作为阴性对照。融合基因检测结果用测序的方法进行了证实。结果　 37例滑膜肉瘤中 33例 (89 2 % )可检测出SYT SSX融合基因。 34例非滑膜肉瘤的肿瘤标本中均未显示SYT SSX融合基因产物扩增信号。此 34例标本中均可检测到PBGDmRNA表达。 33例SYT SSX阳性滑膜肉瘤中 ,SYT SSX1阳性 2 2例 ,SYT SSX2阳性 6例 ,其余 5例无法区分融合基因类型。融合基因类型与组织学亚型间存在相关性。所有 10例双相型滑膜肉瘤均为SYT SSX1型 ,而所有SYT SSX2阳性滑膜肉瘤均为单相型 (P <0 0 5 )。结论　我们的结果提示 ,RT PCR技术可以用于存档的福尔马林固定、石蜡包埋组织 ,作为滑膜肉瘤诊断和鉴别诊断敏感而且可靠的技术。SYT SSX融合基因类型与组织学亚型间存在相关性。SYT SSX2型仅见于单相型滑膜肉瘤。