喉鳞癌微血管密度与颈淋巴结转移及病理临床分期的相关性研究

目的研究喉鳞癌微血管密度与颈淋巴结转移及病理临床分期的相关性。方法采用抗Ⅷ因子相关抗原的抗体标记肿瘤血管内皮细胞并测定喉鳞癌组织微血管密度。结果①颈淋巴结转移组喉鳞癌的微血管密度显著高于非转移组(32.1518±6.489∶18.0672±4.983,P<0.01);②喉鳞癌微血管密度大于均数组则颈淋巴结转移率显著增高(P<0.01);③病理临床分期晚期组喉鳞癌的微血管密度明显高于早期组(P<0.01)。结论喉鳞癌微血管密度可作为预测其颈淋巴结转移的一项指标。     

Transfection of Immortalized Keratinocytes by Low Toxic Poly(2-(Dimethylamino)Ethyl Methacrylate)-Based Polymers

Skin carcinoma are among the most spread diagnosed tumours in the world. In this study, we investigated the transfection of immortalized keratinocytes, used as an in vitro model for skin carcinoma, using antisense technology and poly(2-(dimethylamino)ethyl methacrylate) (PDMAEMA)-based polymers, with original architecture and functionalities. We tested PDMAEMA polymers with different structures: linear, with two (DEA-PDMAEMA) or three (TEA-PDMAEMA) arms. The cytotoxicity of these polymers was assessed over a wide range of apparent M _n (from 7600 to 64 600). At a N/P ratio of 7.38, cytotoxicity increases with the M _n. Keratinocytes were transfected with a fluorescent oligonucleotide and then analyzed by flow cytometry. For the three architectures tested, the percentage of transfected cells and abundance of internalized oligonucleotide were closely related to the M _n of the polymer. Confocal microscopy and FACS analyses showed a wide spread fine granular distribution of the oligonucleotide up to 3 days post-transfection. Then, we assessed the silencing efficiency of the polymers, targeting GFP in GFP expressing keratinocytes. The maximal silencing effect (±40%) was obtained using a DEA-PDMAEMA polymer (M _n = 30 300). These results suggest that PDMAEMA-based polymers can be efficiently used to transfect immortalized keratinocytes and, thus, open new perspectives in the therapy of skin carcinoma.     

Case Report: Determination of Primary Foci of Metastatic Tumors by p53 Mutational Analysis in Intraesophageal Multiple Carcinomas

It is well known that squamous carcinomasfrequently develop multifocally, either synchronously ormetachronously, in the upper aerodigestive tract (1).Such phenomena were first reported by Slaughter et al in 1953, and they were named fieldcancerization (2). Using recent molecular biologytechniques, these multiple carcinomas have been revealedto arise from independent origins (3). Esophagealcarcinomas have been reported to frequently metastasize tothe lymph nodes even at the early stage of tumorextension (4). Furthermore, simultaneous multifocalcancer development is not rare in the esophagus (5). In cases of intraesophageal multiple carcinomaswith lymph node metastases, the primary focus of themetastatic tumors cannot be identified by conventionalhistologic examination. Here we report a case of intraesophageal multiple carcinomas in whichthe attributed foci of lymph nodal metastases could beclearly identified by analyzing the p53 gene mutationalstatus used as a clonal marker.     

乳腺癌间质成纤维细胞的平滑肌分化及意义

目的　观察乳腺癌间质成纤维细胞平滑肌分化情况 ,评价临床病理学意义。方法　对69例乳腺癌标本进行α SMA免疫组织化学染色 ,以 8例无癌区域乳腺组织 (距癌肿边缘 5cm以上 )为对照 ,分析浸润性乳腺癌间质成纤维细胞平滑肌分化与年龄、肿瘤大小、淋巴结转移、组织学分级和雌激素受体状态的关系。结果　无癌区域乳腺组织和原位癌间质无成纤维细胞平滑肌分化现象 ,5 5 .5 %的浸润性乳腺癌间质成纤维细胞有α SMA阳性表达 (P <0 .0 5 ) ;68.3 % ( 2 8/ 41)的淋巴结转移病例出现间质成纤维细胞平滑肌分化 ,且明显高于无淋巴结转移者 ( 2 6.3 % ,P <0 .0 5 ) ;组织学Ⅱ ,Ⅲ级的浸润性乳腺癌间质成纤维细胞平滑肌分化 ( 2 6/ 3 9)明显多于组织学Ⅰ级 ( 7/ 2 1,P <0 .0 5 )。结论　间质成纤维细胞平滑肌分化与乳腺癌的浸润和恶性程度有关 ,肌成纤维细胞可能在乳腺癌的浸润和转移中发挥重要的旁分泌作用。     

晚期乳腺癌术前局部灌注化疗的疗效观察

目的　探讨术前动脉灌注化疗对晚期乳腺癌临床治疗效果及病理特征的影响。方法　回顾性分析 5 2例晚期乳腺癌患者的临床资料 ,其中 2 2例术前行动脉内灌注化疗 (治疗组 ) ,3 0例术前未行动脉内灌注化疗 (对照组 )。结果　治疗组灌注化疗后 ,症状减轻 ,肿瘤缩小 ,有效率 (CR +PR )为 86.4%。术后病理检查均发现癌细胞核固缩、碎裂 ,胞浆凝固、坏死 ;细胞间质水肿、炎性细胞浸润、纤维组织增生 ;血管出现内膜增生 ,血栓形成。对照组癌细胞改变不明显。随访时间 2～ 7年。局部复发率治疗组 13 .6% ,对照组 3 3 .3 % (P <0 .0 1)。治疗组 5年生存率 5 9.1% ,对照组 2 6.7%(P <0 .0 5 )。结论　晚期乳腺癌术前动脉灌注化疗可以缩小肿瘤 ,降低肿瘤分期 ,改变癌细胞的组织学形态 ,提高生存率。     

Non-alcoholic Steatohepatitis (NASH) and Hepatocellular Carcinoma

Non-alcoholic fatty liver disease (NAFLD) is characterized by an excessive accumulation of fatty acids and triglycerides within the cytoplasm of the hepatocytes of non-alcohol users. The natural history varies according to the initial histological diagnosis. A current consideration is that cryptogenic cirrhosis may be representative of a late stage of non-alcoholic steatohepatitis (NASH), which has lost its features of necroinflammatory activity and steatosis in up to 80% of patients. Since NASH is able to progress to cirrhosis, hepatocellular carcinoma (HCC) development may be an end-stage of this disease. We report below two clinical cases of patients diagnosed with NASH who developed HCC. The relationship between NAFLD and HCC is reviewed.     

A Case-Control Assessment of Risk Factors for Gallbladder Carcinoma

Gallbladder carcinoma is an uncommon, but highlyfatal disease. Its symptoms frequently mirror those ofgallstone disease, and in most instances, diagnosis isan incidental finding at surgery. While risk factors have been suggested for this cancer,many may in reality simply be a consequence of the olderage of the population. This study is one of the few toapproach this question by using a case-control study design comparing gallbladder carcinomapatients with a gallstone population, coupled withmultivariate analysis to determine age-independent riskfactors. Univariate analyses showed gallbladdercarcinoma patients to be older than gallstone patientsand to have many age-associated diseases. Followingmultiple regression adjustment for age, this disease wasassociated with female gender and with a previous history of gallstone symptoms. Carcinomapatients were less likely to have cholesterol gallstonesin their gallbladders at surgery. A previous history ofsmoking was a substantial risk but of borderline statistical significance. Previous studiesreport associations that may be due to the older age ofthe gallbladder carcinoma patient. Our results show thatafter adjusting for age with multivariate analysis, gallbladder cancer subjects were predominantlyfemale, more likely to report previous gallstonesymptomology, and to smoke. While gallstones were notuniversally isolated from carcinoma patients atcholecystectomy, when present, they were less frequentlyclassified as cholesterol gallstones based on visualinspection. Further cohort studies which target thesepopulations will allow us to gain a more solid consensus on the risk factors for this disease.     

Use of FDP and F1P Aldolase to Detect Tumorous and Nontumorous Tissue Damage by Ethanol Injection of Hepatocellular Carcinoma

Changes in serum levels of tumor-specificfructose 1,6-diphosphate (FDP) aldolase andnontumor-specific fructose 1-phosphate (F1P) aldolaseactivities were analyzed in patients with hepatocellularcarcinoma (HCC) to detect the damage of tumorous andnontumorous hepatic cells after percutaneous ethanolinjection (PEI). Initial PEI was performed in 20patients containing 22 HCC nodules with a diameter of4 cm. Changes in serum hepatic enzyme activities weremeasured before and after repeated PEI. FDP and F1Paldolase levels were measured by substrate-specificenzymatic methods. Pre- and posttreatment-fetoprotein (AFP) levels were determined byradioimmunoassay. The consequent changes in the totalnontumorous liver volumes after PEI were also analyzedby follow-up CT scans. Serum levels of FDP aldolasereleased by ethanol injection were progressivelyincreased (P < 0.0001) until the third PEI andthereafter decreased. In contrast, serum levels of F1Paldolase were continuously elevated even after the third PEI (P < 0.0001). Serum levels oftransaminases were also elevated after repeated PEI (P< 0.0001). The FDP/F1P aldolase ratio decreasedsignificantly with increased volume (>20 ml) ofinjected ethanol (P = 0.01) caused by nontumorous liverdamage. The elevation of FDP aldolase was markedlyassociated with a decrease in serum levels of AFP (P< 0.001), indicating adequate tumor necrosis. The progression of the total nontumor liver atrophydepended on the volume of injected ethanol andcorrelated significantly with F1P aldolase levels afterPEI (P < 0.01) but not with FDP aldolase. These results demonstrated that caution is needed toavoid nontumorous liver damage caused by the largevolume of ethanol injection in treating HCC. Measurementof FDP and F1P aldolase activities in serum after PEI is clinically useful to detect the degreeof tumorous and nontumorous tissue damage byethanol.