结直肠癌细胞胀亡与肿瘤组织微血管密度的关系

目的探讨结直肠癌组织中细胞胀亡及其与微血管密度(microvesseldensity,MVD)的关系和临床意义。方法利用透射电镜和免疫组化技术对64例结直肠癌组织中细胞胀亡与MVD进行检测。结果结直肠癌组织中存在细胞胀亡;结直肠癌组织中胀亡指数(oncosisindex,OI)随分化程度降低而降低(F=85902,P<0005);淋巴结转移组OI明显低于无淋巴结转移组(t=20630,P<005);MVD在淋巴结转移组高表达,无淋巴结转移组低表达(t=32733,P<0005)。MVD高表达组的OI低于低表达组(t=24108,P<001)。结论细胞胀亡和MVD表达与结直肠癌的生物学行为密切相关。     

T细胞共刺激分子及其亚群在胃癌和大肠癌组织中表达的意义

目的 探讨T细胞共刺激分子及其亚群在胃癌、大肠癌发生及预后中的作用.方法 应用流式细胞术检测38例胃癌、42例大肠癌患者和21例健康人(对照组)外周血T细胞亚群及其共刺激分子CD28的表达.结果 T细胞共刺激分子CD28(CD28 CD3 )表达 胃癌组为(25.80±10.56)%,大肠癌组为(28.95±9.29)%,均明显高于对照组的(0.82±0.98)%,P＜0.01; 总T细胞(CD3 )表达 胃癌组为(53.61±13.84)%,大肠癌组为(55.96±10.68)%,均明显低于对照组的(72.07±7.83)%,P＜0.01; CD4 T细胞(CD4 CD3 )表达 胃癌组为(29.84±9.71)%,大肠癌组为(33.75±9.04)%,也均明显低于对照组的(38.79±5.08)%,P＜0.01, P＜0.05; 细胞毒T细胞(CTL,CD8 CD28 CD3 )表达 胃癌组为(1.57±1.99)%,大肠癌组为(1.93±2.61)%,均明显高于对照组的(0.02±0.04)%,P＜0.01; 胃癌组CD8 抑制性T细胞(CD8 CD28-CD3 )和CD4/CD8比值明显低于对照组[(16.06±6.94)% vs (20.56±6.54)%,P＜0.05; (1.10±0.51)% vs (1.36±0.31)%,P＜0.05]; 大肠癌组调节性T细胞(CD4 CD25 CD3 )明显高于对照组[(19.74±6.89)% vs (13.72±3.08)%, P＜0.01].胃癌组和大肠癌组患者手术前和手术后1周外周血T细胞亚群(除外胃癌组的CD3 细胞和CD28 CD3-细胞)的差异无统计学意义(P＞0.05). 结论胃癌和大肠癌患者T细胞数量明显减少,T细胞共刺激分子CD28表达增高.胃癌患者CD4 T细胞显著减少; 大肠癌患者调节性T细胞显著增加.     

胃腺癌TSP-1的表达与细胞胀亡的关系及意义

目的：探讨胃腺癌组织中凝血酶敏感蛋白-1（TSP-1）的表达与细胞胀亡的关系及意义。方法：利用免疫组织化学方法检测57例胄腺癌组织中TSP-1的表达，利用透射电镜技术观察其中肿瘤细胞的胀亡情况，分析两者的相关性。结果：TSP-1的阳性表达率与肿瘤的淋巴结转移密切相关（P〈0．01）。TSP-1表达阳性的肿瘤细胞较多发生胀亡，胃腺癌组织中TSP-1的表达与胀亡细胞的发生呈正相关（r=0．679，P〈0．01）。胀亡指数（OI）与肿瘤的分化程度、淋巴结转移密切相关（P〈0．01，P〈0．05）。结论：TSP-1表达和细胞胀亡与胃腺癌生物学行为密切相关。     

大鼠肺移植排斥反应中细胞胀亡的发生及其意义

目的探讨移植肺中是否有细胞胀亡发生及其可能的临床意义。方法将26对SD 大鼠进行左侧单肺移植。利用透射电镜及病理学等技术,检测移植肺及对照肺组织中胀亡细胞数、丙二醛(MDA)及超氧化物歧化酶(SOD)含量,分析细胞胀亡在肺移植中的生物学作用。结果移植肺组织中主要是Ⅱ型肺泡上皮细胞发生胀亡,细胞胀亡指数与MDA含量呈正相关性,与SOD含量呈负相关性;受鼠移植肺较健侧肺、空白对照肺及阴性对照肺组织中存在更多的胀亡细胞。结论细胞胀亡在肺移植排斥反应的发生发展过程中可能起重要作用。     

短发夹RNA沉默血红素氧合酶-1基因表达对胃癌细胞系SGC-7901生物学行为的影响

目的 观察血红素氧合酶-1(HO-1)基因沉默对胃癌细胞系SGC-7901生长、增殖的影响.方法 构建靶向HO-1的短发夹RNA(shRNA-HO-1)干扰质粒转染人胃癌细胞系SGC-7901,逆转录-聚合酶链反应(RT-PCR)、细胞免疫化学分别在mRNA、蛋白质水平检测抑制效果.流式细胞仪和噻唑蓝(MTT)检测HO-1基因沉默后细胞的细胞周期和生长情况.结果 shRNA-HO-1在mRNA、蛋白质水平高效特异地抑制了细胞SGC-7901中HO-1的表达(抑制率分别为62.4%、67.6%);较对照质粒组,HO-1的表达被抑制后,G0/G1期细胞百分比明显减少(52.025±1.638比67.525±1.938,P<0.05),细胞生长受抑制[2.036±0.072比2.783±0.067(72 h A值),P<0.05].结论 shRNA-HO-1可有效抑制胃癌细胞中HO-1的表达;HO-1的表达减少抑制肿瘤细胞生长.     

联合检测大肠癌组织中PTEN与CyclinD1的表达及DNA含量的临床意义

目的:探讨大肠癌组织中PTEN和CyclinD1的表达及与DNA含量联合检测的关系及意义.方法:应用免疫组织化学SP法检测58例大肠癌及14例癌旁正常大肠黏膜组织中PTEN和CyclinD1蛋白表达;应用流式细胞术检测以上组织中PTEN和CyclinD1的DNA含量;分析它们之间及与肿瘤分期、分级的关系.结果:PTEN蛋白在大肠癌组织中的表达(65.52%)显著低于癌旁正常组织(100%),CyclinD1蛋白在大肠癌组织中的表达(60.34%)显著高于癌旁正常组织(1.72%),两种蛋白在大肠癌组织中的表达呈负相关(r =-0.71);大肠癌组织的异倍体率(68.97%)显著高于癌旁正常组织(0);PTEN阳性组的DNA指数(DNA index,DI)、S期细胞比率(S-phase fraction ,SPF)均低于阴性组(P<0.05),CyclinD1阳性组的DI及SPF均高于阴性组(P<0.05);两者的表达与肿瘤病理分级、Dukes分期及淋巴结转移相关;淋巴结转移患者的异倍体率及SPF均高于无淋巴转移患者(P<0.05).结论:PTEN和CyclinD1基因的异常改变可能参与大肠黏膜细胞的恶性转化过程,两者的变化存在相关性;DNA含量的变化可能与淋巴结转移有关.联合检测PTEN、CyclinD1蛋白及DNA含量可作为评估大肠癌病理生物学行为和预后的重要指标.     

胀亡初级精母细胞的形态观察及测量

目的研究患者精液中胀亡初级精母细胞的各种形态及变化规律。方法采用瑞-姬氏染色,于光镜油镜下对生精细胞及胀亡生精细胞进行观察、摄像及测量。结果1．初级精母细胞与胀亡初级精母细胞(无核胀出型)胞体直径与胞核直径的比值明显缩小；2．胀亡初级精母细胞可表现出一系列的形态学变化：(1)细胞核肿胀明显,几乎占满整个胞体；(2)细胞核肿胀伴细胞核染色质溶解；(3)细胞核膨胀,使胞核胀出于胞体外：(4)由于胞核膨胀,使胞膜上胀出泡状物；(5)部分胀亡细胞核不膨胀,但胞质内含大量空泡,使胞体胀大；(6)细胞核肿胀、溶解,并出现细胞膜破坏、崩解。结论应用光学显微镜在瑞-姬氏染色下检查胀亡生精细胞,其细胞结构清晰、可靠,该方法简单、实用,并完全可以用于临床患者的检验和研究,是理想的检测胀亡生精细胞的方法。     

CAFs在胃癌组织中的表达及与临床病理特征的关系

目的:探讨胃癌患者间质中肿瘤相关纤维母细胞(CAFs)的表达及与胃癌临床病理特征的关系。方法:采用免疫组织化学Elivision二步法检测71例胃癌组织中α-SMA来验证CAFs的表达,并分析其与胃癌临床病理特征及预后的关系。结果:胃癌组织中黏膜细胞与腺细胞排列杂乱,其中α-SMA在胃癌组织中的表达明显;癌旁组织中α-SMA的表达呈强阳性。胃癌组织α-SMA的表达高于正常组织(P<0.05);癌旁组织高于胃癌组织及正常组织(P<0.05)。胃癌组织α-SMA的表达与胃癌患者的性别、年龄、Lauren分型及组织学分级无关(P>0.05),与肿瘤大小和淋巴结转移相关(P<0.05)。肿瘤直径<3 cm预后较好,5年预后未复发率80.0%,肿瘤直径>5 cm患者5年预后复发转移或死亡者在75.0%。结论:胃癌组织及癌旁组织中CAFs呈高表现,其中癌旁组织表达高于癌组织,其与胃癌肿瘤大小和淋巴结转移呈正相关性,预后较差,与胃癌的侵袭转移密切相关。     

CREB3L1在胃癌中的表达及临床意义

目的探究cAMP反应元件结合蛋白3样蛋白1(CREB3L1)在胃癌中的表达及临床意义。方法收集2019年1月—2020年12月于兰州大学第二医院行外科手术切除的97例胃癌患者为研究对象,其中男性75例,女性22例,年龄27~78岁,平均年龄(57.95±9.27)岁,中位年龄57岁。采用免疫组化方法检测CREB3L1在胃癌组织和匹配的癌旁组织的表达水平,利用实时荧光定量逆转录聚合酶链反应(qRT-PCR)检测胃癌和癌旁组织中CREB3L1表达水平,应用统计学方法分析CREB3L1在胃癌患者癌组织的表达水平与肿瘤细胞分化程度、肿瘤大小、浸润深度、TNM分期之间的关系,并利用Logistic回归分析研究影响胃癌发生的危险因素,探究CREB3L1表达水平在胃癌中的临床意义。结果通过免疫组化结果显示,CREB3L1蛋白主要在细胞核中表达。胃癌组织中阳性率为17.5%(17例),低于配对的癌旁正常组织的阳性率84.5%(82例),差异有统计学意义(χ^(2)=87.15,P<0.001);通过qRT-PCR方法检测胃癌和癌旁组织细胞中CREB3L1表达情况,结果表明CREB3L1在癌旁组织中表达水平显著高于癌细胞中的表达,差异有统计学意义(P<0.05);胃癌患者的癌组织中CREB3L1的阳性表达率低,其表达水平与胃癌患者肿瘤的分化程度、肿瘤大小、浸润深度及TNM分期相关(P<0.05),而与Lauren分型、肿瘤位置等无关(P>0.05);Logistic回归分析结果显示,胃癌患者的癌组织中CREB3L1的阳性表达水平与胃癌患者肿瘤的分化程度具有相关性(P<0.05)。结论CREB3L1在胃癌组织中表达减低,并与患者肿瘤组织的分化程度、肿瘤大小、浸润深度及TNM分期有关,对胃癌患者早期诊断具有重要价值。     

miR-449c在胃癌中的表达

目的:检测胃癌组织中miR-449c的表达情况,探讨其与胃癌发生及预后的关系。方法:选取32例胃癌患者,实时荧光定量PCR(q RT-PCR)法检测癌旁组织(NGT)、胃癌组织(GC)及不同细胞株中miR-449c表达水平,Lipofectamine 2000转染法对相关细胞株miR-449 c表达进行上调和下调,MTT方法检测细胞的生长活力变化,流式细胞术检测细胞凋亡情况;随访30个月,比较miR-449c低表达和高表达患者的生存率。结果:GC组织miR-449c表达(0.36±0.28)明显低于NGT组织miR-449c表达(1.01±0.14)(P0.05),且AGS、SNU-1、SNU-5、SNU-16细胞miR-449c表达(0.39±0.08)、(0.33±0.07)、(0.25±0.06)、(0.22±0.04)均明显低于NGT组织(1.01±0.14)(P0.05);miR-449c模拟物对SNU-16细胞进行转染,其miR-449 c表达水平(8.49±2.50)明显高于空质粒转染(P0.05),第2、3 d细胞生长活力(0.80±0.10)、(0.90±0.12)明显低于空质粒转染(P0.05),凋亡率(80.12±9.01)明显高于空质粒转染(P0.05);miR-449c抑制物对AGS细胞进行转染,其miR-449c表达水平(3.00±0.50)明显低于空质粒转染(P0.05),第2、3 d细胞生长活力(1.20±0.14)、(1.70±0.18)明显高于空质粒转染(P0.05),凋亡率(8.00±1.00)明显低于空质粒转染(P0.05);随访30个月,miR-449c高表达患者生存率50.00%明显高于miR-449c低表达者(P0.05)。结论:miR-449c在胃癌组织中低表达,抑制细胞生长,促进细胞凋亡,其低表达可能与胃癌患者低生存率有关。     

人结肠鳞癌直肠鳞腺癌SCID鼠原位移植高转移模型的建立及其生物学特性的研究

目的 建立人结肠鳞癌直肠鳞腺癌SCID鼠原位移植高转移模型,为探讨理想的治疗结肠癌肝转移和预防结肠癌根治术后肝转移的方法提供实验工具。方法 采用组织学完整的结肠癌手术标本植入SCID鼠结直肠（粘膜层）壁内,观察原位移植的成瘤、移植瘤的侵袭和转移及其形态学特征（光镜、电镜、免疫组织化学）。结果 两株人结肠癌SCID鼠均获原位移植成功。人结肠鳞癌SCID鼠原位移植模型HCS-HMN-1已传至19代,人直肠鳞癌SCID鼠原位移植模型HRSA-HMN-2已传至23代,共移植SCID鼠223只,其移植生长率和自发转移率及液氮冻存复苏成活率均为100％,移植瘤在结直肠内呈广泛原位侵袭性生长、淋巴结转移、肝转移和全腹腔播散转移。并具有分泌CEA的功能。移植瘤细胞病理学和电镜观察、流式细胞仪DNA含量检测及染色体核型分析与瘤源人结直肠癌细胞完全一致。结论 本研究所建立的两株人结直肠癌SCID鼠高转移模型完整地模拟了人结直肠癌侵袭和转移的临床过程。为进一步研究结直肠癌肝转移、治疗和预防结直肠癌根治术后肝转移的方法提供了理想的实验动物模型。     

Appendiceal carcinoma invading the urinary bladder

A case is reported of a 78-year-old woman with appendiceal carcinoma invading the bladder causing irritative symptoms. Although several imaging studies suggested that the secondary bladder tumor was of cecal or appendiceal origin, such as abscess or mucocele, histologic findings on transurethral and transvaginal biopsy were inconclusive. However, following laparotomy, pathologic examination of the frozen sections revealed a mucinous cystadenocarcinoma originating in the appendix and a right hemicolectomy and en bloc partial cystectomy were performed. One year after the operation, the patient was well with no evidence of recurrent cancer.     

An aggressive surgical approach is warranted in the management of cystic pancreatic neoplasms

BACKGROUND: Cystic pancreatic neoplasms encompass a range of benign to malignant disease. Recommendations for surgical management vary. METHODS: Records of patients with cystic pancreatic neoplasms from January 1996 through December 2005 were retrospectively reviewed. RESULTS: Sixty resections were performed for 16 serous cystic neoplasms, 7 mucinous cystic neoplasms (MCNs), and 37 intraductal papillary mucinous neoplasms (IPMNs). Twenty-five percent (15/60) of neoplasms contained invasive cancer. Patients with MCN or IPMN invasive neoplasms experienced significantly diminished overall 5-year survival compared to patients with IPMN carcinoma in situ neoplasms and to patients with MCN or IPMN adenoma/borderline neoplasms (22% vs. 73% vs. 94%, P = .004). CONCLUSIONS: Given the poor long-term survival of patients with cystic pancreatic neoplasms containing invasive cancer and the current difficulty to preoperatively distinguish among the various types of lesions in a reliable manner, our data support an aggressive surgical approach to the management of cystic pancreatic neoplasms.     

p27蛋白在胃癌和大肠癌中的表达及其意义

目的 探讨Ｐ２７蛋白在胃癌及大肠癌组织中的表达及其与临床病理学特征的关系。方法 采用免疫组织化学方法对２４例正常大肠组织、１１例胃癌组织及３８例在肠癌组织Ｐ２７的表达及其与临床病理学特征的关系进行分析。结果 Ｐ２７在正常４结脾性组织中的高表达率为１００％（２４／２４）。而在胃癌及大肠癌组织中的高表达率为５３％（２６／４９）,Ｐ２７在两组织中的表达差异有显著性（Ｐ〈０．００５）,而且Ｐ２７低表达与胃     

合并肺气肿的肺或食管肿瘤切除术中同期行肺减容术

目的评价在肺或食管肿瘤手术中同期行肺减容术（LVRS）的可行性和效果。方法45例肺肿瘤和37例食管肿瘤病人，随机分为甲组和乙组，甲组在肿瘤切除手术中同期行开胸侧LVRS，根据术前胸部CT、灌注通气肺扫描结果，确定肺无功能区，切除一侧肺叶的20％～30％；乙组为单纯肿瘤切除术组。随访6～12个月，对比手术前、后肺功能、血气、呼吸困难指数、6min行走距离（6MWD）等指标。结果两组均无围术期死亡，术后FEW1、PaO2、PaCO2、呼吸困难指数以及6MWD甲组病人较术前改善，乙组较术前变化不明显或有轻度下降。结论对合并肺气肿的肿瘤病人，同期LVRS不仅增加了病人的手术机会，而且提高了病人术后生活质量。LVRS扩大了肿瘤病人的手术适应证。     

Solitary, isolated metastatic disease to the kidney: Memorial Sloan-Kettering Cancer Center experience

Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Usually malignant disease involving the kidneys is characterized by bilateral and multiple lesions in association with widespread dissemination of the primary tumour. Metastasis to the kidney as a solitary, isolated renal mass is an extremely rare event and little is known about its characteristics and outcomes. Our study shows that kidney involvement by other tumours can occur as isolated solitary lesions and the kidney can be the first and only site of metastatic involvement. Of the 14 patients included in the study, 8 were alive at the last follow‐up and 4 without evidence of disease after nephrectomy. In this highly selected group of patients nephrectomy can be offered as a therapeutic option.

OBJECTIVE

? To analyse the clinical characteristics and outcomes of patients who underwent nephrectomy for solitary, isolated metastatic disease to the kidney.

PATIENTS AND METHODS

? From July 1989 to July 2009, we identified 13 patients who underwent nephrectomy for solitary metastasis to the kidney. Patients’ demographics, intra‐operative variables and outcomes are reported.

RESULTS

? The median age at nephrectomy was 52 years (range 33–79). Eleven patients (85%) had an incidentally discovered renal mass, whereas two patients (15%) presented with gross haematuria. ? Median time from initial surgery at the primary site to development of metastatic disease to the kidney was 63 months (range 9–136). No patient had evidence of disease at other sites at the time of nephrectomy. In seven patients (54%), the kidney was the first site of recurrence. ? The most common primary site was the lung in five patients (38%), followed by the colon in two (15%), chest wall in two (15%) and bone, brain, breast and salivary gland in one patient each (8%). ? Of the 14 procedures performed, eight (57%) were partial nephrectomy (PN) and six (43%) were radical nephrectomy (RN). ? Four patients died after progression from the primary tumour, all within 2 years of nephrectomy. One patient with a primary chondrosarcoma had no evidence of disease at last follow‐up and died from other causes 50 months after nephrectomy. The median follow‐up for the eight patients who were alive at last follow‐up was 30 months after nephrectomy. Four of these patients had no evidence of disease and four patients were alive with metastatic disease.

CONCLUSION

? Kidney involvement by metastatic disease can occur as isolated solitary lesions. Some patients will also have the kidney as the first and only site of metastatic involvement. The presence of an isolated renal metastasis should not be considered an end‐stage disease, and nephrectomy can be offered for highly selected patients as a therapeutic option.     

病灶刮除骨水泥充填术治疗骨盆四肢转移性骨肿瘤

目的 评价骨水泥病灶充填术治疗骨盆四肢转移性骨肿瘤的疗效和适应证。方法 52例骨盆四肢转移性肿瘤患者,34例采用肿瘤刮除加骨水泥病灶充填或加内固定治疗,18例采用植骨或截肢治疗。术后随访生存时间、疼痛改善程度和生存质量。结果 随访5～62个月,术后1、2、3年生存率骨水泥组分别为91．2％、82．4％、52．9％,非骨水泥组分别为44．4％、22．2％、11．1％。术后1个月疼痛改善有效率骨水泥组为88．2％,非骨水泥组为33．3％。术后生存质量提高和稳定率骨水泥组为76．5％,非骨水泥组为33．3％。经x^2检验两组差异有显著性（P〈0．05）。结论 骨水泥病灶充填治疗骨盆四肢转移性骨肿瘤能提高生存时间,改善生活质量。     

Risk of various cancers in adults with abdominal aortic aneurysms

BackgroundThe cause of death for patients with an abdominal aortic aneurysm (AAA) can be related to the AAA itself. However, cancer-related mortality could also be a contributing factor. In the present study, we examined the hypothesis that an association exists between AAAs and certain cancers.MethodsInformation from 2009 to 2015 was extracted from the Korean National Health Insurance Service database. We included 14,920 participants with a new diagnosis of an AAA. Propensity score matching by age and sex with disease-free patients was used to select the control group of 44,760 participants. The primary end point of the present study was a new diagnosis of various cancers.ResultsThe hazard ratio (HR) for cancer incidence was higher in the AAA group than in the control group for hepatoma, pancreatic cancer, and lung cancer (HR, 1.376, 1.429, and 1.394, respectively). In the case of leukemia, the HR for cancer occurrence was not significantly higher in the AAA group than in the control group. However, when stratified by surgery, the HR was significantly higher for the surgical group (HR, 3.355), especially for endovascular aneurysm repair (HR, 3.864).ConclusionsWe found that AAAs are associated with an increased risk of cancer, in particular, hepatoma, pancreatic cancer, and lung cancer, even after adjusting for several comorbidities. Thus, continued follow-up is necessary for patients with an AAA to permit the early detection of the signs and symptoms of cancer.     

肾上腺转移癌45例报告

目的：总结肾上腺转移癌的临床特点与诊治体会.方法：回顾性分析1996年12月～2010年2月收治的肾上腺转移癌患者45例临床资料：原发肿瘤包括肺癌23例（51.1%）,肝癌5例（11.1%）,肾癌5例（11.1%）,乳腺癌4例（8.9%）,黑色素瘤2例（4.4%）,其他肿瘤6例（13.3%）.临床表现为全身乏力、消瘦、贫血或低热16例,患侧腰背部胀痛8例.高血压6例.均行B超、CT、MRI及正电子发射断层扫描（PET）检查确诊.35例行手术治疗,10例放弃手术.结果：完整切除转移癌者30例获得随访,生存6～62个月,平均34.2±4.7个月,最长存活已5年2个月;5例失访.10例放弃手术者中,6例获得随访,生存4～8个月,平均6.3±2.7个月,均死于肿瘤晚期或多发转移.结论：对原发肿瘤应重视术中及术后肾上腺部位的检查及随访.B超及CT是诊断肾上腺转移癌的重要检查方法,PET对诊断肾上腺转移癌有较高的临床价值.完整切除肾上腺转移灶可延长患者生存期,但需严格控制适应证.