肺癌的淋巴结转移与nm23—H1,PCNA表达的关系

目的研究ｎｍ２３－Ｈ１,ＰＣＮＡ在肺癌中的表达与肺癌转移的关系。方法应用免疫组化ＳＰ法检测４７例肺癌中ｎｍ２３－Ｈ１,ＰＣＮＡ的表达。结果原发性肺癌中ｎｍ２３－Ｈ１,ＰＣＮＡ的阳性率分别为５１．０６％和６５．９６％。其中ｎｍ２３－Ｈ１在鳞癌中的阳性率４３．３３％（１３／３０）,腺癌６４．７０％（１１／１７）。在鳞癌中无肺门及纵膈淋巴结转移阳性率６２．５％（１０／１６）,有转移组阳性率２１．４２％（３／１４）,差异有显著性（Ｐ＜０．００１）,ｎｍ２３－Ｈ１表达与鳞癌的淋巴结转移呈负相关。在ＰＣＮＡ表达中有淋巴结转移阳性率８２．６％（１９／２３）,无转移组５４．１６％（１３／２４）（Ｐ＜０．００１）,同时低分化癌的阳性率８８．８８％（８／９）明显高于高分化癌４３．７５％（７／１６）,（Ｐ＜０．００１）。结论ｎｍ２３－Ｈ１,ＰＣＮＡ的表达对肺癌予后评估有一定意义。     

nm23基因在食管癌中表达的免疫组化研究

目的研究ｎｍ２３基因表达与食管癌生物学行为和预后的关系。方法应用免疫组织化学ＳＰ法检测７６例食管鳞状细胞癌手术标本中ｎｍ２３表达。结果食管癌原发灶癌组织中ｎｍ２３表达阳性率８１．６％，癌旁形态学正常食管粘膜ｎｍ２３阳性率３６．８％，差异具有显著性意义（Ｐ＜０．００１）；食管癌ｎｍ２３高表达者的区域淋巴结转移发生率（５８．２％）明显高于低表达者（２２．２％，Ｐ＜０．００５）；ｎｍ２３表达水平与癌组织浸润食管深度及食管癌ＴＮＭ分期呈正相关，统计学均具有显著性意义（分别为Ｐ＜０．０５、Ｐ＜０．０２）；ｎｍ２３低表达的患者术后三年和五年生存率分别为６０．０％和５１．６％，显著高于ｎｍ２３高表达者（３８．７％和２２．６％），Ｐ＜０．０５和Ｐ＜０．０１。结论ｎｍ２３基因过度表达与食管鳞状细胞癌的浸润及淋巴结转移有关，是预后不良的指标     

P^53过表达和nm23低表达与胃癌淋巴结转移关系的探讨

应用Ｓ－Ｐ免疫组化方法研究Ｐ５３和ｎｍ２３表达变化与胃癌生物学行及淋巴结转移的关系。发现Ｐ５３阳性染色率为４９％，Ｐ５３过表达与肿瘤浸润深度及癌细胞增殖活性呈正相关（Ｐｅａｒｓｏｎ列联系数分别为Ｐ＝０．３２和Ｐ＝０．３５，Ｐ＜０．０５），Ｐ５３阳性肿瘤的淋巴结转移率（９３％）明显高于Ｐ５３阴性的肿瘤（６０％，Ｐ＜０．０５）。同时发现ｎｍ２３低表达与胃癌侵袭程度显著相关（Ｐｅａｒｓｏｎ列联系数Ｐ＝０．２８，Ｐ＜０．０５）。ｎｍ２３低表达者淋巴结转移率（９３％）比正常表达者高（４９％，Ｐ＜０．０５）。Ｐ５３过表达和ｎｍ２３低表达在胃癌淋巴结转移中的关系为独立的联合作用。提示Ｐ５３过表达和ｎｍ２３低表达在胃癌淋巴结转移和肿瘤浸润及增殖中起重要作用。     

乳腺癌淋巴结转移与nm23,CD44基因表达产物定量分析

应用流式细胞分析技术（ＦＣＭ）对４５例有无淋巴结转移乳腺癌的转移抑制基因ｎｍ２３及ＣＤ４４的基因表达和ＤＮＡ倍体进行了定量检测及综合分析。结果表明：乳腺癌淋巴结转移阳性的ＤＮＡ异倍体率６６．６％（２０／３０）高于阴性组４６．７％（７／１５），Ｐ＜０．０５；其增殖活性阳性组ＰＩ＝２６．９±５．３，阴性组ＰＩ＝２１．５±４．９。４５例转移抑制基因ｎｍ２３表达值范围０．８８～１．２９（ＦＩ＝１．２３±０．４３），淋转阳性组ＦＩ＝１．０９±０．１８，低于阴性组ＦＩ＝１．２６±０．２９，Ｐ＜０．０１。ＣＤ４４前组表达阳性率高于后组，分别为７３．３％和４０．０％，两组有显著差异，研究提示：１）ｎｍ２３，ＣＤ４４与乳腺癌淋巴结转移关系最为密切；２）以ｎｍ２３和ＣＤ４４以及ＤＮＡ倍体多参数综合评价乳腺癌的转移优于单项指标     

nm23－H_1基因蛋白在大肠癌中表达与预后的关系

用ＬＳＡＢ免疫组化法测定２００例大肠癌组织中ｎｍ２３－Ｈ１基因蛋白，结果发现：（１）ｎｍ２３－Ｈ１在２００例大肠癌中阳性表达率２８．５％，其中在乳头状腺癌，高分化腺癌，粘膜内癌及无淋巴结转移者阳性率显著高于其它各型（Ｐ＜０．０１）。（２）ｎｍ２３－Ｈ１阳性病例比阴性病例有较高的生存率和较低的复发率（Ｐ＜０．０１）。结果表明ｎｍ２３－Ｈ１在大肠癌中的阳性表达在抑制肿瘤复发及转移中起了重要作用，可作为大肠癌患者预测转移和预后的有用指标     

nm23与p21在胃癌中表达的意义

免疫组化研究ｎｍ２３与ｐ２１在８８例胃癌的表达变化与胃癌生物学行为及淋巴结转移的关系。结果发现ｎｍ２３低表达与胃癌侵袭程度显著相关（Ｐｅａｒｓｏｎ列联系数Ｐ＝０．２８，Ｐ＜０．０５）。ｎｍ２３低表达者淋巴结转移率（９２．７％）比正常表达者高（４８．５％，Ｐ＜０．０５）。同时发现ｐ２１阳性染色率为６５．９％，ｐ２１阳性染色与肿瘤组织分型及癌细胞增殖活性呈正相关（Ｐｅａｒｓｏｎ列联系数分别为Ｐ＝０．３８和０．３５，Ｐ＜０．０５），ｐ２１阳性肿瘤的淋巴结转移率（８７．９％）明显高于ｐ２１阴性的肿瘤（５３．３％，Ｐ＜０．０５）。ｎｍ２３低表达和ｐ２１过表达在胃癌淋巴结转移中的表现为独立的联合作用。提示ｎｍ２３低表达和ｐ２１过表达在胃癌淋巴结转移和肿瘤增殖中起重要的作用，ｎｍ２３与肿瘤浸润有关，而ｐ２１与肿瘤组织分型和增殖有关。     

食管鳞癌nm23—H1表达及其临床意义

为了探讨肿瘤转移抑制基因蛋白（ｎｍ２３Ｈ１）的表达与食管鳞癌的临床病理特点及预后的关系,采用免疫组化ＳＰ法检测５５例食管鳞癌的ｎｍ２３Ｈ１的表达情况。结果显示５５例食管癌中,ｎｍ２３Ｈ１表达阳性率为５４．５％（３０／５５）。食管癌患者术后５ａ生存率与ｎｍ２３Ｈ１阳性表达率有明显正相关（Ｐ＜０．０５）。淋巴结转移者的ｎｍ２３Ｈ１阳性率（３８．９％）明显低于无淋巴结转移者（７５％,Ｐ＜０．０５）。患者性别、肿瘤大小、肿瘤分化程度及浸润深度与ｎｍ２３Ｈ１阳性表达率无关（Ｐ＜０．０５）。结果表明：ｎｍ２３Ｈ１可作为一种食管癌淋巴结转移及预后的重要生物学指标。     

肾癌组织中CD15和nm23／NDPK表达的临床意义

为了探讨评估肾细胞癌预后因素的指标，应用免疫组化方法研究６０ 例肾癌中细胞粘附分子ＣＤ１５ 和ｎｍ２３ 蛋白表达及其相关关系。结果表明：在肾癌细胞中ＣＤ１５ 和ｎｍ２３ 表达阳性率分别为７０ ．０％ 和５５ ．０ ％ 。肾细胞癌分级、分期和淋巴结转移与ＣＤ１５ 高表达和ｎｍ２３ 低表达有关（Ｐ 均＜ ０．０５） 。ＣＤ１５ 表达与ｎｍ ２３ 表达呈负相关性（ Ｐ＜ ０ ．００５，γ＝ － ０．４２） 。结果提示，ＣＤ１５ 高表达和ｎｍ２３ 低表达对判断肾细胞癌分化程度、预测淋巴结转移是良好指标。     

nm23—H1基因蛋白在大肠癌中表达与预后的关系

用ＬＳＡＢ免疫组化法测定２００例大肠癌组织中ｎｍ２３－Ｈ１基因蛋白，结果发现：（１）ｎｍ２３－Ｈ１在２００例大肠癌中阳性表达率２８．５％，其中在乳头状腺癌，高分化腺癌，粘膜内癌及无淋巴结转移者阳性率显著高于其它各型（Ｐ〈０．０１）。（２）ｎｍ２３－Ｈ１阳性病例比阴性病例有较高的生存率和较低的复发率（Ｐ〈０．０１）。结果表明ｎｍ２３－Ｈ１在大肠癌中的阳性表达在抑制肿瘤复发及转移中起了重要作用，可作为     

甲状腺乳头状癌雌激素受体的检测

目的：探讨甲状腺乳头状癌雌激素受体阳性表达的临床病理意义。方法：应用免疫组化ＳＰ法对８０太腺乳头状癌,３０例滤泡状癌及５０例癌旁正常甲状腺组织雌激素受体（ＥＲ）进行测定。结果：甲状腺乳头状癌、滤咆状癌及正常组织ＥＲ阳性率分别为６７．５０％（５４／８０）、２３．３３％（７／３０）、６％（３／５０）,乳头状癌ＥＲ阳性率显著滤泡状癌及正常组织,乳头状癌中原发癌ＥＲ阳性率显著高于复发癌,无淋巴结转移者ＥＲ     

Immunohistochemical detection of nm23-H1/NDP kinase in childhood thyroid carcinoma

Childhood thyroid cancer is known to be aggressive. High incidence of lymph node and distant metastasis are characteristic features of these cases. In adult, reduced expression of nm23-H1/nucleoside diphosphate (NDP) kinase has been correlated with cancer invasion and metastasis in some tumor types. Therefore, we examined the expression of nm23-H1 gene product in childhood thyroid carcinomas in Japan. 27 primary thyroid carcinomas and 8 metastatic lymph nodes were analyzed by immunohistochemistry using monoclonal antibody H1-229. 21 out of 23 cases (91%) of papillary carcinomas were positively immunostained, whereas none of the 4 follicular carcinomas showed any immunoreactivity. No correlation was found between the nm23-H1/NDP kinase antigen expression and nodal involvement or distant metastasis in primary tumors. However, only 50% (4 out of 8) of metastatic lymph nodes from papillary carcinoma were positively stained, demonstrating a significant decrease comparing to those of primary sites. These data indicate that the expression of nm23-H1/NDP kinase cannot predict tumor metastatic potential in childhood thyroid cancer.     

甲状腺乳头状癌患者发现方式与临床病理特征的相关性

目的:研究甲状腺乳头状癌患者发现方式与临床病理特征的关系,探讨体检筛查是否会导致甲状腺乳头状癌的过度诊断。方法:回顾性分析3 398例甲状腺乳头状癌患者临床资料,根据患者主诉的疾病发现方式,将入组患者分为四组:体检组、颈部不适组、自检组、其他疾病意外发现组。通过单因素和多元逻辑回归分析甲状腺乳头状癌患者发现方式与临床病理特征的相关性。结果:单因素分析表明甲状腺乳头状癌患者发现方式与肿瘤病灶大小、是否侵犯包膜、是否有淋巴结转移以及淋巴结转移位置显著相关（P＜0.05）,而与病灶分布以及病灶的数目无关（P＞0.05）。多元逻辑回归分析表明颈部不适组患者肿瘤病灶>1 cm的发生风险是体检组患者的1.626倍（OR=1.626,P=0.012）,自检组患者肿瘤病灶>1 cm的发生风险是体检组患者的2.245倍（OR=2.245,P＜0.001）;自检组患者肿瘤病灶侵犯包膜的发生风险是体检组患者的1.649倍（OR=1.649,P＜0.001）;自检组患者淋巴结转移的发生风险是体检组患者的1.642倍（OR=1.642,P＜0.001）;颈部不适组患者仅在中央区有淋巴结转移的发生风险是体检组患者的0.575倍（OR=0.575,P=0.044）,在中央区以及颈侧区都有淋巴结转移的发生风险是体检组患者的1.803倍（OR=1.803,P=0.038）;自检组患者仅在中央区有淋巴结转移的发生风险是体检组患者的0.283倍（OR=0.283,P＜0.001）,在中央区以及颈侧区都有淋巴结转移的发生风险是体检组患者的3.299倍（OR=3.299,P＜0.001）。结论:健康体检有助于降低甲状腺乳头状癌患者肿瘤病灶增大、包膜侵犯以及淋巴结转移的风险,对甲状腺乳头状癌早发现、早诊断、早治疗有重要的作用,值得继续大力推广。     

Strong intracellular and negative peripheral expression of fibronectin in tumor cells contribute to invasion and metastasis in papillary thyroid carcinoma

The intracellular and stromal expression of fibronectin (FN) in invading and central parts of papillary thyroid carcinomas with/without lymph node (LN) metastasis (54 metastasizing cases, 52 non-metastasizing cases) were examined immunohistochemically. The intracellular expression of FN in tumor cells in invading parts was stronger than that in central parts in most cases (79/106 cases, 74.5%). In invading parts, negative stromal FN was frequently found at the periphery of the tumor in cases with extracapsular soft tissue invasion (26/37 cases). Tumor cells in invading parts in metastatic cases were significantly more likely to be negative for stromal FN at the periphery of the tumor than those in non-metastatic cases (P < 0.0001). The strong intracellular and negative stromal FN at the periphery of the tumor in invading parts were associated with invasion and metastasis in papillary thyroid carcinoma. These results suggest that these distinctive characteristics of FN may be useful for understanding invasion and metastasis in vivo.     

是否合并桥本甲状腺炎的甲状腺乳头状癌患者的临床病理特征及与淋巴结转移相关性的分析

目的:探讨甲状腺乳头状癌合并桥本甲状腺炎患者临床病理特征以及合并桥本甲状腺炎对淋巴结转移的影响。方法:回顾性分析我院2014年10月至2019年10月术后病理证实为甲状腺乳头状癌3 411例患者临床资料,其中合并桥本患者498例,未合并桥本患者2 913例,经过倾向性评分匹配方法对两组患者进行匹配,得到组间协变量均衡样本,比较两组患者临床病例特征并分析患者淋巴结转移的危险因素。结果:经过倾向性评分匹配后,甲状腺乳头状癌患者是否合并桥本甲状腺炎仅与病灶大小和BRAF V600E基因突变显著相关（P＜0.05）,而与病灶数目、侵犯包膜、淋巴结转移、中央区淋巴结转移、颈侧区淋巴结转移以及淋巴结转移数目无关（P＞0.05）。Logistic回归分析显示年龄≥55岁PTC患者淋巴结转移的发生风险是年龄<55岁患者的0.957倍（OR=0.957,P＜0.001）。肿瘤病灶＞1 cm患者淋巴结转移的发生风险是病灶≤1 cm患者的2.697倍（OR=2.697,P＜0.001）。肿瘤病灶多灶的患者淋巴结转移的发生风险是单灶患者的2.186倍（OR=2.186,P＜0.001）。结论:合并桥本甲状腺炎与更小的肿瘤病灶和更高的BRAF V600E基因突变率显著相关,而与淋巴结转移无关。患者年龄≥55岁是甲状腺乳头状癌患者淋巴结转移的独立保护因素,而病灶>1 cm和病灶多灶是淋巴结转移的独立危险因素。     

miR-374、miR-451、miR-150在甲状腺乳头状癌组织中的表达及其临床意义

目的 探讨血清微小RNA-374(miR-374)、miR-451、miR-150在甲状腺乳头状癌组织中的表达及其临床意义.方法 选择104例行根治手术治疗的甲状腺乳头状癌存档蜡块及癌旁正常组织(距病变部位>5 cm处,且证实为无癌浸润),实时定量荧光聚合酶链反应(qPCR)检测miR-374、miR-451、miR-...     

联合检测nm23-H1、E-cadherin基因蛋白在鼻咽癌中的表达

目的　探讨 nm2 3- H1基因和粘附分子 E- cadherin在鼻咽癌中的表达情况及其与转移的关系。方法　用免疫组化 SP法检测 nm2 3- H1和 E- cadherin基因产物在 42例鼻咽癌中的表达。结果　 42例鼻咽癌活检标本中 ,nm2 3- H1蛋白表达阳性率 5 4 .7% ,E- cadherin表达阳性率 5 7.1 % ,nm2 3- H1蛋白在有颈淋巴结转移患者中表达阳性率为 40 .7% ,在无颈淋巴结转移患者中表达阳性率为 80 .0 % ,两者差异有显著意义 ( P<0 .0 5 )。E- cadherin在颈淋巴结转移阳性患者中表达阳性率为 44.4% ,颈淋巴结转移阴性患者中表达阳性率为 80 .8% ,两者差异有显著意义 ,( P<0 .0 5 )。两种基因产物表达在鼻咽癌中呈正相关 ( P<0 .0 1 )。结论　nm2 3- H1和 E- cadherin基因与鼻咽癌的转移密切相关 ,对临床判断鼻咽癌预后有一定指导意义     

E—cadherin、nm23在甲状腺乳头状腺癌中的表达及其临床意义

目的：研究E－cadherin、nm23在甲状腺头状腺癌（papillary thyroid carcionma,PTC)中的表达及其临床意义。方法：应用免疫组化SP法,检测70例PTC中E－cadherin、nm23的表达。结果：E－cadherin、nm23的阳性表达率分别为44．3％（31／70）,62．9％（44／70）,分别与PTC的病理分级、TNM分期及淋巴结转移有关（P＜0．05）,而与患者性别、年龄及肿瘤大小无明显的关系（P＞0．05;E－cadherin、nm23的表达具有高度的协同性;两者同时阳性表达的PTC,其淋巴结转移为12％（3／25）,同时阴性表达的,其淋巴结转移为75％（15／20）,两组之间有显著性差异（P＜0．01）。结论：E－cadherin、nm23在PTC浸润和转移方面存在相关性,可作为预测PTC生物学行为的标志 。     

甲状腺乳头状癌颈淋巴结转移特点及危险因素分析

目的:探讨甲状腺乳头状癌颈淋巴结转移特点及相关危险因素在颈部不同区域淋巴结转移中的意义.方法:回顾性分析北京世纪坛医院2010年1月至2014年12月术后病理证实为甲状腺癌的404例患者的临床资料,就年龄、性别、术前TSH水平、肿瘤最大径、多灶病变、被膜侵犯、合并桥本甲状腺炎、合并结节性甲状腺肿等因素与颈部不同区域淋巴结转移之间的关系进行分析.结果:甲状腺癌发生淋巴结转移时,多数转移至中央区,其次为颈侧区,颈侧区淋巴结转移中Ⅲ区和Ⅳ区转移率相当,且明显高于Ⅱ区.单因素分析结果显示,性别、肿瘤最大径、多灶病变、被膜侵犯、合并结节性甲状腺肿与中央区、颈侧区淋巴结转移均有关(P＜0.05),而年龄和中央区淋巴结转移有相关性(P＜0.05),合并桥本甲状腺炎与颈侧区淋巴结转移有相关性(P＜0.05);多因素Logistic回归分析结果显示,男性患者、年龄＜45岁、肿瘤最大径＞1cm、多灶病变是中央区淋巴结转移的独立危险因素(P＜0.05),而多灶病变、被膜侵犯、合并桥本甲状腺炎是颈侧区淋巴结转移的独立危险因素(P＜0.05).结论:甲状腺乳头状癌中年龄＜45岁的男性患者、肿瘤最大径＞1cm、多灶病变可增加中央区淋巴结转移的风险.而表现为多灶病变、被膜侵犯、合并桥本甲状腺炎、可疑跳跃性转移及中央区淋巴结转移阳性的患者,颈侧区淋巴结转移风险性增加.     

Predictive factors of skip metastases to lateral neck compartment leaping central neck compartment in papillary thyroid carcinoma

Skip metastasis, referred to as leaping metastasis to the lateral neck without associated lymphadenopathy in the central compartment (level VI), can occur in patients with papillary thyroid carcinoma (PTC). However, there have been few studies on its predictive value in PTC patients. We reviewed the medical records of 90 patients who underwent simultaneous central and lateral neck lymph node dissection for the primary treatment of lymph node metastasis in the lateral neck of PTC patients. No patient was suspected of having metastasis in the central compartment by preoperative imaging study. The frequency of skip metastasis to the lateral neck compartment without central neck metastasis was 19% (17/90). The number of metastatic lymph nodes dissected in the lateral neck of patients with and without skip metastasis was 5.1±2.7 and 9.5±2.6, respectively (P<0.001). Skip metastasis was closely associated with significantly fewer lymphovascular invasion (P=0.009) and extracapsular spread (P=0.035). Skip metastasis can occur significantly frequently in PTC patients. The presence of lymphovascular invasion, extracapsular spread, and number of positive lymph nodes dissected were inversely correlated with skip metastasis.     

New subgrouping of small thyroid carcinomas

Clinicopathologic findings on small thyroid carcinomas measuring 10 mm or less in diameter were analyzed in 78 thyroidectomied cases. The authors divided small thyroid tumors into two subgroups according to diameter: 0 less than or equal to 5 mm (classified as minute carcinoma) and 5 less than 0 less than or equal to 10 mm (classified as tiny carcinomas). Characteristics including sex, age, histologic type, extrathyroid invasion, and lymph node metastasis were examined in each subgroup. In patients with minute carcinoma, very few incidences of extrathyroid invasion and lymph node metastasis were found. However, these involvements, especially lymph node metastasis, were found more frequently in patients with tiny carcinoma. The incidence of cervical lymph node metastasis was 13% in minute carcinoma and 59% in tiny carcinoma. (P less than 0.01). These findings suggest the need for more careful observation and treatment of tiny carcinomas, especially with respect to lymph node metastasis. In accordance with World Health Organization (WHO) classification, the histologic types of thyroid carcinoma were classified into papillary and follicular carcinomas. The papillary carcinoma and follicular carcinoma ratios were compared between the two subgroups. The discovery rate of follicular carcinoma was significantly higher in minute carcinoma than in tiny carcinoma (P less than 0.005). This suggests that the papillary carcinoma/follicular carcinoma ratio (p/f) increases as the size of the carcinoma increases, and that follicular carcinoma is the "seed," or initial form, of thyroid cancer. The female-male ratio in small thyroid cancer suggests that there is no sex difference in carcinogenesis but that there is more probability for cancer development in the thyroid in women.