复方化浊润燥降气方对小鼠食管癌癌前病变的干预作用

目的 观察复方化浊润燥降气方对小鼠食管癌癌前病变的干预作用。方法 130只小鼠分为正常组、模型组、阳性对照组、中药预防组（简称“预防组”）、中药治疗组（简称“治疗组”）,采用4-硝基喹啉-氧化物（4-NQO）制备小鼠食管癌癌前病变模型,用中药复方化浊润燥降气方进行干预,于用药第14周末及实验结束时用光镜、电镜观察各组小鼠食管上皮组织病理形态学变化。结果 模型组第14周末光镜下见小鼠上皮细胞体积增大,数量增多,细胞核增大,证实小鼠食管癌癌前病变模型制备成功。实验结束时癌变形成,各组癌变率正常组为0,模型组为80%、阳性对照组为21.4%、预防组为5.6%、治疗组为12.5%。电镜下见模型组细胞间隙增宽,桥粒减少,核固缩,染色质边移。光镜和电镜下均示阳性对照组、预防组、治疗组病理改变减轻。 结论 复方化浊润燥降气方能减轻小鼠食管癌前病变损害程度,对预防食管癌有一定作用。     

食管鳞状细胞癌及癌前病变组织中p16基因甲基化的研究

目的探讨食管鳞状细胞癌及癌前病变组织p16基因CpG岛的甲基化情况,及其在食管癌发生和早期诊断中的价值。方法采用MSP方法,对食管癌前病变不同阶段、鳞状细胞原位癌和浸润癌的病变组织进行了甲基化检测,并与其相应的正常组织和慢性食管炎组织的甲基化情况进行对比分析。结果轻、中、重度不典型增生、鳞状细胞原位癌和浸润癌的甲基化频率分别为22.73%(5/22)、46.15%(6/13)、77.78%(7/9)、78.57%(11/14)和64.86%(24/37)。67例正常对照组织中3例(4.48%)p16基因甲基化,与病变组织相比,差异有统计学意义,P=0.000。10例慢性食管炎组织中1例(10%)p16基因甲基化。结论p16基因甲基化可能是食管癌发生的最早期事件之一。     

獐宝治疗胃癌前病变的机制研究

目的探讨獐宝治疗胃癌前病变的机制。方法清洁级Wistar雄性大鼠14只,随机分为空白组、模型对照组、胃复春治疗组、獐宝治疗组,每组3只,剩余2只造模16周时取样观察造模情况,造模16周后,分别给予生理盐水、生理盐水、胃复春、獐宝灌胃给药。给药12周后处死大鼠,剖腹取胃黏膜组织,进行苏木素-伊红(HE)染色,应用免疫组织化学法检测各组胃黏膜组织中热休克蛋白60(HSP60)、热休克蛋白90(HSP90)、B细胞淋巴瘤-2(Bcl-2)、Bcl-2相关X蛋白(BAX)、存活蛋白(survivin)的表达量。结果 HE染色评分比较,模型对照组高于空白组,獐宝治疗组与胃复春治疗组均低于模型对照组,胃复春治疗组高于獐宝治疗组,差异均有统计学意义(P<0.05)。模型对照组胃黏膜组织中HSP60、HSP90、Bcl-2、survivin蛋白表达量均低于空白组,BAX蛋白表达量高于空白组;獐宝治疗组胃黏膜组织中HSP60、HSP90、Bcl-2、survivin蛋白表达量均高于模型对照组,BAX蛋白表达量低于模型对照组,差异均有统计学意义(P<0.05)。结论胃癌前病变的病理机制可能与凋亡信号通路过度激活有关,而给予獐宝治疗可能减少凋亡的过度激活。     

胃癌前病变癌变机制及筛查研究进展

胃癌前病变是胃癌发生和发展过程中的一个重要阶段,早期发现和干预是防控胃癌的重要手段。内镜作为筛查的最终手段,存在诸多制约,通过对胃癌前病变的机制研究,发现操作简便、灵敏度高的标志物用于对胃癌前病变的筛查是目前研究的着重点。本文就现阶段胃癌前病变的癌变机制研究及筛查手段进展作一阐述。     

肥城市农村居民食管癌及癌前病变危险因素多元有序Logistic回归分析

目的食管癌是常见的消化道恶性肿瘤,山东省肥城市是我国食管癌高发地区之一。探讨山东省肥城市农村居民食管癌及癌前病变发生的危险因素,为当地食管癌的防治工作提供依据。方法以2013年在"国家食管癌早诊早治示范基地(山东省肥城市)"参与上消化道癌症筛查,并进入食管癌筛查与随访社区人群队列的40~69岁农村居民为研究对象,内镜下碘染色及病理活检结果作为诊断依据,依据诊断标准将其分为不同病变等级,进行问卷调查,并采用多元有序Logistic回归分析食管癌及癌前病变的危险因素。结果共纳入食管正常人1910名、轻度增生511例、中度增生130例、重度增生及以上100例。多元有序Logistic回归分析结果显示,年龄(OR=1.09,95%CI:1.08~1.11)、饮酒(OR=1.45,95%CI:1.13~1.86)、饮茶(OR=1.39,95%CI:1.15~1.68)、燃煤取暖(OR=1.43,95%CI:1.10~1.85)及肿瘤家族史(OR=1.35,95%CI:1.11~1.66)是食管癌及癌前病变发生的独立危险因素,P<0.05。结论年龄、饮酒、饮茶、燃煤取暖及肿瘤家族史是肥城市农村居民食管癌及癌前病变的危险因素,改变不良生活方式有利于做好食管癌的防治工作。     

胃癌前病变癌变机制及筛查研究进展

胃癌前病变是胃癌发生和发展过程中的一个重要阶段,早期发现和干预是防控胃癌的重要手段.内镜作为筛查的最终手段,存在诸多制约,通过对胃癌前病变的机制研究,发现操作简便、灵敏度高的标志物用于对胃癌前病变的筛查是目前研究的着重点.本文就现阶段胃癌前病变的癌变机制研究及筛查手段进展作一阐述.     

hTERT基因在肺癌和癌前病变中的表达研究

目的：探讨端粒酶逆转录酶（human telomerase reverse transeriptase，hTERT）在肺癌癌前病变（支气管黏膜上皮不典型增生）和肺癌中的作用。方法：41例支气管黏膜上皮不典型增生患者经纤维支气管镜取气管上皮组织、150例肺癌患者手术标本及40例正常肺组织，用免疫组化的方法检测hTERT基因在上述肺组织中的表达。结果：5．0％（2／40）的正常肺组织中可检测到hTERT基因的蛋白表达，61．0％（25／41）的支气管黏膜上皮不典型增生组织和90．0％（135／150）的肺癌组织中可检出hTERT基因表达，组间差异有高度显著性，X^2=111．9，P〈0．01；且随着肺组织癌变过程的变化，hTERT基因的表达呈逐渐增高的趋势，X^2trend=107．7，P〈0．01。结论：支气管黏膜上皮细胞的不典型增生和恶性转化与hTERT基因的表达有关；hTERT基因检测有望成为诊断肺癌变的早期生物标志物。     

hTERT基因在肺癌和癌前病变中的表达研究

目的:探讨端粒酶逆转录酶(human telomeras ereverset ranscrip tase,hTERT)在肺癌癌前病变(支气管黏膜上皮不典型增生)和肺癌中的作用。方法:41例支气管黏膜上皮不典型增生患者经纤维支气管镜取气管上皮组织、150例肺癌患者手术标本及40例正常肺组织,用免疫组化的方法检测hTERT基因在上述肺组织中的表达。结果:5·0%(2/40)的正常肺组织中可检测到hTERT基因的蛋白表达,61·0%(25/41)的支气管黏膜上皮不典型增生组织和90·0%(135/150)的肺癌组织中可检出hTERT基因表达,组间差异有高度显著性,χ2=111·9,P<0·01;且随着肺组织癌变过程的变化,hTERT基因的表达呈逐渐增高的趋势,χt2rend=107·7,P<0·01。结论:支气管黏膜上皮细胞的不典型增生和恶性转化与hTERT基因的表达有关;hTERT基因检测有望成为诊断肺癌变的早期生物标志物。     

Bcl-2、Bax在胃癌病变过程中的表达及其与凋亡的关系

Objective： To study the expressions of Bcl-2 and Bax proteins and explore the relationships between them and apoptosis in gastric carcinoma and precancerous lesions, Methods： TUNEL method was used to detect apoptosis and immunohistochemical staining method was used to detect the expressions of Bcl-2 and Bax proteins in 70 cases of chronic gastritis, 49 cases of intestinal metaplasia, 64 cases of dysplasia and 81 cases of gastric carcinoma. Results： The positive incidences of Bcl-2 and Bax were the highest in severe dysplasia, In intestinal metaplasia and dysplasia, positive incidences of Bcl-2 and Bax were higher than those in chronic gastritis and gastric carcinoma. During the process of evolvement from chronic gastritis to intestinal metaplasia then to dysplasia, apoptosis indexes gradually rise up to mid-high dysplasia, which reached the highest point, then it began to fall down, when it reached the lowest point in gastric carcinoma. There were negative correlations between the expressions of Bcl-2, Bax proteins and apoptosis. Conclusion： The expression of Bcl-2 may be an early behavior in the gastric carcinogenesis. Bax had antagonistic effect to Bcl-2, Detections of Bcl-2 and Bax may be beneficial to the early diagnosis of gastric tumor and precancerous lesions.     

结直肠癌前病变及肿瘤患者血清代谢物的差异分析

目的:应用核磁共振方法检测结直肠肿瘤患者及结直肠癌前病变患者血清代谢物质水平变化.方法:收集新疆医科大学第一附属医院确诊结直肠癌患者血清标本40例,新疆医科大学第一附属医院考虑为癌前病变(包括溃疡性肠病、结直肠腺瘤)患者血清标本20例,健康对照组血清标本60例,应用核磁共振技术结合偏最小二乘法,分析三组中血清代谢物质的变化水平.结果:结直肠肿瘤患者血清中的苯丙氨酸、酪氨酸、乳酸、β-葡萄糖、胆碱、亮氨酸、甘氨酸、α-葡萄糖、肌酸、谷氨酰胺、谷氨酸、乙酰半胱氨酸、缬氨酸、脯氨酸丙氨酸等14种化合物较正常者明显下降,而β-羟丁酸、乙酰乙酸的含量升高,差异有统计学意义(P<0.05).结直肠癌前病变患者与肿瘤患者血清亮氨酸、胆碱、β-葡萄糖均比健康者低.除了上述三种化合物以外,结直肠癌前病变患者血清异丁酸、甜菜碱、柠檬酸较健康组低(有统计学差异).结论:以代谢组学为基础的核磁共振技术在结直肠肿瘤的早期诊断中有无创、快速、灵敏度高等临床应用价值.结直肠肿瘤患者与健康者比较,部分血清代谢物质有变化.结直肠癌前病变组患者血清代谢物质的变化呈从正常至肿瘤的过渡变化状态,其部分相关代谢物质的变化间接的预示肿瘤的发生.     

宫颈癌及癌前病变早期筛查的新进展

近年来宫颈癌的发病率与死亡率有逐年增长和年轻化趋势,引起了人们的高度重视。目前临床常用的筛查方法主要有肉眼观察法、细胞学检测、HPV －DNA 检测、电子阴道镜检查及组织病理学检查等。本文对宫颈癌及癌前病变最新的筛查指南、筛查方法进行了综述和评价,便于临床工作者能合理应用这些筛查技术或技术联合,有效阻断宫颈癌的发生。     

Symptomatic granular cell tumor of the esophagus

A case of symptomatic granular cell tumor of the esophagus is described. Another 32 cases collected from the English literature are analyzed. The reported cases have occurred mostly in women of less than 50 years of age presenting with dysphagia. Excision of the lesion is curative.     

Antigen MG7 in gastric cancer and gastric precancerous lesions

Earlydetectionandearlydiagnosisofgastriccancerareessentialtodecreasethemortalityandincreasesurvivalrateofgastriccancer.TheZhuangheregioninLiaoningProvinceisahighriskareaofgastriccancerandanimportantresearchbaseforgastriccancerpreventionandtreatmentinChina[1].AlargescalescreeningofgastriccancerinthisareawascarriedoutbytheCancerInstituteofChinaMedicalUniversitypreviously.Inthepresentstudy,thegastricmucosasamplesfromthescreeningwereusedtoinvestigatethedynamicexpressionofgastriccancer-associat…     

Flow cytometry in analysis of precancerous lesions of the esophagus

DNA content of the severe dysplasia cells in the esophageal epithelium was quantitatively analysed using flow cytometry and compared with those of the normal, mild dysplasia and cancer cells. The results showed that DNA index of the severe dysplasia cells was 1.27 +/- 0.11 and there was a significant difference between its value and those of the normal (1.0 +/- 0.02), mild dysplasia (1.01 +/- 0.03) and cancer cells (1.73 +/- 0.35). The DNA content of severe dysplasia cells lies between the normal and cancer cells. The hyperplasia degree of the severe dysplasia cells parallels their DNA contents. This study indicates that flow cytometry is a useful supplementary tool for diagnosis of the tumor.     

ras蛋白在食管癌及食管癌前病变组织中的表达

目的了解中国食管癌高发区食管癌变发生过程中癌基因ｒａｓ的变化。方法采用卵白素－生物素－辣根过氧化氢酶复合物（ＡＢＣ）方法测定食管癌高发区食管癌及癌前病变组织中癌基因ｒａｓ蛋白的表达状况。结果在正常食管上皮和癌前病变组织中未见ｒａｓ蛋白表达,而３６例食管癌组织有９例出现免疫阳性反应,其免疫阳性反应率为２５％。结论ｒａｓ癌基因表达是食管癌变晚期阶段的一个分子学变化。     

Secondary prevention of esophageal cancer--intervention on precancerous lesions of the esophagus

In 1983, intervention of precancerous lesion of esophagus was undertaken in the high risk area of esophageal cancer, Heshun Village, Linxian County. It had been expected that cancerous degeneration rate of esophageal dysplasia should be reduced by 50% so as the prevention of esophageal cancer could become possible. 6758 subjects of the general population aging from 40 to 65 were examined by esophageal exfoliative cytology, 1729 had marked dysplasia and 2411 had mild dysplasia of esophageal epithelium. Those with marked dysplasia were randomized into 3 groups to take their respective medication: antitumor B (Chinese herbs); retinamide (4-Ethoxycarbophenylretinamide) and placebo. The subjects with mild dysplasia were divided randomly into 2 groups for treatment by riboflavin and placebo. 95% of the subjects had taken 90% or more of the total medication for 3 years, at the end of which they were reexamined by esophageal exfoliative cytology. The reexamination rate was 94.1%. The incidence of esophageal cancer in the antitumor B group (3.9%) was reduced by 53% as compared with that of the placebo group (8.3%). This difference had statistical significant (means 2 = 7.672, P less than 0.05). The incidence of esophageal cancer in retinamide and riboflavin groups were reduced by 33.7% and 19% as compared with those of the control groups. The regression rate of dysplasia in the treatment groups were increased than that of the control groups. The above results showed that our hypothesis about the secondary prevention of esophageal cancer is correct. The intervention of precancerous lesion of the esophagus is effective in the prevention of esophageal cancer.(ABSTRACT TRUNCATED AT 250 WORDS)     

胃宁颗粒治疗胃癌前病变实验研究

Objective: To investigate potential therapeutic effects and mechanism of Weining granule in the treatment of gastric precancerous lesions. Methods: Sixty rats were randomly assigned to a blank group or a model group or to receive retinoic acid or high-, medium-or low-dose of Weining granule. General conditions of the animals were observed before and after treatment. Changes in gastric mucosal pathohistology, telomerase activity, proliferation index (PI) and apoptosis index (AI) were measured. Results: General conditions, including activity and eating, were improved in all Weining-granule-treated groups with the numbers of rats having intestinal metaplasia (IM), atypical hyperplasia (ATP) or positive telomerase activity being significantly lower than those in the model group (P ＜ 0.05 or P ＜ 0.01). Compared with the model group, all doses of Weining granule significantly decreased PI (P ＜ 0.01) and increased AI (P ＜ 0.05). Conclusion: Weining granule may provide a therapeutic benefit for the treatment of gastric precancerous lesions by inhibiting telomerase activity and proliferation of gastric cancer cells and by accelerating their apoptosis.     

宁夏海原县胃癌癌前病变危险因素分析

目的:探讨宁夏海原县胃癌癌前病变可能的危险因素,为预防胃癌提供相应依据。方法:以2018年1月至2019年1月于宁夏海原县人民医院和宁夏回族自治区人民医院宁南医院行胃镜检查的5 280例患者为筛选对象,将通过胃镜检查诊断为萎缩性胃炎,经病理诊断为肠化、异型增生的患者作为病例组。将同期行胃镜检查诊断为非萎缩性胃炎,经病理诊断无肠化、无异型增生的患者,按照1∶1配对作为对照组。用单因素、多因素非条件二元Logistic回归方法进行分析。结果:病例组与对照组单因素分析提示在体质量指数（BMI）、居住坏境、教育程度、吸烟、饮酒、饮绿茶、饮水来源、新鲜蔬菜、新鲜水果、肉蛋奶、豆类食品、腌制食品、油炸食品、烫热食品、大蒜、吃早餐、进食不规律、消化疾病史、幽门螺杆菌（Hp）感染、非甾体抗炎药服用史、睡眠时间因素方面差异均有统计学意义（P＜0.05）。通过Logistic回归分析模型分析提示吸烟、饮酒、饮用地窖水、腌制食品、油炸食品、烫热食品及Hp感染是胃癌癌前病变发生的危险因素。而较高的教育程度、饮绿茶、新鲜蔬菜、新鲜水果、吃早餐、7~8 h睡眠时间是胃癌癌前病变的保护因素。结论:影响宁夏海原县胃癌癌前病变的因素是多方面的,Hp感染、腌制、油炸和烫热食品及饮用地窖水是当地发生胃癌癌前病变最重要的危险因素。所以改变生活习惯,根除Hp是预防宁夏海原县发生胃癌癌前病变的重要措施。     

协同刺激分子B7-H4在食管癌前病变组织中的表达及临床意义

目的：研究协同刺激分子B7同系物4（B7-H4）在人食管癌前病变组织中的表达变化,探讨其在食管鳞状细胞癌形成中的临床意义。方法：收集内镜切除的食管组织标本58例,其中正常组织16例,低级别上皮内瘤变（LGIN）23例,高级别上皮内瘤变（HGIN）19例。通过苏木素-伊红（HE）染色评价食管组织病理变化。分别采用实时荧光定量PCR（qPCR）检测B7-H4 mRNA在食管组织的表达;免疫组织化学和Western blot检测B7-H4蛋白在食管病变组织中的表达;酶联免疫吸附法（ELISA）检测食管组织细胞因子IL-6、IL-10和IFN-γ的表达,并分析各细胞因子与B7-H4蛋白表达的相关性。结果：免疫组化和HE染色结果提示,B7-H4表达与食管组织病理分级呈显著正相关（P < 0.01）。qPCR结果提示,与正常食管组织相比,食管癌前病变组织B7-H4 mRNA表达无显著改变（P > 0.05）。而Western blot实验结果显示,与正常食管组织相比,食管癌前病变组织B7-H4蛋白表达显著升高（P < 0.05）。Westernblot和ELISA实验结果显示B7-H4表达与IL-6表达呈正相关（P < 0.01）。结论：随着食管癌前病变病理分级的提高,B7-H4蛋白的表达逐渐上调,B7-H4可能与IL-6相互作用促进了食管鳞状细胞癌的发生发展。