涎腺腺样囊性癌组织中HIF-1α、VEGF、MVD的表达变化及意义

目的 观察缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)及微血管密度(MVD)在涎腺腺样囊性癌(SACC)组织中的表达变化,并探讨其意义.方法 采用免疫组化SP法检测46例SACC及5例正常涎腺组织中的HIF-1α、VEGF及CD105,计算MVD.结果 SACC组织中HIF-1α阳性表达率为47.8%(22/46)、VEGF为65.2%(30/46)、MVD为(31.50±4.87)条/HP,正常涎腺组织均为阴性,两者相比,P均＜0.05;HIF-1α、VEGF的表达及MVD值与SACC临床病理分型、TNM分期有关(P均＜0.05),HIF-1α与VEGF的表达呈正相关(r=0.472,P＜0.01)、与MVD呈正相关(r=0.431,P＜0.01).结论 SACC组织中HIF-1α、VEGF、MVD表达上调,可作为判断SACC生物学行为及预后的指标.     

涎腺腺样囊性癌中Survivin与nm23表达的研究

目的探讨Survivin和nm23在涎腺腺样囊性癌（SACC）发生、发展及淋巴转移过程中的作用。方法采用免疫组化ABC法检测8例正常腮腺及38例SACC石蜡标本中Survivin和nm23的表达。结果 Survivin蛋白阳性染色和nm23阳性染色标准是细胞胞质中可见棕黄色颗粒或团块。Survivin在正常涎腺组织中表达阳性率为100.0%,在SACC其阳性率为66.7%,两组比较P〈0.05。nm23在正常涎腺组织中表达阳性率为100.0%,在SACC其阳性率为58.3%,两组比较P〈0.05。Survivin、nm23蛋白的表达与SACC病理类型、发病年龄、性别及肿瘤大小均不相关。Survivin阳性率与淋巴结转移呈正相关,nm23阳性率与淋巴结转移呈负相关。在涎腺SACC组织中Survivin与nm23蛋白两者间呈负相关。结论 Survivin蛋白和nm23蛋白在涎腺SACC的发生、发展及淋巴转移过程中起重要作用。     

涎腺腺样囊性癌组织中survivin、livin的表达变化及意义

目的观察survivin和livin在涎腺腺样囊性癌（SACC）组织中的表达变化,并探讨其意义。方法采用免疫组化SP法检测42例SACC及6例正常涎腺组织中的survivin和livin。结果 SACC组织中survivin、livin阳性表达率分别为69.0%（29/42）、59.5%（25/42）,正常涎腺组织均为阴性,两者相比,P均〈0.05;SACC中survivin的表达与淋巴结转移相关（P〈0.05）,livin的表达与临床病理分期、淋巴结转移相关（P均〈0.05）。结论 SACC组织中survivin和livin的表达上调,与SACC的预后有关。     

涎腺腺样囊性癌组织中survivin、COX-2的表达变化及意义

目的观察涎腺腺样囊性癌（SACC）组织中survivin、环氧化酶-2（COX-2）的表达变化，并探讨其临床意义。方法采用免疫组化法检测42例SACC及22例正常涎腺组织中的survivin、COX．2蛋白。结果SACC组织中survivin、COX-2蛋白阳性率分别为59．5％（25／42）、64．3％（27／42），正常涎腺组织中分别为0、4．5％；两者比较，P均〈0．05。SACC组织TNM分期Ⅲ～Ⅳ期survivin、COX-2蛋白阳性率分别为84．6％（11／13）、84．6％（11／13），显著高于Ⅰ～Ⅱ期的48．2％（14／29）、55．1％（16／29），P均〈0．05。相关分析显示，SACC组织中survivin、COX-2蛋白表达呈正相关（r=0．832，P〈0．05）。结论SACC组织中COX-2、survivin高表达，二者在SACC发生、发展中发挥重要作用。     

乳腺癌乳房全切术后局部区域复发和远处转移的相关危险因素

目的探讨乳腺癌乳房全切术后局部区域复发(LRR)和远处转移的相关危险因素。方法收集并分析接受乳房全切术治疗的原发性乳腺癌患者178例,随访7~120个月,随访率97.2%(173/178)。结果 LRR 18例,3年复发率9.5%(14/148),3年生存率91.9%(136/148);远处转移30例,5年转移率21.8%(22/101),5年生存率84.2%(85/101)。术后无放疗组3年复发率显著高于术后放疗组(P<0.01);且切缘阳性术后放疗者复发率明显高于切缘阴性术后放疗者(P<0.05);腋窝淋巴结阳性术后未化疗组5年远处转移率显著高于术后化疗组(P<0.05);肿块>5 cm、切缘阳性与LRR有关(P<0.05),年龄<45岁、腋窝淋巴结阳性、组织学分级G3与远处转移有关(P<0.05)。结论乳腺癌乳房全切术后应放疗,且切缘阳性者应再切除至切缘阴性,腋窝淋巴结阳性者术后应化疗,肿块大小、年龄和组织学分级均是术后不良事件发生的危险因素。     

老年结直肠癌患者手术风险及预后

目的分析老年结直肠癌患者的临床病理特点及影响手术预后因素。方法手术治疗的结直肠癌患者300例,分析不同年龄结直肠癌患者的临床及病理资料,采用多因素COX分析评价影响老年组术后复发的危险因素及3、5年生存率和无病生存率。结果≥70岁组高中分化腺癌比例、TNM分期Ⅲ~Ⅳ期、区域淋巴结转移、腹腔及远处转移发生率均显著高于70岁组(P0.05)。COX多因素分析提示,TNM分期、组织类型、区域淋巴结转移、腹腔及远处转移均为影响≥70岁结直肠癌患者预后的相关因素。≥70岁组3年生存率为57.66%(79/137),3年无病生存率为48.91%(67/137);5年生存率为24.82%(34/137),5年无病生存率为21.17%(29/137)。结论应对TNM分期高、组织类型为高中分化腺癌、存在区域淋巴结转移、腹腔及远处转移的≥70岁结直肠癌患者加强术后监测,以降低术后复发率,提升患者术后生存率。     

血管内皮生长因子、微血管密度与食管鳞癌临床病理及预后的关系

为探讨血管内皮生长因子 (VEGF)、微血管密度 (MVD)与食管鳞癌临床病理和预后的关系 ,对 4 4例原发食管鳞癌、6例食管不典型增生及 10例正常人的食管组织石蜡切片进行血管标记和染色 ,检测 VEGF表达及 MVD。结果显示 ,食管鳞癌患者 VEGF阳性表达率为 6 5 .9% (2 9/ 4 4 ) ,VEGF表达与肿瘤大小、分化程度、淋巴结转移及 TNM分期显著相关 ;MVD与分化程度、淋巴结转移、TNM分期明显相关 ;VEGF表达阳性组 MVD(47.34± 11.5 7条 )明显高于阴性组 (33.73± 11.33条 ) ,VEGF表达与 MVD具有相关性 ;VEGF阴性组和阳性组术后 3年生存率有显著差异 ,高 MVD者和低 MVD者术后 3年生存率有显著差异 (P<0 .0 1)。认为食管鳞癌VEGF表达增强 ,MVD增高 ;VEGF表达在食管鳞癌的生长、浸润和转移过程中起重要作用 ;VEGF和 MVD对于判断食管鳞癌预后有重要参考价值     

Ⅳ型胶原在涎腺黏液表皮样癌中的表达与微血管密度的关系

目的探讨Ⅳ型胶原表达与涎腺黏液表皮样癌(Mucoepidermoid carcinoma,MEC)临床病理的关系及其和微血管密度之间的联系。方法应用免疫组织化学方法,检测46例MEC内Ⅳ型胶原表达与微血管密度(Microvessel density,MVD),并将检测结果进行统计分析。结果Ⅳ型胶原在涎腺黏液表皮样癌中表达的强弱与癌组织的分化程度及淋巴结转移有关(P<0.05),而与患者的性别、年龄无关(P>0.05)。涎腺黏液表皮样癌的MVD与其分化程度及淋巴结转移有关(P<0.01),而与患者的性别、年龄无关(P>0.05)。结论Ⅳ型胶原表达水平及MVD与涎腺黏液表皮样癌组织的分化程度和转移相关,此结果为临床建立新的MEC预后预测因子和指导临床治疗提供依据。     

鼻咽癌伴咽后淋巴结转移与肿瘤复发、转移及预后的关系

目的探讨鼻咽癌伴咽后淋巴结转移与肿瘤复发、转移及预后的关系。方法选择66例鼻咽非角化性或未分化性癌,分期为T1～4N1～3M0。采用常规根治性放疗或放化综合治疗后,观察患者3年复发率、远处转移率及生存率。结果本组3年复发率15.15%,3年远处转移率33.33%,3年总生存率77.27%。单侧咽后淋巴结转移、双侧咽后淋巴结转移患者的3年远处转移率分别为35.29%、33.33%,3年生存率分别为73.53%、81.25%;N1期、N2～3期患者的3年远处转移率分别为16.67%、42.86%(P<0.05),3年生存率分别为91.67%、69.05%(P<0.05);单纯放疗、放化综合治疗患者的3年远处转移率分别为46.67%、22.22%(P<0.05),3年生存率分别为63.33%、88.89%(P<0.05)。结论鼻咽癌伴咽后淋巴结转移、N分期是影响预后的重要因素,放化综合治疗有提高患者生存率的作用。     

结肠癌组织中CBX2蛋白预测老年结肠癌患者腹腔镜根治术后远处转移的临床分析

[目的]分析结肠癌(CC)组织中色素框同源物2(CBX2)蛋白与老年CC患者腹腔镜根治术后远处转移的关系及预测患者术后远处转移风险的价值。[方法]收集腹腔镜根治术治疗且完成3年随访的119例老年CC患者资料,患者均接受病理组织CBX2蛋白检测,病例资料、相关检查资料等完整;统计患者随访期间远处转移发生情况并分组,采集并比较患者相关基线资料、CBX2蛋白表达,重点分析CC组织中CBX2蛋白与老年CC患者腹腔镜根治术后远处转移的关系及预测患者术后远处转移风险的价值。[结果]119例患者随访3年有18例出现远处转移(转移组),转移率为15.13%;转移组TNM/T分期Ⅲ期比例、淋巴结转移比例、癌胚抗原(CEA)水平、糖类抗原199(CA199)水平、CBX2蛋白表达均高于未转移组,差异有统计学意义(P<0.05);组间其他基线资料比较差异无统计学意义(P>0.05);经Logistic回归分析结果显示,TNM/T高分期、淋巴结转移、CEA升高、CA199升高、CBX2蛋白过表达均可能是老年CC患者腹腔镜根治术后远处转移的风险因子(OR>1,P<0.05);绘制ROC曲...     

腋淋巴结阴性乳腺癌中血管生成及nm23-H_1基因表达与预后关系的研究

为探讨腋淋巴结阴性乳腺癌(ANNBC)中血管生成及nm23-H_1基因的表达与预后的关系,筛选80例病理类型为浸润性导管癌的ANNBC患者进行随访,中位随访时间为65.0个月。应用免疫组织化学SABC法检测原发肿瘤标本中的微血管密度(MVD)及nm23-H_1基因表达情况,结合临床随访资料进行生存分析。结果显示MVD、nm23-H_1均可作为估计预后的因素,nm23-H_1与MVD联合检测对预后价值更大,对高MVD者给予有针对性的抗血管生成治疗或基因治疗可能有更重要的意义。     

血管内皮细胞生长因子的表达及微血管密度与胆囊癌浸润、转移及预后的相关研究

探讨血管内皮细胞生长因子 (vascularendothelialgrowthfactor,VEGF)及微血管密度 (Microvesseldensity ,MVD)在胆囊癌发生发展中的作用及与胆囊癌浸润、转移及预后的关系。应用S -P免疫组化技术对 3 1例经手术切除的原发性胆囊癌及 10例经手术切除的慢性胆囊炎标本进行VEGF蛋白和微血管密度检测。 3 1例胆囊癌组织中癌旁VEGF表达及MVD值均明显高于癌中央及正常组织 ,三者差异具有显著性 (P <0 0 1) ;VEGF表达与MVD具有相关性 ,VEGF阳性者MVD值显著高于阴性者 (P <0 0 1) ;VEGF表达和MVD与胆囊癌分化程度、浸润转移、Nevin分期密切相关 (P <0 0 1) ;VEGF阳性者及高MVD者预后较阴性者差 ;Cox比例危险模型多因素分析表明 :VEGF对胆囊癌是一个独立的预后因子。VEGF的表达及MVD在胆囊癌的发生和浸润转移过程中发挥重要的作用 ,VEGF和MVD可作为反映胆囊癌生物学行为的指标     

Microvessel density is a prognostic marker of human gastric cancer

INTRODUCTIONGastric cancer is one of the most frequent and lethal malignancies worldwide, especially in Eastern Asia including China, and the 5-year survival rate is only about 20%[1]. A recent research has shown an increasing trend of gastric cancer mortality in China in the past 20 years, especially in rural areas and among aged people[2]. To date, the treatment outcome of this common malignancy is still not satisfactory. One major difficulty in the diagnosis and treatment of gastric c…     

Expression of two CD44 variant proteins (v3 and v6 ) in human colorectalcarcinoma and its relevance for prognosis

AIM To evaluate the expression of CD44v3 and v6 protein in colorectal carcinoma and its prognosticsignificance.METHODS One hundred and twenty-one cases of formalin-fixed paraffin-embedded colorectal carcinomaspecimens were retrospectively analyzed using EnvisionTM immunohistochemical method with the monoclonalantibody CD44v3 and v6. The median follow-up time was 67.77 months and the prognostic value of theCD44v3 and CD44v6 was assessed using univariate and multivariate survival analysis.RESULTS The positive rates of CD44v3 and v6 protein were 60.3% and 57.9%, respectively. There wassignificant correlation between CD44v3 immunoreactivity and tumor location, lymph node metastasis, distantmetastasis and Duke's stage (P< 0.05, Spearman correlation test). Significant correlation between CD44v6immunoreactivity and patients' gender, lymph node metastasis, distant metastasis, Duke's stage was alsonoticed (P < 0.05, Spearman correlation test). The 5-year survival rates were 81.25% and 60.27% inCD44v3 negative and positive cases, respectively. As CD44v6, the 5-year survival rates were 80.39% and60.00% in CD44v6 negative and positive cases, respectively; these differences between the two groups ofpatients were significant (P<0.05, Log-rank test). In multivariate analysis using the Cox regression model,CD44v3 expression emerges as an independent prognostic indicator.CONCLUSION CD44v3 and v6 might play some important roles in metastasis of colorectal carcinoma, andCD44v3 expression might be a new useful independent prognostic marker of colorectal carcinoma.     

Syndecan-1 and angiogenic cytokines in multiple myeloma: correlation with bone marrow angiogenesis and survival

Angiogenesis is a complex process involved in the proliferation and metastasis of malignant tumours, and partly triggered by the secretion of various angiogenic factors by tumour cells or cells in the stromal environment. We investigated the correlation between bone marrow angiogenesis, estimated as microvessel density (MVD), and interleukin-6 (IL-6), basic fibroblastic growth factor (bFGF), hepatocyte growth factor (HGF) and syndecan-1 in 67 patients with newly diagnosed multiple myeloma, and evaluated the prognostic value of these parameters. Circulating levels of IL-6, bFGF, HGF and syndecan-1 were significantly higher in patients than in controls. Moreover, in patients, bone marrow levels of bFGF, HGF and syndecan-1 were higher than peripheral blood levels. Positive correlations were found between MVD and syndecan-1 blood levels (r = 0.33, P = 0.017), syndecan-1 bone marrow levels (r = 0.49, P = 0.046) and HGF blood levels (r = 0.36, P = 0.008) respectively. High MVD and high blood levels of IL-6, HGF and syndecan-1 were predictive of a shorter survival. In a multivariate survival analysis MVD and blood levels of IL-6 retained independent prognostic significance, while in a survival analysis without MVD the peripheral blood levels of HGF and syndecan-1 were strong independent prognostic factors.     

胆囊癌组织微血管密度变化及其与预后的关系

应用抗人Ⅷ因子相关抗原(F8-RA)多克隆抗体、免疫组织化学(SABC)法，检测40例胆囊癌组织中（MVD)的表达，并分析其与胆囊癌临床病理及预后的关系。结果发现，胆囊癌组织MVD值与肿瘤浸润深度、临床病理分期、淋巴结转移密切相关，与病理类型及分化程度无关。MVD值较高者，中位生存期及3年生存率显著降低。提示胆囊癌组织MVD的增加，可促进病变的发展和转移；检测胆囊癌组织MVD对判断胆囊癌的预后有重要意义。     

Prognostic value of tumor volume for patients with nasopharyngeal carcinoma treated with concurrent chemotherapy and intensity-modulated radiotherapy

Purpose

We aimed to analyze prognostic factors in patients with nasopharyngeal carcinoma (NPC) treated with concurrent chemotherapy and intensity-modulated radiotherapy (IMRT); in addition, we aimed to elucidate the value of primary gross tumor volume (GTVp) in predicting prognosis of patients.

Methods

Between February 2001 and December 2008, 321 patients with NPC treated with concurrent chemotherapy and IMRT were analyzed retrospectively. GTVp was calculated from treatment planning computed tomography scans. A receiver operating characteristics (ROC) curve was used to determine the best cutoff point of GTVp.

Results

The 5-year local failure-free survival (LFFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) for NPC patients were 93.8, 80.1, 73.0, and 83.7 %, respectively. Univariate and multivariate analyses indicated that GTVp had exhibited a statistically significant correlation with LFFS, DMFS, DFS, and OS (P < 0.05, all), whereas T classification was not an independent prognostic factor. According to ROC curve analysis, 49 and 19 mL were determined as the cutoff points of GTVp for local control and distant metastasis, respectively. Based on this, 321 patients were divided into three volume subgroups. LFFS, DMFS, DFS, and OS demonstrated significant differences among patients in different volume subgroups (P < 0.001, all) and were superior to T classification for predicting prognosis of NPC patients.

Conclusions

Primary gross tumor volume is an independent prognostic factor in local control, distant metastasis, disease-free survival, and overall survival in NPC. An adjusted TNM staging system that includes GTVp as a quantitative indicator to evaluate prognosis is warranted.     

Prognostic significance of expression of cyclooxygenase-2 and vascular endothelial growth factor in human gastric carcinoma

AIM: To investigate the role of cyclooxygenase-2(COX-2) and vascular endothelial growth factor (VEGF) in the development of gastric carcinoma and correlation between expression of COX-2 and VEGF and clinicopathologic features in tissues from patients with gastric carcinoma. METHODS: 281 patients with gastric carcinoma who underwent surgical resection between 1990 and 1999 at the First Affiliated Hospital, Anhui Medical University, PRC, were followed up. Expression of COX-2 and VEGF was investigated retrospectively in 232 gastric carcinoma tissues and 60 noncancerous specimens by using immunohistochemistry. RESULTS: The 5-year survival rates of early gastric carcinoma (EGC) and advanced gastric carcinoma (AGC) were 93.4 % and 59.0 %, respectively. Survival time was highly correlated with lymph node metastasis, vascular invasion, depth of invasion and treatment with chemotherapy. Compared with paired noncancerous tissues, expression of COX-2 and VEGF and microvessel density (MVD) value in carcinoma tissue were significantly higher. The MVD value was much higher in COX-2-positive group and VEGF-positive group than that in COX-2-negative group and VEGF-negative group. Expression of COX-2 and VEGF, as well as MVD value were highly correlated with lymph node metastasis and vascular invasion. The 5-year survival rate of patients with expression of COX-2 or VEGF was significantly lower than that of patients without COX-2 or VEGF expression. Multivariate analysis revealed that VEGF overexpression, lymph node metastasis, COX-2 overexpression, depth of invasion and vascular invasion were all independent prognostic factors of gastric carcinoma. CONCLUSION: Overexpression of COX-2 and VEGF in patients with gastric carcinoma can enhance the possibility of invasion and metastasis, implicating a poor prognosis. They may serve as the fairly good prognostic factors to indicate biologic behaviors of gastric carcinoma.