利用传统和微阵列式比较基因组杂交确定与子宫颈内腺癌发生及转移相关的假想基因位点

Objectives This study aimed to estimate the gene loci associated with carcinogenesis of endocervical adenocarcinoma of uterus (EA) and metastasis. Study design Sixteen patients with EA were studied; 6 had nodal metastasis. DNA was extracted from EAs, and subjected to both conventional comparative genomic hybridization (CGH) and arraybased CGH. Copy number abnormalities were compared between cases with and without nodal metastasis. Results In all EAs, high frequencies of copy number losses were detected in genes LRP1B (on 2q21.2)-, DAB2 (5p13), and DCC (18q21.3), as well as regions 3p, 16q, and 22q, and copy number amplifications in genes NRAS (1p13.2), TOP2A (17q21-q22), NCOA3(AIB1) (20q12), and ARSA (22q tel). Nodal metastasis was associated with high frequencies of copy number loss in genes PGRMC2 and LAMA3 and amplification in CDK6 and NCOA3(AIB1). Conclusion This is the first report of gene copy number alterations spanning the whole genome in EA. These altered genes are speculated to be associated with EAs as a tumor suppressor and/or oncogene.

浆液性和非浆液性肿瘤卵巢癌淋巴结转移的差异

Objective. To investigate the lymph node sites most susceptible to involvement relative to primary tumor histology in ovarian cancer. Methods. The locations of metastatic lymph nodes were investigated in 208 patients with primary ovarian cancer who underwent systemic lymphadenectomy covering both the pelvic and para-aortic regions. Results. Lymph node metastasis was present in 12.8%(20/156) of patients with stage I (pT1M0), 48.6%(18/37) with stage II (pT2M0), and 60%(9/15) with stage III (pT3M0) disease, thus in 22.6%(47/208) of all study patients. Isolated para-aortic nodal involvement was present in 23.3%(14/60) of patients with serous tumor and 4.1%(6/148)-of those with non-serous tumor (P = 0.00002). In an analysis of 35 positive nodes from 25 patients with up to 3 positive nodes, 86.4%(19/22) of metastatic lymph nodes from patients with serous tumor were found in the para-aortic region, with 14 positive nodes located above the inferior mesenteric artery (IMA) and 5 below it, whereas metastasis to para-aortic lymph nodes accounted for 53.8%(7/13) of metastatic lymph nodes from patients with non-serous tumor (P = 0.0334). Conclusions. The locations of metastatic lymph nodes in ovarian cancer depend upon the histologic type of the primary cancer. In cases of serous tumor, the para-aortic region, particularly above the IMA, is the prime site for the earliest lymph node metastasis. However, the likelihood of pelvic node involvement is almost equal to that of para-aortic node involvement in cases of nonserous tumor.

腹主动脉旁淋巴结转移的子宫内膜癌患者术后化疗的有效性

Objective:To examine the effectiveness of postoperative chemotherapy for para-aortic lymph node (PAN) metastasis in patients with endometrial cancer. Methods:Among 350 clinical stage I-II endometrial cancer patients who underwent systemic pelvic and para-aortic lymphadenectomy during the period 1995 through 2002,26 patients were identified with PAN metastasis. Of these patients,nine had only one positive PAN and 17 had two or more positive PANs (mean 4.9,range 1-22). All patients were treated postoperatively with a single chemotherapy regimen consisting of ifosfamide,epiadriamycin,and cisplatin scheduled for 5 cycles. Median (range) follow-up for surviving patients was 85 (38-119) months. Treatment outcome,including disease-free survival relative to the number of positive PANs,was investigated. Results:Among the 26 patients with PAN involvement,four developed recurrence. Three of the four patients had 10 or more positive PANs. Estimated 5-year disease-free survival rates were 89%for patients with one positive PAN,82%for those with two or more positive PANs,and 85%for all patients. No significant difference was identified between the first two groups (P = 0.6543). Conclusions:Postoperative chemotherapy can yield a favorable outcome in endometrial cancer patients with PAN metastasis,even those with multiple positive nodes.