Pancreatic cancer secondary to intraductal papillary mucinous neoplasm with collision between gastric cancer and B-cell lymphoma: A case report

BACKGROUND Patients with intraductal papillary mucinous neoplasm(IPMN)have an increased risk of pancreatic and extrapancreatic malignancies.Lymphomas are rare extrapancreatic malignancies,and in situ collisions of early gastric cancer and diffuse large B-cell lymphoma(DLBCL)are even rarer.Here,we report the first case of pancreatic cancer comorbid with in situ collision of extrapancreatic malignancies(early gastric cancer and DLBCL)in a follow-up IPMN patient.Furthermore,we have made innovations in the treatment of such cases.CASE SUMMARY An 81-year-old Japanese female diagnosed with IPMN developed elevated carbohydrate antigen(CA)19-9 levels during follow-up.Because her CA19-9 levels continued to rise,endoscopic ultrasound(EUS)was performed and revealed a suspicious lesion at the pancreatic tail.However,lesions in the pancreas were not found by computed tomography,magnetic resonance imaging,or endoscopic retrograde cholangiopancreatography.To make an exact pathological diagnosis,EUS-guided fine needle aspiration was performed.To our supprise,early gastric cancer was found in preoperative gastroscopy.The gastric cancer was completely resected through endoscopic submucosal dissection before postoperative pathology identified early adenocarcinoma collided with DLBCL.Subsequent EUS-guided fine needle aspiration provided pathological support forthe pancreatic cancer diagnosis, and then laparoscopic distal pancreatectomy andsplenectomy were performed. CA19-9 levels returned to normal postoperatively.CONCLUSION Endoscopic submucosal dissection is appropriate for submucosal lymphomas inpatients intoleratant of chemotherapy. EUS can detect small IPMN-relatedpancreatic tumors.

Composite diffuse large B-cell lymphoma and classical Hodgkin's lymphoma of the stomach:Case report and literature review

The combination of classical Hodgkin’s lymphoma(cHL)and non-Hodgkin lymphoma coexisting in the same patient is not common,especially in one extranodal location.Here we present a rare case of composite diffuse large B-cell lymphoma(DLBCL)and cHL occurring simultaneously in the stomach of a 53-year-old female who presented with upper abdominal discomfort and gas pain.Surgery was performed and the disease was diagnosed pathologically as composite lymphoma of DLBCL and cHL using hematoxylin-eosin and immunohistochemical staining.Epstein-Barr virus(EBV)infection was not detected by in situ hybridization for EBV-encoded RNA or immunohistochemistry for EBV latent membrane protein-1.Polymerase chain reaction analysis from the two distinct components of the tumor demonstrated clonal immunoglobulinκlight chain gene rearrangements.The patient died approximately 11 mo after diagnosis in spite of receiving eight courses of the CHOP and two courses of the rituximab-CHOP(RCHOP) chemotherapy regimen.This case report showed that the two distinct components,DLBCL and cHL,appeared to originate from the same clonal progenitor cell,and that EBV infection was not essential for transformation during the course of tumorigenesis.

基于MRI影像组学构建PD-1/PD-L1抑制剂治疗dMMR/MSI-H直肠癌疗效的预测模型

目的:探讨MRI影像组学模型在程序性细胞死亡蛋白-1(PD-1)/程序性细胞死亡-配体1(PD-L1)抑制剂联合全程新辅助治疗(TNT)局部进展期直肠癌(LARC)的疗效预测价值。方法:收集河南中医药大学第一附属医院PD-1/PD-L1抑制剂联合TNT治疗的80例错配修复基因缺陷(dMMR)/微卫星高度不稳定(MSI-H)基因型中低位LARC患者的临床和影像资料。将入组患者按7∶3比例分为训练集和测试集,提取影像组学特征,从中筛选并构建影像组学模型。描绘影像组学模型的Rad-score与病理金标准之间的受试者工作特征(ROC)曲线,计算曲线下面积(AUC),并评价模型的诊断效能。采用决策曲线分析(DCA)计算风险阈值的范围,并评估临床获益情况。收集湖南省人民医院25例dMMR/MSI-H基因型LARC患者的影像资料作为外部验证集。结果:训练集、测试集及外部验证集三者之间的临床特征无统计学差异(P>0.05)。经过降维处理、t检验及一致性检验以及LASSO交叉验证后,筛选出一阶偏度特征和体积2个特征构建影像组学模型。训练集、测试集和外部验证集的影像组学预测模型ROC曲线的AUC、灵敏度、特异度、阳性预测值和阴性预测值分别为0.920、97.1%、85.7%、91.9%、94.7%;0.885、80.0%、88.9%、92.3%、72.7%;0.875、87.5%、88.9%、93.3%、80.0%。DCA曲线显示,当风险阈值范围为0%~82%时,采用影像组学模型预测LARC患者为病理完全缓解(pCR)的获益大于将所有患者都视为pCR或者无病理完全缓解(npCR)。结论:基于MRI影像组学构建的dMMR/MSI-H型局部进展期直肠癌PD-1/PD-L1抑制剂联合全程新辅助放化疗疗效预测模型,有较大潜力为不同基因分型的直肠癌患者制定个体化治疗策略提供量化依据。

Gastrointestinal B-cell lymphomas:From understanding B-cell physiology to classification and molecular pathology

The gut is the most common extranodal site where lymphomas arise. Although all histological lymphoma types may develop in the gut, small and large B-cell lymphomas predominate. The sometimes unexpected finding of a lymphoid lesion in an endoscopic biopsy of the gut may challenge both the clinician (who is not always familiar with lymphoma pathogenesis) and the pathologist (who will often be hampered in his/her diagnostic skill by the limited amount of available tissue). Moreover, the past 2 decades have spawned an avalanche of new data that encompasses both the function of the reactive B-cell as well as the pathogenic pathways that lead to its neoplastic counterpart, the B-cell lymphoma. Therefore, this review aims to offer clinicians an overview of B-cell lymphomas in the gut, and their pertinent molecular features that have led to new insights regarding lymphomagenesis. It addresses the question as how to incorporate all presently available information on normal and neoplastic B-cell differentiation, and how this knowledge can be applied in daily clinical practice (e.g., diagnostic tools, prognostic biomarkers or therapeutic targets) to optimalise the managment of this heterogeneous group of neoplasms.

Gastric infiltration of diffuse large B-cell lymphoma: Endoscopic diagnosis and improvement of lesions after chemotherapy

Diffuse large B-cell lymphoma (DLBCL) is the most common histologic subtype of the non-Hodgkin’s lymphoma (NHL) accounting for about 40% of all NHLs. This is a case report about the endoscopic appearance of a DLBCL with infiltration to the stomach in a 39-year-old female. She had a 6-mo history of lumbar and left upper quadrant pain with intermittent episodes of melena. A computer tomograghy (CT) scan showed mural thickening of the gastric antrum. Endoscopic examination revealed multiple gastric ulcers. Definite diagnosis could be made by endoscopic biopsies and the patient had a good response to chemotherapy. This response correlated well with a further endoscopic follow-up. A follow-up endoscopic examination could be considered to evaluate a good response to chemotherapy in DLBCL patients with secondary gastric dissemination.

Case Report: Fever of Unknown Origin <br/>—An Unusual Presentation for Diffuse Large B-Cell Lymphoma

A 61-year-old male initially presented with fever of unknown origin. He had extensive work-up over two years including an infectious diseases panel, autoimmune studies, and Rheumatology and Hematology evaluations. The patient was initially diagnosed with Adult Still’s disease and underwent an out-patient right nodal fine-needle aspiration that was indeterminate. After continued failure of treatment for Adult Still’s disease, the patient had surgical resection of a right axillary lymph node that yielded the diagnosis of diffuse large B-cell lymphoma. Further work-up revealed Epstein-Barr virus positivity, the possible trigger behind his mutation for diffuse large B-cell lymphoma and its uncommon presentation. The patient met criteria for central nervous system prophylaxis and received multiple administrations throughout his therapy. He ultimately expired following recurrence of his disease at its initial site but without central nervous system involvement. We report an uncommon presentation of a patient with diffuse large B-cell lymphoma. This lymphoma can have numerous, vague presentations requiring a broad differential diagnosis and may lead to multiple evaluations prior to an ultimate diagnosis. We will also discuss the need for central nervous system prophylaxis, how this patient is qualified for prophylaxis, and how central nervous system prophylaxis benefits, harms, or does not affect patients with diffuse large B-cell lymphoma.

Spatial autocorrelation analysis of 13 leading malignant neoplasms in Taiwan: a comparison between the 1995-1998 and 2005-2008 periods

Spatial autocorrelation methodologies, including Global Moran’s I and Local Indicators of Spatial Association statistic (LISA), were used to describe and map spatial clusters of 13 leading malignant neoplasms in Taiwan. A logistic regression fit model was also used to identify similar characteristics over time. Two time periods (1995-1998 and 2005-2008) were compared in an attempt to formulate common spatio-temporal risks. Spatial cluster patterns were identified using local spatial autocorrelation analysis. We found a significant spatio-temporal variation between the leading malignant neoplasms and well-documented spatial risk factors. For instance, in Taiwan, cancer of the oral cavity in males was found to be clustered in locations in central Taiwan, with distinct differences between the two time periods. Stomach cancer morbidity clustered in aboriginal townships, where the prevalence of Helicobacter pylori is high and even quite marked differences between the two time periods were found. A method which combines LISA statistics and logistic regression is an effective tool for the detection of space-time patterns with discontinuous data. Spatio-temporal mapping comparison helps to clarify issues such as the spatial aspects of both two time periods for leading malignant neoplasms. This helps planners to assess spatio-temporal risk factors, and to ascertain what would be the most advantageous types of health care policies for the planning and implementation of health care services. These issues can greatly affect the performance and effectiveness of health care services and also provide a clear outline for helping us to better understand the results in depth.

‘Les liaisons dangereuses’: Hepatitis C, Rituximab and B-cell non-Hodgkin’s lymphomas

Rituximab has provided a revolutionary contribution to the treatment of B-cell non-Hodgkin’s lymphomas (NHL). A high prevalence of hepatitis C virus (HCV) infection has been described in B-cell NHL patients. Cases of liver dysfunction in HCV-positive patients have been reported with Rituximab-containing regimens. In this paper we review the recent data regarding the effects of Rituximab in NHL patients with HCV infection. We also added a section devoted to improving communication between oncohaematologists and hepatologists. Furthermore, we propose a common methodological ground to study hepatic toxicity emerging during chemotherapy.

CHOP-like Regimen in Combination with Rituximab and Peginterferon Alpha-2b in Newly-diagnosed Diffuse Large B-cell Non-Hodgkin＇s Lymphoma： Experience in a Chinese Center

OBJECTIVE To evaluate the efficacy of rituximab combined with CHOP-like regimen with or without IFN in patients newly diagnosed diffuse large B-cell Non-Hodgkin＇s lymphoma （DLBCL）.METHODS From January 2003 to July 2008, 51 patients received CHOP-like chemotherapy （cyclophosphamide 750 mg/m2, epirubicin 80 mg/m2, vindesine 2.8 mg/m2 on day 1, and prednisolone 100 mg/day on day 1 to day 5）. Thirty-one patients received CHOPR-like treatment （rituximab 375 mg/m2 1 day before CHOP-like chemotherapy）. Twenty patients received CHOP-like regimen in combination with peginterferon （pegIFN） （1μg/kg on day 5） and rituximab （on day 6）.RESULTS -The CR （complete remission） rate in the CHOPR-like （with or without pegIFN） group and in the CHOP-like group was 78.4% and 45.1% （P = 0.005）, respectively. The estimated mean time of overall survival （OS） in the CHOPR-like group and CHOP- like group was 58.7 ± 2.8 and 36.4 ±3.4 months, respectively （P = 0.002）. The rates of CR and OR （overall remission） in CHOPR- like with IFN arm were 85.0% and 95.0%, and the rates of those in CHOPR-like without IFN arm were 74.2% and 87.0% （P 〉 0.05）. The estimated mean time of 4-year-PFS （progression- free survival） in CHOPR-like with IFN arm and in CHOPR-like without IFN arm was 62.9 ±3.0 months and 51.0 ± 4.6 months （P = 0.092）, respectively. In the CHOPR-like with IFN arm, no patient relapsed after achieving CR, while the estimated rate of 4-year- DFS （disease-free survival） in the patients who reached CR in the CHOPR-like without IFN arm was （63.4 ± 19.3）% （P = 0.061）. CONCLUSION Rituximab combined with CHOP-like chemotherapy improved the prognosis of DLBCL patients. The IFN may help to improve the quality and duration of response of DLBCL patients treated with rituximab and CHOP-like regimen.

Treatment of aggressive pancreatic solid pseudo-papillary neoplasms with apatinib plus S-1 chemotherapy:A case report and literature review

Solid pseudopapillary neoplasm(SPN) is a rare indolent pancreatic neoplasm that occurs mostly in females. Although the malignancy potential is quite limited for SPN, these tumors can sometimes be aggressive and lead to inferior prognosis for male patients. In this case report, we present a special case of a male patient with SPN who experienced an aggressive tumor expansion after two surgical resections. For further treatment, we decided to administer chemotherapy with apatinib and S-1, and subsequent CT/MRI tumor monitoring indicated satisfactory control of tumor expansion. The effectiveness of apatinib plus the S-1 regimen should be tested for more patients with SPN in the future.

Observation of the Curative Effect of Mabthera in Combination with the CHOP Regimen in Treating Invasive B-Cell Lymphoma:A Report of 45 Cases

OBJECTIVE To observe the clinical efficacy and toxic effects of Mabthera （rituximab） in combination with the CHOP （R-CHOP） regimen for treating invasive B-cell non-Hodgkin＇s lymphoma. METHODS A total of 45 patients with CD20 positive B-cell non- Hodgkin＇s lymphoma were randomly divided into the R-CHOP （22 cases） and CHOP groups （23 cases for controls）. They received the regimens of Mabthera in combination with CHOP or single CHOP therapy respectively. An appraisement of the curative effect could only be performed following 4 cycles of chemotherapy for the 45 patients. Follow-up was conducted to observe the conditions of survival. RESULTS The rate of complete remission （CR） in the R-CHOP group was 68.2%, with a total effective rate of 81.8%, and in the CHOP group these rates were 34.8% and 78.3% respectively. There was a significant difference in comparing the CR rates between the two groups （P 〈 0.05）. The 1, 2 and 3-year overall survival （OS） rates of the RCHOP group were 90.9%, 81.8% and 77.3%, respectively. In the CHOP group, the OS rates were respectively 91.3%, 69.5% and 47.8%. The difference in the 3-year OS between the two groups was significant （P 〈 0.05）. The toxic effects of the two groups were mainly a slight and moderate bone marrow depression and a gastrointesinal reaction, with similar tolerable toxic effects in the two groups （P 〉 0.05）. Adverse effects related to the Mabthera infusions occurred in 6 cases of the R-CHOP group （27.2%）. These effects lessened after symptomatic treatment. CONCLUSION The therapeutic regimen of Mabthera, in combination with CHOP （R-CHOP） has an obvious curative effect for treating invasive B-cell non-Hodgkin＇s lymphoma, with a favorable tolerance. It is highly recommended as the treatment of choice.

Unusual Presentation of Non-Hodgkin’s B-Cell Lymphoma with Unilateral Right Limb Lymphedema

Background: In clinical practice and setting of general practice it is common to see patients with leg edema. To correctly identify the etiology of the edema and then properly manage the cause is not always easy. The unilateral lymphedema of the lower limb has rarely been reported as an initial presentation for lymphoma, especially in females, usually without classic signs or symptoms, but often with inguinal lymphadenopathy or abdominal masses. Case Report: In this article, we report a rare case of unilateral lower limb edema in a healthy obese woman who complained about the appearance of the disease for several months and for whom deep vein thrombosis and other diseases had been excluded. The histological examination of the biopsy of an enlarged lymph node in the right groin, which was compressing the iliac and femoral vein, revealed the presence of B cell non-Hodgkin lymphoma with high-grade malignancy. Conclusions: A common challenge for primary care physicians is to determine the cause and find an effective treatment for leg edema of unclear etiology. Non-Hodgkin’s B-cell Lymphoma should be considered in the differential diagnosis in patients with unilateral leg edema when the swelling is chronic and deep venous thrombosis is promptly excluded.

Rare Primary Diffuse Large B-Cell Lymphoma of a Male Breast

Background: Breast lymphomas are typical extranodal types of lymphoma, also known as Extranodal-lymphoma (ENL), which occur extremely infrequently, aggregating into a very small proportion of malignant breast tumors. The rarity of breast lymphomas is attributed to the scant lymphoid tissue content of the chest wall. Aims of Study: This case report is aimed at providing an up-to-date review of the literature on breast lymphomas for clinicians to, therefore, consider the possibility of this disease entity while treating a breast mass. Case Presentation: A case was reported of a 52-year man with chief mammary non-Hodgkin breast ENL when fine-needle aspiration cytology (FNAC) was not leading to a firm conclusion or result. Following an incisional biopsy, he was found to have a primary breast lymphoma. Later, the patient was diagnosed with the diffuse large B-cell type of lymphoma also known as non-Hodgkin’s Lymphoma (NHL). He had a complete reduction and disappearances of all the signs and symptoms of the disease after a course of neoadjuvant chemotherapy: Cyclophosphamide, Doxorubicin, Vincristine and Prednisolone (CHOP). CONCLUSION: Based on the above case presentation, it is vital for health care professionals and oncologists to recognize the disease by assessing the breast mass accurately with more entities so that proper diagnosis via core biopsy (incisional biopsy) can eliminate the PBL before further treatment is required.

Solid pseudopapillary tumor of the pancreas:A systematic review of clinical,surgical and oncological characteristics of 1384 patients underwent pancreatic surgery

Background:Pancreatic solid pseudopapillary tumors(SPTs)are rare clinical entity,with low malignancy and still unclear pathogenesis.They account for less than 2%of exocrine pancreatic neoplasms.This study aimed to perform a systematic review of the main clinical,surgical and oncological characteristics of pancreatic SPTs.Data sources:MEDLINE/PubMed,Web of Science and Scopus databases were systematically searched for the main clinical,surgical and oncological characteristics of pancreatic SPTs up to April 2021,in accordance with the preferred reporting items for systematic reviews and meta-analyses(PRISMA)standards.Primary endpoints were to analyze treatments and oncological outcomes.Results:A total of 823 studies were recorded,86 studies underwent full-text reviews and 28 met inclusion criteria.Overall,1384 patients underwent pancreatic surgery.Mean age was 30 years and 1181 patients(85.3%)were female.The most common clinical presentation was non-specific abdominal pain(52.6%of cases).Mean overall survival was 98.1%.Mean recurrence rate was 2.8%.Mean follow-up was 4.2 years.Conclusions:Pancreatic SPTs are rare,and predominantly affect young women with unclear pathogenesis.Radical resection is the gold standard of treatment achieving good oncological impact and a favorable prognosis in a yearly life-long follow-up.

20(s)-原人参二醇对前列腺癌RM-1细胞的生长抑制作用及其机制

目的:观察20(s)-原人参二醇(PPD)对前列腺癌RM-1细胞生长的影响,并探讨其作用机制。方法:建立前列腺癌RM-1细胞动物模型,将36只C57小鼠随机分为3组:模型组(橄榄油等体积灌胃每天1次、生理盐水等体积腹腔注射每周1次),紫杉醇(Taxol)组(20mg.kg-1,腹腔注射每周1次),PPD组(20mg.kg-1,灌胃每天1次),连续给药4周。每隔3d测量肿瘤体积1次,给药第4周末处死动物。观察指标:动物一般状态、肿瘤体积、瘤重、抑瘤率、死亡率,采用RT-PCR和Western blotting法检测肿瘤组织Cyclin D1蛋白表达水平。结果:PPD组小鼠一般状态明显好于模型组,表现为活泼好动、毛色光亮;而模型组小鼠步履蹒跚、行动迟缓、精神萎靡;肿瘤组织出现破溃、糜烂、出血。给药13d时,PPD组小鼠肿瘤体积明显减小(P<0.05);21d时PPD组肿瘤体积明显小于Taxol组(P<0.05)。与模型组比较,PPD组小鼠瘤质量明显降低(P<0.05),死亡率为零;与Taxol组比较,PPD组小鼠抑瘤率增高(P<0.05),死亡率降低(P<0.05)。各给药组小鼠肿瘤组织Cyclin D1基因转录、蛋白表达水平均明显低于模型组(P<0.05),与Taxol组比较,PPD组Cyclin D1基因转录明显减弱(P<0.05),而蛋白表达水平差异无显著性(P>0.05)。结论:PPD有明显抑制前列腺癌RM-1细胞生长的作用,其作用机制可能与下调Cyclin D1蛋白表达有关。

大肠癌Fas、FasL表达、突变与肝转移关系的研究

探讨Fas、FasL系统表达、突变与大肠癌转移的关系。方法 :采用RT -PCR和PCR -SSCP方法检测大肠癌原发灶、肝转移灶、癌旁肠粘膜、门静脉血淋巴细胞中Fas、FasL表达、突变。结果 :在 86例大肠癌原发灶、肝转移灶、癌旁肠粘膜、门静脉血淋巴细胞中Fas表达阳性率分别为 67.4 % ,63 .2 % ,4 1.9% ,87.2 %。Fas突变率分别为 50 .0 % ,70 .8% ,2 5.% ,8.0 %。在大肠癌原发灶、肝转移灶中Fas突变率较高 (P <0 .0 1)。3 8例肝转移灶中全部有FasL表达 ,而在原发灶、癌旁肠粘膜、门静脉血淋巴细胞中FasL表达阳性率分别为2 5.6% ,14 .0 % ,50 .0 %。肝转移灶中FasL表达高于其它组织 (P <0 .0 1)。结论 :Fas突变和FasL增强表达是大肠癌细胞逃避免疫监视和杀伤并发生肝转移的机制之一。

乳腺癌患者手术前后血清S-CD105的表达及相关因素分析

目的探讨乳腺癌患者手术前、后血清S-CD105的表达情况及其影响因素。方法用酶联免疫吸附实验(ELISA)检测37例乳腺癌,10例乳腺良性肿瘤患者及10位健康成年女性血清S-CD105的浓度。结果乳腺癌患者血清S-CD105浓度明显高于乳腺良性肿瘤患者及健康女性(P=0.021);手术前组血清S-CD105浓度明显高于术后30天组(P=0.000);术后30天组血清S-CD105浓度与乳腺良性肿瘤患者及健康女性之间无差异(P=0.311);进一步研究发现:肿瘤最大直径>5cm、淋巴结转移≥4枚、临床TNM分期Ⅱ期以上以及肿瘤组织血管内皮生长因子(VEGF)表达强阳性的患者,血清S-CD105浓度均明显升高(P<0.05);1例骨转移患者血清S-CD105浓度明显升高。结论手术前乳腺癌患者血清S-CD105表达明显升高,且与肿瘤大小、淋巴结转移、临床分期以及肿瘤组织中VEGF表达水平明显相关,表明其具有评价预后的临床价值。1例术后骨转移患者血清S-CD105浓度显著升高,表明其可能具有监测复发和转移的临床价值,有待于进一步研究。

GSTT1和GSTM1基因缺失多态与胃癌易感性

目的 探讨与致癌物解毒有关的谷胱甘肽转硫酶 (GST) T1和 M1基因遗传缺失多态与胃癌易感性的关系。方法 采用病例对照分子流行病学研究方法 ,以 PCR技术对福建省福州市 92例胃癌病例和 92例正常对照者的 GSTT1和 GSTM1基因型进行检测。结果 GSTT1基因在胃癌病例和对照组中的缺失率分别为 5 3.3%和41.3% ,差异无显著性 (x2 =2 .6 4,P=0 .10 4)。而 GSTM1基因在胃癌病例和对照组中的缺失率分别为 6 9.6 %和5 2 .2 % ,差异具有显著性 (x2 =5 .84,P=0 .0 15 7)。携带 GSTM1(- )基因型者发生胃癌的危险性是携带 GSTM1(+)基因型者的 2 .1倍 (OR=2 .10 ,95 % CI=1.10～ 4.0 1)。联合分析表明 ,GSTT1和 GSTM1基因之间可能存在联合作用 ,携带 GSTT1(- )和 GSTM1(- )基因型者发生胃癌的危险性高于携带 GSTT1(+)和 GSTM1(+)基因型者 (OR=4.6 7,95 % CI=1.5 5～ 14.41)。结论

荷S-180移植瘤小鼠血清干扰素γ含量的变化及免疫调节药物的干预作用

目的研究荷S-180肉瘤小鼠血清干扰素γ(IFN-γ)含量的变化,并采用具有调节免疫功能的药物进行干预,探讨内源性IFN-γ在抗小鼠移植瘤方面的意义。方法建立荷S-180实体瘤小鼠动物模型,分别用灵芝多糖(GLP)、环孢素A(CsA)灌胃给药,每天1次,连续9d,用ELISA试剂盒检测小鼠血清中IFN-γ的含量,并分离肿瘤称重。结果首次发现荷S-180实体瘤小鼠血清中IFN-γ含量在所观察的接种后20d内随荷瘤时间的延长而升高。GLP(400、200、100mg/kg)使荷瘤小鼠血清中的IFN-γ含量增加、肿瘤重量减轻,但增加IFN-γ含量以高剂量最为明显,抑瘤效应以中剂量最佳,两者之间相关关系无统计学意义。CsA(20、10、5mg/kg)可降低荷瘤小鼠血清中IFN-γ的含量,但对肿瘤重量无明显影响,两者之间无相关关系。结论灵芝多糖增加荷瘤小鼠血清中IFN-γ含量与抑瘤效应无明显相关,环孢素A降低荷瘤小鼠血清中IFN-γ的含量对肿瘤重量无明显影响,提示内源性IFN-γ在抗小鼠S-180移植瘤方面并不是主要的免疫调节因素。

糜烂性食管炎、Barrett食管及食管腺癌中SOX2、CDX2的表达及其临床意义

目的探讨CDX2、SOX2在糜烂性食管炎、Barrett食管的3种不同组织类型(胃底型、贲门型、肠化生型)及食管腺癌(esophageal adenocarcinoma,EAC)中的表达及意义。方法采用免疫组化Eli Vision两步法检测CDX2和SOX2在35例贲门组、23例胃底组、14例肠化组、10例糜烂性食管炎组、7例EAC组、10例正常食管下段黏膜中的表达情况。结果 CDX2在肠化组及EAC组中的阳性率均为85.7%,显著高于其他四组(P<0.05);CDX2阳性率在贲门组(11.4%)、胃底组(0)、糜烂性食管炎组(0)及正常食管组(0)中的差异无显著性(P>0.05)。CDX2在贲门组(75%)及EAC组(66.7%)以(+)为主,差异无统计学意义(P>0.05),与肠化组(91.7%)以()为主显著不同(P<0.05)。SOX2在Barrett食管三组中的阳性率均为100%,显著高于EAC组(28.6%)(P<0.05)。SOX2以(++)表达方式在胃底组(95.7%)及贲门组(74.3%)中差异无统计学意义(P>0.05);显著高于肠化组(50%)和EAC组(50%)(P<0.05)。SOX2和CDX2的表达在肠化型Barrett食管中呈负相关(P<0.05),在贲门组、胃底组、EAC组中无明显相关(P>0.05)。结论短段贲门型Barrett食管中CDX2的阳性率不高,可能只是一种柱状上皮化生,与EAC的关系不大;CDX2在鳞状上皮向特殊肠上皮化生转化过程中发挥重要作用,SOX2的沉默促进EAC发生。