Genetic predisposition to Helicobacter pylori-induced gastric precancerous conditions

Gastric cancer is the most common malignancy of the gastrointestinal tract in East Asian populations and the second most frequent cause of cancer-related mortality in the world. While previous studies have investigated the genetic factors involved in gastric carcinogenesis, there still exist relatively few studies that have investigated the genetic traits associated with the risk of gastric precancerous conditions. In this paper we will review the biology and genetic polymorphisms involved in the genesis of gastric precancerous conditions reported to date and discuss the future prospects of this field of study. The associations of gastric precancerous conditions with polymorphisms in the cytotoxin-associated gene A-related genes (e.g. PTPN11 G/A at intron 3, rs2301756), those in the genes involved in host immunity against Helico-bacter pylori (H. pylori) infection (e.g.TLR4 +3725G/C, rs11536889) or polymorphisms of the genes essential for the development/ differentiation of the gastric epithelial cells (e.g. RUNX3 T/A polymorphism at intron 3, rs760805) have been reported to date. Genetic epide-miological studies of the associations between H. pylori-induced gastric precancerous conditions and other gene polymorphisms in these pathways as well as polymor-phisms of the genes involved in other pathways like oxidative DNA damage repair pathways would provide useful evidence for the individualized prevention of these H. pylori-induced gastric precancerous conditions.

Gastric epithelial histology and precancerous conditions

The most common histological type of gastric cancer(GC)is gastric adenocarcinoma arising from the gastric epithelium.Less common variants include mesenchymal,lymphoproliferative and neuroendocrine neoplasms.The Lauren scheme classifies GC into intestinal type,diffuse type and mixed type.The WHO classification includes papillary,tubular,mucinous,poorly cohesive and mixed GC.Chronic atrophic gastritis(CAG)and intestinal metaplasia are recommended as common precancerous conditions.No definite precancerous condition of diffuse/poorly/undifferentiated type is recommended.Chronic superficial inflammation and hyperplasia of foveolar cells may be the focus.Presently,the management of early GC and precancerous conditions mainly relies on endoscopy including diagnosis,treatment and surveillance.Management of precancerous conditions promotes the early detection and treatment of early GC,and even prevent the occurrence of GC.In the review,precancerous conditions including CAG,metaplasia,foveolar hyperplasia and gastric hyperplastic polyps derived from the gastric epithelium have been concluded,based on the overview of gastric epithelial histological organization and its renewal.

Determination of an Appropriate Endoscopic Monitoring Interval for Patients with Gastric Precancerous Conditions in China

Objective Gastric precancerous conditions such as atrophic gastritis(AG)and intestinal metaplasia(IM)are considered independent risk factors for gastric cancer(GC).The suitable endoscopic monitoring interval is unclear when we attempt to prevent GC development.This study investigated the appropriate monitoring interval for AG/IM patients.Methods Totally,957 AG/IM patients who satisfied the criteria for evaluation between 2010 and 2020 were included in the study.Univariate and multivariate analyses were used to determine the risk factors for progression to high-grade intraepithelial neoplasia(HGIN)/GC in AG/IM patients,and to determine an appropriate endoscopic monitoring scheme.Results During follow-up,28 AG/IM patients developed gastric neoplasia lesions including gastric low-grade intraepithelial neoplasia(LGIN)(0.7%),HGIN(0.9%),and GC(1.3%).Multivariate analysis identified H.pylori infection(P=0.022)and extensive AG/IM lesions(P=0.002)as risk factors for HGIN/GC progression(P=0.025).Conclusion In our study,HGIN/GC was present in 2.2%of AG/IM patients.In AG/IM patients with extensive lesions,a 1–2-year surveillance interval is recommended for early detection of HIGN/GC in AG/IM patients with extensive lesions.

A preliminary study on ras protein expression in human esophageal cancer and precancerous lesions

INTRODUCTIONThe esophageal carcinoma is a common malignanttumor in Linzhou City (Linxian) of Henan Provincein northern China.Although the etiology andnatural history of csophageal carcinoma are notclear,a substantial amount of evidence has beenprovided to suggest that the development of humanesophageal squamous cell carcinomas (SCC) is amultistage progressive process.An

Clinical and experimental study of therapeutic effect of Weixibaonizhuan pills on gastric precancerous lesions

IMS To observe the therapeutic effect of Weixibaonizhuan pills on gastric precancerous lesions.METHODS Thirty patients with gastric precancerous lesions were treated with Weixibaonizhuan pills for 3 months. Of the 36 cases, 13 (361%) were mild atrophic gastritis, 14 (389%) moderate atrophic gastritis and 9 (250%) severe atrophic gastritis; among them 22 (611%) and 27 cases (750%) were accompanied with intestinal metaplasia (IM) and dysplasia (DYS) respectively. Of the 36 patients, 20 were men and 16 women, aged from 30-60 years and those aged 30-59 years accounted for 611%. The course of disease ranged from 3 months to 21 years, and 20 (556%) of them had a course of 5-10 years. The clinical manifestations were fullness of the abdomen (31 cases), abdominalgia (27 cases), anorexia (30 cases), gas eructation (26 cases), acid regurgitation (6 cases) and loose stool (9 cases). When treatment ended, the improvement of patients′ clinical symptoms, atrophy of gastric mucosa, IM and DYS were analysed.RESULTS After 3 months′ treatment with Weixibaonizhuan pills, 7 cases recovered, 11 cases were much improved, 13 cases showed some improvement, and 5 cases were ineffective; the total rate of symptomatic improvement was 861%. Of the 13 cases with mild atrophic gastritis, 11 cases changed into superficial gastritis, and 2 cases had no changes. Of the 14 cases of moderate atrophic gastritis, 4 cases changed into superficial gastritis, 7 cases changed into mild atrophic gastritis, and 3 cases had no changes. Five of 9 cases of severe atrophic gastritis were reduced to moderate atrophic gastritis, and 4 cases had no changes. The total effective rate was 778% in chronic atrophic gastritis. Of the 9 cases with mild IM, IM disappeared in 6 cases and 3 showed no change. Of the 10 cases with moderate IM, it disappeared in 2 cases, 5 cases changed to mild IM, and 3 cases had no change. One of the 4 cases of severe IM changed to moderate IM and 3 had no change. The total effective rate was 636% in IM. Of the 16 cases of mild DYS, 11 cases showed disappearance of DYS and 5 had no change. In 9 cases of moderate DYS, 2 showed disappearance, 5 changed to mild DYS and 2 had no change. Two cases of severe DYS, both showed no change. The total effective rate was 667% in DYS. Before treatment, the Ⅰ, Ⅱ, Ⅲ and Ⅳ degree positive expressions of CEA were present in 13, 12, 9 and 2 cases, respectively, whereas after treatment, the positive expressions were present in 25, 7, 3 and 1, respectively. Before treatment, the Ⅰ, Ⅱ, Ⅲ and Ⅳ degree positive expressions of PCNA were present in 16, 11, 10 and 4 respectively, but after treatment, they were present in 21, 9, 5 and 1 respectively. In short, the positive expressions of CEA and PCNA of gastric mucosa were significantly decreased after treatment (P<001).CONCLUSION Weixibaonizhuan pill has a therapeutic effect in gastric precancerous lesions..

Effect of garlic and garlic-green tea mixture on serum lipids in MNNG-induced experimental gastriccarcinoma and precancerous lesion

ＥｆｅｃｔｏｆｇａｒｌｉｃａｎｄｇａｒｌｉｃｇｒｅｅｎｔｅａｍｉｘｔｕｒｅｏｎｓｅｒｕｍｌｉｐｉｄｓｉｎＭＮＮＧｉｎｄｕｃｅｄｅｘｐｅｒｉｍｅｎｔａｌｇａｓｔｒｉｃｃａｒｃｉｎｏｍａａｎｄｐｒｅｃａｎｃｅｒｏｕｓｌｅｓｉｏｎＳＵＱｉ，ＬＵＯＺｈ...

Tumor suppressor gene p16 and Rb expression in gastric cardia precancerouslesions from subjects at a high incidence area in northern China

AIM:To further understand the molecular basis for gastric cardia carcinogenesis and to provide etiological clues. METHODS: Endoscopic mucosa biopsy and histopathological examinations were made on 37 subjects from a high incidence area for both esophageal and gastric cardia carcinomas in northern China. All the biopsy samples were fixed in 850 ml. (-1)L alcohol and embedded in paraffin. Each block contained one piece of tissue and was serially section at 5 microm. Immunohistochemistry (ABC) was carried out on these gastric cardia samples to determine the alterations of p16 and Rb. RESULTS: Based on the histopathlogical examination there were 11 cases of chronic superficial gastritis, 12 cases of chronic atrophic gastritis and 14 cases of dysplasia. The immunostaining demonstrated different levels of unclear immunostaining of p16 and Rb in normal gastric cardia tissue and the tissues with different severity of lesions. With the lesions progressing, the positive immunostaining rates for p16 protein had a decreasing tendency. In contrast, the positive immunostaining rate for Rb protein had an increasing tendency. There was a significant negative relationship between the two parameters. Changes of p16 was CSG 11(100%), CAG 7(58%), DYS 4(29%) and changes of Rb was CSG 2(18%), CAG 8(67%) and DYS 12(86%), (P【0.05). CONCLUSION: The alterations of p16 and Rb protein may play a role in the early stages of gastric cardia carcinogenesis.

Expression of bcl-2 oncogene in gastric precancerous lesions and its correlation with syndromes in traditional Chinese medicine

AIM: To observe the protein and mRNA expression of bcl-2 oncogene in gastric precancerous lesions (GPL) and to analyze its correlation with syndromes in traditional Chinese medicine (TCM). METHODS: Sixty-seven patients with GPL confirmed by gastroscopy and pathology were studied,including 39 cases of moderate gastric mucosal dysplasia,19 cases of severe gastric mucosa dysplasia, 9 cases of incomplete colon metaplasia. In syndrome differentiation of TCM,17 cases belonged to the syndrome of qi and yin deficiency of the spleen and stomach complicated by qi stagnation, 21 cases belonged to the syndrome of qi and yin deficiency of the spleen and stomach complicated by stomach heat, 29 cases belonged to the syndrome of qi and yin deficiency of the spleen and stomach complicated by blood stasis. Protein and mRNA expression of bcl-2 oncogene were detected by labeled streptavidin biotin (LSAB) immunohist-ochemistry and in situ hybridization respectively. RESULTS: Abnormal expression of protein and mRNA on bcl-2 oncogene was found in GPL,which increased gradually with the course of lesions. In moderate and severe gastric mucosal dysplasia and incomplete colon metaplasia,there was no difference in the expression of bcl-2 oncogene (P>0.05).In different accompanying syndromes, the expression of protein and mRNA on bcl-2 oncogene increased gradually in the following order: deficiency of both qi and yin of the spleen and stomach accompanying qi stagnation→stomach heat→blood stasis. In GPL, compared with accompanying blood stasis, there was an obvious difference in the expression of bcl-2 oncogene between the syndrome of qi and yin deficiency of the spleen and stomach and accompanying stomach heat, so did accompanying qi stagnation (the level of protein: X2=8.45, P<0.05;the level of mRNA: X2=7.35, P<0.05). CONCLUSION: Apoptosis-associated bcl-2 oncogene is abnormally expressed in GPL,which correlates with different accompanying syndromes in TCM.

Possibility of non-invasive diagnosis of gastric mucosal precancerous changes

AIM: To assess the possibility of non-invasive screening of atrophic chronic gastritis for preventing further development of gastric cancer.METHODS: One hundred and seventy-eight consecutive Helicobacter pylori ( H pylori)-positive dyspeptic patients after detection of serum levels of pepsinogen-1 (PG-1) and gastrin-17 (G-17) by enzyme immunoassay were proposed for endoscopy and histology. The serologic and morphologic results were compared with estimating the sensitivity, specificity and prognostic values of the tests.RESULTS: There was statistically significant reverse dependence between the grade of stomach mucosal antral or corpus atrophy and the proper decreasing of serum G17 or PG1 levels. The serologic method was quite sensitive in the diagnosis of non-atrophic and severe antral and corpus gastritis. Also, it was characterized by the high positive and negative prognostic values.CONCLUSION: Detection of serum G-17 and PG1 levels can be offered as the screening tool for atrophic gastritis. The positive serologic results require further chromoendoscopy with mucosal biopsy, for revealing probable progressing of atrophic process with development of intestinal metaplasia, dysplasia or gastric cancer.

Effect of garlic on micronucleus frequency of peripheral blood lymphocytes in MNNG-induced gastric carcinoma and precancerous lesion in rats

IM To investigate the effects of garlic on micronuclei frequency (MNF) of peripheral blood lymphocytes (PBL) in gastric carcinoma (GC) and precancerous lesion (PL) in Wistar rats induced by NmethylN′nitroNnitrosoguanidine (MNNG). METHODS Gastric carcinoma and precancerous lesions were induced by MNNG 125mg/5ml per day for 10 months. 10% garlic 10ml per day were given to the experimental group, and running water to control group. MNF of PBL in the control CG (n=16), MNNG (n=30), prevention (n=30) and treatment groups (n=20) were detected at 10 and 16 months by the technic of micronucleus cell culture. RESULTS MNF of MNNG group at the 10th and 16th month was similar; that of MNNG, GC and PL was remarkably higher than the control group (P<001), respectively; and that of PL was lower than GC (P<001). MNF of prevention and treatment groups was decreased, with significant difference from MNNG group (P<001). MNF of the prevention group at the 16th month was lower than that at the 10th month (P<001), the difference between the prevention and treatment groups was not significant. CONCLUSION MNNG was a continuous mutagenicity and carcinogenicity, and garlic has a remarkable antimutagenic and anticarcinogenic effect. The micronucleus frequency of PBL may be a new marker of earlystage gastric carcinogenesis.

Effects of San Qi on Gastric Secretion and Protective Factors of Gastric Mucosa in the Rat with Precancerous Lesion of Stomach

In the model rat with precancerous lesion of stomach induced by the combined method of insertion of a spring into the pylorus and high salt hot paste,effects of San Qi (三七 Radix Notoginseng) on gastric secretion and protective factors of stomach were investigated.The results indicated that gastric secretion,gastric mucosal blood flow (GMBF) and aminohexose content lowered significantly,and malondialdehyde (MDA) increased significantly (P<0.01) in the model group as compared with the normal group;after treatment with San Qi Powder for 12 weeks,both gastric secresion and GMBF increased,and MDA content decreased as compared with the negative control group (P<0.01),with no significant increase of aminohexose content.It is suggested that San Qi (三七 Radix Notoginseng) may improve gastric secretion,and that increase of GMBF and antagonism against the lesion of oxygen free radicals are possibly one of its mechanisms.

Life Is Quantum Biology Effects Explained from the Schrödinger Equation, Serious or Life-Threatening Conditions or Diseases, and COVID-19 Results

Background: A plant based approach was undertaken to ascertain the efficacy of the Technology/Innovation of a new medical Technology based on similar activity to the circulatory system of plants. Basic Technology formulations were introduced into plant structures to evaluate the responses for cell division and plant growth which ultimately lead to the final product. This Technology/Innovation transforms and enhances common botanical/herb products such that they can be used to treat COVID-19 infection and Serious or Life-threatening conditions or diseases. They can restore the diseased cell’s abnormal metabolism to homeostasis and return it to normal function by slowing or reversing the cell’s malfunctioning metabolism, or in other words, slowing or reversing the disease process. Methods: A systematic treatment for COVID-19 infection and Serious or Life-threatening illness in patients is based on theories of traditional Chinese medicine. The Technology/Innovation is developed as dietary supplement products for treatment of Serious or Life-threatening conditions or diseases. Results: The results consist of over one hundred Serious or Life-threatening patient medical records. The U.S. Food and Drug Administration (FDA) reviewed/evaluated/accepted the Technology/Innovation patient medical record results, which included fifty-four COVID-19 patients with Prioritized Review Expedited No.: 2020-2867 CR2020-2596 information on September 16, 2020 and twenty-seven cancer patients Cancer Survival Rate Results in (Table 1) with FDA Establishment Identification No.: 3012327979 information on March 25, 2019 as FDA-Regulated medical products and meet the requirement under FDA Significant Scientific Agreement standards.

Relationship between gastric cancer and precancerous lesions

ＲｅｌａｔｉｏｎｓｈｉｐｂｅｔｗｅｅｎｇａｓｔｒｉｃｃａｎｃｅｒａｎｄｐｒｅｃａｎｃｅｒｏｕｓｌｅｓｉｏｎｓＭＡＪｕｎＬｉｎｇ１，ＬＩＵＷｅｉＤｏｎｇ２，ＺＨＡＮＧＺａｉＺｈｅｎ１，ＺＨＡＮＧＬｉａｎ３，ＹＯＵＷｅｉＣｈｅｎｇ３ａｎｄＣＨＡＮ...

ESD与EMR治疗早期结直肠癌、癌前病变的手术效果及并发症观察

目的探究内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)与黏膜切除术(endoscopic mucosal resection,EMR)对早期结直肠癌、癌前病变患者的手术效果及并发症的影响。方法回顾性我院治疗的早期结直肠癌、癌前病变患者120例,根据手术方式分组,对照组55例,观察组65例。对照组行EMR治疗,观察组行ESD手术。对2组患者的手术指标进行比较,观察两组术前及术后7 d的氧化应激水平,术后对患者进行6个月随访,比较其术前及术后的生活质量水平,统计患者术后发生穿孔、感染及出血的情况,并记录患者术后6个月内是否复发。结果与对照组相比,观察组手术时间较长,术中出血量较多,切除的标本厚度及创面直径均大于对照组,差异均有统计学意义(P<0.05)。观察组病灶整块切除率及治愈性切除率与对照组比较,差异无统计学意义(P>0.05)。治疗后,患者的丙二醛(malondialdehyde,MDA)、氧化型谷胱甘肽(glutathione disulfide,GSSG)、皮质醇(cortisol,Cor)水平均有所上升,与术前比较差异有统计学意义(P<0.05),但2组比较差异无统计学意义(P>0.05)。2组术前的生活质量各维度评估结果差异无统计学意义(P>0.05)。经治疗,对患者术后3个月的生活质量再次评估,其生活质量评分均有提高,且观察组患者的升高幅度高于对照组(P<0.05)。观察组穿孔、术中出血、感染的发生率为12.31%,低于对照组(34.55%),术后6个月内,观察组复发1例(1.54%),与对照组复发率(8例14.55%)比较,差异有统计学意义(P<0.05)。结论与EMR相比,对早期结直肠癌、癌前病变患者行ESD治疗,操作难度较大,手术时间较长,但患者术后氧化应激水平变化相当,可以有效降低患者术后复发率,改善术后并发症的发生情况,提高患者生活质量。

声带癌前病变组织中基质金属蛋白酶抑制剂-1、果蝇母亲DDP同源物4表达水平与术后复发和恶变的相关性研究

目的探讨声带癌前病变组织中基质金属蛋白酶抑制剂-1(tissue inhibitor of metalloproteinases 1,TIMP-1)、果蝇母亲DDP同源物4(drosophila mothers against DDP homolog 4,Smad4)表达水平与术后复发和恶变的相关性。方法回顾性分析2018年8月~2021年8月郑州大学第一附属医院收治的162例声带癌前病变患者的临床和病理资料,收集手术切除癌前病变组织(癌前病变组)及病变旁正常黏膜组织(对照组),采用免疫组织化学法检测组织中TIMP-1、Smad4表达情况。分析TIMP-1、Smad4阳性率与临床病理特征的关系,并采用Kaplan-Meier法和Cox回归分析法分析其对术后复发和恶变的影响。结果与对照组正常黏膜组织比较,癌前病变组的TIMP-1阳性率较高,Smad4阳性率较低(P<0.05)。不同病变范围、是否累及前连合、不同程度上皮异常增生患者的TIMP-1、Smad4阳性率存在差异(P<0.05)。术后随访时间24~60个月,中位随访时间36个月,随访期间失访患者6例,随访率96.30%(156/162),随访期间术后复发35例(21.60%),术后恶变16例(9.88%);Kaplan-Meier生存分析显示,TIMP-1阳性患者术后复发率和恶变率高于TIMP-1阴性患者(P<0.05);Smad4阴性患者术后复发率和恶变率高于Smad4阳性患者(P<0.05)。多因素Cox回归分析显示,喉咽反流、病变范围>1/2、中/重度异型增生、TIMP-1阳性、Smad4阴性是复发的独立危险因素(P<0.05),年龄>60岁、累及前连合、TIMP-1阳性、Smad4阴性是恶变的独立危险因素(P<0.05)。结论声带癌前病变组织中TIMP-1高表达、Smad4低表达,且TIMP-1阳性、Smad4阴性表达者术后复发和恶变风险较高。

miR-26a、miR-663联合幽门螺旋杆菌对老年胃癌癌前病变诊断价值

目的探讨分析微小RNA-26a(microRNA-26a,miR-26a)、微小RNA-663(microRNA-663,miR-663)联合幽门螺旋杆菌对老年胃癌癌前病变诊断价值。方法连续入选经胃镜及病理学检查确诊的胃部良性病变、癌前病变或早期胃癌的老年患者136例作为研究对象。采用实时荧光定量聚合酶链反应检测其血清miR-26a、miR-663表达,并采用13 C尿素呼气试验检测幽门螺旋杆菌阳性情况,分析miR-26a、miR-663和幽门螺旋杆菌及联合检测对胃良性病变、癌前病变及早期胃癌等不同病变程度的诊断价值,并绘制(receiver operating characteristic curves,ROC)曲线,评估其诊断准确性。结果胃良性病变、癌前病变、早期胃癌患者性别、年龄、体重指数、吸烟史、饮酒史差异无统计学意义(P>0.05);而胃癌前病变和早期胃癌患者胃癌家族史高于良性病变患者(P<0.05),而癌前病变和早期胃癌患者胃癌家族史差异无统计学意义(P>0.05)。胃癌前病变和早期胃癌患者血清miR-26a、miR-663表达量低于胃良性病变患者,早期胃癌患者血清miR-26a、miR-663表达量低于癌前病变患者,幽门螺旋杆菌阳性率高于胃良性疾病患者(P<0.05),而癌前病变和早期胃癌患者幽门螺旋杆菌阳性率差异无统计学意义(P>0.05)。三者联合检测的敏感度显著高于单一miR-26a检测(χ^(2)=4.680,P=0.031)、单一miR-663检测(χ^(2)=8.223,P=0.004)、单一幽门螺旋杆菌检测(χ^(2)=6.363,P=0.012)。血清miR-26a截断值为2.63时诊断老年胃癌癌前病变的ROC曲线下面积为0.79(95%CI:0.774~0.856),此时的敏感度和特异度分别为75.43%和79.85%;血清miR-663截断值为4.35时诊断老年胃癌癌前病变的ROC曲线下面积为0.83(95%CI:0.796~0.875),此时的敏感度和特异度分别为81.37%和78.56%;幽门螺旋杆菌诊断老年胃癌癌前病变的ROC曲线下面积为0.72(95%CI:0.648~0.769),此时的敏感度和特异度分别为68.93%和78.45%;三者联合诊断老年胃癌癌前病变的ROC曲线下面积为0.89(95%CI:0.815~0.873),此时的敏感度和特异度分别为89.72%和74.43%。结论miR-26a、miR-663联合幽门螺旋杆菌对老年胃癌癌前病变具有较高诊断价值,联合诊断有助于提高诊断敏感度,进而为老年胃癌早期诊断提供指导依据。

加味蜀羊泉散对湿热下注型宫颈鳞状上皮内病变合并高危型人乳头瘤病毒感染术后患者免疫功能及阴道微生态的影响

目的观察加味蜀羊泉散对湿热下注型宫颈鳞状上皮内病变(SIL)合并高危型人乳头瘤病毒(HR-HPV)感染术后患者免疫功能及阴道微生态的影响。方法将112例湿热下注型SIL合并HR-HPV感染宫颈环形电切术(LEEP)患者按照随机数字表法分为2组,对照组56例术后予重组人干扰素α-2b阴道泡腾胶囊治疗,治疗组56例术后在对照组治疗基础上应用加味蜀羊泉散治疗,2组均连续治疗3个月。比较2组术后6个月疗效;比较2组术前、术后6个月中医证候评分、免疫功能、阴道微生态指标变化。结果治疗组中途退出2例,对照组中途退出2例、病例资料缺失2例,最终治疗组54例、对照组52例完成研究。治疗组总有效率92.59%(50/54),对照组总有效率73.08%(38/52),治疗组疗效优于对照组(P<0.05)。2组术后6个月各项中医证候评分及总评分均较本组术前降低(P<0.05);治疗组术后6个月带下量多、色黄或兼绿、质稠或似泡沫、气秽或臭、阴户灼热瘙痒评分及总评分均低于对照组(P<0.05)。2组术后6个月免疫球蛋白(Ig)A、IgM、IgG、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较本组术前升高(P<0.05),CD8^(+)较本组术前降低(P<0.05);治疗组术后6个月IgA、IgM、IgG、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P<0.05),CD8^(+)低于对照组(P<0.05)。2组术后6个月菌群密集度(Ⅱ~Ⅲ级)、菌群多样性(Ⅱ~Ⅲ级)、乳酸菌(Ⅰ~Ⅱa级)均较本组术前升高(P<0.05),pH值较本组术前降低(P<0.05);治疗组术后6个月菌群密集度(Ⅱ~Ⅲ级)、菌群多样性(Ⅱ~Ⅲ级)、乳酸菌(Ⅰ~Ⅱa级)均高于对照组(P<0.05),pH值低于对照组(P<0.05)。结论加味蜀羊泉散治疗湿热下注型SIL合并HR-HPV感染术后患者,能改善患者临床症状,提高HR-HPV转阴率及疗效,可能与改善免疫功能、调节阴道微生态等因素有关。

胃癌及癌前病变hTERT的表达与细胞免疫功能

目的观察在胃癌及癌前病变组织中端粒酶催化亚单位hTERT的表达与患者细胞免疫功能,探讨hTERT及细胞免疫功能对胃癌诊断、治疗、预后的临床意义。方法用原位杂交方法对116例内镜胃粘膜活检标本的端粒酶催化亚单位hTERT、进行检测,包括慢性浅表性胃炎(CSG)30例,慢性萎缩性胃炎(CAG)27例、腺瘤型息肉8例、胃溃疡9例,胃癌(GC)42例,并按肿瘤部位、大体类型、有无淋巴结转移及分化程度分组,同时,用流式细胞技术(FCM)检测了30例慢性浅表性胃炎、27例慢性萎缩性胃炎、42例胃癌的外周血T淋巴细胞亚群及自然杀伤(NK)细胞,并与正常对照(NC)相比较。结果 CSG的hTERT阳性率为0％(0/30),癌前病变为36％(13/44),GC为86％(36/42)。胃癌组织hTERT阳性率与肿瘤部位、大体类型、有无淋巴结转移及分化程度无显著可关性,CSG组CD3^+,CD4^+较NC已有明显下降(P<0.05),CAG组T细胞功能(CD3^+,CD4^+,CD4^+/CD8^+)及NK各值较NC及CSG组均明显降低(P<0.05～0.01),GC组T细胞及NK细胞各值较CAG组显著异常(P<0.05-0.01),并随着胃癌进展,CD3^+,CD4^+,CD4^+/CD8^+各值进一步降低。结论端粒酶活化可能是胃粘膜癌变的关键步骤,胃粘膜活检标本hTERT的表达是胃癌癌变过程中重要的生物学标志物,胃癌和癌前病变患者细胞免疫功能低下,对胃癌的发生发展有重要意义。

新制抗癌方对AFB_1染毒的HBV转基因小鼠肝癌前病变组织PCNA、P21^(ras)和NF-KBP65表达的影响

Objectives:This study is to investigate the effects of new anti-tumor formular(NAF)on expression of PCNA,P21 ras and NF-KB P65 in liver precancerous lesions of HBV large envelope transgenic mice injected by aflatoxin B1(AFB1).Methods:The precancerous HBV large envelope transgenic mouse injected by AFB1 liver model was used.Mice was given water,NAF concentrated water solution throughout the whole experiment(48 weeks).PCNA,P21 ras and NF-KB P65 protein expression were detected by immunohistochemical method.Results: PCNA,P21 ras and NF-KB P65 expressions were significantly inhibited by NAF treatment.Conclusion NAF inhibited PCNA,P21 ras and NF-KB P65 protein expressions,therefore,NAF could show obvious effects on protecting against synergistic hepatoearcinogenesis of HBV and AFB1.

人乳头状瘤病毒负荷量与宫颈癌及宫颈癌前病变的相关研究

目的：探讨人乳头状瘤病毒（HPV）负荷量与子宫颈癌及其癌前病变的关系.方法：2003年3月～2003年12月在我院行宫颈癌筛查的2 651例患者为研究对象,采用杂交捕获2代（HCⅡ）方法定量检测宫颈HPV DNA的含量（以此表示宫颈HPV负荷量）.按HPV DNA含量分成5组,分别为：HPV＜1,1≤HPV≤100,101≤HPV≤500,501≤HPV≤1 000,HPV＞1 000.对其中HPV DNA阳性妇女,随后进行阴道镜检查、宫颈多点活检和颈管诊刮术.结果：794例阳性患者中的783例进行了阴道镜下多点活检和细胞学诊断,其中子宫颈炎650例（83.23%）,CIN 102例（13.47%）,宫颈癌26例（3.3%）.650例对照组、102例癌前病变组和26例宫颈癌组中,3组的HPV DNA定量总体分布有显著差别（P＜0.005）.在HPV-DNA定量＞100时,宫颈癌前病变的阳性率显著升高（P＜0.005）;当HPV-DNA的定量＞500时,宫颈癌的阳性率显著升高（P＜0.001）.CINⅡ、CINⅢ及宫颈癌在HPV DNA定量＞1时的诊断阳性率较显著＜1时显著高（P＜0.01）.结论：HCⅡ方法是检测宫颈HPV感染的有效手段,HPV DNA含量随宫颈病变的严重程度而增加,可作为宫颈癌前病变及宫颈癌的筛查及病情追踪监测的1项客观指标.