Differential analysis of lymph node metastasis in histological mixed-type early gastric carcinoma in the mucosa and submucosa

AIM To investigate the relationship between histological mixed-type of early gastric cancer(EGC) in the mucosa and submucosa and lymph node metastasis(LNM).METHODS This study included 298 patients who underwent gastrectomy for EGC between 2005 and 2012. Enrolled lesions were divided into groups of pure differentiated(pure D), pure undifferentiated(pure U), and mixed-type according to the proportion of the differentiated and undifferentiated components observed under a microscope. We reviewed the clinicopathological features, including age, sex, location, size, gross type, lymphovascular invasion, ulceration, and LNM, among the three groups. furthermore, we evaluated the predictors of LNM in the mucosa-confined EGC.RESULTS Of the 298 patients, 165(55.4%) had mucosa-confined EGC and 133(44.6%) had submucosa-invasive EGC. Only 13(7.9%) cases of mucosa-confined EGC and 30(22.6%) cases of submucosa-invasive EGC were observed to have LNM. The submucosal invasion(OR = 4.58, 95%CI: 1.23-16.97, P = 0.023), pure U type(OR = 4.97, 95%CI: 1.21-20.39, P = 0.026), and mixedtype(OR = 5.84, 95%CI: 1.05-32.61, P = 0.044) were independent risk factors for LNM in EGC. The rate of LNM in mucosa-confined EGC was higher in the mixedtype group(P = 0.012) and pure U group(P = 0.010) than in the pure D group, but no significant difference was found between the mixed-type group and pure U group(P = 0.739). Similarly, the rate of LNM in the submucosa-invasive EGC was higher in the mixedtype(P = 0.012) and pure U group(P = 0.009) than in the pure D group but was not significantly different between the mixed-type and pure U group(P = 0.375). Multivariate logistic analysis showed that only female sex(OR = 5.83, 95%CI: 1.64-20.70, P = 0.028) and presence of lymphovascular invasion(OR = 13.18, 95%CI: 1.39-125.30, P = 0.020) were independent risk factors for LNM in mucosa-confined EGC, while histological type was not an independent risk factor for LNM in mucosa-confined EGC(P = 0.106).CONCLUSION for mucosal EGC, histological mixed-type is not an independent risk factor for LNM and could be managed in the same way as the undifferentiated type.

IMMUNOHISTOCHEMICAL STUDY OF CARCINOEMBRYONIC ANTIGEN IN THE TRANSITIONAL MUCOSA ADJACENT TO COLORECTAL CANCER

A combined histopathological, mucin histochemi-cal and immunohistochemical study of the transitional mucosa (TM) adjacent to colorectal cancer is presented. Twenty-six resected specimens were studied by hematoxylin and eosin (HE) and high iron diamine-alcian blue (HID-AB). Carcinoem-bryonic antigen (CEA) was demonstrated by peroxi-dase antiperoxidass (PAP) technique. The appearance of the TM is usually thicker, longer and dilated crypts with increased immature and intermediate cells. Variable amount of sialomucins and decrease sulphomucins content as well as increased CEA content are found in the TM. These changes are not seen in non-transitional zone and normal colorectal mucosa. It is suggested that the mucin changes and expression of CEA in the TM may indicate an early primary premalignant changes and may be one of the reasons for the TM affecting the prognosis of patients with large bowel cancer after radical resection.

A Case of Secretory Carcinoma That Occurred in the Buccal Submucosa

Secretory carcinoma (SC) is a malignant salivary gland tumor that has been first reported by Skalova et al. in 2010. Histologically, it shows solidity infiltrated with very small cystic cavities and cribriform and papillary features and includes periodic acid-Schiff stain-positive, acid-fast secretions. The cells have oval nuclei, and vacuolated cytoplasm and foamy secretions are seen. Anaplasia is not strong and mitotic figures are rarely seen. These features closely resemble AciCC. Immunohistologically, it is thought to be positive for S-100 protein, vimentin, and mammaglobin and negative for DOG1. The presence of the ETV6-NTRK3 fusion gene is essential in diagnosing secretory carcinoma. In this report, we describe a case of SC in a 52-year-old woman. She was referred to our center because of a mass in left buccal mucosa. A soft and elastic submucosal mass measuring approximately 10 mm × 10 mm in size with a smooth surface was seen in the buccal mucosa in an area corresponding to the left mandibular canine to premolars. The imaging findings revealed that a high-intensity lesion was seen on T2-weighted images. Immunohistochemicalstaing for S-100 protein and vimentin were positive. Furthermore, genetic examination detected the presence of the ETV6-NTRK3 fusion gene. Based on these findings, the definitive diagnosis was secretory carcinoma.

Value of histomorphometric tumour thickness and smoothelin for conventional m-classification in early oesophageal adenocarcinoma

AIM To test the validity of tumour thickness measurement in distinguishing between the different infiltration depths, especially when the duplication of muscularis mucosae cannot be demarcated clearly. METHODS We re-evaluated 100 completely embedded Barrett's adenocarcinomas regarding m-classification, maximum tumour thickness, and muscularis mucosae duplication. For validation, smoothelin staining was performed on a subset of cases. RESULTS The m1-, m2-and m3-classified adenocarcinomasshowed a significant lower tumour thickness compared to the m4-and sm1-classified lesions(P < 0.001). Smoothelin staining determined a clear muscularis mucosae duplication in 64% of the tested samples and enabled the differentiation of the two layers in diffuse and merged splits. CONCLUSION Tumour thickness in early oesophageal adenocarcinoma significantly correlates with the depth of infiltration and demonstrates its worth as an accurate p T classification in non-polypoid lesions. We created a new algorithm, which combines histomorphology with morphometric analyses. It is noteworthy that it facilitates the assessment of mucosal vs submucosal infiltration depth. The smoothelin staining strengthened our results of the tumour thickness evaluation and can be used in cases of doubt.

STUDY OF ESTROGEN RECEPTOR AND PROGESTERONE RECEPTOR IN SQUAMOUS CELL CARCINOMA TISSUE OF ORAL MUCOSA

By means of the enzyme linked affinity histothemical method, 45 cases of squamous cell carcinoma(SCC) of the oral mucosa and 15 cases of the approximately normal oral mucosal tissue were detected for estrogen receptor(ER) and progesterone receptor(PR). The results indicated that In the SCC tissue of the oral mucosa there were 5 cases of ER+ and PR- and 32 cases of both ER+ and PR+. Thirty-seven cases, the summation of the above two items, were considered as receptor(+),therefore the rate of the receptor(+) being 82.22%. ER+ and PR+ were cd related to the sex and age of patients, the neck lymph nodes' metastasizing or not and affected parts of the tumor, while they were related to the differentiation degree of the tumor. The rate of receptor(+) decreased with the decrease of the differentiation degree of the tumor. By X2 test a remarkable difference between grade Ⅰand grade Ⅲ of SCC of the oral mucosa was shown. It is suggested that SCC of the oral mucosa may probobly be hormone dependent tumor. The authors consider that the SCC detection for ER and PR could not only be one of the indices of biologic characteristics for that tumor but also as bases of anti-hormone treatment.

IMMUNOCHEMICAL IDENTIFICATION AND LOCALIZATION OF CYTOCHROME P-450HSjISOZYME, AN ENZYME RELATED TO NITROSAMINE METABOLISM, IN HUMAN GASTRIC MUCOSA AND GASTRIC CARCINOMA

Monoclonal antibody (MAb) to rat liver cyto-chrome P-450j isozyme, an activating enzyme specific to nitrosamine metabolism, was used coupled with immunoblotting, densitometer scanning of SDS-PAGE gels and immunohistochemical technique. The trace P-450HSj isozyme (Mr. 51.5 Kd) was found in human gastric mucosa. It was similar to P-450j in molecular weight, catalytic and immunochemical properties. The concentrations of P-450HSj in mucosa of lesser curvature were higher than those in greater curvature. This might be one of the important reasons that lesser curvature is the commonest area for gastric carcinoma. But there was possibly less P-450HSj in gastric mucosa with cancer. Im-munohistochemically, P-450HSj was discovered in the cytoplasm of some glandular epithelial cells, especially in the glands with hyperplastic and intestinal metaplastic changes adjacent to carcinoma. It was also found in some normal glands and in tumor cells of high-differentiated adenocarcinoma, but not in those of low-differentiated ones. Following subjects are discussed: (1) the method of detecting trace P-450HSj, (2) the rule of distribution of P-450HSj, and (3) the relationship between the isozyme and the occurrence of gastric cancer caused by nitrosa-mines.

Relationship between trefoil factor 1 expression and gastric mucosa injuries and gastric cancer

AIM:To determine whether trefoil factor 1 (TFF1) is associated with mucosa healing and carcinoma suppression, we assess the expression of trefoil factor 1 in normal and pathologic gastric mucosa. METHODS: TFF1 in normal and pathologic gastric mucosa was assessed by immunohistochemical method, and the average positive A was estimated by Motic Images Advanced 3.0 software. RESULTS: Increased TFF1 was detected in gastritis, gastric ulcer and duodenal ulcer compared with normal mucosa. The same result could be seen in multiple and compound ulcer compared with simple ulcer. There was no significant difference between gastric ulcer and duodenal ulcer, gastritis and simple ulcer respectively. Increased TFF1 was detected in the peripheral mucosa of the gastric adenocarcinoma compared with normal mucosa. The expression of TFF1 in gastric adenocarcinoma was related to the differentiation of adenocarcinoma. The lower the differentiation of adenocarcinoma, the weaker the expression of TFF1. There was no TFF1 expressed in low-differentiated adenocarcinoma. The expression of TFF1 in middle and highly differentiated adenocarcinoma was a little lower than that in normal mucosa. But there was no significant difference. No TFF1 was assessed in esophageal squamous carcinoma and peripheral tissue. There was no significant difference between male and female. CONCLUSION: The expression of TFF1 was higher in gastritis and peptic ulcer than that in normal mucosa, and was also higher in multiple and compound ulcer than in simple ulcer. It seems that TFF1 plays a role in gastric mucosa protection and epithelial restitution. Increased expression of TFF1 in peripheral tissue suggests that TFF1 is associated with mechanism of carcinoma suppression and differentiation. Decreased expression of TFF1 in carcinoma and its relativity to the differentiation suggests that TFF1 is related to gland and cell destruction of carcinoma.

Molecular forms of trefoil factor 1 in normal gastric mucosa and its expression in normal and abnormal gastric tissues

AIM： To study the molecular forms of trefoil factor 1 （TFF1） in normal gastric mucosa and its expression in normal and abnormal gastric tissues （gastric carcinoma, atypical hyperplasia and intestinalized gastric mucosa） and the role of TFF1 in the carcinogenesis and progression of gastric carcinoma and its molecular biological mechanism underlying gastric mucosa protection. METHODS： The molecular forms of TFF1 in normal gastric mucosa were observed by Western blot. The expression of TFF1 in normal and abnormal gastric tissues （gastric carcinoma, atypical hyperplasia and intestinalized gastric mucosa） was also assayed by immunohistochemical method. The average positive AO was estimated by Motic Images Advanced 3.0 software. RESULTS： Three patterns of TFF1 were found in normal gastric mucosa： monomer, dimmer, and TFF1 compound whose molecular weight is about 21 kDa. The concentration of TFF1 compound was the highest among these three patterns. TFF1 was expressed mainly in epithelial cytoplasm of the mucosa in gastric body and antrum, especially around the nuclei. The closer the TFF1 to the lumen, the higher the expression of TFF1, The expression of TFF1 in peripheral tissue of gastric carcinoma （0.51 ± 0.07） was higher than that in normal gastric mucosa （0.44 ± 0.06, P 〈 0.001）. The expression of TFF1 in gastric adenocarcinoma was positively related to the differentiation of adenocarcinoma. The lower the differentiation of adenocarcinoma was, the weaker the expression of TFF1. No TFF1 was expressed in poorlydifferentiated adenocarcinoma. The expression of TFF1 in moderately-well differentiated adenocarcinoma （0.45 ± 0.07） was a little lower than that in normal mucosa （P 〉 0.05）. The expression of TFF1 in gastric mucosa with atypical hyperplasia （0.57 ± 0.03） was significantly higher than that in normal gastric mucosa （P 〈 0.001）. No TFF1 was expressed in intestinalized gastric mucosa. There was no statistically significant difference between the expressions of TFFI in gastric mucosa around the intestinalized tissue （0.45 ± 0.07） and normal gastric mucosa （P 〉 0.05）. CONCLUSION： TFF1 is expressed mainly in epithelial cytoplasm of the mucosa in gastric body and antrum. Its main pattern is TFF1 compound, which may have a greater biological activity than monomer and dimer. The expression of TFF1 in peripheral mucosa of gastric ulcer is higher than that in mucosa 5 cm beyond the ulcer, indicating that TFF1 plays an important part in protection and restitution of gastric mucosa. The expression of TFF1 is increased in peripheral tissues of gastric carcinoma and gastric mucosa with atypical hyperplasia, but is decreased in cancer tissues, implying that TFF1 may be related to suppression and differentiation of carcinoma. The weaker expression of TFF1 in poorly-differentiated carcinoma may be related to the destruction of glands and cells in cancer tissues and the decrease in secretion of TFF1.

Role of angiogenesis in oral squamous cell carcinoma development and metastasis: an immunohistochemical study

Although a few studies have shown that vascularity is increased from normal mucosa to dysplasia to carcinoma suggesting that disease progression in the oral mucosa is accompanied by angiogenesis. The role in lymph node metastasis in oral squamous cell carcinoma （OSCC） is equivocal. Role of angiogenesis in OSCC development and metastasis is evaluated in this study. This retrospective study of 50 samples consisted of 9 normal buccal mucosa, 22 leukoplakias, and 19 OSCC. Polyclonal antibodies to von-Willebrand factor were used to highlight the microvessels. Images were captured and morphometric image analysis was done for microvessel density （MVD）, area, and perimeter. Highest, as well as mean values of these three parameters were compared. MVD and perimeter, but not area, are significantly different between normal mucosa and OSCC, and leukoplakia and OSCC. There were no differences between normal mucosa and leukoplakia. MVD, area, and perimeter were not significantly different between the OSCC with and without lymph node metastasis. The highest and mean values of MVD are significantly correlated. In the development of OSCC, angiogenic phenotypic change occurs in carcinomas rather than in the pre-cancerous stage, and quantification of angiogenesis in OSCC does not predict the risk of lymph node metastasis.

P^（53） PROTEIN OVEREXPRESSION IN PREMALIGNANT AND MALIGNANT LESIONS OF ORAL MUCOSA：IMMUNOHISTOCHEMICAL OBSERVATION

Ｐ^（５３） ＰＲＯＴＥＩＮ ＯＶＥＲＥＸＰＲＥＳＳＩＯＮ ＩＮ ＰＲＥＭＡＬＩＧＮＡＮＴ ＡＮＤ ＭＡＬＩＧＮＡＮＴ ＬＥＳＩＯＮＳ ＯＦ ＯＲＡＬ ＭＵＣＯＳＡ：ＩＭＭＵＮＯＨＩＳＴＯＣＨＥＭＩＣＡＬ ＯＢＳＥＲＶＡＴＩＯＮＰ^（５３）ＰＲＯＴＥＩ...

Nitric oxide synthases expression in human bladder cancer and their relationship with angiogenesis

Objective Evaluated NOS expression in bladder tissue from the patients with transitional cell carcinoma (TCC) of the bladder and studied its relationship with angiogenesis. Methods Bladder carcinoma tissue specimens were procured from 58 patients with TCC and 14 cases of benign bladder tissue as contrast group. NOS immunohistochemistry was performed on all tissue specimens and microvessal density (MVD) was counted by endothelial cells immunostained. Results Inducible NOS specific proteins were found in 47 of 58 bladder cancer specimens but not in control bladder tissue. The malignant cells and inflammatory cells within the carcinomas were highly iNOS positive whereas specimens of bladder mucosa outside the malignant regions showed only a weak positive iNOS immunostaining. The endothelial cells in both normal urothlium and tumor tissue showed a highly positive eNOS immunotaining but its immunoreaction was not detected in either malignant or benign epithelium. MVD was (39. 3 ± 19. 5)/HP and (29.3 ± 10.

Cell-type specificity of β-actin expression and its clinicopathological correlation in gastric adenocarcinoma

AIM: To investigate cell type specific distribution of &#x003b2;-actin expression in gastric adenocarcinoma and its correlation with clinicopathological parameters.

Expression of semaphorin 6D in gastric carcinoma and its significance

AIM: To investigate the protein and mRNA expression of semaphorin 6D in gastric carcinoma and its significance. METHODS: The protein and mRNA expression of semaphorin 6D was detected by semi-quantitative rever- se transcription PCR and Western blotting respectively in 30 cases of gastric carcinoma and normal gastric mucosa. RESULTS: The protein and mRNA expression of semaphorin 6D in gastric carcinoma was significantly higher than that in normal gastric mucosa (0.24 ± 0.06 vs 0.19 ± 0.07, 0.26 ± 0.09 vs 0.20 ± 0.10, P < 0.05). CONCLUSION: Semaphorin 6D may play an important role in the occurrence and development of gastric carcinoma, and is related to tumor angiogenesis.

Incidence of bone metastasis in squamous cell carcinoma of the buccal mucosa

Aim:This retrospective study was performed to show the incidence of bone metastasis from carcinoma of the buccal mucosa.Head and neck cancer is a leading health problem in India due to an increased incidence of tobacco use and poor oral hygiene.Squamous cell carcinoma of the buccal mucosa is common and roughly 2.5%of all malignancies that present to our center.Moreover,most patients present at late stages(III/IV)and consequently,survival rates are low.Bone metastasis in advanced cases of such carcinomas is rarely reported worldwide but is more prominent in parts of India.Methods:Here,we present a series of patients diagnosed with buccal mucosa carcinomas within the past 5 years that also demonstrated bone metastases.Results:These patients were young,with a history of tobacco chewing with locally advanced disease and bone metastases that developed within one year of diagnosis.Flat bones and vertebrae were mainly involved and the survival was short after diagnosis of metastasis despite treatment with local radiotherapy and chemotherapy.The cause of such frequent metastases cannot be proved but subclinical seeding of malignant cells before the eradication of the primary tumor is probable contributory with advanced local and nodal disease with high grade tumor.Conclusion:A pretreatment bone scan should be performed in locoregionally advanced buccal mucosa carcinomas at the time of diagnosis to defi ne the treatment plan.

HMGB 1在浸润性喉鳞状细胞癌发生和发展中的作用及临床意义

目的:浸润性喉鳞状细胞癌(invasive laryngeal squamous cell carcinoma,I-LSCC)早期诊断、早期干预治疗是降低其发病率和病死率的关键。本研究旨在探讨高迁移率族蛋白B1(high mobility group box-1,HMGB1)在I-LSCC发生和发展中的作用及临床意义。方法:收集2009年11月至2011年6月北京同仁医院病理科的石蜡包埋标本281例,包括I-LSCC 123例、喉黏膜异型增生(laryngeal precursor lesions,LPLs)103例(其中低级别异型增生31例、高级别异型增生49例、原位癌23例)及声带息肉(vocal polyp,VP)55例。应用免疫组织化学染色检测标本中HMGB1及Ki-67的表达,其中HMGB1阳性强度和阳性率得分相加总分为0~7(0~4分为低表达,5~7分为高表达);Ki-67阳性率≥50%为高表达,<50%为低表达。结果:HMGB1在I-LSCC中的表达(4.35±1.33)高于在LPLs(3.12±0.95)及VP(2.11±0.71)中(均P<0.001)。HMGB1表达在喉黏膜低级别异型增生、高级别异型增生及原位癌之间无明显差异(P>0.05)。36.59%的I-LSCC同时具有HMGB1高表达及Ki-67高表达,且HMGB1高表达组和低表达组的Ki-67阳性率差异有统计学意义(P=0.01);33.33%的I-LSCC同时具有HMGB1高表达及淋巴结转移,且HMGB1高表达组和低表达组的淋巴结转移率差异有统计学意义(P<0.001);47.15%的I-LSCC同时具有HMGB1高表达及高临床分期(III期及IV期),且HMGB1高表达组和低表达组的临床分期差异有统计学意义(P<0.001)。HMGB1表达与年龄、性别、吸烟指数、饮酒情况及癌细胞分化程度无明显差异(均P>0.05)。HMGB1高表达的I-LSCC患者预后较HMGB1低表达的患者更差(P<0.05)。结论:HMGB1在I-LSCC中高表达,可能在I-LSCC的发生和发展中起重要作用。

光动力治疗右颊黏膜疣状癌1例报道及文献回顾

目的探讨口腔疣状癌的光动力治疗方法及疗效,为临床提供参考。方法本研究遵循医学伦理学要求,对1例发生在右颊黏膜直径约2.5 cm的口腔疣状癌的光动力治疗进行总结,结合文献对口腔疣状癌的特点、治疗及口腔黏膜潜在恶性疾患的光动力治疗进行回顾性分析。结果该口腔疣状癌患者先后进行4次光动力治疗,右颊病损面积显著减小。术后随访6个月,右颊白色疣状增生完全消退,无明显瘢痕形成。术后3年,右颊病损无复发,治疗区域无明显瘢痕形成,张口度3指,双侧颌下、颏下、颈部均未触及淋巴结肿大。文献回顾表明,口腔疣状癌是一种少见的鳞状细胞癌亚型,具有生长缓慢、低度恶性、极少转移的特点,手术是首选治疗手段,但存在一定局限性。光动力治疗具有微创性、可重复操作、不良反应轻微等优势,近年来光动力治疗已逐步应用于口腔黏膜潜在恶性疾患和早期口腔鳞状细胞癌的治疗,并取得了积极结果,但尚未见用于口腔疣状癌治疗的报道。结论光动力治疗为口腔疣状癌提供了一种非手术切除的新选择。

BAZ1A在肝癌和子宫颈癌中的共同促癌机制分析

目的通过转录组测序,探讨毗邻锌指结构域的溴结构域蛋白1A(bromodomain adjacent to zinc finger domain 1A,BAZ1A)在肝癌和子宫颈癌中促癌机制的共同点。方法在肝癌和子宫颈癌转录组测序结果中使用“DESeq2”包进行筛选肝癌组差异表达基因(different expression genes,DEGs)和子宫颈癌组DEGs。肝癌组DEGs与子宫颈癌组DEGs取交集获得共有DEGs。通过基因本体论(gene ontology,GO)、京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)对以上3组DEGs相关的功能及通路进行分析。采用STRING数据库对上述3组DEGs进行蛋白质互作(protein-protein interaction,PPI)网络的富集分析,并使用Cytoscape软件筛选出各组DEGs中的核心基因。结果得到肝癌组DEGs为294个,子宫颈癌组DEGs为5662个,共有DEGs为170个。肝癌组DEGs、子宫颈癌组DEGs和共有DEGs都富集到的KEGG通路包括细胞外基质-受体相互作用通路、焦点黏附通路。肝癌组DEGs和子宫颈癌组DEGs都显著富集的GO条目包括细胞运动、生物黏附。PPI网络分析得到肝癌组核心基因为H4簇状组蛋白5(H4 clustered histone 5,H4C5)、H4簇状组蛋白14(H4 clustered histone 14,H4C14),子宫颈癌组核心基因分化簇44(cluster of differentiation,CD44)、激太原1(kininogen 1,KNG1)、圆盘大MAGUK支架蛋白4(discs large MAGUK scaffold protein 4,DLG4),共有组核心基因为H2A簇状组蛋白18(H2A clustered histone 18,H2AC18)。结论在肝癌和子宫颈癌中,BAZ1A都可以通过影响癌细胞运动、迁移的能力,发挥促癌作用。

胃癌组织和细胞中P115、MIF的表达及意义

目的观察胃癌组织和细胞中高尔基体转运蛋白P115和MIF的表达情况,探讨其在胃癌发生、发展中的意义。方法用S-P、Western blot和RT-PCR法检测P115及MIF在正常胃黏膜和胃癌组织,3种细胞株(正常胃黏膜上皮GES-1,不同分化程度的胃癌细胞株MKN-28,BGC-823)中的蛋白和mRNA表达情况。结果 P115和MIF在胃癌组织中的阳性表达率分别为73.3%、80%,在正常胃黏膜中的阳性表达率分别为40%、46.7%,胃癌组织中P115和MIF的表达明显高于正常胃黏膜(P<0.01),且P115的表达和MIF的表达呈正相关(r=0.433,P=0.017);胃癌组织中P115、MIF的蛋白和mRNA表达水平明显高于正常胃黏膜组织(P<0.01)。免疫细胞化学,Western blot和RT-PCR结果显示:P115、MIF在胃癌细胞株MKN-28、BGC-823中的蛋白及mRNA表达水平明显高于正常胃黏膜上皮GES-1(P<0.01);且低分化胃癌细胞株BGC-823中P115和MIF的表达水平明显高于高分化胃癌细胞株MKN-28(P<0.05)。结论 P115和MIF的过表达,可能在胃癌的发生过程中起协同作用;对P115和MIF相互作用机制的深入探讨有可能使其成为研究胃癌发生、发展的分子机制的新靶点。

胃粘膜肠上皮化生类型与胃癌发生的关系

目的寻找与胃癌发生有密切关系的肠上皮化生的类型，为胃癌早期诊断提供可靠的理论依据。方法应用ＡＢ－ＰＡＳ、ＨＩＤ－ＡＢ粘液组织化学方法，区别癌旁组织和背景粘膜组织伴有肠上皮化生的类型。结果 ①３９例胃癌组织当中，癌旁伴有肠上皮化生的为３１例，背景粘膜伴有肠上皮化生的为２５例。②癌旁肠上皮化生的ＡＢ－ＰＡＳ染色， １００％阳性； ＨＩＤ－ＡＢ染色，８７．１％阳性。背景粘膜肠上皮化生ＡＢ－ＰＡＳ染色， １００％阳性； ＨＩＤ－ＡＢ染色， ４０％阳性。③３１例癌旁组织的肠上皮化生中，７４．２％为不完全大肠型；２５例背景粘膜的肠上皮化生当中，５２％为不完全小肠型和３２％为不完全大肠型。结论癌旁组织的不完全大肠型肠上皮化生与胃癌的发生有密切关系。背景粘膜组织当中的小灶状不完全大肠型肠上皮化生，具有潜在发生癌变的可能性。

调强放射治疗对鼻咽癌患者口腔黏膜及免疫功能的影响

目的:研究调强放射治疗(intensity modulated radiation therapy,IMRT)对鼻咽癌临床疗效、口腔黏膜反应和免疫功能的影响,并探讨免疫学改变对临床疗效及口腔黏膜反应的影响。方法:选择2008年10月至2011年11月于佛山市第一人民医院鼻咽放疗1科治疗的200例鼻咽癌患者,两组均先进行常规化学治疗,再进行放射治疗。根据其放射治疗方法不同分为观察组与对照组,每组各100例。对照组进行常规二维放射治疗,观察组采用IMRT,随访记录两组5年生存率和复发率,完成放射治疗后参照美国放射治疗肿瘤协作组织(Radiotherapy Oncology Group,RTOG)急性放射性黏膜炎的分级标准对患者口腔黏膜进行评价,并检测治疗前后T淋巴细胞亚群。结果:观察组无区域复发生存率、无瘤生存率、局部复发率与对照组相比,差异均有统计学意义(均P<0.05);无远处转移生存率两组差异无统计学意义(P>0.05)。对照组1级、2级、3级、4级口腔黏膜急性反应率分别为8.00%,20.00%,12.00%和7.00%,观察组分别为7.00%,22.00%,15.00%和1.00%,两组患者1级、2级、3级口腔黏膜急性反应率差异均无统计学意义(均P>0.05),观察组4级口腔黏膜急性反应率显著低于对照组,差异有统计学意义(P<0.05)。两组治疗前后CD8+,CD4+/CD8+和CD4+T细胞亚群差异均有统计学意义(均P<0.01),且治疗后观察组与对照组之间的差异亦有统计学意义(均P<0.01)。结论:在鼻咽癌患者治疗过程中,在化学治疗的基础上使用IMRT的效果较常规放射治疗更加显著,可相对减少严重的口腔黏膜急性反应(4级),对患者的免疫功能有更好的保护作用。