影像组学预测肝细胞癌免疫组化标志物的研究进展

免疫组化标志物对肝细胞癌(HCC)病人的预后分析和个性化治疗有重要的指导意义。目前免疫组化主要依靠手术病理或组织活检等有创方法,而影像组学具有广泛表征空间异质性的潜力,可以于术前无创预测与HCC相关的免疫组化标志物。就影像组学预测HCC Ki-67等免疫组化标志物的研究进展予以综述,并就其在该研究领域的应用前景进行展望。

原发性肺腺癌中Napsin A、TTF1及SPA蛋白的表达及其与EGFR基因突变的相关性

目的探讨Napsin A、TTF1、SPA在原发性肺腺癌中的表达及与EGFR基因突变的相关性。方法免疫组织化学法检测306例原发性肺腺癌组织中Napsin A、TTF1、SPA蛋白的表达。ARMS法同时检测这些组织中EGFR基因是否突变。结果 Napsin A在原发性肺腺癌中表达率为87.25%,TTF1在原发性肺腺癌中表达率为80.72%,SPA在原发性肺腺癌中表达率为60.46%。EGFR基因在原发性肺腺癌中的突变率为40.20%。TTF1、Napsin A、SPA蛋白表达阳性患者EGFR基因突变率均较表达阴性患者高,差异均有统计学意义(P<0.01)。结论我们可以通过检测Napsin A、TTF1和SPA是否表达来简单预测原发性肺腺癌中EGFR基因是否会有突变,这对于一些组织不够用于开展分子检测的患者或不能开展分子检测的医院十分实用。

The Expression and Clinical Significance of Fas and FasL in Lung Cancer

Objective: To investigate the expression and clinical significance of Fas andFasL in lung cancer. Methods: SP immunohistochemical technique was used to detect the expression ofFas and FasL in 46 cases of lung cancer and 30 cases of adjacent non-neoplastic tissue. Results:Down-regulation, of Fas and up-regulation of FasL were found in lung carcinoma. The levels of Fasexpression in squamous cell carcinoma, adenocarcinoma and SCLC were significantly lower than that ofadjacent normal tissues (P<0. 01) , while the expression levels of FasL were the opposite (P< 0.05). Fas expression was associated with high histological grade and no metastasis (P<0. 05). FasLexpression was related to histological grade, late clinical stage and metastasis (P<0. 05). BothFas and FasL expression was not related to the histological type of lung cancer (P>0. 05). Thelevel of Fas expression was negatively related to that of FasL (P<0. 05). Conclusion:Down-regulation of Fas and up-regulation of FasL may work in coordination with the occurrence,development and metastasis of lung cancer. Fas or FasL can be used as one of markers in earlydiagnosis of lung cancer. Therefore, the combined assay may be helpful in predicting the grade ofmalignancy and the prognosis of patients with lung cancer.

The expression and clinical significance of β-catenin and colorectal cancer stem cells marker EpCAM^(high)/CD44^+ in colorectal cancer

Objective： The aim of the study was to explore the role of Wnt βcatenin signalling pathway in the maintenance, invasion and metastasis of colorectal cancer stem cells. Methods： Double immunohistochemical staining was used to detect the expression of EpCAMhigh/CD44~ which is regarded as the marker of colorectal cancer stem cells in 80 cases of colorectal cancer and their corresponding liver metastases. The SP method of immunohistochemistry was used to detect the expression of the key protein βcatenin in the Wnt pathway in these tissue. The expression and correlation of ^-catenin and EpCAMh^gh/ CD44＋ in colorectal cancer were analyzed and their role on the biological behavior of colorectal cancer was explored. Results： The abnormal expression of βcatenin was significantly higher in colorectal cancer than in the paraneoplastic normal intes- tinal mucosa [55% （44/80） vs 10% （2/20）, P 〈 0.05]. The positive expression of EpCAMhigh/CD44＋ was significantly higher in colorectal cancer than in the paraneoplastic normal intestinal mucosa [66.25% （53/80） vs 0% （0/20）, P 〈 0.05]. In the 80 cases of colorectal cancer, the abnormal expression of ^-catenin has no correlation with gender （P = 0.079）, age （P = 0.416） and the magnitude （P = 0.816） of the tumor （P 〉 0.05）, but it was significantly correlated with degree of differentiation （P = 0.001）, depth of invasion （P = 0.001）, clinical stage （P = 0.000） and metastasis （P = 0.000）. In the colorectal cancer, the expression of EpCAMhi^h/CD44~ cells has no correlation with gender （P = 0.934） and the magnitude （P = 0.160） of the tumor （P 〉 0.05）, but was significantly correlated with age （P = 0.021）, degree of differentiation （P = 0.013）, depth of invasion （P = 0.000）, clinical stage （P = 0.000） and metastasis （P = 0.000）. In the corresponding liver metastases, we could also detecte EpCAMhih/CD44＋ cells. In cases with abnormal expression of βcatenin, the positive expression rate of EpCAMhigh/CD44＋ was significantly higher than those with normal expression of β-catenin （84.1% vs 44.4%）, and the difference was statistically significant （P 〈 0.05）. Conclusion： The abnormal activation of Wnt β-catenin signalling pathway may prompt the abnormal proliferation of the colorectal cancer stem cells, which leads to the recurrence and metastasis of the cancer.

胃癌淋巴结转移及其组织病理特征的回顾性研究

目的探讨胃癌的淋巴结转移规律并分析其与胃癌患者的临床病理特征及免疫组织化学标志物的关系,从而为选择合理的手术方式提供依据。方法对兰州大学第二医院2013年8月至2016年5月期间接受胃癌标准根治术(D2)、扩大根治术(D3)及D3+手术的160例胃癌患者的临床病理资料进行回顾性研究,分析不同部位胃癌的淋巴结转移情况及其与胃癌患者的临床病理特征及免疫组织化学标志物的关系。结果 (1)胃癌的淋巴结转移与胃癌的大体分型、T分期、分化程度及Borrmann分型有关,即在进展期、T4期、分化程度不良及BorrmannⅢ+Ⅳ型胃癌患者中的淋巴结转移率均分别明显高于早期胃癌患者(P<0.05)、T1~T3期胃癌患者(P<0.05)、分化程度良好的胃癌患者(P<0.05)以及BorrmannⅠ+Ⅱ型胃癌患者(P<0.05);而胃癌的淋巴结转移与胃癌患者的性别、肿瘤部位及肿瘤直径均无关(P>0.05)。(2)贲门部癌分化程度良好时,淋巴结转移主要出现在第一、二站;而其分化程度不良时,淋巴结转移除第一、二站以外,No.13淋巴结也出现转移。胃体部癌分化程度良好时,淋巴结转移多出现在第一、二站,偶有No.12淋巴结出现转移;而其分化程度不良时,除第一、二站淋巴结转移以外,No.12、No.13及No.14淋巴结也会出现转移。胃窦部癌分化程度良好时,部分病例的淋巴结转移已达No.11、No.12及No.13淋巴结;而其分化程度不良时,部分病例还出现No.15和No.16淋巴结转移。(3)TopoⅡα、Villin、Ki-67、CK-8及CK-18蛋白在分化程度不良的胃癌患者中的表达阳性率均明显高于分化程度良好者(P<0.05),而P-gp、GST-π及c-erb B-2蛋白在分化程度不良的胃癌患者中的表达阳性率均明显低于分化程度良好者(P<0.05)。TopoⅡα、P-gp、Villin、Ki-67、CK-8及CK-18蛋白在有淋巴结转移的胃癌患者中的表达阳性率均明显高于无淋巴结转移者(P<0.05),但GST-π和c-erb B-2蛋白表达在无论有无淋巴结转移的病例中差异均无统计学意义(P>0.05)。(4)肿瘤所在的不同部位与胃癌患者的性别、大体类型、临床分期、T分期、分化程度、肿瘤直径及Borrmann分型均无关(P>0.05)。结论进展期、肿瘤浸润深度达到T4、分化程度越低以及BorrmannⅢ+Ⅳ型胃癌患者的淋巴结转移率较高。对于贲门部癌分化程度良好的患者宜行标准D2术式,分化程度不良者宜行D2+No.13术式;对于胃体部癌分化程度良好的患者宜行D2+No.12术式,分化程度不良者可行D3术式;对于胃窦部癌患者无论其分化程度如何均应当施行D3术式,且对于分化程度不良患者需视术中情况选择性清扫No.15和No.16淋巴结。联合检测TopoⅡα、Villin、Ki-67、CK-8、CK-18、P-gp、GST-π及c-erb B-2免疫组织化学分子标志物可能有利于提高淋巴结转移检出的准确性并对胃癌恶性程度及患者预后进行评估。